Quality Assurance and Patient Protection in Health Care Informatics Free Essay

Features of the Introduction of It Systems in the Healthcare Sector

 

Modern world demands from the healthcare system to involve innovative information technologies with the aim of providing of higher level of patient care. Successful implementation of IT systems in the sphere of healthcare is an obligatory condition for providing of safe care for the patients along with satisfying and beneficial experience for clinicians and other staff representatives. The process of implementation is not easy, as it is made up of numerous components, such as high-quality patient care, safety, contingency plans for the system and so on. In addition IT system implementation includes several stages. Before establishing of the IT system, it is necessary to define the care processes, which are needed, define the hardware and software, which should be used and be patient and clinician-friendly. Configuring the system is not an easy task and thus involvement of a team of professionals could be the correct solution. Practicing clinicians should obtain knowledge of how to make technology safe and supportive for the clinical processes and efficient operating of the organization. Multiple aspects of communication both inside and outside of the health IT system should be organized along with interaction with other technologies and processes. All the potential integration issues and problems need to be solved in advance in order to reach the higher level of patient safety in the future. One of the important aspects to consider is also patient identification process. It is not enough just to plan the configuration for accurate identification of the patients. Any health care organization, which is ready to implement health IT system, is to work out the strategies for the new technology to handle the generation of the new records for the patients, their registration and retrieval of the information. All these issues are important for avoiding of the problems, related to duplicate records or any kind of mix-ups. Implementation of information technology interventions is a logical process in many countries of the world; still this undertaking requires serious strategic planning along with corresponding organizational changes, needed for successful implementation of these programs.

Health information technology is used in the sphere of health and health care. It was developed with the aim to support health information management in the computerized systems and create secure paths for exchange of health information between providers, consumers, payers.  Consistent application of HIT is expected to bring a number of benefits: to improve the quality of health care and effective operating of the facilities, provide support for health information management via involvement of computerized systems, participate in exchange of health information between various health care representatives, payers, consumers, quality managers and so on. Other important aims of HIT implementation include prevention of medical errors and increase of accuracy for various procedural operations, reduce health care costs, increase the effectiveness and efficiency of the work processes in the health care sphere, secure real-time communication and quicker reactions, finally to expand access to health care in general. Utilization of health information technology was also expected to bring not only individual benefits for the patients and managers, but also public health benefits, such as timely detection of infectious diseases, better control of chronic disease management, precise evaluation of health care and quality of the information provided.

Launching of the health information technologies demands a lot of human, organizational and financial investments for making the electronic health records, electronic prescribing and so on really beneficial for the patients and healthcare providers. According to Cresswell et. al. (2013) the variety of technologies could be turned into a serious obstacle for the clinicians and medical organizations due to the fact they their systems won’t be associated with normal workflows and that there is a need to wait some time, before the potential organizational benefits will become the reality. In order to be able to introduce technology successfully into the sphere of healthcare, it is necessary to consider certain aspects. First of all it is important to analyze from the very beginning the types of problems, which could be solved with the help of technology. Such terms as “improved quality of care” and “improved efficiency” are widely applied, it is still rather difficult to calculate the concrete degree of functionality. In this case it is difficult for the organizations to prepare short-and long-term plans for transformation. There should be clear understanding of the concrete technology and the way, how it could help to solve the existing problems. On the basis of this information, further plans should be built. For realization of these plans, managerial and administrative consensus is obligatory. There is a need to analyze, whether the goal of radical changes within the organization, including application of electronic health records systems, is really needed. It is possible that it could be correct to focus more upon streamlining processes first of all and then consider expanding of the sphere of functionality.

Nowadays the impact of technological innovation upon health care industries is still growing. It plays significant role in all process in health care, starting from the moment of the patient’s registration and passing lab tests. Moreover such devices as smartphones and tablets became active participants in this communication chain, substituting older systems of monitoring and recording. Patients obtain much more opportunities, they are even able to get full consultations from their own homes. Technological innovations in health care help to support privacy and make all the services user-friendly. Considering the newly developed advancements in healthcare it is necessary to mention the most important ones in the last decades. Around the year 2009 only 16% of hospitals in America used the electronic health record (EHR). “By 2013, about 80 percent of hospitals eligible for CMS’ meaningful use incentives program had incorporated an EHR into their organizations. “For such a long time we had such disparate systems, meaning you had one system that did pharmacy, one did orders, one that did documentation,” says Jeff Sturman, partner at Franklin, Tenn” (10 Biggest Technological Advancements for Healthcare in the Last Decade,  2014, p. 2). EHR is an obligatory factor for creation of the system of centralization of data and medical records in the sphere of health care. Moreover this tool has a great potential for the future as well. Better organization of the medical schools work and their cooperation with health care organizations is expected to bring improved outcomes for the consistency of the medical care delivered to the patients in any part of the country. Mobile health devices have become the reality for most patients. They allow the patients and the medical specialists control and check the health processes in real time. According to R&R Market Research report the global mHealth market will make $20.7 billion by 2019, which would mean that it became bigger. Health care provides will have less limited access to the needed information with the help of tablets and cell phones. mHelath tools will help to sort out the problems with documentation and obtain and store more information about the patients. At the same time mHealth allow patients to become active players in the process as well, as they are free to do their health monitoring from home or from office at any convenient moment of time.

Special attention should be paid to telemedicine. There were enough studies conducted, which proved that telemedicine has great meaning for the patients in rural settings, who have difficulties with reaching of the resources, provided in the big cities. “A large-scale study published in CHEST Journal shows patients in an intensive care unit equipped with telehealth services were discharged from the ICU 20 percent more quickly and saw a 26 percent lower mortality rate than patients in a regular ICU.” (10 Biggest Technological Advancements for Healthcare in the Last Decade,  2014, p. 3). The field of telemedicine continues to develop and to grow. There are also evident cost benefits, which are related to telehealth. There is an example with Indianapolis-based health insurer WellPoint. It produced a video consultation program in 2013 for the patients to get full assessment with the help of a video chat, organized with a physician. Claims were generated automatically and the fees were reduced. Along with this employees from telemedicine clinics do not have to travel to primary care office and leave their work places.

Portal technology tools turn the patients into active players in their own healthcare. Portal technology allows patients and physicians have access to medical records and communicate using online resources. Thus patients become more closely involved and have better understanding about their care. Availability of medical information is also the direct outcome of portal technologies development. Patients, who are better informed, tend to become more responsible and active. Self-service kiosk is the type of technology, which is very close to portal technology. Patients do not have to contact anyone and to wait before they make the registration procedure and this is a great advantage for staff saving and speeding up of the processes. Certainly human to human communication could not be completely eliminated, as some patients still prefer personal communication with health care representatives. By the end of the 2012 more than 2.8 million patients in the world started to use home monitoring systems. This type of monitoring helps to reduce costs and makes visits to physician’s office unnecessary. “The wearable medical device market is growing at a compound annual growth rate of 16.4 percent a year, according to a Transparency Market Research report. Wearable medical devices and sensors are simply another way to collect data, which Dr. Chopra says is one of the aims and purposes of healthcare.” (10 Biggest Technological Advancements for Healthcare in the Last Decade,  2014, p. 5). These sensors could be simple for just sending an alert signals to care providers, in case a patient falls down for example, of the skin PH level informs about possible infection. Instant messaging technologies could not be considered new any more, still they become actively involved into heath care facilities settings, replacing beepers and pagers. Nowadays there are Vocera Messaging systems along with other platforms, for sending secure messages for the users with lab tests and various alerts. These messaging systems prove to be secure and quick options for tracking and passing of the information.

Application of the information systems in the sphere of health care has without any doubts a lot of benefits for modern medicine as well as reveals a great potential for the future as well. Still there are a lot of challenges, which need to be considered in order to introduce these information technologies successfully. Privacy protection is one of the key concerns in the modern health care. Health care research has great meaning for improving of human health and qualitative health care. At the same time it is necessary to focus upon protecting patients, who are involved in research, preserving their rights and following the basic ethical principles. Protection of personal privacy and thus related to protection of the interests of individual patients, whereas collection of personally identifiable health information is the key towards appropriate research for society. It is necessary to underline the fact that the issues of privacy are of greatest meaning for the society, due to the fact that a lot of sophisticated activities are included, such as research or public health activities. All these steps should be made with consideration of the individual dignity. Health research is equally beneficial for individual patients as well, as this is a path towards finding new therapies and diagnostics methods for preventing of illnesses and providing of better care. Protection of the security of health research data is utterly important, as health research presumes collection and storing of huge amounts of personally identifiable information, which could also be sensitive or embarrassing. In case if security is broken, then personal information could be assessed by other people with subsequent harm for their patients’ job, health insurance, etc. An example to consider here could be revealing of information about individual patients, diagnosed with HIV or any other type of sexually transmitted infection, which could lead towards his or her social isolation or even psychological pressures. The major goals of security are based upon three important elements: providing access to the stored information only for authorized individuals, providing only accurate information and finally letting them reach the data, when it is necessary for the an authorized purpose. With the aim to reaching of all these goals the HIPAA Security Rule was established with employment of traditional solutions for protecting security. The HIPAA Security Rule was formulated with the aim to protect from unauthorized access deletion or transmission. In reality there are a lot of gaps in the HIPAA Security Rule, which are related to application of the rule only to covered entities, whereas a lot of researchers, doing health research, are not considered covered entities.  “Although federal research regulations include protections of privacy, there are no other laws that specifically require researchers to implement security protections for research data.” (Rupp,  2018, p. 2).

Nowadays, the tendency towards further growth of the data security importance in health care industry is evident, and it is closely connected to implementation of electronic health records. The higher is the percentage of utilization of electronic records in health care, the greater is the meaning of finding the means for protecting of the data. Currently there are no strict recommendations for technology solutions, still there are options, which have the highest potential.  The process of protecting starts already at the moment of selection of the EHR. One of the options is role-based access control. With the help of it, it is possible to define concrete access privileges for all staff representatives and ensure that only those individuals, who were authorized, can get access to the health information of the patients. For example administrative staff could be restricted to have access only to basic information about the patients, like their address, date of birth and so on. Audit trails are track activities, which are conducted with the aim to let the staff members log in or out of the system, open and make changes in the documents, delete or create records. With the help of audit trails such information as date and time of all events is stored, and it is possible to trace the name of the individual, who had conducted those events. Password protection belongs to the list of standard means for protecting of the patients’ health information. “The practice administrator should be able to define the rules for password complexity and expiration, like the practice may require all users to have passwords with five letters and at least one number, and that staff members change their password every three months.” (Rupp, 2018, p. 2). In order to prevent the cases of using the data, if hardware is stolen, EHRs are to encrypt patient data.

Great role in establishment and operating of the advanced health care technologies is played by HIM managers. These are highly trained professionals, who bear the responsibility for planning, organization, management and control of all the activities, which are related to HIM department along with clinical and financial data. They are to ensure that healthcare providers get the access to complete and accurate patient health information at the moment, when they need it. Health information managers usually deal with physicians, nurses, case managers, chief financial officers. Actually, they perform the function of connection between payers, providers and patients. Sometimes health information managers have enough skills and experience to manage the following specialists: clinical documentation improvement, transcriptionists, coding managers, administrative staff, compliance analysts and so on. Most of the HIM departments are virtual, in other words, HIM department staff works remotely either from home or from some separate headquarters of the organization. This means that health information managers are to control and monitor the work of remote staff members. The list of primary responsibilities of health information manger is rather long. They are responsible for implementation of the processes and systems for accurate medical record documentation, for cooperation with physicians with the aim to improve the quality of the medical documentation, for the work of coding staff and complying with state and federal laws and standards, for tracking audits and denials from third-party payers, for analyzing of the clinical data for research and mandatory reporting and so on. Health information managers are to organize paper and digital records, obtained from doctors, diagnostic laboratories and patients. It is important that all this data is accurate and complete and this is the basic responsibility of HIM professionals. Taking into consideration the fact that medical records have high degree of sensitivity, one of the major responsibilities of health information technicians is related to protection of the data and securing that only responsible personnel has access to it. “Security measures can be as simple as locking up paper records or dimming data entry screens whenever technicians leave their desks. Or, in the case of digital records that may be stored in offsite networks, technicians must collaborate with computer security professionals to prevent hackers from depositing malicious viruses or gaining unauthorized access.” (Rupp,  2018, p. 4). Health information managers are to have post-secondary education at vocational schools and community colleges.

Healthcare continues to change significantly due to the new technological developments. This trend will continue in the future, as new devices, new drugs and approaches will be developed, and human factor will be one of the most important for this transformation. The Affordable Care Act (ACA) is closely connected to the development of electronic health records. It aims at reduction of costs and improvement of health care quality. There is no specific section in the law, related to health information technology (HIT), instead it is related to some extent to all initiatives of ACA.

Overall, the basis for successful implementation of health information technology is certainly related to careful and accurate planning and critical evaluation of the progress. It is important to consider both potential advantages and challenges, which are brought by establishment of information technology in health care sphere in order to prevent possible pitfalls and problems.

References:

10 Biggest Technological Advancements for Healthcare in the Last Decade. Health Informational Technology, 2014 Retrieved from https://www.beckershospitalreview.com/healthcare-information-technology/10-biggest-technological-advancements-for-healthcare-in-the-last-decade.html

Cresswell, Kathrin M., Bates, David, Sheikh, Aziz.Ten key considerations for the successful implementation and adoption of large-scale health information technology. J Am Med Inform Assoc. 2013 Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3715363/

Eduardo Ortiz, M.D., Clancy, Carolyn M . Use of Information Technology to Improve the Quality of Health Care in the United States.Health Serv Res., 2003 Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1360897/

Menachemi, Nir,  Collum, Taleah, H. Benefits and drawbacks of electronic health record systems. Risk Manag Healthc Policy. 2011 Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3270933/

Nass, S.J., Levit, L.A., Gostin, L.O. Institute of Medicine (US) Committee on Health Research and the Privacy of Health Information: The HIPAA Privacy Rule;Washington (DC): National Academies Press (US); 2009

Rupp, Scott. Keys To Maintaining the Security of a Practice’s EHR Data. Electronic health reporter, 2018 Retrieved from https://electronichealthreporter.com/role-based-access-control-audit-trails-password-protection-encryption-consent-keys-maintaining-security-practices-ehr-data/

Southard, Peter B., Hong, Soongoo. Information Technology in the Health Care Industry: A Primer. International Conference on System Sciences, 2000

The terms offer and acceptance. (2016, May 17). Retrieved from

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