The 21st Century Healthcare Information System

Many nations in the world have continued to strengthen their healthcare system and driven more concentration on the effectiveness of service delivery. Besides, the initiative reforms are aimed at integration of the programs to ensure that individuals fully enjoy the quality of the services provided by the healthcare system. This is achieved through the implementation of viable reforms and initiatives that culminate into quality care improvement and sustainability. The 21st-century healthcare information system has increasingly become a critical factor in the provision of healthcare services. The health care system encounter significant pressures arising from need to prioritize the limited resources appropriately to ensure effectiveness and efficiency in the service delivery.

Keywords: healthcare information system, computerized physician order entry, Patient portals, Telehealth, telemedicine, Electronic Information Record

21st Century Healthcare Information System - Implication of the Reform initiatives

Undoubtedly, the ever advancing technology of the healthcare system has driven reform initiatives like “patient portals, and computerized physician order entry (CPOE)” telehealth and telemedicine, patient portals and health insurance exchange that have ensured affordable healthcare (Miles & Asbridge, 2014). These initiatives provide the supportive system that makes the healthcare providers get asses to a computerized system and huge networks.

Patient portals and computerized physician order entry (CPOE)

The initiates will also have an implication on computerized physician order entry (CPOE). This is the process under which the medical practitioners enter the medical orders or other physician instructions electronically as oppose to the use of the paper charts. The e-prescribing system employed in CPOE notify the physician and the clinical providers on specific drug allergies of a patient and the present medication process. The implication also results in reduced medical errors that are commonly done in the health care system and reduce the severity levels (Miles & Asbridge, 2014). The use of the CPOE comes along with faster medical retrieval of information of a given patient and knowing the history of allergy. This beneficial implication does pave the way in the creation of more importance. An example of the importance includes being accurate and efficient to a given patient and attending to the patient fully and satisfactory. Besides, the files are well kept and do not face the risk of being misplaced or getting lost.

Implication on Telehealth and Telemedicine

Telemedicine has been widely utilized by the healthcare practitioners to provide broad traditional practices of medicine that are experienced outside the standard medicine practices. Telemedicine has led to the efficient provision of the clinical services to healthcare individuals who are positioned at different locations. Indeed, video conferencing, image transformation, patient portals and e-health prove to be significantly beneficial to the healthcare service provision. Besides, the vital signs of off-patient, remote monitoring, nursing call centers along with the medical education are the fundamental information technology that profoundly provides support to the healthcare system. The reform initiatives are concerned with the technical capacity which that impact on the telehealth and telemedicine which prove to be accurate, safe and reliable. The accuracy in the diagnosis impacts to the accuracy correlation of diagnosis where the medical practitioners make viable decisions (Hirsch, 2010). Furthermore, the impact on the telemedicine and telehealth has an influence on the management of the patient such as enabling accessibility of emergency cardiac telemetry along with the improvement of the patient healthcare outcome. Another major implication is realized on the motivation factor that is underlined in the improved accessibility to healthcare through decreasing the cost and the rates of healthcare initiatives of cost escalation.

Affordable Care Act and Policy in Health Care

The initiative reforms impacts on the care delivery and the patient's accessibility of healthcare through enabling affordable healthcare. The affordability of the healthcare care act means and the realization of high-quality, affordable medical insurance that covers many citizens. The framework of affordability significantly impacts on the goals of lowering the cost of the healthcare. The increase in the healthcare coverage at low costs require the implementation of the policy in the Medicaid and promoting new health insurance and the establishment of ways that focus on effectiveness. The affordable healthcare will result in reduced death cases. Affordable healthcare is also significant to the uninsured people as it will enable people to get accessibility to the medical care at less cost and in a prompt manner. The fiscal burden that comes with expensive healthcare provision will be eliminated and become a key goal in the developmental goals. The affordable health care will be beneficial to the low-income individuals who face difficulties in accessing the health care.

Patient Portals

Patient portals are a breakthrough in the implementation of the reform initiatives in the healthcare information system. A patient portal is a secure online website which provides the patient with an internet connection and accessibility to the internet at any given time of convenience and has access to the personal healthcare information. Patients can view data like the medications they are prescribed to take, the doctors to attend to the patient and the lab results. Though the implication of the patient portals, the patients can send emails to the healthcare practitioners and make a request for prescriptions, appointments and make payments. The technology also has importance in enabling the patient to check information relating to health insurance, view the educational materials along with updating the personal information. The educational materials and individual health plans help the patient in detecting and preventing early diseases. The patient portals are increasing becoming more popular and prevalent in the delivery of the healthcare. They are fundamental tools for health practitioners and the patients. The patient portals help in putting the patient in a better control of healthcare along with creating splendid communication between the patient and the provider. The patient portal is also important in keeping office visits and assist in detection and prevention of illness.

Challenges

Despite the numerous significance that comes with the 21st reform initiatives such as the functionality in healthcare delivery, there are potential challenges that present to be problematic arising from the implication. The challenges are associated with financial problems, temporary loss of productivity, changes in the workflow, prove my concerns and the adoption of the implications. Patient portals and computerized physician order entry (CPOE) are associated with financial problems in the implementation process. The technology is expensive, and the adoption of the implementation is costly. The patient portals also require high maintenance costs and present deterrent for hospital physician to adopt and implement. Purchasing and installation of the technology that comes with the implication are also costly, for example converting paper charts to electronic. Additionally, the technology required training of the users which also ends up being costly. The implication on telehealth and telemedicine could lead to disruption of workflow leading to loss of productivity and thus a problem to the chief information officer. CPOE also poses a challenge of errors ranging from duplication, wrong medication, and poor decision designs. The COPE is also prone to pitfalls and thus fails to result into the promise of improving the medication dosing and prevention of the adverse events.
The CPOE can also pose unnecessary delays and thus mirror inconveniences. The patient portal system could also present to be sophisticated to some patients particularly to those who are illiterate. Making the cost of healthcare affordable can also result in the delivery of poor quality healthcare services. It will lead to the strain on the medical facilities and thus causes poor service delivery. Affordable healthcare will also make some people abuse the initiative particularly the individuals who can afford the healthcare delivery. Due to this, the low-income individuals face a problem in accessing the health care services. Undesirable healthcare spending is likely to result from the financial spending and fail to reflect in the healthcare insurance. The legislation on the adaptability of the technology in the healthcare is likely to affect the implementation process. The technology could have a problem in the adaptability in use in the local context. The technologies that tend to have technical adjustments require given modification that has to be adopted and accepted. Complexity factors that are likely to arise could lead to slower system performance. Some of the software could be technical in the adoption process and thus fail to provide real-time accessibility, reliability, and handling. Unplanned downtime accompanied by slow speed are also the other factors that are likely to influence the implementation process (Ho & Pinney, 2015). The connectivity issues arising from the incorporation of the technology and problems stemming from professionalism in the healthcare setting is a major inhibiting factor. The technology can also fail to be user-friendly and thus inhibit appropriate functionality and pose a big challenge to the CIO. The costs that are involved in the buying and payment of the trends in the information system could implicate heavy costs to the government. The absence of inadequate legislative measures from the governance and the government could prove to be a liability of concern that could hamper the implementation process.

Solution to the Challenges

The implementation climate has to include compatibility that will be fitting to the information e-health advancement. The workforce also has to be trained on the use of the new healthcare system. A major drawback that is involved in the implementation of the new technologies in a health system includes disruption of the workforce in the delivery of the healthcare. Thus offering training to the healthcare providers will provide an enlightening to the use of the new system and the technologically designed systems. The integration of the processes into user-friendly helps in minimizing the inefficiencies in the workflow during the implementation process and also minimize the disruptions and thus helping the CIO to draw an advantage in the use of the system. Physician resistance to the technology implementation is also facilitated by disruptions and uncertainties in the new roles and duties that come along with the technology. Careful training of the task and building a dedicated technical support staff has to be a priority to CIO in the implementation process.
The solution to the challenges also calls for leadership engagement at all the implementation stages. The leadership should also drive the development of the processes that will help in improving an effective implementation (Zeugolis & Pandit, 2015). Leadership management support is crucial to the success of the implementation process. There should be available resources that will aid in the appropriate implementation process. These resources include available electricity, accessibility to computers a network. Accessibility to knowledge and information is fundamental to the adoption of the technology process. Education of the staff proves to be a staff motivation in the acceptability and benefits the accessibility to high quality, well-funded and readily available facilitation.
The establishment of standard measures could serve to offer a reduction of the problems that arise from the governance. The need to recognize the policies for the provision on the information initiatives will increase the patient safety and the professional liability along with facilitating the exchange of the electronic heath information between the system and the healthcare information and marinating integrity. Besides, delivery of incentives from the government could massively facilitate the adoption of the healthcare information system in the healthcare organization (Zeugolis & Pandit, 2015). The financial incentives involve the provision of the initial finds on coverage of the upfront costs, reimbursement for adoption and financial sponsorship along with pay for performance initiatives. Establishment of cost effective means of an information system on the healthcare has to be a priority for the government. Formal evaluations have to be carried out to establish how the cost can be reduced and suggestion of strategies that are related to cost-related barriers to be implanted.

Influence of the Regulation and Legislation

The Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule is federal legislation that could influence the implementation of the health information management system. The regulation set a baseline for protection of the patient’s data. This law could have an impact on the uncovered health care providers and other key features such as payment, treatment, and the healthcare operations. The implementation of the patient electronic health information exchange regulation could be an impediment as the healthcare providers could make decisions to offer patients a choice on whether to electronically exchange data. This could have an impact on the opt-in and opt-out policy (Ho & Pinney, 2015). This requires the practitioner to obtain patient choice on whether they have to participate in the electronic health information exchange and thus to affect the patient portal. Nevertheless, inadequate information that is at the disposal of the patient could make the patient not to trust the system. The legislation on the patient consent influences the personal choice and confidentiality.

Trends in Adoption Process

The HMIS could have an impact on the electronic health record (HER) diffusion goal. The HMIS will help in achieving the adoption of EHR and enhance prospective innovations in diffusion modeling. The system will help in the identification of the EHR target adoption and the external factors that influence EHR adoption. The implementation of the EHR represents a disruptive change in the healthcare workplace and the introduction of new technological equipment and design in jobs that can accommodate the transformation in the healthcare system. Payoff performance programs will prove to be rewarding to the physicians and will result in improved quality care and adherence to the best practices that improve the patient outcome. The trends will also lead to the identification of the internal factors that affect EHR adoption which will rapidly celebrate the diffusion of the technology. The trends will also lead to internalization of the system initial purchases on the ongoing operational costs. The return on investment arising from EHR will accrue to provide short run reimbursement schemes and thus improved quality and efficiency that will reduce the barriers to adoption. The trends will also educate the physicians’ social network and measurement of the EHR diffusion.

Conclusion

Indeed, the reform initiatives in the information healthcare system will lead to the implication of beneficial aspects to the health care provision. It will enhance the service delivery promptly and lower the costs of delivery. It will provide more efficiency that will result in more healthcare accessibility. The affordability will also enable the low-income individuals to access healthcare. Nevertheless, the HIMs comes with its challenges which all the stakeholders have to be vigilant in addressing the problems.

References

Hirsch Gary , Jack Homer, Geoff McDonnell and Bobby Milstein . (2010). Achieving Health Care Reform in the United States: Toward a Whole-System Understanding. Centers for Disease Control and Prevention, Atlanta, GA, USA. http://www.garybhirsch.com/consulting_files/F-health-reform-final.pdf
Ho, A., & Pinney, S. (2015). Redefining ethical leadership in a 21st-century healthcare system. Healthcare Management Forum, 29(1), 39-42. http://dx.doi.org/10.1177/0840470415613910
Miles, A., & Asbridge, J. (2014). On the need for transformational leadership in the delivery of person-centered clinical practice within 21st Century healthcare systems. European Journal For Person Centered Healthcare, 2(3), 261. http://dx.doi.org/10.5750/ejpch.v2i3.938
Zeugolis, D., & Pandit, A. (2015). Regenerative Medicine in the 21st Century: Advances in Engineering, Chemistry, Biology and Medicine Revolutionize Healthcare. Advanced Healthcare Materials, 4(16), 2324-2325. http://dx.doi.org/10.1002/adhm.201500849