Impact of Informatics in Healthcare Delivery - Research Paper Example

Impact of Informatics in Healthcare Delivery and Impact of informatics in healthcare deliveryAbstract The advent of technology has seen a change in operations in many fields, and the medical field has not been left out. Informatics has not only revolutionized how healthcare providers operate but it has also led to an improvement in the level and rate of healthcare provided to patients. There are numerous benefits that all stakeholders in the medical field can derive from informatics. It has enhanced disease management, improved and promoted patient care and safety and even led to adoption of a paperless system. However, even with the many benefits, there are many barriers faced in the adoption of informatics, especially in areas where people in the lower class reside. Some of the main barriers include insufficient financial resources, difficulty in end user acceptance among others. The healthcare providers should be enlightened on the need for informatics. The conclusion drawn is that informatics has revolutionized the operations of healthcare providers and also improved patient care. This paper embarks on a detailed discussion of the impact of informatics on healthcare delivery and on health care providers. Introduction That healthcare has become increasingly demanding and complex is an undeniable fact. Today, the focus is not just about dealing with acute problems but also managing the mounting chronic diseases and preventing communicable diseases. The number of patients has increased and so have the expectations heaped on healthcare providers to enhance and ensure efficiency in their operations. With healthcare increasingly becoming a community based issue, nurses and other healthcare providers are feeling the pressure and the strain. In addition, the issues of patient privacy and doctor-patient trust with regards to information handling and disposal are further weighing on the healthcare providers (Hart, 2011). Informatics, which has greatly enhanced the outcome of the health care providers and the rate and level of health, is defined as a discipline that intersects information science and computer applications with healthcare (Ricchesson and Andrews, 2012). This branch of knowledge brings educational and practical applications of computer and information technologies to be merged with healthcare, education health and biomedical research. Informatics, therefore, has a big impact on healthcare delivery and in affecting the operations and effectiveness of healthcare providers (Ball, 2003). This paper embarks on establishing the impact that informatics has on healthcare provision and on healthcare providers. It shall also discuss the barriers towards successful implementation of informatics in healthcare The four cornerstones Research conducted shows that there are four common cornerstones upon which informatics in healthcare are based as noted by Lorenzi (2000). One is the production of structures that combines and allows a representation of data and collected knowledge, therefore enabling the visualization of multifaceted relationships. The second pillar is developing means and processes through which data can be acquired and presented, and at the same time avoid and address information overload (Lorenzi, 2000). The other cornerstone is the proper management of change, the people affected by the change and the installed processes so that the information and data gathered is optimized. The last cornerstone, as Lorenzi (2000) and Tang et al (2006) note, relates with integration of information. Since the information is accessed from diverse sources, it should be integrated into work processes so that if need be, this information can be acted upon without much pressure and strain. This four cornerstones call for clinicians to be advanced in their knowledge of technology as they extend well beyond the basic skills required in data processing. Literature review and theoretical framework Many texts have been written and published, campaigning for the essence and importance of adopting and incorporating technological and information systems into the healthcare world. The inclusion of technology is important in boosting the results and outcomes of the work of healthcare providers. Health care providers are faced with new conditions and circumstances in patients every new day; making their performance even more complicated (Tang et al, 2006). With technology, the healthcare providers are able to communicate with each other in a simplified way and acquire new knowledge by combining the medical field and the technological field. Scholars have continuously argued that incorporating technology has brought massive changes in the medical field, especially in the level of patient care (Hart, 2011). Leo Cherne forwarded one of the most famous quotes (usually misattributed to Albert Einsteen) in a bid to show how important technology is. He said that computers are incredibly fast, accurate but stupid. Human beings on the other hand are inaccurate, slow but very intelligent. The marriage of these two is a force beyond imagination, beyond calculation (Nelson and Staggers, 2013). This quote has been used to show the superb result of allowing people to incorporate technology in their daily operations. Other people, however, argue that technology has not made much impact, and if anything, it has only increased the costs incurred in the hospitals. To them, treatment and handling of patient is too noble a task to assign to a computer, and after all, there was no technology in the past yet people still received proper medical attention (Hart, 2011). However, a comparison from twenty years ago, in USA only, shows that informatics in healthcare has reduced the mortality rate of patients by over 60%, has reduced complications in treatment and medications by over 40% and has reduced the costs by over 30 % (Ricchesson and Andrews, 2012). This shows that in healthcare, technology has now become an indispensable tool. There are several theories that have been suggested to explain the incorporation of technology in healthcare delivery. The systems theory, the change theory and the communication theory are good examples. The change theory developed Kurt Lewins is the most widely applied theory as it is suitable for personal and organizational changes (Nelson and Staggers, 2013, Khoumbati, 2010). Kurt argues that change is necessary, especially when the new system to be adopted is better than the currently existing one. He gives three stages of change which are the unfreezing stage, the change/moving to a new level stage and the refreezing stage. In the unfreezing stage, people realize the need for change. This realization might be due to the challenges of the current system, its rigidity and the chances for a more suitable system. People let go off of the old system and the desire for change is generated (Khoumabati, 2010). An example of such a change, and which aptly fits in this discussion is the desire to shift from paper based documentation to a paperless one. The second stage, the change state, is where the people to be affected by the change are made to understand that the decision is important. The old thoughts, way of operations and feelings towards the old system is slowly replaced by the thoughts and process of the new system. From the paper based to paperless example given above, the change state involves putting up structures and processes to start tuning the mind of nurses and clinicians to the new system. This stage is usually expensive and a lot of time is taken but the productivity, and the effect realized in the long run, is worth it. The refreezing stage is the last stage of the change process. The established process now becomes the basis of operation or the status quo. The changes in the new system slowly become integrated in the working routine and the old system is slowly discarded. Kurt also added the three forces of equilibrium, driving force and the restraining forces as factors that affect how successful, or otherwise, change implementation might be (Ricchesson and Andrews, 2013). The change process, therefore, lays a basis for informatics in healthcare. It is diagrammatically represented below. Figure 1: The change theory illustration The Shannon and Weaver model has also been used to explain the importance of communication in a bid to enhance quality healthcare delivery. In addition, the systems theory has been used to explain the importance of systems interrelations, which can be seen in the interrelationship between healthcare and technological systems (Khoumbati, 2010). Impact of informatics in healthcare delivery and healthcare providers As earlier stated, the value of informatics in promoting the value of healthcare delivery and in enhancing the performance of healthcare providers is undeniably important. The systems are imperative, especially with the witnessed demand for healthcare services. Today, thanks to informatics, many patients consult their doctors and even receive their medicine prescriptions from the internet. This is a milestone of development in the medical field. A 2006 study conducted in a hospital in New York revealed that application of IT in the ICU department had effectively reduced ICU mortality cases from 40 % to 68% and the level of complications in the ICU from 44% to 50%. The hospital mortality, in overall, reduced from 10% to 35% (McGuiness, 2007). This shows that health informatics is pertinent in creating value. Informatics has affected healthcare in the following positive ways. Management of diseases Presently, nations all over the world are working towards prevention of diseases rather than treatment. It has been realized that prevention of diseases plays a great part in cost reduction and is simpler than the treatment itself. For example, a research carried out in 2012 showed that 80 % of deaths in the USA are chronically related. They are also attributed to 90% of the morbidity and to 70% of the total medical costs in USA (Nelson and Staggers, 2013). Informatics programs aimed at prevention of chronic diseases have proven to be very effective as compared to treating people when they are ill. Such programs might include a platform in the internet where doctors advise people, providing them with important information on how to stay healthy, what food or lifestyle practices to avoid and incase of one who is already suffering from the chronic diseases; they are advised on their medication. When one is able to access such information, it not only saves time from physically visiting the doctor but also saves the doctors enough time to attend to the people who have physically visited the hospital (Lorenzi, 2000, Tang et al, 2006). These consultations can be done at any time and better still, there is an allowance of people leaving their inquiries when the doctors are not available, and these inquiries are responded to when the doctors are available. One such program for diabetes patients, and another for congestive heart failure were established in a local hospital in USA. The results for the diabetes cases, which was made up of people who were already suffering from diabetes showed that in a four year period, none of these people was hospitalized. As a result, there was a significant net savings of approximately $ 510, 130 every year (Khoumbati, 2010). For the congestive heart failure program, readmission rate for the patients reduced significantly to about five in a thirty day period. The rate at which the participating patients were readmitted, in a period of ninety days, reduced by 85%, resulting to a reduction in costs and expenses in the hospitals (Khoumbati, 2010). All this was possible due to telemonitoring and educating patients on healthy lifestyle practices. Telehealth Telehealth refers to use of communication technologies such as video conferencing and video streaming to support long distance healthcare provision. This technology has been adopted by many hospitals in the USA and other nations and has proved useful. The telehealth programs are not just important in saving time but also in reduction of costs (Braunstein, 2012). Patients can stream live videos shared by doctors which are educative and informative, follow the prescribed procedures and as a result, minimize their need to physically see their doctors (Nelson and Staggers, 2013). The advantage of this platform and program is that the information shared is supported or co-authored by many doctors all over the world. Telemedicine coverage has also played a big role in promoting the outcome of healthcare. In U.K, a local hospital added telemedicine to its operations and the results were impressive. The patient mortality reduced drastically by about 58%, complications reduced by 38/5 and the costs further decreased by 35% (Thede, 2012; Braunstein, 2012). From the reduced admissions, the hospital realized a reduction in costs by over $ 150,000 per year for every intensive care unit bed (Thede, 2012). These figures depict the much importance of informatics in changing the operations of the traditional hospitals and in reducing the costs and expenses incurred in hospitals. Telehealth is definitely one of the most adopted technologies. Improved patient safety Researchers and medical scholars have staggered on many horrific and disheartening cases of medical errors made by well known doctors. These errors have resulted to fatal outcomes and have consequently lead to doctors and hospitals being sued. Some of the mistakes and errors include doctors prescribing an overdose of drugs, prescribing the wrong drugs to patients and even injecting them with the wrong medicine. To err is human, but doctors, as scholars argue, are bestowed with the responsibility to preserve life. Nobody understands it when an investigation is carried out and it is discovered that the doctor committed a genuine mistake, unknowingly (Hart, 2011). Informatics has helped to drastically reduce such cases, especially in the well developed countries. Information regarding the dosage for a particular disease, the different drugs to be prescribed and even a comparison of characteristics and symptoms has been matched and all computerized. This has given a chance for doctors to consult and clarify when they have doubts regarding a certain dosage or a particular medication. As a result, a statistical research carried out in 2012 showed that the support systems have abridged the chances and occurrence of errors by over 60% (CDC, 2014). When patients seek medical care and services, they entrust their lives to the healthcare providers and they believe that the doctors, being experts in their professions, will do and prescribe what is best for them. Informatics has therefore reduced these errors and the level of patient-doctor trust has increased. In addition, the rate of information that doctors have to grasp and internalize is a lot. For instance, different antibiotics are prescribed for different diseases and different chronic diseases have different symptoms. Some of the symptoms expressed by a patient might be very similar yet the medication is totally different. In a condition where there is no time to dig deeper and establish what the patient is suffering from, or there is no time to carry out a blood test, the computerized systems will easily show the differences, and this further reduces the chances of a doctor prescribing the wrong medicine or the incorrect dosage to the patient. Informatics, therefore, has greatly increased the value and rate of patient care (Thede, 2012). Replacement of paper based systems The EHR system has played a big role in improving the quality and outcome of patient care. Replacement of the paper based system has gone a long way in enhancing the efficiency of healthcare providers. Traditionally, there wasn’t a unified system of collecting, retrieving, storing or integrating the different patient information. This made it complex and hard for nurses to retrieve information needed by patients, especially if they were urgently needed (Ball, Weaver and Kiel, 2010). However, the electronic health record system has computerized all information for the different patients to ensure that time is not wasted retrieving them. This has also reduced the chances of documents with sensitive patient information and records landing into the wrong hands (Ball, 2003). The fact that they are computerized into the system means that they are only accessed when needed, and are only accessed by the authorized person. Informatics has also empowered the patients by allowing them to monitor who has access to their medical records. The patients have the chances to review any medications which have been prescribed to them earlier and also see the results of any tests done on them (McGuiness, 2007). Chronic disease patients find this particularly important as they can analyze the results or the effectiveness of all healthcare providers who have treated them. Barriers to adoption of informatics We cannot deny the fact that informatics has played a great role in enhancing and promoting the level of patient care and increasing the efficiency of health care providers. However, there are many challenges that have barred healthcare institutions from adopting information technologies (Hart, 2011). In a study carried out in 2011, lack of financial support was cited as the greatest reason as to why some people have not adopted informatics in their operations. This was especially the case in hospitals located in locations where the low class people live. Lack of enough staffing resources was also cited as well as the inability of the vendor to deliver the product. End user acceptance, as noted, is also a barrier to hospitals attempts to transit to longitudinal care. The diagram below is a representation of the major barriers towards the adoption and incorporation of informatics in hospitals. Figure 2: Major barriers to informatics adoption in healthcare delivery Implications Informatics has generally redefined the networks of healthcare and has also led to optimization of the healthcare delivered to patients. It has also fostered communication between the healthcare providers and patients, an aspect that is imperative for successful healthcare delivery. Informatics has seen to the changeover from an episodic healthcare to a longitudinal care and has also created an impetus for healthcare providers to work as a team (Thede, 2012Tang et al, 2006). In addition, it has improved the quality of operations of individual nurses as they have had to keep up with the drastically changing technology. The September 11th attacks played a major role in depicting the importance of informatics in the medical field. The nation was put on alert and triggered the government to address the importance of computers and technology in the healthcare system. The ability to have information collected, analyzed and distributed to different people at such emergency times is important (Ball, Weaver and Kiel, 2010). This makes it possible for healthcare providers to provide quality care in terms of disasters such as bioterrorism. In case of a disaster, informatics earlier developed and put in place enhances quick response and coordinates the health systems from different points. The above impacts are just a few of the many impacts and benefits of informatics in healthcare delivery and healthcare providers. We cannot dispute the fact that informatics has greatly improved the level of healthcare delivery. It is extremely wonderful when one does not have to go all the way to see their doctors over a few inquiries. Videoconferencing and telemedicine are two of the many aspects that have influenced how people access medical support today. Physical presence of the patient is not mandatory, especially when the patient just wants to make inquiries. This means that even the nurses who are in their training and medical schools ought to be trained on how to practically incorporate informatics in their practice (Braunstein, 2012). This not only makes work easier for them but also improves patient safety. However, the government and the relevant ministries still need to channel some resources and time to educate the healthcare providers and the nurses on the importance of informatics. In addition, the problem of inadequate funding ought to be addressed as soonest possible to ensure that all hospitals adopt informatics. Conclusion It is evident, from the discussion above, that the four cornerstones are important in laying a base for successful incorporation of informatics. The advantages and benefits of informatics are undeniably numerous, with a promise of more advantages in the drastically growing technological levels. The amount of information, references and information resulting from clinical trials, tests and studies is growing at an astonishing rate, yet doctors are expected to master every single bit of it. Information technology has made it easier for doctors, especially those who are new in practice, to gradually master this information without much pressure (CDC, 2014). They can constantly make references from the integrated computer systems and this saves them the burden of grasping new information all at one. Informatics has also provided a platform through which healthcare providers interact and exchange knowledge and as a result their performance has gradually increased. The fact that patients can comfortably and easily monitor their health without physically going to the doctors is a thing of excitement to many, especially to those who suffer from chronic illnesses. The nursing practice, and the general healthcare provision practice has revolutionized overtime and this has made it possible for healthcare providers to enjoy their chosen professions. The barriers to informatics adoption should be addressed as this will improve the level of healthcare and also reduce the medical costs and expenses. One major problem that has been cited by many is the lack of a standard unit upon which the informatics systems should be based. Since it should be similar for pharmacists, dentists and even occupational therapy, a common standard should be developed to ensure that the operations are uniformed. Informatics should also be encouraged in places where the low class residents reside to ensure that all people receive affordable and high quality healthcare. References Ball, M. (2003). Better health through informatics: Managing information to deliver value. Retrieved from http://www.springer.com/cda/content/document/cda_downloaddocument/9780387954745-c3.pdf?SGWID=0-0-45-101715-p2287227 Ball, M., Weaver, C., & Kiel, J. (2010). Healthcare information management systems: Cases, strategies and solutions. New York: Springer. Braunstein, m. (2012). Health informatics in the cloud. New York: Springer. CDC. (2014). How is CDC using informatics to improve public health systems? Retrieved from http://www.cdc.gov/globalhealth/healthprotection/ghsb/gphi/what/roles.html Hart, M. (2011). Compelled by demand, driven by experience. Nursing Management, 42 (5), 21-23. Lorenzi, N. (2000). The cornerstones for medical informatics. Journal of American Medical Informatics Association, 7(1), 204-205. McGuiness, S. (2007). Healthcare informatics: A skills based resource. American Journal of Pharmaceutical Education, 71(2) 39-40. Nelson, R., & Staggers, N. (2013). Health informatics: An inter-professional approach. New York: Elsevier Health Sciences. Ricchesson, R., & Andrews, . (2012). Clinical research informatics. New York: Springer. Tang, P., Ash, J., Bates, D & Snads, D. (2006). Personal health records: Definitions, benefits and strategies for overcoming barriers to adoption. Journal of American Medical Informatics Association, 13(2), 121-126. Thede, L. (2012). Informatics: Where is it? Retrieved from http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/Columns/Informatics/Informatics-Where-Is-It.html Read More