Describe three situations in which lack of integration of information systems with clinicians’ workflow

Describe three situations in which lack of integration of information systems with clinicians’ workflow can lead to inadequate patient care, reduced
admin | June 21, 2013
Q:Describe three situations in which lack of integration of information systems with clinicians’ workflow can lead to inadequate patient care, reduced physician productivity, or poor patient satisfaction with an HCO’s services. Identify and discuss the challenges and limitations of two methods for improving process integration.

The integration of healthcare software systems has remained one of the most prominent issues in healthcare software development. Improving work in healthcare, (e.g. to support patient-center care and regional healthcare networks), requires integrating health information systems and many workflows in the health care facilities involving more than one application. At the same time, the application architectures for the new systems in healthcare are evolving towards the use of web-enabled and components of service-based systems.

The need for healthcare systems integration is multidimensional and is being driven by a number of medical, technical, organizational and political factors. Benefits resulting from an integrated healthcare environment are numerous and substantial. Integrated data can greatly assist the various caregivers in making correct assessments and administering the proper treatments, as well as facilitating the optimization of operations across the enterprise. The collaboration and widespread sharing of data can help identify and pursue opportunities for improving outcomes, lowering costs, enhancing access to services, assuring quality of care, and diminishing the overall health care expenditures. Integrated data is quickly becoming the desired characteristic for a new replacement of current healthcare systems. On the other hand, lack of information system integration may greatly attribute to insufficient data sharing across health care processes and activities extending back to health professionals productivity and forward to patients satisfaction; as a result the productivity of the HCO can be decreased dramatically. These aspects can be illustrated in the following situations:

1. Greater inefficiencies due to longer wait times for information.
Surely, the lack of integration in health care processing affects both patients and health care members, at different levels. Shortage of information integration, within hospital’s health care team as well as between medical professionals and patients, compromises patient care. Which in turn, is a serious yet a recurring problem, particularly in people nearing the end of their life. Death might occur due to longer wait times for exchange of information between ER physicians, doctor’s office and nurses. For instance, without automated link to current and past patient medical history, physicians in ER cannot diagnose a patient in a timely manner causing poor, slow and inadequate patient care, as in case of accidents. Long wait times for the information will make the HCO process inefficient, which leads to poor patient care and compromised physician production. Alternatively, if hospitals implemented an Integrated Health Enterprise and Health care Information exchange, improved outcomes will become well established.

2. Increase human errors due to manual exchange of data.
In an information system enterprise, there will be only one record for each patient with a health care member. The central database would be used by all functions at the organization. So the database would permit an organization to operate its business processes in a consistent manner throughout the organization. Absence or lack of information system, results in processes disaggregation. The disaggregated processes would there need a manual exchange of data. During the exchange, error or inaccuracies cause absence of some data in the handling process misreading or interpretation of hand- writing in patient’s file. For example, in the radiation treatment, due to the large number of steps (e.g. stimulation, external beam radiation) and the number of persons who are involved in the preparation time (e.g. medical physicist and dosimetrist), transfer of information from one step to the next is a very critical point. Errors due to inadequate transfer of information will be reflected in every next step and can seriously affect the final results in patient’s treatment (Wager et al., 2009).

3. Lack of documentation or failure to document and excess paper work requirements in the process.
In the eyes of the court, if something wasn’t documented, it wasn’t done. The physical assessment may reveal crackles of new onset, but if he doesn’t document this finding, other healthcare providers will lack the information they need to formulate an appropriate plan of care for the patient.
Lack of documentation also can result in a nursing intervention being done twice. Say he or she administered a medication dose but failed to document this action, and then a colleague administers the same dose to the same patient short after; this will put the patient at risk for injury or death due to excessive dose. Therefore, clinicians must make sure to document all patient information, evaluation findings, and interventions. That not only promotes continuity of care, it also helps substantiate their care from a legal standpoint (US Congress, 2004).

Challenges and limitations of two methods for improving process integration:

1. Health care information exchange and interoperability:
This process will be the key to the future health care system. The interoperability will bind together a wide network of real-time and life critical data that not only transform but also become a well health care system. Physicians then will have access to a longitudinal medical record among hospitals, laboratories, and pharmacies. Also, communication will be more efficient among all health care systems. Interoperability is a fundamental requirement of ensuring widespread of electronic medical record (EMR) adoption, giving us the social and economic benefits that we want and could also save billions of money yearly (Wager et al., 2009). Without interoperability, EMR adoption will further strengthen the information silos that exist in today’s paper-based medical files, resulting in even greater proprietary control over health information and, with it, control over patients health.
The challenges and limitations are many and need to be overcome; especially that, health care organizations have little real-world experience with electronic information exchange and almost no experience with transactions that bear on clinical matters (Walker et al., 2005).
2. Personal Health Records:
Web-based applications have been developed that allow patients to enter their own information, medical history, medications, laboratory tests, diagnostic studies, and immunizations into secure personal health records. This application is being promoted as means of providing patients and providers with universal access to updated medical information.
The challenges are to make patients update their own medical information through these applications. The limitations are faced because the available PHRs demonstrate limited functionality. For instance, the data entry, validation, and information display methods they employ, may limit their utility as representations of medical information and sometimes physicians may complain of overwhelming number of alerts received (Shortliffe et Cimino, 2006).

In conclusion, this paper discussed three different situations through which lack of integrated systems can have disastrous consequences inside HSO including diagnostic errors, paralysis, Mutilation and loss of lives, all of which contribute to worker stress and burnout. Applying methods such as interoperability to improve the integration process complemented by initiation of personal health record and integrate them with the EMR could be one way to improve health care services leading to safe care, increased production and increased patient satisfaction.




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