The impact of Health Information Systems (HIS) in the healthcare sector
Healthcare results have changed a lot in the 21st century. Improvements in healthcare information technology have definitely led to better care, easier access to healthcare services, and safer knowledge about patients. Health information technology refers to tools that can record, analyze, and share health data about patients to help them get better care. The use of these tools has shown to improve the quality of patient care by reducing medication mistakes and making it easier for patients and providers to talk to each other. Because there is more competition in the health care business, different health information systems are being used to improve service delivery. Even though these systems are still the most popular, there are still problems, like problems with data protection. The main focus of this paper is on how HIS is used in a company and the major issues that come up when these systems are used in healthcare.
What are the pros and cons of an HIS?
Health Information Systems (HIS) are hard to understand and always changing. It is important to understand the pros and cons of some of the most important parts of an HIS. To improve the systems, it is important to look into the pros and cons of HIS usability, interoperability, scalability, and compatibility, which affect safety and efficiency (Wager, 2017). By using health information systems like EHRs, care for patients can be given more collaboratively, tracking for disease conditions can be done better, medication errors can be reduced, and care costs can go down (Mastriana & McGonigle, 2021).
Usability means that the people who are supposed to use it can do their jobs in a way that is useful, efficient, and effective (Wager, 2017). When software is easy to use, the user knows how to use its parts to make documents quickly and easily (Wager, 2017). Poor usability of EHR systems makes doctors and nurses angry and can lead to mistakes that put patients at risk (Wager, 2017). Common complaints include displays that are hard to understand, icons that don’t look or act the same every time, and the feeling that systems don’t support clinicians’ cognitive workflow or make it hard for them to quickly draw conclusions or insights from the data (Wager, 2017). Even though more and more healthcare groups are buying EHR systems, they still face big problems with interoperability, usability, and health IT safety (Wager, 2017).
(Mastrian & McGonigle, 2016) Interoperability means that different health systems and groups can work together to share information. The goal of a health system is for all healthcare organizations to be able to work together so that providers can quickly access and use patients’ safe health information from all sources when the systems talk to each other. (Wager, 2017). The goal of the health system is to improve the health of the whole population. It does this by turning shared data into knowledge, which helps people, clinicians, health agencies, and researchers make better choices and quickly learn, develop, and offer new treatments (Wager, 2017). Patient safety is the most important thing for anyone who works in health care. HIS gives important information that can help prevent bad events or medicine mistakes. For example, an electronic record can tell you about a potentially dangerous drug interaction or allergy that might not be obvious otherwise (Electronic Health Reporter, 2018). Interprofessional care providers can make better choices about how to care for a patient and when changes or adjustments need to be made (Electronic Health Reporter, 2018) when they can look at a patient’s medical records and see how they have changed over time.
EHR interoperability is a big, complicated, and ongoing project in health care delivery that involves a lot of different people and groups, both inside and outside of care settings (Reisman, 2017). EHR systems need to be able to share information with each other using standard, safe data that the other system can understand (Reisman, 2017). Due to different clinical terminologies, technical specifications, and functional powers, it has been hard to make a universal interoperable system work well (Reisman, 2017). Interoperability between healthcare workers and organizations seems to be a way to improve care for patients, cut down on medical mistakes, and lower costs (Reisman, 2017). Reisman (2017) says that the future of EHR and its ability to be an important tool for care coordination and team-based care will rest on the government and the agencies involved coming up with a system for successful EHR interoperability.
Scalability means that a health information system can grow with a company that is growing (Mastrian & McGonigle, 2021). If a hospital chooses to merge with another hospital, it will be a scalable merge if their systems can connect and work with all users (Mastrian & McGonigle, 2021). Zhang and Zhang (2013) say that scalability is a requirement for building and implementing an EHR system that can handle a lot of data exchange. (Zhang & Zhang, 2013) One of the most important parts of a system is its ability to grow and share resources with other health-related information systems. When designing and putting in place a new system, it can be hard to set up a structure that lets a lot of users share a lot of data at the same time (Zhang & Zhang, 2013). The most important thing is to find a way to protect data while keeping performance good (Zhang and Zhang, 2013). Zhang and Zhang (2013) say that a plan should be made and put into action to improve the system’s ability to scale up and down.
Zhang and Zhang (2013) say that a company that wants to grow could spend too much money on a health information system that can’t be scaled. When a hospital grows and has to learn new methods all the time, it can be confusing for the staff (Zhang & Zhang, 2013). (Electronic Health Reporter, 2018) The modern health care system is based on each patient’s needs and medical history, which are stored in an EHR and shared electronically so that providers can better control and improve the quality of care.
Compatibility means that software can be used on different platforms. For example, there are versions of software that can be used on a MAC, a Windows computer, and both an IOS and an Android mobile device (Mastrian & McGonigle, 2016). (Mastrian & McGonigle, 2016) A system is suitable if all of its devices can work together on the same platform without any help from the system. Users can look at information about patients on a laptop in the hospital room while someone in the lab enters the lab data for that patient. It also has a way to send a text message when lab results are flagged. The goal is to share these information-related parts of the organization in a way that is efficient, effective, and suitable (Mastrian & McGonigle, 2016). This will help users of the organization learn more and improve care services across different providers. Multiple types of devices, such as device-linked mobile apps, medical image scanning, lab reporting systems, personal health records (PHRs), electronic medical records (EMRs), portable heart monitors, fitness trackers, smartwatches, blood glucose monitors, and other connected health consumer products and gadgets (Mastrian & McGonigle, 2016), can be used to collect, store, and analyze important health information in real time.
(Mastrian & McGonigle, 2016) Subscribing patients will benefit from software that works on multiple devices because it will give them easy and safe access to their health and clinical information anytime, anywhere. This will give them the power to keep track of their health and well-being. When taking care of their subscribed patients, providers will now have digital information that is up-to-date and accurate (Mastrian & McGonigle, 2016). This will help them make quick and good clinical decisions. Connected devices that collect specific information in real time and send it to patient records automatically fill out a huge amount of paperwork (Electronic Health Reporter, 2018).
Care for the patient and keeping records
The EHR can improve patient care and documentation by letting all parts of a patient’s health record be recorded in the system. This helps keep care consistent across all organizational groups of the health system. EHR makes it much easier for the medical care team to look at the chart because all of the information is in one place. All of the information about a patient is written down in the same tracking system, which makes it easy for the medical team to work well together. Nurses can write things down at the bedside, which allows for real-time recording. Vital signs and test results that are out of range are red flags that the care team needs to know about right away. As soon as the nurse enters the patient’s information, the alerts for sepsis will go off instantly. The alert tells the nurse to tell the doctor right away so that the doctor can decide right away whether to change the patient’s fluids or start an IV medicine. It also lets a night provider who is on call see the full medical history of a patient, which helps them make better choices about their care.
Quality of nursing care, how it is given, and how patients do as a result
EHR will improve patient results, quality, and nursing care by making sure that the information in the database is correct, accurate, and consistent (Mastrian & McGonigle, 2016). (Mastrian & McGonigle, 2016) The information in the EHR system makes it possible to get data from the computer whenever it is needed. The EHR can give information about a patient that could lead to preventive care for fluid buildup, sepsis, or slow breathing, which would improve the patient’s health. It can also give information that helps the decision-making process, like drug conflicts, contraindications, or allergy alerts, which can help stop bad things from happening. By using EHR documentation instead of paper documentation, mistakes caused by bad handwriting will be less likely to happen. This will also make it easier to get data and do quality checks across the entire healthcare company. When used in a clinical setting, EHR will improve the health of patients and the level of care they receive.
Health information systems have made a big difference in the level of patient care, which is how well the services meet the standards that are expected. For example, getting medical data from the EHR will help the doctor know how the patient was doing before and make the right plans. By making a plan, the provider can reduce the number of medication errors that could lead to bad results for the patient. In terms of making decisions, EHR systems can now be linked to clinical decision support systems (CDS), which help the doctor choose the best treatment. Since information technology systems were put in place, death and illness rates have gone down a lot. This is because the level of services has gone up (Krick et al., 2019).
Relationship-based care (RBC) is an idea in nursing that looks at how nurses, patients, families, other members of the healthcare team, and the person interact with each other (Krick et al., 2019). To build these relationships, the nurse takes on different responsibilities, does tasks, and reacts to the patient’s needs in the right way. Through the development of RBC, the use of HIT has greatly improved the way nursing care is given. For example, the information tools make it possible for healthcare workers to talk to each other when they switch shifts. Because information about a patient is available from different groups, it is easy for care to move from one unit to another. EHRs let the doctors keep track of the care they give and suggest treatments. The nurses can look at the doctor’s notes to figure out how to best care for the patient. HIT makes it easy to take care of patients when this kind of relationship happens.
The term “patient outcomes” refers to the effects of nursing care in the hospital, such as improved health, staying safe, and patient happiness. Metrics like death rates, hospital readmissions, and patient experience reports (Brenner et al., 2016) are used to measure how people’s health changes over time. The use of health information technology has made a big difference in how well patients do by lowering the number of people who die and go back to the hospital. For example, the systems are used to make discharge plans for patients, which include giving them directions and making sure they do what they are supposed to do. This helps to cut down on hospital readmissions. The doctor or nurse can use the EHR to make health education information based on the patient’s health trends. EHRs have also made it easier for doctors and nurses to talk to each other, which has made patients happier.
How QI Data Can Lead to Changes That Can Be Measured
Quality improvement is a set of systematic and ongoing actions that make healthcare services and the health of people better in ways that can be measured. (Lackey & Tesh, 2016) Among the things that are used to measure the quality of nursing care are death rates, patient happiness, and hospital readmission rates. Adding health information technology to healthcare has changed how institutions do in terms of the quality measures listed above. For example, many institutions look at statistics on death rates to see if the quality of services has gotten better over time. Death rates in hospitals can be made better by using data from health information systems like EHRs.
Medication mistakes, lack of safety measures, and other problems in healthcare, like not having enough staff, are to blame for higher death rates. By looking at medication mistakes, the data from electronic health records can be used to improve the area of death. For example, the EHR will keep track of the number of old patients who died from too much sedation or the wrong use of narcotics. This information is then used to plan for process improvement in the facility by putting into place methods that have been shown to work. In the long run, the health information helps lower the number of deaths in the hospital. One more example is the problem of sepsis, which kills a lot of people in hospitals. With the help of new technology, it is easy to keep an eye on sepsis patients. The EHR sends out alerts that allow nurses and other medical professionals to move quickly when needed. The end result is that death rates are lower because sepsis and other deadly diseases are treated well.
The second measure that can be improved with the help of health IT is the number of people who have to go back to the hospital. There is a lot of proof that technology may be making a big difference in the health of patients, as shown by fewer hospital readmissions. For example, new data from more than 269 hospitals in the US show that the use of technology has led to a 3% drop in the number of readmissions (Lackey & Tesh, 2016). Meaningful use of EHRs, which includes collecting patient information in a systematic way and using it to make clinical choices, has made sure that patients spend less time in the hospital. Data from the EHR, especially about hospital-acquired infections, is used to help come up with ways to keep people from having to go back to the hospital. The EHR system also gives the healthcare worker information that can be used to make individualized discharge plans for each patient. This makes it less likely that the patient will have to go back to the hospital.
Security Rules and Standards for HITECH and HIPAA
Before the Health Insurance Portability and Accountability Act (HIPAA) was passed, there was no set of security rules that everyone agreed on to protect health information. The HIPAA privacy and security rules were put in place in 1996 to make sure that health information was safe as technology kept getting better. The HIPAA privacy rule sets national standards for protecting patient information, and the HIPAA security rule sets national security standards for protecting certain health information that is stored or transferred electronically (HHS.gov, 2013). After these rules were put in place, the use of electronic health data in healthcare needed to be pushed more. The Health Information Technology for Economic and Clinical Health Act (HITECH Act) was signed into law in 2009 to encourage the use of EHRs and to make sure they are used in a useful way. The use of health information technology, as well as the safety of patient information, is governed by HITECH and HIPAA.
The HITECH act has information that helps healthcare workers and their business partners make good use of EHRs. Under this law, healthcare workers must show that they use certified EHR technology in a way that lets them measure quality and quantity. With the help of the HITECH rule, many organizations have improved how quickly, safely, and well they serve patients. The rules have also made sure that EHRs are used well for care management, improving public health, and making sure that protected health information (PHI) is kept private and secure (HHS.gov, 2013). The HITECH and HIPAA rules are different, but they work together to make sure that EHRs are used and that information is safe when using health information systems.
Different parts of the HIPAA act show what information is protected by the law, who is covered by the security rule, and what the general rules are for protecting health information. For example, the HIPAA security rule applies to health plans, health care clearinghouses, and any health care provider who sends health information in electronic form as part of a transaction for which the Secretary of HHS has set guidelines under HIPAA (HHS.gov, 2013). In general, health groups should make sure that PHI is kept private, is correct, and is easy to get. These systems have to make, receive, and send health information while making sure their employees follow the rules. When a company uses EHRs, it must also find and protect against threats to the security and integrity of information that can be expected. Lastly, the security guidelines say that health information must be protected from uses or disclosures that are likely to be illegal (HHS.gov, 2013).
In healthcare, data storage integrity means that information should be full, correct, consistent, and up-to-date while it is being stored. The goal of HIPAA when it comes to storing information is to protect the privacy, security, and availability of protected health information (PHI). For example, cloud data storage is a common and easy way for healthcare organizations to keep information. This method makes it easy, safe, and decentralized to store an unlimited amount of health information. So, healthcare groups should make sure they have a system that can store information in the cloud and that their cloud storage provider is trustworthy. When information is stored in the cloud, only the business company has the right to access it when it’s needed.
The second way to make sure that the data is stored correctly is to limit access to the data in the computers. Passwords are the most basic way to protect something, especially when it comes to EHRs. The passwords make sure that only people who are allowed to see the patient’s details can do so. To avoid a data breach, there are also policies and procedures in the healthcare field that control how patient information is shared. Technology has also led to tougher security measures, such as two-factor authentication for external access to information, which makes sure that only approved computers and people can get to information. EHRs can also handle data integrity by using antivirus software, network firewalls to stop unauthorized access, and encryption mechanisms to stop computers from sharing data without permission.
The HIPAA rules say that backing up data is a must. All organizations should back up electronic health information so that exact copies can be retrieved (HHS.gov, 2013). Under the technical safeguards rule, policies and processes must be put in place to show how information should be stored and how to get it when it’s needed. The HIPAA rules say that service providers should set up a full backup plan for the system and the whole healthcare infrastructure that has information about patients. For example, a data backup should be stored in at least two places to provide security. The information should be encrypted, and there should be a platform for managing and restoring it that is regularly checked. The backup services should be checked on a daily basis, and reports should be made when a backup fails.
One way to make sure that patient information is available when needed is to store it somewhere else. All backup stations should be put in a safe place with CCTV, water sensors, and more physical security. Even though these layers of security are in place, the backup and recovery of data should be part of a written and recorded plan for what to do in case something goes wrong (HHS.gov, 2013). A contingency plan or program is a list of rules, policies, and processes that an organization follows in case of disasters or other emergencies that could stop the business from running as usual. The last step to make sure information is backed up and can be retrieved is to try and review the plan regularly. Tests of the backup and recovery plan should be done with the help of trusted third parties.
Protecting the privacy of patients
One of the most important things to think about when setting up HIS is protecting the privacy of patients. Passwords are the first way that the networks protect your privacy. Passwords make sure that only people who are allowed to can get into patient information when they need to. Second, the exchange of patient information is encrypted so that third parties don’t get access to the information. Sometimes, you can only share info on certain computer systems or browsers. Also, extra security steps like two-factor authentication make sure that information can be accessed safely from different places.How well an organization works and how productive it is
Standardizing paperwork. Health information systems make it easy to keep track of information about patients, with areas for different kinds of information. For example, the EHR has areas for nursing notes that are set up in a way that makes sure information doesn’t get mixed up. EHRs have also made sure that the information that is recorded is easy to understand by using medical terms and going beyond the handwritten directions. Providers of health care can give clear directions that every member of the care team can understand.
Using less trash. By cutting down on trash, health information systems have made them more efficient and productive. For example, EHRs have cut down on the use of paper-based systems, which waste time and resources. The backup and recovery system makes sure that information is easy to find and takes less time than looking through paper records. Through the use of CDS and EHRs, HIS has made sure that extra costs for evaluation and treatment have gone down. With these tools, there is no need to do the same tests or go through extra steps.
Getting people to work harder. Health information systems have made workers more productive by making their jobs easy. Things like standardizing documentation, making it easy to get patient information, and making it easy to talk about patient care have all led to better health results. EHRs make it possible to serve a lot of patients at once, which brings in more money for the company.
People and money are resources. Because of the introduction of HIS, healthcare groups now need different amounts of people and money. Because the HIS is new, it needs new people to run it and keep an eye on the data. The company needs to hire people for its IT team to make sure that electronic information is sent and kept well. To keep things going smoothly, you will have to pay more to buy computer hardware and install software. During the implementation phase, workers need to be trained so they have the knowledge and skills to use the new technology.
Identifying the Interdisciplinary team
Specialist in nursing informatics. Nursing informatics specialists (NIS) use nursing science, information technology, and analytical sciences to help nurses, patients, and other healthcare workers process, handle, and share important information. The nurse informaticist’s job will be to learn about the new technology and give advice on the best way to use it. The nurse informaticist will help choose the best HIS to use and teach other parties about how important it is to use information technology. This is because of his education and experience.
Nurse Educator. To use the new technology, people will need to learn how to use EHRs and how they fit into the healthcare setting. The nurse educator is a good person to teach nurses and other members of the healthcare team about how important it is to use technology to improve the level of care in the facility. Having the nurse educator work on this project will make sure that workers are ready for new organizational changes.
The person in charge of money. The CFO is a top executive who is in charge of running the financial side of the business as a whole. During the execution of the HIS, the CFO will help decide how much money to spend on hardware, software, and other project-related items. The CFO’s understanding and experience with project management will help a lot with the right way to manage money while the technology is being put in place.
Expert in information technology. An IT specialist is in charge of keeping an eye on a company’s computer systems, figuring out what went wrong and how to fix it, and keeping the systems up-to-date. This person will make sure that a good HIS is chosen from the market, installed correctly, and that workers are trained on how to use it. The IT expert knows a lot about computer systems, and he will be a key part of choosing the best technology for the business.
Plan for figuring out how well a system is working
Education: One of the nursing informatics standards of professional performance with competencies is education, which talks about how important it is for healthcare workers to know about HIS (ANA, 2014). The education standard, which is backed by the American Nurses Association (ANA), will be used to measure how well an HIS is being used in the company. The nurse educator and the nurse informaticist will work together to teach nurses how important HIS is to the company. To figure out how well this method works, nurses will fill out a survey about how HIS is used and list any places where they need more training. Each person will have to show that they understand how to use an EHR, including how to record and keep patient information safe. At the end of the year, the review will be done.
Collaboration. Collaboration is a way for members of a healthcare team to work together to reach a shared goal, according to the American Nurses Association (ANA, 2014). To assess this practice, the committee will look at the meetings that were held to make sure that nurses, doctors, IT team members, and the most important people were there. Second, each team should give a list of what they do and what they bring to the HIS application. At the end of the year, each team will talk about their relationships and any problems they ran into while putting their plans into action.
American Nurses Association. (2014). Nursing Informatics: Scope and standards of practice, second edition. https://www.himss.org/sites/hde/files/FileDownloads/ANA%20NI%20Scope%20%26%20Standards%20of%20Practice.pdf
Brenner, S. K., Kaushal, R., Grinspan, Z., Joyce, C., Kim, I., Allard, R. J., Delgado, D., & Abramson, E. L. (2016). Effects of health information technology on patient outcomes: A systematic review. Journal of the American Medical Informatics Association : JAMIA, 23(5), 1016–1036. https://doi.org/10.1093/jamia/ocv138
HHS.gov. (2013). Health information privacy: Summary of the HIPAA security rule. https://www.hhs.gov/hipaa/for-professionals/security/laws-regulations/index.html
Krick, T., Huter, K., Domhoff, D., Schmidt, A., Rothgang, H., & Wolf-Ostermann, K. (2019). Digital technology and nursing care: A scoping review on acceptance, effectiveness and efficiency studies of informal and formal care technologies. BMC Health Services Research, 19(1), 400. https://doi.org/10.1186/s12913-019-4238-3
Lackey, S., & Tesh, P. (2016). Nursing quality measures (simplified). Nursing Made Incredibly Easy, 14(3), 20-24. https://journals.lww.com/nursingmadeincrediblyeasy/Abstract/2016/05000/Nursing_quality_measures__simplified_.5.aspx
Reisman, M. (2017). EHRs: The challenge of making electronic data usable and interoperable. P & T : A Peer-Reviewed Journal for Managed Care and Hospital Formulary Management, 42(9), 572–575. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5565131/
Wager, K. A., Lee, F. W., & Glaser, J. P. (2017). Health care information systems : A practical approach for health care management (4th ed.) [ProQuest Ebook Central]. John Wiley & Sons, Incorporated. https://doi.org/https://ebookcentral.proquest.com/lib/westerngovernors-ebooks/detail.action?docID=4815068.
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