The rapid development of advanced technologies has a tremendous impact on all fields of human activity, especially in the healthcare industry, because it enables new attainments and discoveries, facilitates workflow, and promotes reducing errors. Nevertheless, the introduction of contemporary technologies can appear to be a challenging process since it requires a coherent and streamlined plan, active cooperation between stakeholders, and competent management from the administration. Therefore, this paper aims at examining the issues related to the implementation and use of the health information system (HIS), such as funding, usability, interoperability, and scalability, offering possible solutions, and discussing ethical implications.
Description and Impact of HIS
Health Information System refers to the systems that manage, collect, store, process, and transmit healthcare-related information. In other words, HIS is a digital instrument specially developed to provide healthcare providers or patients with person-specific information, clinical guidelines, research, summaries, and intelligently-filtered diagnostic support to facilitate decision-making in the medical workflow. Currently, depending on purposes and functions, the system has many prototypes, including electronic medical record (EMR), clinical decision support (CDS), computerized provider order entry (CPOE), practice management software (PMS), among others. For example, CDS filters and analyzes data from different clinical-resources and administrative databases to predict possible medical events, such as drug compatibility, and promote more accurate patients’ diagnoses.
Impact on Patient Care and Documentation
Generally, HIS provides significant betterments in patient’s treatment since it enhances staff’s and clinician’s adherence to clinical guidelines by delivering timely recommendations and instructions from electronic protocols, manuals, and guides. In addition, HIS arranges clinical documentation and delivers the appropriate quality of patients’ records by promoting documentation accuracy concerning the patient’s history. Moreover, CDSS, for instance, provides important and urgent reminders and alerts for both medical practitioners and patients concerning the order of medications and their portions, especially in critical situations (Sutton et al., 2020). Finally, the system assists healthcare providers in various workaday operations, including billing and scheduling, through automating many administrative tasks, thereby reducing the waste of time and improving productivity in the healthcare service.
Problems of the Implementation and Application
Although HIS has a marked and positive contribution to the healthcare service and the treatment overall, the wrong and unthoughtful implementation procedure can cause significant problems, thus nullifying all its advantages. The first issue is associated with funding opportunities since the introduction of HIS implies the installation of expensive software and hardware, the involvement of specialized service personnel, and the allocation of a separate room. In this regard, advanced computer technologies are unaffordable for the budgets of most medical facilities and organizations, hence requiring the support of external financial sources. The second problem relates to the usability requirements since many users may encounter considerable difficulties in understanding software design and display, which can cause significant setbacks in the workflow and errors occurring while obtaining data. Furthermore, poor usability complicates the process of adaptation and acceptance by staff to the system, sometimes arousing determined opposition to it.
The third issue is connected with software interoperability because when HIS is designed as a stand-alone system, it cannot adequately exchange data through the universal network as well as process and represent data in the standard file formats and protocols. As a consequence, this disrupts the workflow and does not allow using HIS to the full potential (Sutton et al., 2020). Finally, sometimes, the software system cannot meet scalability requirements that can be described as the capability to process an ever-increasing amount of incoming information concerning patients’ history and research findings as the facility expands. Finally, it is worth noting that there is much debate regarding the ability of the system to ensure the security and privacy of personal information and protect it from external interventions, hacker attacks in particular.
Potential Solution
First, to provide confidentiality and integrity of all electronic healthcare information, the management of an organization should develop a policy that protects a patient’s data against any anticipated threats or hazards and its illegal dissemination. This policy must establish clear rules of access to the information and identifies individuals who are permitted to access it. In case of violation of the regulations, strict penalties must be imposed (“HIPAA and HITECH data security requirements,” n.d.). In addition, the entrance to private data must be provided only via using personal passwords that only relevant individuals know, including patients, clinicians, operators, and trustees.
Second, to ensure sufficient funding for the implementation of the system, the national government must develop a program that assumes a significant part of the cost of the implementation or provides affordable loans. For example, USAID plans to enter into a $200 million collaboration agreement that delivers a five-year program on the use of health information systems in 20 and middle and income countries (Wayan, 2019). Additionally, via advertisement and promotion, an administration of facility or organization can turn to the support of society and private entrepreneurs.
Regarding usability, interoperability, and scalability requirements, it should be indicated that the successful development of the software significantly depends on the cooperation of all stakeholders. For instance, healthcare providers should actively interact with vendors by giving them the right information about patients’ histories, guidelines, protocols, and clinical requirements. At the same time, the vendor should design the system that provides smooth and seamless work and integration of the system with the rest software. Lastly, the management should develop a solid strategy of the application, which considers the system’s features and the possibility of further expanding the amount of information input to the HIS.
Possible Ethical Implications
HIS brings immeasurable benefits for patients, physicians, and clinical staff by managing the documentation and providing constant access to accurate healthcare information. However, along with the benefits, the system also raises ethical issues that are primarily related to patient-physician relationships, impact on nurses’ and clinicians’ skills and reasoning, as well as privacy and confidentiality. In particular, distractions and time pressures caused by technology can result in communication barriers since patients prefer proximate interaction with active discussion and listening nd, comprehensive physical examination, and eye contact (Sulmasy et al., 2017). In addition, excessive reliance on information technologies can impede the development of critical-thinking and decision-making skills. Lastly, there are constant risks of private patient information leak and unauthorized use, producing confidentiality and privacy concerns.
Conclusion
In summary, the paper has discussed the problems connected with the implementation and application of the health information system, such as funding, usability, interoperability, scalability, and information integrity. In particular, the paper has revealed the fund-related issues are primarily determined by the need for attracting significant material and educational resources. The usability, interoperability, and scalability problems are caused by inadequate cooperation between all groups of stakeholders, including clinicians, patients, management, and vendors. Finally, information integrity concern is raised because of an ineffective policy that protects a patient’s data against any anticipated threats or hazards and weak measures that can impede the unauthorized entrance to private data.
References
HIPAA and HITECH Data Security Requirements. (n.d.). Henry Schein MicroMD.
Sulmasy, L. S., López, A. M., Horwitch, C. A., & American College of Physicians Ethics, Professionalism, and Human Rights Committee. (2017). Ethical implications of the electronic health record: In the service of the patient. Journal of General Internal Medicine, 32(8), 935-939.
Sutton, R. T., Pincock, D., Baumgart, D. C., Sadowski, D. C., Fedorak, R. N., & Kroeker, K. I. (2020). An overview of clinical decision support systems: Benefits, risks, and strategies for success. NPJ Digital Medicine, 3(1), 1-10.
Wayan, V. (2019). Apply Now: $200 million USAID funding for health information systems. ICTworks.