This paper discusses the critical factors that are relevant for implementing an IT system in health facilities. The level of complexity in healthcare has been increasing over the years, and as a result of this complexity, it is possible that the healthcare practitioners can easily be miss-informed as regards previous and current treatment and health status of the patients due to lack of a supportive IT system. It is essential to note that the presence of modern information technologies has made it possible to have an increased level of health-related electronic information. Such modern information technologies include: continuous development of software, availability of high-capacity computers, easily affordable massive storage devices, modern high-speed networks, remarkable development of intranets and internets and many more IT developments that could be underway (Wager & Glaser, 2013). All these developments have collectively led to increased organization and consumption of electronic health information by the healthcare practitioners. It is essential to note that lack of proper systematization of the existent information limits its availability to healthcare professionals, especially if it exists in paper form.
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Why some HealthCare Organizations have been reluctant to implement Electronic Medical Records
The first reason is the cost of implementation of electronic medical records. In most cases, healthcare organizations have had to weigh the options of whether engaging external vendors to offer the services, or creating and maintaining their own IT applications and structure. However, the underlying factor that scares them in both options is the cost of maintaining Electronic Medical Records in healthcare organizations. The involved costs in this case entail the purchasing price, monitoring costs, coordination costs, governance costs, and upgrade costs, negotiating costs (Balgrosky, 2014). In fact, it is clear that the cost, under this consideration, does work against the benefits that the Electronic Medical Records are supposed to provide. The issue of cost continues remaining the main barrier to adoption of EMR, especially for small and medium healthcare organizations whose IT budgets do not match the needs of such applications. In some instances, the barrier to adoption of such a system is increased by uncertainty as regards the financial benefits that will accrue to the company over time.
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The second reason is vendor trust. Lack of support and inadequate technical training from vendors has been cited as one of the factors that enhance reluctance among healthcare organizations in regard to adopting Electronic Medical Records. In this regard, the reception of EMRs depends on the quality of the companies that sell such systems considering that such products are still recognized as new products in the market (Balgrosky, 2014). Therefore, absence of suitable vendors of such systems implies immaturity in the industry; – one that lacks competitors or adequate products to ensure availability of better services. Also, lack of adequate vendor information limits chances of informed decisions thereby scaring healthcare organizations from adopting and implementing EMRs.
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The third reason is inadequate data exchange. Most healthcare organizations have encountered difficulties managing electronic exchange of data between the EMR and systems assigned to other clinical data such as referral, radiology, and lab systems (Balgrosky, 2014). Therefore, having parallel paper-based and electronic systems pushes healthcare practitioners to switch in between both systems; something that slows the workflow due to manual input of data from external systems.
Health Insurance Portability and Accountability Act (HIPAA) and its Impact on the Patient’s Medical Record
One of the main roles of nurses in healthcare organizations has always been protection of patient confidentiality. The federal medical privacy regulations are some of the few government regulations that have been seen to generate a lot of concerns among healthcare organizations. Within the realms of healthcare, nurses are usually placed in unique positions as they are the ones who make the first contact with the patients when they visit. They are the ones who receive and record intimate and personal details of the patients that could entail personal habits, past medical history, and their living conditions. The underlying assumption is that nurses should never disclose patient information unprofessionally and unrespectifully to any other person that does not matter in their care (Amatayakul, 2012).
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Therefore, the HIPAA regulations impact on the patient’s medical records by increasing their privacy and confidentiality, including those that are contained in electronic media. HIPAA affects medical records by establishing limits for suitable utilization and release of healthcare data; delineating criminal and civil penalties so that those who violate HIPAA regulation become accountable in the event that the confidential healthcare privacy of the patient becomes compromised; requiring all individuals in the healthcare fraternity embrace measures for protecting the privacy of health-related information; and increasing the capacity of individuals to control their health information (Amatayakul, 2012).
Advantages of the Adoption of HITECH Act for HealthCare Professionals
Adoption of HITECH Act by healthcare professionals will lead to reduction of wastage in the healthcare industry. Health information systems’ advocates argue that HITECH helps in reducing the superfluous laboratory tests and medical imaging. Various estimations indicate that the United States has almost 30 percent of its medical care going to waste. However, the amount of waste that would be prevented following adoption of HITECH Act has not yet been established (Wager & Glaser, 2013). The second advantage of adopting HITECH Act for healthcare professionals is improvement of clinical medicine through improved information sharing. Integration of patient treatment databases across huge populations can promote outcomes research; thereby yielding information to indicate the treatments that work best. The third advantage is HITECH helps in addressing security and privacy concerns of personal health information through extension of the corresponding HIPAA laws to vendors of health information that were not previously included in the law such as Microsoft and Google.
Disadvantages of the Adoption of HITECH Act for HealthCare Professionals
The first disadvantage is that while many other Federal legislation together with programs necessitated by HITECH Act are essential, they are not sufficiently fulfilling factors for healthcare providers as regards the espousal of the PCMH model (Amatayakul, 2012). Amatayakul further claims that funding by HITECH is no longer adequate to support meaningful adoption and implementation of EHRs (2012). It is also not enough for funding the wider change in care delivery required to reinforce PCMH. The second disadvantage is that the current Federal legislation and HITECH Act are vital, but not adequate elements for healthcare providers due to the espousal of medical home model, like safety net providers like Federal qualified health centers including the ones serving Medicaid, Medicare, and CHIP beneficiaries. The third disadvantage is that insofar as the HITECH Act was created to promote utilization of electronic health records in order to improve healthcare coordination and quality, limitations traditional to the physician’s office and hospital settings usually affect the coordination of care for individuals who use several health-related services away from these settings.
The one strategy that can enable medical staff members to overcome the main disadvantages that result from their adoption of the HITECH Act by ensuring that the health IT professionals possess the required skills that will enable them manage all the electronic health records that the HITECH Act encourages (Cerrato, 2016). Lack of sufficient computer and technology skills is what has been the main hindrance to proper organization and utilization of electronic health records.
The Typical Workflow Processes within Health Organizations
Workflows in healthcare usually automate healthcare processes without the involvement of a user interface. In the recent past, healthcare organizations have become under pressure following the effect of a broad variety of demographic and market forces. All these forces work together to reinforce the many continuing initiatives in order to improve operations within healthcare domain without compromising the approved level of care quality. However, despite all these collaborations from different quotas, the looming impression has always been the existence of uncertainty regarding the selection of the most suitable tools, techniques and methods that can serve as basis for improving initiatives (Amatayakul, 2012). The introduction of health IT into clinical practices has been cited as the main reason clinicians of today have raised their keenness as far as workflow is concerned. Even though health IT gives a lot of promises for improving healthcare quality and efficiency, its introduction into healthcare amounts to disruption of the already existing workflows.
The first workflow process in healthcare is the admission processes. Automation of admission processes has assisted to save time, promoted the experience of patients, and generally enhanced the efficient operation procedures. The second workflow process is the emergency room operation procedures. This is vital because there has to be connection of core processes between registration and ER specialists and physicians, and check-in sections. The third workflow processes is the medication process. Workflow technology in this case is essential for reducing medical errors and thereby enhance operational efficacy. One of the typical workflow processes is the client/server based information management and imaging system, which works in such a way that integrates and supplements healthcare-based applications (Amatayakul, 2012). This technology is founded on the system that reinforces the centralization of electronic capture, then indexing followed by storage and then retrieval of information that is available on different media and many other electronic platforms.
The supply-driven health system that is founded on what physicians can do is the single most important workflow process that should be eliminated. The workflow process should undergo reorganization to support a patient-centered system that addresses the needs of the patients. This implies that there is need to shift focus from profitability and volume of services provided, which usually entails hospitalization, physician visits, tests and procedures to patients outcomes that should be achieved (Amatayakul, 2012). Executing re-organization in this workflow process is essential for ensuring that patients get maximum value for low cost.
Primary Ways in Which the key Federal Initiatives impact the Standards of health care information for patient privacy, safety, and confidentially
The federal government has put in place certain initiatives that affect the standard of healthcare information for patient safety, privacy and confidentiality. In order to reinforce patient care, healthcare organizations keep electronically Protected Health Information (ePHI) in different electronic systems besides EHRs. Through establishment of HIPAA, the federal government has been able to increase its efforts in maintaining high standards of healthcare information for safety, privacy and confidentiality. Through HIPAA privacy rule, the federal government establishes or creates national standards, which aim at safeguarding the health information of patients. HIPAA security rule, also, helps in creating security standards that are meant for enhancing the security of patient health information (Shore, 2014). Federal funding is also another federal initiative that affects the standards of healthcare information for patient safety, privacy and confidentiality. The federal government, through the HITECH Act, sets aside billions of dollars each year and puts it as an incentive for encouraging healthcare providers accelerate adoption of HER systems.
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Advantages of IT systems in Healthcare Organizations
- Improved care quality – automation of hospital information systems promotes the quality of care due to their far-reaching potentials. For instance, the HELP system supports many applications including HIS routine applications such as charge capture/order entry, ADT, radiology, pharmacy, ICU monitoring, nursing documentation, and decision support function (Shore, 2014). Computers can also generate vital reminders for clinicians and physicians besides alerting them about changing and abnormal clinical values.
- Decreased costs – whenever a healthcare practitioner orders a test via computer, the information automatically displays thereby promoting testing as well as cost-effective treatment. For example, workstations that are connected to an all-inclusive electronic medical record system can tremendously reduce admission costs. The use of computers promotes paperless workstations since there will be no need to make prints of test information, test results and appointment information, which in turn saves money and trees (Cerrato, 2016).
- Patient Knowledge – Computers enable patients to understand the visual perspectives that involve their health. X-rays, radiographs and many other visual representations can be helpful in promoting patient knowledge. Besides, computers provide an easy way to retrieve patient information whenever need arises (Cerrato, 2016). This application reduces chances of losing information.
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Many new IT developments within the healthcare industry are expected to happen in the next 20 years. The following are a few of the many developments:
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- Home automation solutions and smart healthcare devices will be developed in plenty. The driving force behind this development will entail the need to assist elderly to stay at home for longer periods, and also to encourage high-quality of healthcare.
- There will be increased availability of open data because there will be need to increase health information level among consumers.
- Intelligent processors will become embedded in almost all possible devices due to the need to increase availability of information especially in fitness and health devices.