Improving Perioperative Care through IT - Research Paper Example

?  Improving Perioperative Care through IT- Research Paper Introduction Perioperative period refers to a duration of a patient’s surgical procedure that commonly involves admission, anesthesia, surgery and recovery. The goal behind this period is to provide better conditions for patients before, during and after operations. It is estimated that hospitals generate around 60% of their gross revenues as well as it accounts to an average of 40% of their hospital expenses though the perioperative period (Randa 142). However despite the adoption of clinical information system in hospital operations, the area of surgery processes remains yet to be fully automated. This has also been as a result of the complex nature of surgical information systems, implementation challenges, resources to make them work as well the lack of sound practices required to automate perioperative systems yet it is believed that whatever enhancements will greatly improve care delivery process and the quality of care in the long term. Case studies: Adoption and success Recent adoption on implementation of IT through perioperative health care has been evident in two hospitals which are Basset Healthcare located in Cooperstown, New York and the University of Connecticut Health Care Center in Farmington, Connecticut. In both cases automation has been adopted and this has resulted in notable improvements in patient’s safety as well as clinical productivity and process efficiency (David Green 821). It has been reported that there have been improvements as a result of automated perioperative system at Mary Imogene Bassett Hospital which is the Basset Healthcare’s core patient facility that yielded a 33% turnaround time improvements and a supply cost reduction of $200 per case. As for University of Connecticut Health Center there has been strong enhancement in the efficiency of anesthesia management following its implementation of surgical information system just a few years after Bassett’s adoption of the same. This is more specifically in charge capture for billing which has since shown improvement. Perioperative technology: what it entails The technology that is required for the perioperative environment must be supported from a holistic point of view. In this case each component must be integrated with a larger set of technology that will be used in or throughout the perioperative process this is inclusive of perioperative information technology and clinical facilities (Karen A. Wager 253). To facilitate this, data sharing must be enabled in this case all perioperative data and knowledge bases must share common metadata. It is also paramount that the technology supports all clinical and administrative data for perioperative care, from the initial identification of surgical case all through surgery, recovery and ongoing outcome analysis. Database that support these processes must be modernized so as support all types of data, and equipment usage in the surgical process. Clinician’s workflow must also be enhanced to make it easier, faster and less complicated. Data entry should be facilitated at once with real time precision and facilitate sharing ubiquitously as needed (Kenneth Laudon 92). This must be made possible by high level of surgical equipment and software application interoperability throughout the entire perioperative process. Data interoperability is important so as to reduce cases of data redundancy as well as errors. The use of management information systems should facilitate automated data entry without the need for manual re-entry so as to enhance clinical acceptance and accuracy of data by minimizing user workloads and errors in transcription. To better illustrate how the perioperative requirements have been less addresses we have to consider the much anticipates software support computerized physician order entry (CPOE) which was created with the sole intent of making possible direct, online order entry by physicians (Paul J. St. Jacques & Minear). CPOE software is highly focused for inpatient care unit environment. However CPOE has several limitations as it fails to meet the needs of anesthesiologist or a practitioner who performs functions such as ordering, filling and administration. Furthermore CPOE does not support planning as well as the preparation of medication inventories, after-case documentations and inventory replenishment. It is therefore important that optimal software design be adopted to enable the support of clinical tasks and provide simplicity rather than complicate the process of clinical documentation. Technology is to be adopted in perioperative if it only improves workflow and workplace ergonomics. Health care technologies used in the perioperative environment. There are two types of healthcare technologies that emerged in perioperative environments each having its area of specialization in technology application. These areas are Heath care information technology (HIT) and Clinical information technology (CIT). Whereas HIT refers to a broad function of software applications CIT describes clinical equipment, clinical imaging and other instrumentation (Paul J. St. Jacques & Minear). An example of HIT includes software applications that support admission, scheduling, clinical documentation, pharmacy, laboratory and other departments. As for CIT examples include picture archives and communication systems, clinical imaging technologies, robotics surgical systems, infusion pumps, mechanical ventilators, anesthesia technologies which are all critical for the performance of surgical procedures. These two types of systems are usually developed and supported by different vendors and as such are focused on different outcomes. It is common to find hospitals and medical centers implementing these two technologies superlatively for instance they may be installed in different networks and secured from each other hence there is no interoperability between these two technologies (David Green 82). It is therefore important that future products break through this legacy technologies and software so as to facilitate the interoperability between these two technologies. This has been the challenge facing perioperative informatics. It is only when perioperative technologies are implemented as a unit that modern software will be able to fully support perioperative process. Perioperative Informatics By improving perioperative focus in informatics, this will provide a critical foundation for improving the way technology and information support perioperative clinicians (Randa 72). The reality of surgical case scheduling and timing must be supported by real-time, current-state schedule that changes dynamically and automatically in tandem with the work load. It is only upon a conversion to a single and shared digital surgery process will modern software be able to support perioperative process. Recent discovered medical evidence can take years to become utilized into general practice. However, new techniques guidelines such as perioperative beta-blockade, prophylactic antibiotics administration, and normothermia maintenance can be added to online knowledge deployed with perioperative software. As for real time data access for potential error conditions, expert systems as well as predictive alerting systems should be designed to assess data before patients are harmed. Expert systems should be made more intelligent to analyze digital patient data and create evidence-based treatment possibilities at certain points within the perioperative care process. Another implementation would involve the use clinical application suites that are well integrated so as to provide high level of software interoperability so as to deliver sophisticated clinical support functions (Karen 821). However it is important that they are able to deliver the level of function as expected by clinicians and medical staff in the perioperative care process. Implementation The adoption of HIT in the perioperative process has always been a slow, expensive and complex undertaking even when implemented through project management software. This is further made difficult by the lack of tolerance and patience by medical personnel when these system under perform even when they offer an improvement over conventional means (Randa 82). It is therefore important that work flow be made easier, faster and simpler for clinicians. It is also important that these systems deliver improvements that can justify the investments made in their adoption. The aspect of training is also critical in adoption of any perioperative technology implementation especially in a clinical setting. Successful training is also a challenge considering there is time limited in training surgeons, anesthesiologist, nurses and other support staff. This can be a difficult since it interrupts surgery schedules. It is also important that once the software and hardware have been installed, continuous investment must be made each year to support the technology needs and advancements. The new versions can be deployed in smaller scale in less consuming manner as compared to the initial installment but should also not be done trivially (Karen 82). This is advisable as it minimizes cases of bugs, as well as allows for the addition of new beneficial features. In line with other patient handling environments, ethical and legal expectations of rights to privacy must be maintained. This would involve access control in perioperative systems from unauthorized access as well as use discreet data handling techniques such as encryption and hiding of patient’s information. Conclusion The challenges involved with preoperative care are difficult since technological approaches have not been sufficient despite the fact they are promising. In order to achieve the promises of new informatics and technology it is important that changes have to be made in how technology is designed, deployed and maintained within the perioperative setting. It is therefore important that technology be designed to adequately address the needs of perioperative care so as to deliver optimal clinical efficiency and results (Randa, 2008). We can then conclude that by proper design and implementation of such systems there would be improvements in safety as well as patients and medical staff satisfaction in clinical care. Work cited David Green, Max Ervine, Stuart White. Fundamentals of Perioperative Management. Cambridge University Press, 2002. Karen A. Wager, Frances W. Lee, John P. Glaser. Health Care Information Systems: A Practical Approach for Health Care Management. John Wiley & Sons, 2009. Kenneth Laudon, Jane Laudon. Essentials of Management Information Systems. Pearson Education, Limited, 2010. Paul J. St. Jacques, MD and Michael N. Minear. Improving Perioperative Patient Safety Through the Use of Information Technology. Report. Nashville, n.d. Randa, Kermit. "Improving perioperative Care through IT: An Automation Imperative." Patient Safety & Quality Healthcare (2008). Read More