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