Automating Health Care

Automating Health Care

Walk through your local hospital and there is a good chance that you will see secretaries, nurses, and even doctors working at computers. This is because most hospitals have incorporated or are in the process of incorporating healthcare information systems (HCIS). Application of information technology has been identified by the Institute of Medicine as one of the principal ways to improve the quality of health care. The days of paper medical records are moving rapidly into the past, and the electronic medical record is the wave of the future. An Electronic Health Record (EHR) provides each individual with a secure and private lifetime record of their key health history and care within a health system. The record is available electronically to authorized health care providers anywhere, anytime, in support of high quality care. Through the implementation of EHRs, the goal is to use clinical data to improve communication with patients while achieving better treatment results. HCIS have been shown to improve nursing efficiency, increase patient safety, and improve documentation. If a hospital will adopt an HCIS is no longer the question; rather, the more appropriate question is, “which one it will be?” Evaluating HCIS to ensure it will meet a health system’s needs is critical in ensuring a smooth transition. Accurate evaluation relies upon the choice of appropriate evaluation indicators.

[Insert photo of a nurses’ station with doctors and nurses working on computers]

HCIS Evaluation

The following factors influence the evaluation of an HCIS:

 use of the HCIS by a variety of specialists

 use of the HCIS for re-engineering

 change in evaluation results with new recruits

 multi-functional health information system (admission, discharge, transmission etc.)

 use of the same HCIS by different organizations

By adhering to a logical and systematic selection process, a healthcare organization will be able to make a high-quality decision about which HCIS to choose. Potential benefits have to be weighed against all costs. There are two categories of costs associated with the implementation of a healthcare information system: system costs and induced costs. System costs include the cost of the software and hardware, training, implementation, and ongoing maintenance and support. Induced costs are those involved in the transition from a paper to electronic system, such as the temporary decrease in provider productivity after implementation.

[Insert Cost/Benefit Analysis of an HCIS]

Determining the criteria to be used in a healthcare information systems evaluation depends on many factors, including what type of system is being evaluated, who the stakeholders are, what methodology is being used and what financial or time constraints need to be considered. In a survey of industry and health professionals, data availability, waiting times, workflow process, costs of training, system response times, time to complete tasks, and service quality were ranked as the most important factors in evaluating EHR initiatives. One of the primary reasons a healthcare facility implements an HCIS is to speed up the flow of information, and there is an expectation that all data will be available at all times. Any system that seems to slow down the flow of data or makes data unavailable when it is needed will create frustration among the doctors and nurses, as well as the patients.

Systems should also be evaluated for their ability to meet the legal requirements of healthcare professionals. HIPAA (Health Insurance Portability and Accountability Act) was enacted by the U.S. Congress in 1996 and it drastically changed the way healthcare data was managed. HIPAA provisions address the security and privacy of health data. The standards require the protection of confidentiality and security of health data.

Measuring HCIS Success

In a landmark article, Delone and McLean (1992) provided a framework for characterizing and measuring the success of information systems. The framework includes 6 major dimensions or categories: system quality, information quality, information use, user satisfaction, individual impact, and organizational