Design and Implementation of Health Information Systems - Assignment Example

Name Tutor Course Date Question 1 As the health care enters Information based Society, there is an increasing need to employ the use of integrated health information system (HIS) in health institutions as it is associated with tremendous benefits and opportunities in the improvement of health care. However, its implementation is often quite a challenge and sometimes even elusive especially in the face of fragmented funding of Emergency departments (Bra1a et al, 10). A careful review during the implementation is vital. In the context of this paper, Health Information Systems entails a range of interfaced application and information systems which aims at enhancing and offering of quality health services both at the crucial Emergency Department and other departments. The section that follows describes the major steps and consideration needed in relation to the additional workload and other staffing issues or measures required during the implementations of HIS in the emergency department (B2raa et al, 91). The major phase towards the modification and implementation of HIS in the ED is an assessment of information prerequisites and evaluation of the existing information system followed by enlisting all the existing data or communication components and subsystems (3Lippeveld, Sauerborn and Bodart, 79). At this stage, it may also be of necessity to review the components of HIS that are actually in place and their operation in the ED as well as the level of integration associated with the prevailing components. In addition, it is important to consider the contextual framework in which the existing system function and the extent of resources supporting the system (4Health Metrics Network, 8). It may also be necessary to consider the scalability/scope; the number of people the system is supposed to serve particularly in relation to available resources and infrastructure (Braa et al, 4). An analysis of all these is a vital step towards the assessing the priority areas. There is also need to come up with some level of governance/administration. This can be achieved by mobilizing simple yet flexible structures of governance, management and implementation groups within the ED. It has been argued that the more simple and flexible leadership structure is, the more ease in maintaining or controlling the whole change process (5Health Metrics Network, 6). There is need to clearly define and identify suitable actors or working groups. It is only though this can one can be able to understand their attitudes and roles, which are important in the adoption of information systems (6Mantzana et al 91) as some staff members may be inclined towards holding back on the successful implementation of the new system. The groups of staff or people at these levels may comprise piloting committees to give oversight and appropriate direction towards the success of the process. The second group of people may be composed of technical team to oversee the improvement and maintenance of the system. In order to successfully create a HIS within the ED there is need to establish a clearly distinct data sources followed by development of data collection tools followed by a survey. Information from the various health departments can be combined with information from other sectors or sources. It is important at this level to have a standard and well-adapted procedures and approaches, which can comprehensively identify on the level and use of the information at the service delivery level (7Lippeveld, Sauerborn and Bodart, 111-120). The survey is aimed at the identification of existing gaps, duplication or revealing data/records that are no longer meaningful. After the survey, more attention should be channeled towards working on established priority areas. For instance, prioritizing on various tasks and appropriate action based on the status, needs and short as well as the long-term strategies followed by formulation of data- transmission and processing mechanism system depending on the identified needs aimed at generation of acceptable and good quality information for management of the health system. For implementation of HIS to be a success there is need to integrate several departments within the organization. The staff also needs to be trained and updated on the necessary changes in regards to the use and implementation of HIS. The system will enable easy coordination of different departments and quality provision of health care services. The system also allows for easy access and storage of large volumes of medical/patient’s data within the health facility. In the It has been established that data alone doe not adequately give the full picture and that one can only benefit only by carrying out comprehensive data analysis and interpretations but within the context of the health unit delivery of health services(8Health Metrics Network, p.12). The importance of data has also been highlighted by Lippeveld, Sauerborn and Bodart (101) who believe that it is the overall aim or objective of the information system and one of the critical step in ensuring appropriately designed feed back system and innovative mechanism in data presentation. It is imperative at this level to come up with objectives of the new system within the Emergency Department, look at alternative ways of achieving the prescribe goals while also assessing resources needs including human resources, financial , time available, equipments among other things. The system will enable data at the ED to be faster and enable easy coordination of data between the different departments for quality health service. There may be a need to assess the financial requirement for various options and find out the best of implementation in the context any resource challenges (9Rajaraman, 32). Question 2 Exits interviews are important components of human resource in any organization. It is usually encouraged when a particular employee leave the organization. In the context of health system, the interviews are often carried out in order to understand why employees leave the organization so that appropriate action can taken to fix the gaps identified during the interview( 10Flint and Webster 56-60). For effectiveness, there is need to have a well structured interview so that critical issues are addressed. The following section describe a structure of an exit interview for Health Information Service (HIS) who has been in the organization for the last five years. Interview Structure 1. An introductory section 2. Identification of position and other relevant classification information 3. Evaluation of organization working environment 4. Assessment of sensitive issues like bias, harassment, abuse, discrimination 5. Evaluation of reasons for exit 6. Feedback to improve the work environment 7. Feedback to improve the department and/or company 8. Thanks and appreciation for contribution Sample of Typical Questions 1. How would you describe your work experience at the department/organization? 2. Why have your decided to leave? 3. Is there anything we could have done differently (changes or improvements) that would have prevented your exit? 4. What did you like most about working for this department/health unit? 5. What did you like least? 6. How would you evaluate the performance of your supervisor? 7. Did you feel the organization provided sufficient training, opportunities for advancement, benefits, etc.? 8. What are the areas, which need adjustments to promote productivity within the organization? An introductory part is very important in any given interview as it gives an explanation but also gives an assurance of confidentiality. By asking the employee to describe his or her working experience at the department/ organization and further asking why he or she reached at the decision to leave the organization, one is able to get a rough picture on the existing gaps within the work environment that needs adjustments. Other questions are related to suggestions for improvement so that it is done from the perspective of employees. The last part is appreciating or thanking the interviewee for taking part. This is often aimed at nurturing and maintaining good relationship. Question 3 According to Bovey and Hede resistance to change in any given organization is inevitable. Employees usually resist changing especially the technological change due to the fear of the unknown (41). They feel that change will affect their work performance, their associations with other employees and other job interrelated aspects. Thus employees fear that change will jeopardize their jobs and render them jobless if they do not conform to the rules of the adopted technology knowhow. As a Health Information Manager I will ensure that the employees get to know the importance of electronic systems change in the organization. The importance of the three health facilities of aged care and rehabilitation should be stressed since it is vital. It is also important to integrate the information service clerical, admissions and discharges, reception, switchboard, ward clerk and data staff entry so as to ensure the smooth running and uphold efficacy in the health facility. This integration can only be done through the use of an electronic system that will ensure that several employees in different departments work as one interrelated group for the provision of quality service. Hence the willingness of the top management to embrace change is crucial in any organization. This will enable change to run smoothly through the organization’s hierarchy and fear of losing one’s job will be eliminated. When different departments work together and play interrelated goals the organization is able to achieve its goals and objectives (11Bovey and Hede 40-42). The following steps will be considered in the implementation process of the electronic systems change; 1. Readiness of the top management for the change 2. Change suitability 3. Organization’s willingness for change 4. Change effectiveness 5. Organization’s history of dealing with change Question 4 Read the article provided: Mair, J. 2011. Privacy, employees and human resources: a case report. Health Information Management Journal 40(1): 36-42. Imagine that you are the Health Information Manager in the employee’s hospital. Assume this hospital is located in the state of Victoria. • Provide (a) an advisory memo (approximately half to three-quarters of a page in length, maximum) to your Chief Health Information Manager outlining the types of policies that must be in place, the precautionary efforts required of employers, and the steps to be followed after such an OHS incident. Incorporate provision for compliance with employers’ legal obligations to employees (using Health Information Service example[s] to illustrate), and relevant occupational health and safety legislation. • Develop and write (a) a policy, and (b) a procedure, for dealing with the health information of staff members, for all clinical and other health professional staff members (including Health Information Service staff) that will ensure that the situation described does not reoccur. [10 marks] Sydney Central Coast Area Health Service State of Victoria Memo To: Chief Health Information Manager From: Health Information Manager Date: 13th June, 2013. Subject: Advisory Memo Following the OHS incident that occurred at our health facility the following precautions and policies required of employers have been put into place; All employees are reminded that privacy and confidentiality in regards to employee patients’ data privacy and health records must be upheld at all time. Employees are reminded that it is their legal obligation in regards to the information protection principle to uphold the disclosure of access to information concerning employee patient. This is in accordance to the Health Privacy Act’ and the Privacy and Personal Information Act 1998. It is the duty of the employer to protect the retention and security of medical records and at no given point is unauthorized access to the patients, health records permitted. A patient medical record should be used for its intended purpose and no other secondary purpose permitted to use a patient’ medical records The employer should not misuse employee patient personal information or use the information against the patient. b) The health information of staff members should be handled with utmost confidentiality. It is therefore the health facility policy to ensure that the health information is discussed with the staff member privately and not shared with other staff members. The health information of a staff member can only be shared with other when appropriate but it must be done so with the full consent and permission of the staff member. Discussion of a staff member’s health information should not be allowed whether between the other staff members or with staff of another health facility. In addition all patients’ records should be safely stored and out of bounds for other staff members and patients. According to Mair, confidentiality is vital and also mandatory in management of test results by all health professional staff (37). Confidentiality also involves the policy of disclosure of a patients’ health information to others. Thus this policy stipulates that a patients’ health information must remain private and not shared with others unless with the consent of the patient if it deems necessary. The procedure of ensuring that the policy of confidentiality in regards to the staff member health records should be done in such a way that all the staff members are made aware of the importance of confidentiality in health records keeping. The health facility should also ensure that within the records department utmost confidentiality with the patients’ health record is upheld. This can be achieved through adoption of a system of filing that is done electronically and each medical record protected from unauthorized access to information. This will therefore ensure that the OHS incident as illustrated in the case study does not occur in the health facility and the rights of staff members patients enhanced. The policy of documentation of health records should also be adopted. This will ensure that whenever there is doubt the records can be useful as evidence in proficient medical accountability cases (12Mair, 36-42). Question 5 Filing health records is an essential element of every health data department. According to Hughes, the health care sector is moving towards the electronic filing system of the patient’s records (120). Straight numerical filling system is a numeric labeling method whereby records are labeled in a succeeding numerical structure. This system is time consuming and has diverse consequences on the effects of patient care. It is usually suitable for a smaller filling system. Since the Australian outback health service is 90 years old its medical records has pilled up and therefore the need to device a new system of record management that is efficient and will in turn allow the hospital to receive accreditation by 2014. The remedy for the straight numerical system of filing is terminal digit filing that develops distribution of space. Thus it is the only way to allow the extension of files at an equal rate. Hence in a Terminal Digit Filing system the latest two, three or four figures of the digit are treated as a distinct number. All numbers in the file are arranged by their culmination digits and each section stores almost equal number of folders and the shelves divided to create room for expansion. The system does not redevise the medical record numbers used by the health facility. Information on a terminal figure file is arithmetical; the system offers more privacy. Terminal Digit filing will also allow a smooth transition to the electronic patient management system that will take effect in six months. Electronic system of filing is the most appropriate and allows for large storage and easy retrieval of files. It also ensures the privacy and confidentiality of the information filed (13Hughes, 120). The implementation strategy will consist of the following steps; 1. Training of employees on the new system of filling 2. Evaluation of information needs and assessment of the existing information system 3. Classification of the available files since the inception of the facility 4. Availability of space for the filing system 5. Method of retrieval for the files must be stated 6. The duration of filing should be considered Works Cited Lippeveld, Theo, Sauerborn, Rainer., Bodart, Claude. Design and Implementation of Health Information Systems, World Health Organization, 2000. Rajaraman. Rajesh. System Analysis and Design/ Systems Analysis and Design Life Cycle, Indian Institute of Science, Bangalore, 2004. Flint Anndrea, Webster Joan. Exit interviews to reduce turnover amongst healthcare professionals. Cochrane Database of Systematic Reviews 2013, Issue 3. Art. No.: CD006620. DOI: 10.1002/14651858.CD006620.pub3 Mair, Judith. Privacy, employees and human resources: a case report. Health Information Management Journal 40(1): 36-42. 2011. Braa et al.Health Information Systems in Developing Countries. MIS Quarterly Vol. 31 Special Issue pp. 1-XXX/ 2007. Bodart Claude (eds), (2000), Design and Implementation of Health Information Systems. Geneva, World Health Organization pp.270 Health Metrics Network. Fiji Health Information System: Review and Assessment. By. Health Information Unit. Ministry of Health. 2009. Bovey, Wayne and Hede, Andy. ‘Resistance to organizational change: the role of defence mechanisms’, Journal for Managerial Psychology, Vol. 16 No. 7. 2001. Public Health Service, Department of Health and Human Services, “Confidentiality of Alcohol and Drug Abuse Patient Records.” Code of Federal Regulations. 2000. Hughes, James, “Defining the Designated Record Set (AHIMA Practice Brief).” Journal of AHIMA 74, no. 1.2003. Department of Health and Human Services. “Breach Notification for Unsecured Protected Health Information; Interim Final Rule.” Federal Register 74, no. 162. 2009 De Janasz, S.C., Dowd, K.O. and Schneider, S.C. Interpersonal skills in organizations, 3rd edn. Boston, MS: McGraw-Hill Irwin. 2009 Mantzana Vasiliki, LeRouge Cynthia and Vance Wilson. Health care information systems research, revelations and visions. European Journal of Information Systems 16, 669–671.2007. Read More