Question

Imagine you are the CEO of a health care organization. You would like to implement a patient-centric health information management system (HIMS) within the organization. This system needs to take into consideration health care costs and safety. You need your executive team on board to ensure the successful implementation of this patient-centric health care technology information system. You plan to present a detailed report to your management team about the patient-centric approach, its benefits and challenges, and why your organization needs to embrace this approach.

Thoroughly answer the following questions:

1. Taking into consideration patient safety and health care costs, explain why a patient-centric approach is important in today’s health care system along with the challenges involved in implementation. Provide specific examples to justify your reasoning.
2. Analyze the benefits derived by health care organizations that practice a patient-centric approach, stating their unique characteristics. Provide at least two examples to support your ideas.
3. Identify two examples of a patient-centric health care practice and propose three ways patient-centric technology could increase patient access to quality health care.
4. Suggest three ways that HIMS can improve the patient experience within a health care organization or with a health care provider.
5. Predict three ways you would use patient-centric health care practice principles to improve quality care measures within your organization.

Provide references

Answer 1

HEALTH INFORMATION AND MANAGEMENT SYSTEM

Introduction

Health information systems also include those systems that handle data related to the activities of providers and health organizations. As an integrated effort, these may be leveraged to improve patient outcomes, inform research, and influence policy-making and decision-making. Because health information systems commonly access, process, or maintain large volumes of sensitive data, security is a primary concern.

Definition

It is that the system in which collection, utilization, analysis and transmission of information is done for conducting health services, training and research.

Objectives

• To provide reliable, latest and useful health information to all levels of health officers and administrators.

• To amend health policies and working system on the basis of feedback, received from health information system.

• To provide information about periodically and time bound programmes and for mid term evaluation.

• To contribute towards achievement of objectives of health policies and programmes.

• To increase efficiency and quality in health management.

Characteristics

According to WHO,

• The information should be problem oriented.

• Information should be population based.

• Functional and directorial wording should be used.

• Information should be expressed in short and in imaginative form (graphs, chart, table etc).

• Facility for data feed back must be present in health information system.

• Latest technology should be used in health information system.

• Unnecessary figures or data should not be present in information system.

• For information management, organizational structure must be present.

Domains/fields of health information system

It includes

· Demography

· Vital statistics

· Health system input

· Output

· Health determinants

· Health economics

· Health status

· Health infrastructure

· Resources and outcome

· Financial statistics,

· Environmental health statistics.    

Sources of HMIS

· Census

· Registration of vital events( birth, death, marriage etc)

· Notification of diseases and disease registers.

· Records and reports of hospitals

· Statistics regarding environmental health.

· Statistics regarding health resources and services.

· Sample survey( national sample survey organization)

· Population survey

· Statistics regarding efforts to check epidemiological diseases and researches in this field.

· School record

· Economic planning

· Plans of social security

Problems or constraints of HMIS

1. Structural

• Multiplicity of institutions and departments

• Fragmentation of data.

• Lack of infrastructural facilities for storage and maintenance of records.

2. Procedural

• Excessive information

• Encryption/hidden issues

• Exhaustive information, seldom used.

• Overburden of collection and recording of data along with General health care.

• Incomplete, unreliable and intentionally managed information.

• Repetition of general information

• Inappropriate forms/cards/reports

• Less interest of users in information

• Time consuming procedure

• Confusing coding, long list of indices

• Absence of feedback to information suppliers.

3. Related to content

• Mostly service utilization statistics.

• Only summarized information reaches at higher level.

• Less emphasis on socioeconomic information.

• no user friendly

4. Related to human resource

• Absence or lack of skilled medical record professionals

• Lack of opportunity for in service training for the staff.

• Health care providers/nurses/biomedical trained persons are collecting and preparing data.

• Lack of motivation/extra incentives

5. Technological

• Much manual paper based system.

• Absence or lack of computerized data base system

Subsystems/sub components of HMIS

• Epidemiological surveillance

• Routine service reporting

• Specific program reporting

• Administrative systems

• Vital registration

Challenges for HMIS

• Low levels of public will, about vital registration system.

• Inadequate government’s capacity and lack of firm political decision

• Gender issues in vital events registration

• Fragmentation of health information

• Establishing a unified information system with in country.

Benefits of HMIS

• Helping decision makers to detect and control emerging and endemic health problems.

• Help in monitoring progress towards health goals and promote equity.

• Empowering individuals and communities with timely and understandable health related information.

• Improving quality of services.

• Strengthening the evidence base for effective health policies.

• Permitting evaluation of scale up efforts and enabling innovation through research.

• Mobilizing new resources and ensuring accountability in the way they are used.

• Improving governance.

Example:

Nursing management information system(nims)

Nursing information systems (NIS) are computer systems that manage clinical data from a variety of healthcare environments, and made available in a timely and orderly fashion to aid nurses in improving patient care.

Applications of NMIS

• Workload Measurement And Staffing Requirements
• Personnel Management
• Staff Scheduling
• Fiscal Resource Management

Fiscal resource management

• The information generated can be used to monitor past performance or to predict future performance.
• Accumulated data can be analysed for the development of trends that can be used to project future expenditures.
• Necessary reallocations and budgetary adjustments can then be made on the basis of these projections.

Workload measurement and staffing riequirements

• It helps to store, manipulate and retrieve large volumes of data.
• The information generated assists nursing managers in planning, monitoring and evaluating use of nursing resources on a daily basis and in the longer time frame.
• It is used to generate staff schedules with conjunction with personnel management.

Staff scheduling

• Nursing managers are able to plan schedules in advance with considerable time savings.

• Staffs are informed well ahead of time.

• Staffing records, if maintained properly, provide useful information for monitoring absenteeism, scheduled time off, and turn over.

Personnel management

• An employee with a special mix of skills can be located.

• Records are readily accessible needed for accreditation purposes or to monitor contract compliance.

• The information may be retrieved on a daily basis for use in conjunction with workload measurement and contract requirements to plan staffing assignments.

Advantages of NIS

1) In nursing administration:

· Evaluate quality assurance programs

· Defend resource allocation to nursing

· Demonstrate the contribution nursing, makes to the care of the patient.

· Identify outcomes of nursing care

2) In nursing practice:

· Enhance documentation by nurses

· Provide data to enable research directed at examining the inter relationships between data elements and nursing outcomes.

· Facilitate development of the nursing process

3) Nursing research:

· To assess variables on multi levels including institutional regional, and national.

· Identify trends to build information and to further synthesize to develop nursing knowledge

4) Nursing education:

· To develop body of knowledge with focus on nursing process

· To enable staff educational needs based on follow up care and outcomes.

· To enhance student nurses accurate documentation

Electronic Medical Record (EMR) and Electronic Health Record (EHR)

These two terms are almost used interchangeably. The electronic medical record replaces the paper version of a patient’s medical history. The electronic health record includes more health data, test results, and treatments. It also is designed to share data with other electronic health records so other healthcare providers can access a patient’s healthcare data.

Summary

The health information system provides the underpinnings for decision-making and has four key functions: data generation, compilation, analysis and synthesis, and communication and use. The health information system collects data from the health sector and other relevant sectors, analyses the data and ensures their overall quality, relevance and timeliness, and converts data into information for health-related decision-making.