Health and the NHS Information Strategy - Term Paper Example

Health and the NHS Information Strategy Name Institution Executive Summary The technological advancement in the contemporary word is changing almost every aspect of human way of life. In order to achieve the provision of effective and efficient health care services, the NHS in the UK is shifting to information strategies that enable people to have easy access to quality and affordable health care services. According to Frank Burns on the report on information for health; an information strategy for the Modern NHS (1998 – 2005), having a better health care for patients and improving health sector is dependent on information that is accessible and reliable when needed. Having a good information strategy will enable the health professionals to understand the needs of the population they are serving. Through that, the health providers will be able to understand the effectiveness of different health services and how some of the applied treatments work with a reference to the health history and treatment records. Therefore, the report aim at addressing the impact of health information system on the general performance of organizations strategies and the effectiveness of the UK National Health Care systems. Section 1 Health and the NHS Information Strategy Introduction The need for an effective information system in the health sector is neither to reinvent the larger information system nor to set conventional mechanisms for delivery. The need rather requires route maps and framework that would lead a transformation in the ways in which information’s are collected and applied in the health services. According to the information management and technological strategy of the UK National Health Service, by David Wainwright and Teresa Waring, The strategic information system ambition is to apply the use of information acquired to drive integrated health care to the entire social and health care sector, including relevant organizations. A national white paper released by the UK national health service NHS, provide the vision and the mission of the healthcare system (NHS Information Authority, 2004). According to the white paper, the vision is to ensure that in the patient in the future are informed and given the choice about their care. Moreover, the patients would be able to choose the GPs that they intend to register to, the type of treatment that they require and to some extent the consultants that would attend to them within the hospitals (NHS Information Authority, 2004). The system would offer the patient an opportunity rate the hospitals and clinical departments. Initially, there were several inequalities within the healthcare systems (Gaba, 2004). However, the system would remove such inequalities and give all the patients an opportunity to be the healthcare watch within U.K. Vision of the Healthcare System and Strategy of Achieving the Vision With reference to the Information for health; an information strategy for the modern NHS (1998-2005) by Frank Burns, the Britain prime minister considers information as the key to the modern age. According to the prime minister's statement, having current information provide possibilities for future, which is limited by imaginative boundaries. Therefore, it is the responsibility of the UK Government to develop vision for planting new technologies in Britain. According to the NHS information strategy, (government issue, 2012).The main area of focus is on how health care professionals can apply integrated information and the contemporary technology in improving the health services, make informed decisions and to be effective in ensuring the delivery of safer and integrated care. In a bid to bring the primary healthcare systems closer to the people, the white paper reports outlines the vision of making the GPs the official representatives of the care system within the country. As a result, such practices would help in the prevention of most diseases by getting quicker information (Department of Health, 2001). Achieving these objectives depends on the strategies in place to solve some of the obvious barriers influencing healthcare systems through ensuring quality services and efficient management of the funds meant for the development of the care system. In order to a achieve the vision and mission of improving the health sector, the government has seen that it is appropriate to improve communication and information system in the entire public sector. The vision, therefore, has led to the establishment of the national NHs policy context that is in line with the government vision of modernizing the NHS. The policy, which is stated in the new NHS and the Green paper; our healthier Nation have criterions on ensuring faster, convenient, uniformly high standards services that is designed with consideration to the needs of the patients and not the organizations. Moreover, to ensure better performance of the whole care system, it is significant to create a new public health service that would help in running the services associated with the care system, which ensure every pound is spent on maximizing the care of the patients. Within the local authorizes, there is need to set the national goals to improve the health outcomes of the population. Through the establishment of the health and wellbeing boards, the boards has been able to take the responsibility of commissioning NHS services at the local levels as well as improving health and social cares (International Organization for Standardization, 2008). The white paper outlines the importance of establishing the NHS commission board to replace the Strategic Health Authorities indirectly authorizing some NHS services such as maternity. Legacy systems and the current integrated systems A publication on legacy information systems Issues and directions (Jesús B. et al., 1999), describes legacy systems as the backbone of every organization information flow and a key factor in consolidating business information. Alternatively, the legacy Information systems (LIS) can also be described as the information systems that will remain unchanged, thus resisting modification and revolution. The failure of this legacy information can be a major drawback to an organization in case the systems fail. LIS however, has issues that can make its application to cause a problem to the health service provision. The system operates under absolute hardware that is slow in terms of performance and the cost of maintaining it is high. The high cost of maintenance result from the documentation and interpretation of the system complexities, which lack tracing faults and is time-consuming. Moreover, the system lack integration with other systems due to lack of interfaces and the systems are also difficult or impossible to extend. The LIS however, is known to offer short-term solution to the long-term problems. The LIS adopt various migration approaches which include the Chicken Little methodology and the butterfly migration approach. The two methodologies are presented below. Figure 1. The Chicken little strategy, which is a refinement of the composite database approach that rebuild the LIS applications on the targeted platform. Figure 2; the butterfly methodology splits target systems. The system is aimed at migrating the LIS data and temporary storage to the target system. Contrary to the LIS, the contemporary integrated information systems are described as an extension of the basic information system achieved using various system designs. The system incorporates different components of the information management systems. Its implementation helps organization to manage large quantities of information, resources, improve the level of accuracy, reduce the cost of managing organizational process, and improving the services offered to both internal and external clients. As a result, the system helps organizations achieve greater effectiveness. Within NHS, contemporary integrated information system helps in managing different types of data, which are stored in various formats. The application of integrated information system in the health care system has proven to be a success in transforming the efficiency of health service delivery. The IT deficit and proximate cause, which involves the process of gathering information, communication, processing information and information management are very important in improving health service delivery. According to a clinical operation research unit (BMJ, 1993), information management and technology strategy of the NHS is a professional concern and requirement the NHS policies have given much consideration when investing on health care systems. To ensure the application of integrated information systems in the health sectors, various projects have been implemented in the UK national health sectors. The projects have seen the development of infrastructures for IM&T, which include administrative registers and networking of the NHS. The networking of health professionals and sharing information has seen health professionals achieve personal and organizational goals in service delivery. The application if integrated information systems provide mechanisms for collecting and sharing data to and from various sources. The data is therefore made available to the clinical information systems that address various conditions and patients personal information. The data, which can take the form of coded data, text, document imaging and speech can be accessed 24 hours, and the relevant personal information be retrieved to support care. Successful implementation of the integrated information system has helped in managing outstanding issues in the contemporary NHS Information management and technology by addressing standards such as clinical information. Privacy, security and confidence, improving accessibility to social health care, improving the use of NH network and the establishment of national health electronic library (Frank, 2005). The adoption of integrated information system has brought solution to current issues and challenge that face the health service and service delivery. Quite a good number of issues have been addressed through the implementation of the IM and Technology in the NHS. One such issue is the absence of common records structures and terminologies applicable in both the primary and secondary health care. Additionally, health sector lacked internationally set standards and conventions that could be applied in the health care systems. Finally, the integrated information has managed to solve the issues that evolved around drug information by creating a universal coded drug dictionary (Frank, 2005). The implementation strategy of NHS integrated information and technology to the current health sectors in the UK has been a challenge and complex, considering the various models and frameworks that are involved. First attribute goes to the information systems maturity frameworks, which is the application of models in information systems and information technology in the organizations. The implementation and adoption of integrated information management system in the NHS, according to the Nolan model, consider four stages; initiation, contagion, control, and maturity. The implementation and adoption of a new integrated information system in the NHS characterize six stages. The first stage, which is the initiation stage is characterized with adhocracy, including lack of knowledge in the current issues in information technology. Consequently, contagion and control may increase unfulfilled demand for the Information and technology services and create a centralized dictatorship from the IT departments due to security issues. Successful adoption of the information systems take the last three stages of the framework, which involves integration, data administration and maturity in the application and use of the IM&T in NHS (Wainwright and Waring, 2000). A commonly used contemporary integrated management information system within the healthcare sector is the electronic health service system (EHR). Initially, most healthcare systems utilized the green screen legacy systems, which had numerous challenges that new system has been able to address. The integrated systems allow different data including administrative records, results from x-rays, pathology, laboratories, and blood tests to be stored in a single place. It is possible to share such records across any connected network on matters relating to various health information of the patient. Nevertheless, it is important to note that these management systems require adequate security measures to prevent unauthorized access to confidential information. Moreover, most organizations have been able to improve the quality of services with the healthcare system using EHR since it reduces the chances of errors occurring during the episodes of care. Initially, most healthcare organizations lacked evidenced based practices. Nevertheless, with EHR, there is promotion of evidence-based medicine (Wainwright and Waring, 2000). Discussions and conclusions The historical exploration of information management and technological advancement in the NHS is well presented in the maturity model approach, where the progress in the implementation of information systems can be traced. Considering various literatures, the NHS has not fully embraced the implementation of integrated information systems in their dealings. The challenge to the implementation can be attributed to the rise in private health care services, which competes with the public health facilities. Sharing information can be deemed as offering professional services to other organizations (Wainwright and Waring, 2000). Strategic implementation of information systems and technology may be driven by the government as a way of promoting development and improving service delivery in the health sector. However, some of the implementations can come from stakeholders or individual directives with the desire to meeting organizational goals. Adoption of integrated information system and technological advancement in the NHS require the persons involved to provide adequate time for familiarizing with the new developments. It will require the organizations to take time in adopting the new approach in information management and even give time for the residents to integrate the new system. Section 2 Analysis and Critique of the NHS Information Strategy and Efficiency in the Healthcare System Majority of the organisations consider information strategy as a method, which can capture, integrate, refine, deliver, and present information in an organized and logical manner (Smith, 1993). With the United Kingdom, the role of NHS information strategy is to empower those within the healthcare profession with the information required to treat the patients. Besides the medical practitioners, the strategy is also designed to empowering the patients and the public (Gaba, 2004). Those within the care systems will be in a position to choose the most appropriate episodes of care while the patients the method they desire for their treatment process. The strategy also plays a significant part in creating creating new systems within the care professions (Lee, 2009). Furthermore, the NHS information strategy, as a plan, would ensure most activities put in place by the NHS run as planned to prevent inefficiencies associated with inadequate information. Initially, before the U.K. introduced NHS information strategy, most healthcare organizations used the information management and technology (IM&T) strategy. However, when the country scrapped the strategy in 1992, there was need for systems that would enhance the coding process of the medical terms and the national standards in computing. After IM&T, and information for health strategy emerged with an objective of proving the right information when and where there is need (Frank, 2005). Introduction of the NHS information strategy focused on ending the adverse issues experienced with the healthcare sectors. Some of these issues include reduced confidentiality between the patient and practitioner, inadequate and ineffective methods of communication, data redundancy, and disappearance of crucial records while required. The strategy was to set the expectations as far information is concerned within the new NHS vision and the methods of achieving these requirements. Such implementation would improve the level of reliability of the information required by the practitioners to execute their duties effectively (Paranjape & Sadanand, 2010). Conversely, it is important to note that several factors are prone various With the current technological advancement, several processes utilizing technological components are prone to various challenges. Globally, the numbers of hackers have been on the rise, with most organization looking for solutions to these problems through employing those with advanced information technology (IT) skills to help manage organizational database as, stated in the International Organization for Standardization of 2008. Consequently, this is the major critique associated with implementation of the NHS information strategy. Within the United Kingdom, the issue of implementing the strategies lies within issues associated with privacy and safety of the programme in storing confidential information (Buikstra & Roberts, 2012). Implementing the strategy would mean that all the practitioners within a particular organization have access to the database. Increasing the number of people accessing the database tend to increase the level of vulnerability of the database to cybercrime-related activities (Wainwright & Waring, 2000). Using personal login details of a practitioner with an access to the database, the hackers might hack into the system and leak confidential information. In most cases, managing data using modern technology might increase the cost of operation through hiring most employees with adequate skills database management and internet security. However, there benefits associated with effective implementation of the NHS information strategy. The general advantage of applying the strategy with the healthcare system is that it would give the patients control over their records, which complements the vision of the NHS that aims at ensuring that the patients have free access to their health records (Buikstra & Roberts, 2012). There are several issues associated with monitoring of the system that needs to be considered while implementing the strategy. Moreover, there have been n increasing concerns that the strategy does not have set targets and objectives that are necessary if the government needs to monitor spending and achievements. Discussion and Conclusions The government of the United Kingdom has been able to set out the strategy required to realize the unprecedented shift in the delivery of the healthcare (Department of Health, 2001). Moreover, the major concern of the strategy lies within deliverance of quality services, integration of the services the continuum of care, and ensuring long-term sustainability of the healthcare system. With the introduction of the white paper report by the government, it is clear that there would effective and efficient utilization of the resources. Besides, the government would save a lot of money within the health sector by ensuring accountability within the healthcare system (Smith, 1993). The strategy would increase efficiency with the healthcare system as it seeks to make health systems accessible and fair to all the citizens of the United Kingdom (Department of Health, 2002). Through implementation, the patients would feel more satisfied with the services they receive from the primary care providers as well as ensuring that the care providers work together in a more effective at the local levels to help meet the needs of the patients. Therefore, integration of the information system would ensure deliverance of better value for the investments acquired from the healthcare system. All healthcare providers and commissioners require confidence while managing their systems and policies. Implementing the NHS information strategy would offer such benefits; however, it is important to note that these systems are fully efficient in managing organizational information. Besides, they are prone to cybercrime-related activities of which it might lead to exposure of organizational confidential information. Within the healthcare systems, other health IT besides EMR include the clinical decision support, computerized disease registers, computerized provider order entry, consumer health IT applications, electronic prescribing, and Telehealth (Gaba, 2004). The integration of these IT concepts the care system is to help in managing information on the health of the patients and the healthcare for individual patients and groups of patients. As a result, management within the healthcare profession has become easier since there is reduction of more paperwork (Gaba, 2004). The systems are important since they assist organizations manage patient care effectively through secure use and sharing of health information. Health IT improves the quality of the care system as well as making the healthcare cost effective in terms of management (Paranjape & Sadanand, 2010). With the implementation of the information systems, care systems would enjoy accurate and complete information on patients and with such, there is a possibility of providing medical emergencies. Moreover, it offers a convenient way of sharing information with the patients and the family caregivers over the internet especially for the patients who choose such methods for convenience. Vision and Strategy for Diabetes Several studies indicate that diabetes is the fourth leading cause of death in the United Kingdom. However, such incidence rises with ages with old people showing fewer symptoms compared to the younger people (Department of Health, 2002). Approximately 5% of the people suffering from diabetes require intervention of social services. The top priorities in the U.K. are early detection, prevention, and good management of the disease. As a result, the government published the National Service Framework Delivery Strategy the outlines the accepted standards and steps that need to be considered while preventing, detecting and managing the disease. NSF outlines 12 standards of dealing with diabetes with an aim of preventing diabetes, identifying and empowering those suffering from the disease, and ensuring that they access high-quality treatment that is evidence based (Department of Health, 2001). These standards include prevention of Type 2 diabetes, identifying people with diabetes, empowering them, clinical care of adults, children, and young people with diabetes, management of the emergencies, care for people within the hospitals, focusing on the diabetes and pregnancy, and detecting and managing the long-term complications. Within U.K., there are predominantly two types of diabetes, Type 1 and Type which occur when the body is not producing any insulin and when the body does not produce enough insulin respectively (Department of Health, 2002). Currently, approximately 2.6 million people in the U.K. have diabetes with 1.1 million considered undiagnosed. Moreover, most studies indicate that more than four million people in the U.K. would be suffering from the Type 2 diabetes by 2025 (Department of Health, 2002). These statistics are quite sterling considering that Type 2 diabetes is the major challenge affecting the U.K. with most people treated entirely by the National Health Service who are the major provider of healthcare system for all levels of diabetes (Department of Health, 2002). In addition, the NHS spends about 10% of all the resources in managing diabetes. There are several frameworks and policies within the U.K. that guides the standards of care, improve the quality of life, and increase life expectancy of those suffering from diabetes. With reference to the NHS information, strategy set out to improve the quality of services offered within the healthcare, there have been rising standards that move towards centering the patients (Gaba, 2004). For example, publishing of the NSF for diabetes have been able to outline the standards of that aim at ensuring deliverance of improved services and reduction in inequalities within a period of ten years (All Parliamentary Group for Diabetes and Diabetes UK, 2006). The major objective of the framework is to ensure that people suffering from the diabetes receive standardized treatment in the United Kingdom. Moreover, NSF for Diabetes: Deliver Strategy gives guidance on the ways in which the desired standards could be achieved. According to the NHS Information Authority (2004), the frameworks play an important role ensuring the achievement of all the desired outcomes. They outline important actions and set out clear goals and target. However, such strategies do not do address the social, economic, and environmental causes of diabetes. Moreover, they do not consider the available finances and staffing resources. Although NSF for Diabetes tend to support such shortfalls as it notes that besides the retinal screening, there are no funds initially made available to ensure effective implementation of twelve standards (Whyman, 2008). The achievement of the standards would have been significant if the government had availed the funds, as more diabetes patients would access the healthcare system (Armoni, 2002). Nevertheless, in 2004, the Quality Outcome Framework offered financial rewards of meeting the targets outlined in the NSF like maintaining the practice-based registers for those suffering from diabetes to enable the healthcare providers proactively execute their roles. Through incorporation of such registers, the healthcare sectors dealing with diabetes would be complying with the requirement of the vision and vision of the NHS information strategy. Several publications have followed NSF for diabetes with an attempt of giving guidance to the healthcare practitioners (Brown, 2011). However, these frameworks are not work in isolation but through a collaborative process with one another at different levels while attempting to produce quality health services. The document used in the U.K. for the diabetes relates to that of the NHS information strategy since both of them aim at improving the quality of the healthcare systems with major focus on the affected population (Armoni, 2002). United Kingdom prioritizes the health status of its citizens; as a result, the implementation of the electronic registry would assist in monitoring the affected population and establish whether they are following the episodes of their medication as required (All Parliamentary Group for Diabetes and Diabetes UK, 2006). Moreover, implementation of the framework would help in improving the health of those suffering from diabetes. Initially, most people considered the cost of undergoing the diabetes treatment to quite expensive. To some extent, majority of the poor people with adequate finances would prefer failing to seek medical attention (Whyman, 2008). Before the government published the framework of monitoring the standards used in offering treatment, most of the people in the United Kingdom were not able to access medication since most healthcare facilities required deposit of some amount before the treatment commence (NHS Information Authority, 2004). The framework for diabetes is patient-centered. Currently, the diabetes patients receive different standards of care depending on their ability to attend the surgery or not (Department of Health, 2002). Consequently, those with not ability of attending the surgery, overlooked, or missed screening would be able to receive one the most fundamental right at their convenience. Despite the NSF stating that there are inequalities in the provision of services to the diabetes, it is important that the government address these issues to ensure that the patients access high standards of care that meet their needs (Wainwright & Teresa, 2000). Moreover, through creating awareness, the number of those seeking treatment would improve. References All Parliamentary Group for Diabetes and Diabetes UK. (2006). Diabetes and the disadvantaged: reducing health inequalities in the UK. Author. Armoni, A. (2002). Effective healthcare information systems. Hershey, PA: IRM Press. Brown, L. R. (2011). Home health competency management system. Danvers, MA: Beacon Health. Department of Health. (2001). National Service Framework for Diabetes: Standards. London: Author. Department of Health. (2002). Diabetes Information Strategy. London: Author. Frank Bburns (2005), Information for health; An information strategy for the Modern NHS (1998-2005): A national strategy for local implementation. Department of health publications, West Yorkshire. Gaba, D. M. (2004). The future vision of simulation in health care. Qual Saf Health Care, 13(1), 12-25. International Organization for Standardization. (2008). The integrated use of management system standards. Geneva: Author. Lee, R. (2009). Economics for healthcare managers. Chicago: Health Administration Press. NHS Information Authority. (2004). Health informatics education and development for clinical professionals: Making progress? : research reports sponsored by the NHS Information Authority into the implementation of Learning to manage health information: a theme for clinical education, carried out between April 2001 and March 2004 in four parts. Birmingham: Author. Paranjape, R., & Sadanand, A. (2010). Multi-agent systems for healthcare simulation and modeling. Hershey, PA: Medical Information Science Reference. Smith, R. (1993). The new information management and technology strategy of the NHS. BMJ, 307, 271. Wainwright, D., & Teresa, W. (2000). The information management and technology strategy of the UK National Health Service. The International Journal of Public Sector Management, 13(3), 241. Whyman, R. (2008). The Stanislavsky system of acting: Legacy and influence in modern performance. Cambridge, UK: Cambridge University Press. . Read More