NURS 8210 Health Information Technology Project [Major Assessment 5]

Sample Answer for NURS 8210 Health Information Technology Project [Major Assessment 5] Included After Question

To complete:

Your deliverable is a 12- to 15-page scholarly report, not counting the title page or references. A successful report should leave the reader with confidence in understanding the answers to all the questions listed below. Graphics may be used to illustrate key points.

Organization Information

  • Briefly describe the health information technology system/application and the organization type (hospital, clinic, public health agency, health care software company, government health information website, private virtual health information site, etc.).
  • Is the health information technology system/application clinical, administrative, educational, or research related?
  • What were the key reasons for the development of this health information technology system/application, i.e., what made the organization believe this system/application was needed? How did this organization determine those needs? Did the organization use specific tools to conduct needs assessments, staff opinions, or workflows?
  • How did the organization determine that this specific system/application could fulfill its predetermined needs?
  • Who manages this health information technology system/application and where are they located within the organization’s administrative structure?

Information System Application Design and Development

  • Many health care systems have multiple independent entities that work together toward the common goal of providing high-quality care. How did—and do—the various stakeholders make decisions related to this health information technology system/application? Were the end users involved in the development of this health information technology system/application?
  • How are individuals trained to use the health information technology system/application?
  • How are security issues addressed? How does this health information technology system/application support a legally sound health care record?
  • Where did initial funds for this health information technology system/application come from?
  • Who manages the budget for this health information technology system/application?
  • Have organizational or political issues impacted the ongoing funding for this health information technology system/application?
  • What are the arrangements for planned or unplanned downtime?
  • How are health information technology system/application upgrades scheduled or planned?
  • How has the health information technology system/application changed in response to health care reform and related legislation?
  • What suggestions could you make regarding changes needed to support health care reform and related legislation?

Innovative Aspects of the System

  • How does the health information technology system/application utilize technology innovations?
  • What technology innovations would you recommend for this organization? What innovations presented in this course, or found through your own research, could this organization benefit from?
  • What innovations could further promote evidence-based practice and efficiency within this organization?

A Sample Answer For the Assignment: NURS 8210 Health Information Technology Project [Major Assessment 5]

Title: NURS 8210 Health Information Technology Project [Major Assessment 5]

Health information technologies have transformed significantly the provision of healthcare services in the modern world. Healthcare organizations embrace new technologies on a regular basis with the aim of enhancing the safety, quality, and efficiency of their patient care. The realization of such goals in care process contributes to improved organizational performance, competitiveness, and trust by the healthcare consumers. Healthcare providers play a pivotal role in facilitating the implementation of new health information systems in their organizations.

They provide insights into the system needs of the technologies they need to enhance patient care and explore evidence-based data to support its use. Healthcare organizations can embrace different types of technologies to enhance their service provision. One of such technologies is telehealth. Therefore, this research paper explores telehealth, as a technology adopted in the practice site to enhance the quality, safety and efficiency of patient care. The paper explores aspects that include organization information, information system application, design and development, and innovative aspects of telehealth system use in the organization.

Organization Information

Description of the System

The selected health information system is telehealth. Telehealth is a technology used in delivering and facilitating health as well as health related services such as medical care and patient education through digital communication and telecommunication technologies. The technology is also applicable for use in the delivery of healthcare services such as self-care, provider education, and health information services through digital communication and telecommunications technologies (Tuckson et al., 2017). The examples of telehealth technologies utilized in healthcare include liver video conferencing, electronic transmission of patient data, remote patient monitoring, and mobile health applications.  

Telehealth technology has different modalities that that enable the healthcare providers and patients to interact in the care delivery process. The modalities include synchronous, asynchronous, and remote patient monitoring. Synchronous entails the real-time live audio-video interactions that are possible with telehealth system. Asynchronous refers to the store and forward technology that enables the transmission and interpretation of images, messages, and data (Tuckson et al., 2017). Cumulatively, synchronous and asynchronous anchor the remote monitoring of the patient status through the transmission of clinical data from a distance.

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The organization type where the selected technology is being utilized is a hospital setting. The hospital uses the technology to provide remote care to its patients suffering from chronic illnesses. It uses it to ensure that patients receive timely care that minimizes the risk of adverse events in disease management. The organization also uses the technology as part of its approaches to enhancing care coordination. Through telehealth, the hospital has been able to provide patient-centered care that enhances their level of satisfaction with care and their empowerment.

Type of the Health Information Technology System

Telehealth is both clinical, educational, and research related system. Accordingly, telehealth can be used for clinical purposes. It is used in providing remote monitoring of patients. Healthcare providers and patients interact through the system to explore the response to treatment and need for additional interventions. Healthcare providers also use telehealth to facilitate remote inter-professional collaboration. Different healthcare providers can work together in patient care through methods such as teleconferencing.

The remote inter-professional collaboration ensures that patients receive the best care that addresses their actual and potential health related needs (Lurie & Carr, 2018). Examples of the ways in which telehealth is used in clinical practice includes remote management of chronic conditions such as heart disease, diabetes, asthma, and depression.

NURS 8210 Health Information Technology Project [Major Assessment 5]
NURS 8210 Health Information Technology Project [Major Assessment 5]

Telehealth system is also an educational application. Healthcare organizations adopt telehealth systems for patient and provider education. Healthcare providers offer education remotely to patients using the telehealth system. They educate patients about lifestyle and behavioral interventions that can be used to improve the health outcomes of their patients. They also use it to empower them on the self-care interventions used to minimize the need for hospital visits and hospitalizations (Young & Schneider, 2020). Examples of the ways in which telehealth is utilized in the education of patients includes patient education on the self-care management of obesity, diabetes, heart disease, and recurrent conditions such as asthma.

The delivery of education to patients through telehealth minimizes the costs incurred in travelling for physical encounter with the healthcare providers (Rush et al., 2018). Telehealth is also utilized in clinical research. Telehealth technologies such as mHealth technologies have been explored for use in improving treatment adherence among patients. They have also been explored for use in promoting sustained lifestyle and behavioral modifications in patients with conditions such as obesity, diabetes and heart disease (Döğer et al., 2019). Therefore, the research outcomes inform the clinical practice of nursing.

Reasons for Technology Adoption

The hospital developed telehealth technology for use in the management of patients with chronic conditions due to a number of reasons. One of the reasons was to prevent and minimize unnecessary hospital visits by patients with chronic conditions. Patients with chronic conditions such as diabetes and heart disease comprise the majority of individuals with the highest utilization of care services in the US. The statistics from the US shows that about 30% of the emergency visits by patients with chronic illnesses are unnecessary.

The unnecessary visits cost the patients, hospitals and health organizations about $8.3 billion on an annual basis (Castellucci, 2019). The leading conditions that cause unnecessary visits to hospitals include hypertension, heart failure, diabetes, chronic obstructive pulmonary disease, and behavioral health conditions such as substance abuse and mental health issues (Sarkies et al., 2020). Therefore, the hospital adopted the technology to prevent and minimize unnecessary hospital visits and hospitalizations for patients with chronic illnesses.

The other reason that led to the adoption of telehealth system in the organization was to reduce healthcare costs that patients with chronic illnesses incur. Telehealth eliminates the need for unnecessary hospital visits as well as travelling by patients. Through it, patients incur minimal costs in managing their conditions, leading to cost-efficiency in the care process. Telehealth also eliminates the risk of adverse events in chronic conditions (McGrowder et al., 2021). For example, the timely engagement of the patients with their healthcare providers ensures that symptoms of adverse events in chronic conditions are identified and managed in a timely manner. As a result, it ensures safety, quality and efficiency in chronic disease management.

The organization also adopted telehealth system to enhance the level of patient engagement. Accordingly, telehealth technology enables patients to take enhanced control over their health and wellbeing. Telehealth systems such as educational videos and health management applications provide patients with informed knowledge and skills for the effective management of their chronic health problems. They also empower the patients to take action for their health problems through initiatives such as physical activity to lose weight and gain the emotional support that they need (Gajarawala & Pelkowski, 2021). Patients are also able to undertake other activities such as scheduling their appointment, secure online portals for communication, and interact with their patients, hence, enhanced patient engagement to achieve outcomes such as satisfaction and empowerment.

A number of things made the organization believe that telehealth system would work in enhancing chronic disease management in the organization. One of them was evidence-based data. The organization involved its healthcare providers such as nurse practitioners and physicians in undertaking systematic analysis of the existing evidence on the effectiveness of telehealth in chronic disease management. The analysis showed that telehealth could enhance the safety, quality and efficiency of patient care, thereby informing its adoption (Lillicrap et al., 2021).

The other thing that made the hospital believe that telehealth would work was evidence from other organizations in the region. Most of the hospitals in the region were successfully adopting telehealth systems for chronic disease management. Therefore, it considered its use to maintain and improve its competitiveness in the industry.

The organization determined the need for telehealth using a number of indicators. One of them was the efficiency of operations in the hospital. The analysis of operational efficiency showed that the emergency department was overcrowded in most of the times. Overcrowding led to delays in service provision to patients with acute health needs and diversion of incoming referrals. A further analysis showed that almost 30% of the patients in the emergency department were those with chronic illnesses that did not need any emergency visits or services.

Therefore, the hospital considered adopting telehealth to eliminate unnecessary emergency visits and overcrowding in the emergency department due to patients with chronic illnesses (Castellucci, 2019). The other indicator was the cost of care incurred by patients due to unnecessary hospital visits. Therefore, the indicators informed the need for the telehealth system in the hospital.

Determining the System

The organization utilized a number of methods to determine if telehealth system could fulfill its pre-determined needs. One of the methods was piloting the use of telehealth in chronic disease management. The hospital implemented the use of telehealth system in chronic disease management in a sampled population of patients with chronic illnesses. It compared the findings with another group of patients that did not receive telehealth services. The two groups were followed for six months to determine the feasibility of telehealth system in chronic disease management. The analysis of data obtained from the two groups showed that telehealth reduced significantly the need for hospital visits and hospitalizations in the patients that received telehealth services.

The data also showed a significant reduction in healthcare costs incurred by patients in the telehealth group. The level of engagement, empowerment and satisfaction with care in the telehealth group was also higher when compared to the usual care group (Baernholdt & Boyle, 2021). There was also a projected reduction in overcrowding in the emergency department with the use of the telehealth system. The other approach was the administration of surveys to the healthcare providers. The survey showed that healthcare providers were ready to implement the project for chronic disease management in the institution.

Management of the System

The information technology officers in the hospital manage the telehealth system. They ensure its optimal functioning to address the care needs of the patients and providers. They also provide the technical support that the healthcare providers need in utilizing the system (McGonigle & Mastrian, 2021). The information technology officers are located in the IT department in the administrative structure of the hospital.

Information System Application Design and Development

Making Decisions about the System

The organizational stakeholders were actively involved in making decisions related to the need for telehealth system in the organization. The stakeholders included nurses, physicians, nurse leaders and managers in the organization. They worked in collaboration in undertaking needs assessment in the organization to determine the relevance of telehealth system. They also worked actively in assessing, planning, implementing, monitoring, and evaluating the effectiveness of the telehealth system in chronic disease management.

Nurses and physicians were actively involved in making critical decisions related to the need for the system in the hospital. Their active involvement was critical in ensuring minimal resistance to change, empowerment, and sustained use of the system in the provision of care to patients with chronic illnesses (Ruiz Morilla et al., 2017). Open communication was also promoted to minimize misunderstanding between the stakeholders. Through the above processes, the adoption of telehealth system for use in the hospital was successful.

Training

The use of telehealth system requires that its users have the required knowledge and skills. The healthcare providers that included nurses and physicians were trained on the use of the system. The training focused on aspects such as scheduling sessions, interaction with patients, and developing educational tools such as videos for patients through the system. The training also focused on equipping them with knowledge and skills on the ways in which they can provide inter-professional care remotely to enhance the treatment outcomes for their patients. Training was important in this project, as it enhanced the adoption and use of the system in patient care (Ruiz Morilla et al., 2017). It also eliminated the potential of poor adoption and use of telehealth systems for chronic disease management by the healthcare providers.

Addressing Security Issues

Telehealth systems are prone to cyber-attacks that can lead to loss of data integrity. As a result, the hospital adopted a number of interventions to ensure security of the telehealth system was maintained. One of the interventions that were adopted is securing its remote devices as well as network access tools. The hospital deployed tools having appropriate security levels by ensuring that all the systems had software for protecting against viruses and malaware. The devices also supported software updates to ensure the installation of patches that filled security gaps (Stone, 2017). The internet used for delivering telehealth services was also protected with two-factor authentication and strong passwords to eliminate infiltration of the systems by third parties.

The second strategy that the hospital utilized was training its healthcare providers on the use of the telehealth system. The staffs were trained on the different ways in which data could be lost and the strategies that they needed to avoid them. They were trained on the use of strategies such as not accessing unauthorized sites and opening suspicious emails, as they could threaten the integrity of data contained in the system. The other strategy the hospital has been using is undertaking system maintenance on a regular basis. System maintenance is effective in eliminating any potential risks that could lead to data loss (Camarines & Camarines, 2021).

The hospital also has in place security controls to ensure integrity of data in telehealth systems. The security controls include data encryption to lock data being transmitted electronically. Data encryption ensures that data is meaningless should cyber attackers access it. The other security control is the face-to-face distribution of telehealth devices and software to patients. This approach ensures that healthcare providers authenticate the devices as well as the identity of the users of the systems. As a result, it eliminates the introduction of security risks to potentially unsafe individuals (Bassan, 2020). The last strategy used in the hospital is abiding to regulations such as HIPAA provisions of health information use in healthcare. The hospital has implemented measures that align with legal provisions of HIPAA, hence the safety and security of the data.

Initial Funding

The hospital provided the initial funding of the telehealth systems for use in patient care. It used its surplus budget to support the project initiatives that led to the successful implementation of telehealth system in chronic disease management.

Management of the Budget

The finance department manages the budget for telehealth information system. It undertakes cost-benefit analysis of the system to ensure that it supports its intended purpose in the organization. It also provides regular feedback about the ways in which the hospital can optimize the use of telehealth in enhancing the care outcomes of patients with chronic conditions.

Organizational or Political Issues

Organizational issues affect the funding of the telehealth use in chronic disease management in the hospital. One of them is shortage of healthcare providers. Covid19 pandemic has placed immense pressure on healthcare organizations and systems. The pandemic has increased the number of patients seeking treatment services in the hospital (Monaghesh & Hajizadeh, 2020). The increase in care needs of the patients has not been in alignment with the workforce level of the hospital, leading to high workload for the healthcare providers.

As a result, the organizational resources have been diverted from the provision of telehealth services to patients with chronic illnesses to addressing the needs of the high volume of patients and provider needs. The other organizational issue is changes in the priorities of the hospital. The hospital experiences a constant shift in its priorities, which may affect the funding for the use of telehealth in patient care (Baernholdt & Boyle, 2021). For example, an acute shortage of staffs often forces the hospital to use funds for telehealth in acquiring new staffs to address the care needs of its patients.

Arrangements for Planned or Unplanned Downtime

The hospital has put in place mechanisms to be adopted in case of planned or unplanned downtime with the use of the telehealth systems in chronic disease management. For the planned downtime, the hospital communicates it to the healthcare providers two weeks before the event. The communication aims at creating awareness and eliminating disruption of the organizational activities by the downtime. The early communication also prepares the staffs and patients that are likely to be affected by the downtime. It also enables them to consider the alternative plans to be adopted for continuity in patient care (McGonigle & Mastrian, 2021).

For the unplanned downtime, the hospital has kept the contacts of critical individuals to be contacted to address the problem. It also prioritizes the use of conference calls among these individuals to enhance the coordination efforts for downtime minimization. The hospital also has a backup plan for the data to ensure minimal disruption in cases of prolonged unplanned downtime with the use of telehealth systems. The backup for data ensures that healthcare providers still have access to vital information that they need for planning, assessing, implementing, and evaluating the effectiveness of care given to the patients.

Scheduling of Information Technology System Upgrades

Telehealth systems should be upgraded on a regular basis to enhance their efficiency in patient care. Upgrading them also seals the loops that are likely to threaten system and data integrity. The upgrade of telehealth system used in the hospital is planned. The hospital notifies its members about the upcoming updates to minimize disruption of processes. Often, system upgrades occur after every six months to strengthen the safety, efficiency, and effectiveness of the telehealth system.

Change in the Technology System in Response to Health Care Reform and Legislation

Healthcare reforms and legislations have an effect on the health information systems being used in healthcare. Healthcare reforms such as those related to HIPAA affect the nature of systems and improvements needed to achieve the desired safety outcomes in patient care. The hospital continually improves its systems to ensure that it abides with the HIPAA provisions (Lee et al., 2020). It has established a technical team involved in the regular assessment of system to ensure its optimum efficiency.

It also develops policies guiding health information systems use in the organization that are revised on a regular basis to ensure it remains up-to-date with the changes in the legal aspects of care (Bhate et al., 2020). An example of a response by the hospital to needs of the meaningful use is enabling patients have access to their data via the telehealth systems. Therefore, the hospital has been responsive to changes in the health care reforms and legislations.

Suggestions

The suggestion that I would make regarding changed needed to support healthcare reforms and legislations is ensuring capacity development among healthcare providers. Healthcare providers play a critical role in implementing actions that align with reforms and legislations affecting telehealth use. As a result, it is critical for the hospital to ensure that healthcare providers are competent enough to facilitate successful transitions in health information systems in response to legislation and health care reforms.

Interventions such as the provision of training opportunities for them are recommended (Monaghesh & Hajizadeh, 2020). The other suggestion is the need for the adoption of highly interoperable systems. Having highly interoperable systems will minimize the disruption of the organizational activities in cases of a shift in processes as a response to new legislation and healthcare reforms.

Innovative Aspects of the System

Utilization of Innovation

Telehealth system being used in the hospital utilizes technology innovations. One of the ways in which it utilizes technology innovations is that it not only substitutes hospital visits but also diagnosing and guiding the treatment of health problems too. Healthcare providers can use the system for telehealth consultation, patient assessment, planning, monitoring, and evaluation of treatments. The system also extends to enhancing the long-term management of chronic illnesses that need highly personalized and well-coordinated care (Döğer et al., 2019). The other way in which telehealth utilizes innovation can be seen from its continuous improvements in use in healthcare.

Initially, telehealth was developed to provide basic care interventions such as assessment, education, and increasing patient engagement. Significant transformations have been seen in the modern world, with a focus being on the possibility of utilizing telehealth to enable patients to self-diagnose as well as access the different options of healthcare (Gajarawala & Pelkowski, 2021). Through it, patients with chronic illnesses will have an expanded access to personalized, high quality and efficient care services.

The other way in which telehealth utilizes innovation is the facilitation of patient screening and engagement prior to entering a hospital or care facility. Accordingly, telehealth enables the online assessment and engagement of patients. The online engagements enable healthcare providers to determine the need for hospital visits and hospitalizations for patients. Through it, health organizations plan for their resource needs on time, eliminating disruption of their services.

An example of this impact can be seen with the experience of the US hospitals with covid19 pandemic (Monaghesh & Hajizadeh, 2020). Accordingly, technology innovations of telehealth enabled hospitals to screen and engage patients before their hospital visits, thereby, minimizing patient and provider exposure to unnecessary risks as well as the optimum utilization of the available, limited resources.

Recommended Technology Innovations

The hospital has achieved considerable milestones in implementing the use of telehealth in the provision of care to patients with chronic illnesses. However, it is still required to consider a number of additional technology innovations. One of them is the adoption of barcode medication administration. Barcode medication administration is a healthcare technology used in medication administration processes. The technology has demonstrated effectiveness in reducing and preventing medication errors.

Since the hospital is dedicated towards promoting safety and efficiency in patient care, the adoption of barcode medication administration should be part of its priorities (Zheng et al., 2021). The existing evidence shows that barcode medication administration also reduces the costs incurred by patients in seeking the care they need and enhances operational efficiency in healthcare.

The other recommended system that the hospital should adopt is the integrated health records system. Integrated electronic medical record systems are considered an integral part of successful organizations in the modern world. The system provides highly accurate and timely access to the healthcare data of the patients. It also provides healthcare providers enhanced abilities to improve the outcomes of patient care at reduced costs. The adoption of the system would enhance the service provision, safety and quality of care in the hospital (Yang et al., 2021).

The technology presented in the course that the hospital should also consider is patient portals. Patient portals are effective in enabling the patients to undertake roles such as medication refills, scheduling, and accessing their health-related information. The portals may also be used for interaction between the patients and healthcare providers. The incorporation of patient portals patient care would enhance the efficiency, patient engagement, and accuracy of care that patients receive (Dendere et al., 2019). Therefore, the adoption of the above technologies would enhance the safety, quality, and efficiency of care given in the hospital as well as its performance and productivity.

Additional Innovations

One of the additional innovations that are needed in the hospital to further promote evidence-based practice is the adoption of legislations that provide incentives for technology use in healthcare. Healthcare providers should advocate for the adoption of enabling legislations that provide incentives for the use of telehealth in patient care. The incentives will motivate the healthcare providers to explore additional interventions that can be incorporated into telehealth to achieve optimum outcomes of care for their patients (McGonigle & Mastrian, 2021). Incentives will also enhance the efficiency of care interventions utilized in patient care via telehealth.

The other innovation that should be considered to promote evidence-based practice in the hospital is training and facilitating healthcare providers to implement best practice interventions in patient care. Accordingly, the implementation of evidence-based practice in healthcare settings depends largely on the competency level of the healthcare providers. Healthcare providers should understand the ways in which evidence-based data can be translated into practice. As a result, providing opportunities such as training and allowing them to implement evidence-based practice projects will drive the desired excellence in the use of evidence-based practice interventions (Baernholdt & Boyle, 2021). Therefore, the above recommendations should be considered in the practice setting.

Conclusion

Health information technologies have transformed significantly the provision of patient care in the current world. Health information technologies such as telehealth have enhanced the safety, quality and efficiency of patient care. They have also increased patient engagement and patient-centeredness in patient care. The use of telehealth for chronic disease management has been effective in the hospital. The effectiveness can be seen in the reduction in healthcare costs incurred by patients and the institution and unnecessary hospital visits by patients with chronic illnesses. Therefore, it is recommended that the hospital explore additional technologies such as barcode medication administration and integrated health records system to enhance its performance and competitiveness in its markets.

References

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Bassan, S. (2020). Data privacy considerations for telehealth consumers amid COVID-19. Journal of Law and the Biosciences, 7(1). https://doi.org/10.1093/jlb/lsaa075

Bhate, C., Ho, C. H., & Brodell, R. T. (2020). Time to revisit the Health Insurance Portability and Accountability Act (HIPAA)? Accelerated telehealth adoption during the COVID-19 pandemic. Journal of the American Academy of Dermatology, 83(4), e313–e314. https://doi.org/10.1016/j.jaad.2020.06.989

Camarines, T. M., & Camarines, J. C. M. (2021). Discussing data security and telehealth during the COVID-19 pandemic. Journal of Public Health (Oxford, England), fdab284. https://doi.org/10.1093/pubmed/fdab284

Castellucci, M. (2019, February 7). Unnecessary ED visits from chronically ill patients cost $8.3 billion. Modern Healthcare. https://www.modernhealthcare.com/article/20190207/TRANSFORMATION03/190209949/unnecessary-ed-visits-from-chronically-ill-patients-cost-8-3-billion

Dendere, R., Slade, C., Burton-Jones, A., Sullivan, C., Staib, A., & Janda, M. (2019). Patient Portals Facilitating Engagement With Inpatient Electronic Medical Records: A Systematic Review. Journal of Medical Internet Research, 21(4), e12779. https://doi.org/10.2196/12779

Döğer, E., Bozbulut, R., Soysal Acar, A. Ş., Ercan, Ş., Kılınç Uğurlu, A., Akbaş, E. D., Bideci, A., Çamurdan, O., & Cinaz, P. (2019). Effect of Telehealth System on Glycemic Control in Children and Adolescents with Type 1 Diabetes. Journal of Clinical Research in Pediatric Endocrinology, 11(1), 70–75. https://doi.org/10.4274/jcrpe.galenos.2018.2018.0017

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Monaghesh, E., & Hajizadeh, A. (2020). The role of telehealth during COVID-19 outbreak: A systematic review based on current evidence. BMC Public Health, 20(1), 1193. https://doi.org/10.1186/s12889-020-09301-4

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A Sample Answer 2 For the Assignment: NURS 8210 Health Information Technology Project [Major Assessment 5]

Title: NURS 8210 Health Information Technology Project [Major Assessment 5]

Health information technology (IT) refers to the technology and infrastructure used to document, analyze, and share patient health information. Health technologies include health record systems and personal health tools such as smart devices and applications (Wienert, 2019). Health IT seeks to improve patient care and help attain health equity. It supports the documentation of patient data to enhance healthcare delivery and allows for analysis of the data for healthcare practitioners and the entire healthcare system (Wienert, 2019). Besides, Health IT increases patient safety, improves the quality of healthcare delivery, minimizes medical errors, and supports the interaction between patients and healthcare providers. This paper will discuss a health IT system in my organization, including the organizational information, the system’s design and development, and the innovative aspects of the system.

Information on Organization

This section will discuss the health information technology system adopted in my current organization and describe the organization type.  Besides, I will discuss the main purpose of the health IT system and why it was developed. I will also discuss how the organization determined that the IT system will meet its predetermined needs and how it is managed.

Health Information Technology System

The Electronic medical record (EMR) is one of the health information technology systems adopted in my current healthcare organization. An EMR system is a digital form of patient paper records implemented in hospitals, clinics, and physician offices (Honavar, 2020). The EMR is used to examine a patient’s medical history and is used by health providers for diagnosis and treatments. An EMR usually contains clinical notes and information collected by the providers in the clinic or hospital (Wali et al., 2020). EMR systems are more effective than traditional paper records because they allow clinicians to monitor a patient’s health over time. Furthermore, the EMR allows providers to identify patients who require preventive care and screenings and improve the quality of health care for these patients (Wali et al., 2020). The EMR uses various tools that help improve clinical decisions, thus creating a safe, effective and efficient healthcare system.

Organization Type

            My current healthcare organization is an acute mental health hospital providing both inpatient and outpatient mental health services.  The organization is a leading provider of mental health and addiction treatment services in the region. We strive to offer a safe and supportive environment where clients in crisis receive comprehensive care delivered with compassion and respect. Inpatient services include child, adult, and geriatric psychiatric care, acute medical detox, and addiction rehabilitation. Outpatient services include addiction treatment and outpatient psychiatric care. The most common conditions treated in the organization include Behavioral and mood disorders, Depression, Anxiety, Bipolar disorder, Emotional Trauma, Schizoaffective disorder, Schizophrenia, and Suicidal disorder. The organization is run by a team of medical and non-medical staff, including receptionists, record officers, informaticists, psychiatrists, PMHNPs, registered nurses, pharmacists, social workers, nutritionists, and counseling therapists.

Type of Health Information Technology System

The EMR was adopted for clinical purposes, mainly collecting and documenting patients’ health data. The EMR is used to record and avail patients’ demographic and clinical health data, such as patient identification data, clinic attendance, and encounter data (Honavar, 2020). Clinical data recorded in the EMR include patients’ medical history, psychiatric history, medication, allergies, diagnostic tests and results, vital signs, weight, nutritional information, and clinical progress notes. Besides, the EMR contains information on clinical encounters between a mental health practitioner and a patient (Honavar, 2020). The EMR has clinical decision support (CDS), which notifies providers of abnormal diagnostic results, vital signs, drug allergies, and potential drug interaction (Sutton et al., 2020). The CDS also reminds clinicians of the appropriate patient care interventions such as tests and medication. Furthermore, the EMR is used by health providers to insert patient care orders in the system, accept drug prescription orders, and manage referrals with details of the referring practitioner and of the specialist.

Key Reasons for the Development of the EMR

The main aim of developing an EMR system in the organization was to improve health care quality. The decision to acquire the system was driven by the need to improve coordination in the healthcare team, reduce medical errors caused by missing patient data, and maximize cost-efficiency (Lin et al., 2020). The previously used paper records were faced with a myriad of challenges from errors caused by illegible handwriting, misspellings, and the use of varying terminologies that created much confusion. Consequently, the EMR was created to eliminate these paper-based irregularities and standardize patient records across the hospital.

Paper records were often misplaced, affecting efforts to monitor patients over time, and misplaced data led to repeated tests. As a result, the organization developed the EMR to ensure that patients’ records were securely stored and to improve providers’ access to these records (Lin et al., 2020). Furthermore, the EMR was developed to merge patients’ data in one central system rather than having scattered paper records (Wali et al., 2020). Clients had expressed discontent with the wait times and the loss of their previous clinical data contributed by paper records. They suggested that the hospital adopt an electronic system similar to other organizations to store and quickly retrieve their clinical information, which would reduce the wait times.

How the Organization Determined That the EMR Could Fulfill Its Predetermined Needs

The organization’s management conducted a survey to determine if the EMR could meet its predetermined needs of reducing medical errors, improving quality of care, coordination of care, and cost-efficiency. Healthcare providers were administered questionnaires that collected information on the challenges they came across when providing patient care and the factors that caused these challenges. The most reported challenges included errors in documentation, misplacement of patient data and clinical notes, poor coordination among providers, and time wastage when retrieving patient records. The questionnaires also asked the health providers about the approaches that the organization can implement to address those challenges.  Providers suggested an electronic system that would enhance the retrieval of patient data while ensuring that the patients’ records are secure. The success of the EMR implementation in other healthcare organizations further led the organization’s management to determine that the EMR would meet its predetermined needs.  Organizations that had successfully adopted the EMR system reported that it improved the quality of patient care, patient experience, and cost-efficiency.

Who Manages The EMR?

The EMR system is managed by health informaticists who have the role of running and maintaining the system. The health informaticists work with other staff by assisting them to key in patient information in the EMR and retrieve it. Informaticists ensure that the EMR’s user interface is easy to navigate to save time for health providers. Clinicians consult the maintenance team in cases of a system failure that is beyond their capacity. The health informaticists who manage the system fall under the IT department in the administrative structure and report to the head of IT.

Information System Application Design and Development

Information systems design and center around accomplishing a project. The design and development of a health information system are crucial since it determines the success of adopting the system in the organization.  This section will describe the design and development of the EMR, including how stakeholders make decisions about the EMR, training, security issues, initial funding, arrangements for downtime, system upgrade, and how the EMR changed in response to health care reform and related legislation.

How the Various Stakeholders Make Decisions Related To the EMR

The hospital’s board and the heads of the various hospital departments collaboratively make decisions regarding the EMR. When developing the EMR system, the heads of departments involved the staff on how the EMR can be designed to address priority patient care needs and enhance the quality and coordination of care. The employees in various departments were consulted in the design and development because they would be the end-users and would highly impact the system’s success. For example, the head of the Rehabilitation department enquired from nurses and therapists on how the EMR should be designed, including vital features to help address challenges they encounter when using the paper records. The head of the outpatient department also asked employees about features crucial in making the EHR successful in achieving its predetermined needs. The departmental heads presented the employees’ views to the hospital board members to analyze and choose the most practical ones.

Training of Individuals to Use the EMR

The EMR training was conducted at the beginning of the implementation phase by the health informaticists team. The team conducted seven-day training on the EHR and how to implement it. Training centered on the EHR’s core functions, potential benefits and challenges, security and privacy measures, and HIPAA and HITECH regulations. Besides, health providers were equipped with basic skills on how to maintain the EHR system. They were also trained on recording and retrieving patient information in the system, utilizing the system’s features such as CDS and Order entry, coordinating patient care using the EHR, generating reports, and using usernames and passwords.  In addition, training is conducted when the EMR system is upgraded. CMEs and seminars are conducted in the organization to train end-users about the upgrade and how to use new features introduced in the system.

How Security Issues Are Addressed And How the EMR Support a Legally Sound Health Care Record

Potential security issues in the EMR include malware and ransomware, and cloud threats. The EMR system contains large amounts of sensitive patient data, which puts it at risk of breach by hackers. The health informaticists team handles security issues pertaining to the EMR. The team uses technical, physical, and administrative security-safeguard themes to reinforce the security of the EMR. Technical safeguards protect the whole EMR information system. The safeguards include antivirus software, virus checker, firewalls and encryption, cloud computing, strategies to validate information, and the use of information security officers (Keshta & Odeh, 2020). The physical safeguards seek to physically protect patient data so that the EMR software or hardware cannot be accessed by unauthorized persons (Keshta & Odeh, 2020). They include policies and procedures that dictate the hospital’s access controls, workstation use, workstation security, and device and media control.

The administrative safeguard theme centers on having conforming security procedures and policies. It consists of security measures such as performing audits, establishing contingency plans, and having an informaticist in charge of information security (Keshta & Odeh, 2020). The organization’s EMR system fosters a legally sound health care record by satisfying all regulatory, statutory, and professional requirements on using an EMR for clinical purposes. It uses technical, physical, and administrative safeguards to avoid legal issues arising from data breaches (Keshta & Odeh, 2020). Furthermore, the EMR uses a secure network that links various physical sites in the hospital, and clinicians can access it at home through a secure authentication code.

Initial Funding and Management of Budget

Developing and implementing the EMR requires substantial funds to cater for equipment, contracts, human resource, and training. The initial funds used to develop and implement the EMR were obtained from the organization’s development fund. Every yearly budget in the organization contains funds dedicated to funding new projects. The funds for development are usually a percentage of the profits obtained from the previous financial year. The money from the project’s fund was used to purchase the EMR system and conduct training. Effective budget management is crucial to the success of implementing a health system in any organization.

Budget management involves making monthly budget allocations, managing the budget baseline, regulating the budget, and assessing the budget performance. The hospital’s account department manages the EMR’s budget. The accounts department is tasked with creating a cash flow management plan before any expenditure is made. Besides, the accountants manage the budget baseline to establish that the project expenditures are consistent with the cash management plan. Managing the baseline involves verifying and approving all charges coded to the system and timely payment of bills related to the EMR.

Organizational or Political Issues Impacting the Ongoing Funding

            Organizational issues that negatively affect the ongoing funding of the EMR system include insurance companies delaying processing bills. Delays by insurance companies result in the organization also delaying the payment of the monthly funds to the system’s vendor. Recruitment of new staff also impacts ongoing funding since it lowers the funds for maintaining the program. Staff recruitment usually requires huge finances and takes a large percentage of the capital budget, which impacts the funding of the EMR.        

Arrangements for Planned or Unplanned Downtime

Downtimes in the EMR system are usually caused by problems in the internal hardware or an external source, especially if the system has cloud hosting. The EMR vendor has a contingency plan that ensures data backups are secured during a system failure. This protects crucial information from getting lost permanently during downtime. During a planned downtime, the health informaticists inform the medical and non-medical staff that the EMR system will experience downtime at a specific time. The reception staff then notifies patients when they get to the hospital that there will be a temporary delay due to the EMR system downtime, which may prolong their clinic visit. Besides, the administrative staff usually prepares a set of pre-approved paper forms beforehand in a planned EMR downtime.  During unplanned downtime, the health informaticists team usually contacts the EMR vendor to alert them of the system hitch and identify if the downtime is only in the hospital or widespread to other organizations. Paper sign-in forms are used to track when clients arrive in the outpatient department. The organization also has blank encounter forms and charge slips used for new patients to assign them temporary record numbers until an official electronic record can be generated. Paper charts and printed templates are also used for documentation during EMR system downtime.

Schedule of EMR Upgrades

Regular EMR upgrades are essential to avoid having inefficient, outdated software, which causes delays and hinders the desired success of any clinical practice.  Our organization’s EMR system has an annual upgrade schedule, which aims at enhancing the system’s overall efficiency, adaptability, and productivity. The health informaticists and system vendor plan for the EMR upgrade by assessing the system’s features and templates that need to be improved, removed, or added. The vendor also examines if the EMR system will be compatible with the new features and templates to be added to the EMR. They check the existing EMR system’s hardware, backups, data exports, and reporting when assessing the compatibility. Besides, the vendor verifies that the needed bandwidth for the system upgrade is available to sufficiently support the upgraded EMR system.

Staff training is also included when planning the system upgrade to ensure the health providers are well-versed with the new features and system upgrades and promote the smooth running of the system. Training is a major element in adopting, sustaining, and ensuring the success of the EMR system after the upgrade. EMR system upgrades in our organization result in improved patient care efficiencies and increased patient satisfaction. Besides, an improved EMR system enables clinicians to monitor a patient’s progress closely, improving patient care.

How the EMR Changed In Response to Health Care Reform and Related Legislation

The Affordable Care Act (ACA) of 2010 introduced comprehensive health care insurance reforms that aim to improve quality of care, access to health care, and reduce health care costs. The EMR has changed with respect to the ACA reform by including features that guide health providers to implement evidence-based interventions and reduce duplication of services, improving quality and lowering healthcare costs (Borbolla et al., 2019). In addition, the HITECH Act gives authority to DHHS to create programs that improve health care quality, safety, and efficiency using health IT systems, such as EMRs (Borbolla et al., 2019). The EMR has evolved with regard to the HITECH legislation by integrating the CDS feature. The CDS streamlines the healthcare process and clinical outcomes by enhancing the quality and efficiency of patient care.

Changes Needed To Support Health Care Reform and Related Legislation

The changes that can be effected in the EMR to support the ACA reform include incorporating features that increase patients’ engagement, thus improving efficiency in patient care. The features can include those that allow patients to schedule their clinic appointments and request prescription refills, which increases engagement in their health care and encourage them to take charge of their health (Borbolla et al., 2019). In addition, the EMR can be modified to have a feature that allows clinicians to send patients appointment reminders, thus reducing cancellations and increasing patient engagement.

Innovative Aspects of the System

Healthcare is an area that has gained the most from technological innovations, which continue to make healthcare delivery more efficient. Technology innovations ensure that systems used in healthcare contain key inputs to increase access and promote quality and logical use of inputs. This section will describe how our organization’s EMR uses technology innovations and recommend technological innovations that would benefit the organization and promote evidence-based practice and efficiency.

How the EMR Utilize Technology Innovations

Technology innovations have had an immense impact on healthcare technology systems, including the EMR. The EMR has embraced technology innovations, significantly reducing technology barriers in EMR interoperability, usability, and documentation (Guo et al., 2017). For example, technology innovations have been used to incorporate a well-designed EMR scribe tool into the EMR system’s workflow. It also uses innovations such as the CDS system, which helps reduce unnecessary or repetitive medical procedures through soft and hard stops (Sutton et al., 2020). For example, if a psychiatrist requests a diagnostic test not indicated in the clinical guidelines, an EMR soft stop informs the psychiatrist. The CDS system may then require the psychiatrist to indicate the rationale for overruling (Sutton et al., 2020). Besides, the CDS hard stop inhibits the psychiatrist from requesting unnecessary tests without approval from the radiologist. The EMR’s technological innovations streamline the workflow for clinicians in the hospital and enable them to provide patient care efficiently.

Technology Innovations I Would Recommend For the Organization

Cloud computing is my recommended technology innovation for my organization. Cloud computing entails using remote servers over the internet to offer on-demand access to information services (Ratten, 2020).  It uses IT infrastructure to foster flexibility with accessing online data.  Cloud computing supports the delivery and access to computing services and resources through the internet, including databases, developmental platforms, and analytics (Ratten, 2020). It allows for safe and affordable data storage with portable access to health informatics. Health informatics depends on access to huge amounts of medical data and EMRs. The cloud computing capacity for high-volume data storage can thus lower costs for health care organizations. Besides, real-time information sharing can foster better communication among healthcare providers (Ratten, 2020). Cloud computing monitors patient and clinician interactions remotely and thus promote better patient care in the organization. Furthermore, it promoted fast data sharing, which can improve psychiatric research in our organization.

Innovations That Could Further Promote Evidence-Based Practice and Efficiency within the Organization

The Smart bed technology innovation can further promote EBP and efficiency in the organization. Smart bed technology helps nurses track patients’ movement, weight, and vitals (Hong, 2018). It allows nurses to monitor patients constantly and provide frequent updates and communications on a patient’s activities, especially for acute-ill psychiatric patients. Smart beds play a key role in keeping patients safe and comfortable during a long hospital stay by preventing falls since the nurse can monitor the patient’s movement (Hong, 2018). Falls are a point of concern for psychiatric and dementia patients. Smart bed technology uses a sensor, which is placed under the mattress, to help prevent patient falls. Besides, they can help nurses identify patients’ patterns, leading to a new diagnosis or a different understanding of a patient’s disorder (Hong, 2018). Smart bed technology promotes efficiency in patient care since nurses spend less time going to patients’ rooms to monitor them or adjust their comfort since they can control that with the smart bed.

Conclusion

The EMR is a health IT system implemented in my health care organization, a psychiatric hospital.  Mental health practitioners utilize the EMR in the hospital to store and access patient information and clinical notes and aids in the diagnosis and treatment. It was developed to improve the quality of health care. There was a need to improve coordination in the healthcare team, reduce medical errors, and maximize cost-efficiency. Besides, it is managed by health informaticists who operate and maintain the system. The EMR has embraced technology innovations, significantly reducing technology barriers in EMR interoperability, usability, and documentation. It uses clinical decision support, which reduces unnecessary medical procedures and tests through soft and hard stops.  I would recommend the organization to adopt cloud computing since it promotes safe and affordable data storage with portable access to health informatics. The smart bed technology would promote EBP by promoting patient safety and improving the efficiency of nursing care.

References

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