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The research proposal aims to investigate the benefits of Health Information Technology in the health care systems across the world. The research will interview various stakeholders and key players within the healthcare such as health care providers, experts and patients to determine the effectiveness of the Health Information Technology in the health care systems in term of improved efficiency of service delivery and quality of health care services.
The research will investigate the impacts of Health Information Technology such as Electronic Health Records on the health care systems. These impacts will be measured in terms of administrative efficiency, cost of healthcare, and quality of the health care service and accuracy of health information. The secondary and primary data collected through the study will be analyzed by the use of statistical software such as Statistical Packages for Social Sciences, STRATA, and Microsoft Excel. The subsequent interpretation of the research findings will be published for general use.
The expected outcome of the research anticipates that the Health Information Technology (HIT) improves the provision of healthcare services, the administrative efficiency, and the accuracy of health information within the health care industry. The findings of this research will be useful to governments, insurers, health care providers, international health agencies, and medical practitioners in the sense that they will all acknowledge the place of Health Information Technology such as Electronic Health Records in the heath care industry. Consequently, all stakeholders will fully support computerization of the health records over the conventional method of file storage.
1.1 Background Information
Health Information Technology (HIT) provides an overall logical framework upon which computerized systems are used to manage healthcare information within the healthcare sector (Tomasi, 2010). HIT makes the exchange of the healthcare information between the insurers, consumers, healthcare providers, independent quality and governmental agencies possible. The main purpose of the Health Information Technology is to improve the overall efficiency, safety, and quality of the service delivery within the healthcare systems. The health care experts, policy makers, payers and consumers consider health information technologies, such as electronic health records and computerized provider order entry, to be critical to transforming the health care industry.
W. defines Health Information as the systems of computer program software and physical hardware components that systematically function to process, store, retrieve, use, and share healthcare knowledge, data, and information for the purposes of the communication within the healthcare system. The information, knowledge and data accrued from the Health Information Technology (HIT) are very useful in the development of various public health policies because they provide precise details about the patterns of all epidemics in a given population, prevalence of infections, frequency of various diseases within the healthcare system.
The concept of HIT has fully infiltrated all the major healthcare systems in the provision of primary health care across the world. As observed by Tomasi (2010) in their health care publication, Health information technologies in primary health care in developing countries: a literature review, all the major health care systems provides for the computerization of their data system within their expansive areas of operation. The report further elaborates that the success of this technological advancement in the healthcare sector calls for the concerted efforts of the IT experts, consultants, policy makers, medical care givers and insurers. Each of these stakeholders plays an important role in the computerization of the healthcare systems.
The information technology experts will develop all the necessary hardware and software programs that will meet the demands of the healthcare services as far as networking of all healthcare systems within a given area of operation is concerned. These are the basic components which are necessary for the effective computerization of the health care systems. Similarly, the contributions of the healthcare experts and healthcare policy makers are also crucial in the development of Health Information Technology because they lay down all the fundamental features to be included in the programs under development. The contributions of these stakeholders ensure that the HIT covers all the major areas of the healthcare systems without any fail.
According to W., there are basic features of the Health Information Technology that must be put into consideration in the development of various healthcare programs. First of all, software programs of the HIT must be user friendly in the sense that all categories of the healthcare practitioners and service providers must find these programs easy to learn and use. This quality will ensure that the HIT programs and the subsequent computerization of the healthcare information is realized considering that all the healthcare providers fully embrace its applications in the management of health information. Secondly, the HIT must indiscriminately integrate all areas of health care operations into its systems for the purposes of universality. In this way, the HIT will comprehensively satisfy all the needs within the healthcare systems.
The HIT has completely revolutionized the operations of the healthcare provision in different parts of the world. Many governments have made it their policy that all health records have to be stored within the Electronic Health Record . The health records in paper files are no longer kept in the metallic cabins where they are liable to physical destruction, misplacement, or manipulations and are difficult to retrieve should there any need arise. Walker, Bieber & Richard, Electronic Health Record (EHR) is the commonest application of the Health Information Technology applied within the health care industry on a day-to-day basis.
According to W., Electronic Health Record (EHR) is the systematic gathering and storage of an individual patient’s electronic health information within the systems of Health Information Technology. These stored electronic health information could then be retrieved for future uses. EHR provides a technological platform upon which all heath records of a particular individual entity could be all consolidated under one portfolio within the healthcare system. The resultant e-records could then be accessed by different healthcare providers from the system in different locations at the same time. This is the superiority of the EHR over the filing system of health information records. The use of Health Information Technology (IT) in the healthcare sector is a growing reality in many parts of the world- both developed and developing alike. Many governments have made a policy that the healthcare facilities such as hospitals must keep electronic records of the health information within the HIT and these governments have also provided adequate funds to ensure that the cost of installing HIT systems are catered for. According to the statistics given by W., 61% of the world healthcare systems have fully embraced the HIT in the management of their information, 31% are still in the process of computerizing their health records while a small percentage of 8% use the traditional filing system. However, the Elaine is categorical that in healthcare systems (mostly poor developing countries) where HIT is either partially or not embraced, strategic plans are underway to ensure that all their healthcare systems are computerized by the year 2018 as stipulated in their strategic development goals.
All the information systems within the healthcare systems as given by healthcare providers, insurers, and the medical facilities are interconnected through the highly modernized infrastructure of the healthcare information technology. The highly centralized healthcare information system acts as a server to all component terminals within the infrastructure. All forms of data are first sent to the central database for storage after which they can be strictly accessed by authorized entities from the system. Besides the data security maintained within the Electronic Health Records, the independent Information systems are capable of storing, relaying and retrieving clients’ information from the database at any given time without any difficulty. For this reason, it greatly increases the efficiency of the healthcare systems.
The components of the Health Information Technology systems ensure that all the healthcare facilities and service providers can adequately manage their database without any possible error. All information entered into the EHR is accurate and not liable to any manipulation since they system highly encrypted to lock out manipulations of stored data. Unlike in the filing system, the EHR guarantees the clients’ confidential information maximum safety against unauthorized access. This feature makes the EHR a preferred choice of keeping healthcare information. Data security is another reason why healthcare providers resort to the electronic health records. Once clinical/medical information is collected from the client (patient), it is converted into digital electronic records which is then stored into the system for future references. The e-records cannot be lost from the system as would be the case with physical paperwork kept in a file.
There are several side benefits that are associated with the HIT. Considering that the HIT tracks all the clinical history of a patient, all the medications and prescribed drugs are enlisted in the system against the exact dates when they were dispensed. Most importantly, the system also contains other sensitive information about an individual patient before hand for example group of drugs the patient adversely reacts to, medical conditions such as hypertension, and asthma. In this way, any attending doctor or medical practitioners will be able to get all the relevant information on the onset of medication. As such, the electronic health record system reduces medical error by a larger margin above 78%.
Furthermore, the improvement of the heath care quality is another advantage that HIT introduces into the health care system. The introduction of the telemedicine allows the patients to directly seek the expertise services of the medical practitioners without necessarily visiting the health facilities. The Health Information Technology will then allow the medical experts to conduct elaborate diagnosis online via Electronic Health Record with precision (Gartee, 2011). This unfolding technological advancement in the health sector makes heath accessible and affordable to an increasing number of people within the society.
The existence of an elaborate Information Technology infrastructure between the healthcare service providers and healthcare facilities such as hospitals and medical care services allows for the maintenance of accurate electronic health records (Kirch, 2008). The electronic health records contain all the necessary medical information about a particular patient in a consolidated manner notwithstanding changes in the medical service providers or geographical location because all these information are integrated at the wider National Health Information Network.
The architectural design of the EHR guarantees accurate and reliable transmission of data within the integrated healthcare system. The EHR has made it possible to integrate all the components of the Clinical Information Systems (information about the medications given by medical practitioners to a particular patient) and the hospital information systems (records of patients’ particulars by a particular health facility for their internal use). The introduction of health information technology has brought about much transformation in the healthcare industry. HIT increases efficiency of the healthcare services therefore many hospitals and other healthcare providers have increased their capacity to extend their services clients (Walker, Bieber & Richards, 2006). Similarly, patients are happy with the high quality services of the healthcare providers.
1.2 Research Problem Statement
Over the past three decades, the healthcare systems in many countries have experienced serious problems in the management of their medical information across the world. Majority still resort to the use of physical files in keeping patients’ records. As a result, lots of medical and clinical healthcare information are liable to get damaged or lost altogether. Additionally, the much required information about the increasing numbers of patients becomes extremely difficult to retrieve- a phenomenon that contributes to the inefficiency of the healthcare systems.
For the past three decades, all the healthcare systems have experienced a serious lapse in the management of their health information records following the increasing number of patients who come to the health facilities seeking for the healthcare services. Considering that the healthcare facilities relied on the explicit use of outdated methods of file storage systems to keep their information, they are liable to lose most of their information contained in the files for various reasons. This leads into reduced profitability of the health care firms.
The method of file storage compromises the security of the healthcare information. Over a period of time as the healthcare facilities and insurance companies expand their businesses, their volumes of data increases far beyond the capacity of the existing conventional types of file storage. This phenomenon compromises the security of patient files stored within file storage system. In the event of transferring files from one storage device to another, information is lost since some parts of the files could be lost, misplaced or get damaged altogether. The limitation of the available space is the major challenge of using the conventional file storage.
The use of outdated methods of file storage presents the problem of accessibility. Due to the increased demand for the health care services, the required data could not be accessed with speed as desired. The administrators will spend more time and energy trying to locate where a particular file is placed. This manner of inconveniences will reduce the efficiency of the health care facilities since their rate of working is slowed down especially if the patient volume is high. Similarly, this system of data storage does not readily allow for the regulatory that ensures that data are verified within the system.
Finally, the compromised data safety within the conventional file storage system renders it obsolete in the management of data since the files could easily to a number of factors. The number enemy to the filing system of keeping health records is fire. In case of any fire break out, the papers files normally stored within the metallic cabins are most likely to catch fire. Over a period of time, the paperwork can also be lost to oxidation and yellowing of the record papers.
1.3 Objective of study
The main purpose of the study is to asses the benefits of the Health Information Technology into the health care systems across the world in its main goal of transforming the provision of health care services to the growing number of patients. In specific the study will aim at:
- i. Examine the effectiveness of the Health Information Technology in the management of health information within the heath care sector.
- ii. Establish the effect of Electronic Health Records on the quality of heath care service offered to the patients by the health care providers such and medical practitioners, insurers, and medical facilities.
- iii. To evaluate the extent to which the HIT is applicable to the management of health information in the mainstream health care industry.
- iv. Determine the effects of Health Information Technology in the efficiency of the heath care service offered to the patient population by the health care providers within the healthcare industry.
1.4 Research questions
The study seeks to answer the following research questions
- i. To what extent does Health Information Technology contribute to the effectiveness of health information management within the health care sector?
- ii. How does Electronic Health Records affect the quality of health care service offered by each category of the health care providers to the patients?
- iii. To what extent does Health Information Technology impact on the management of health information in the mainstream health care industry?
- iv. In which way does Health Information Technology affect the efficiency of the heath care service offered to the patient population by the health care providers within the healthcare industry?
1.5 Significance of the Study
The research study will be of great significance to the all stakeholders within the health care industry since it will contribute towards the establishment of major impact of Health Information Technology (HIT) within the sector. Through this research study, all the health care providers will acknowledge the importance of Health Information Technology in improving the efficiency of the health care systems so as to increase profitability since the populations of patients served in these facilities are on the increase. In this manner, the health care facilities will be under an obligation to understand the limitation of the conventional methods of file storage system and in turn appreciate the use of the Health Information Technologies within their systems.
The research study will also equip the heath care providers with the expertise knowledge on the technical requirement of the Health Information Technology. This information is critical in the planning and development of policies governing the operations of the health care systems. All the health care systems will be fully equipped with the necessary their experts need to incorporate Health Information Technology through computerization of heath records in their systems. The insurers and other health care facilities will fully understand the basic requirement of Health Information Technology in their respective areas of operations.
The findings of this research study will be of great importance to medical practitioners who work in the health care facilities on a regular basis. The medical doctors, clinical doctors, registered nurses, and specialized physicians will be informed on how the Health Information Technology can make their work easy, less laborious, accurate and precise given that most of the crucial information they require to know about an individual patient will be retrieved from the electronic health records (EHR). Such information includes medical history, clinical history, and latest health status and blood biochemistry. HIT is a companion and a medical guide to all medical practitioners.
These research findings will cut across the continents. All the governments will be properly informed on the overwhelming advantages that come with the implementation of Health Information Technology across the world. All those governments (especially the ones in the developing worlds) that have not fully computerized the operations of their health care systems in their countries will be find HIT a necessity hence prioritize it in their national policies. Consequently, the introduction of HIT in all governments across the world can lead to the formation the much desired universal health care systems whereby one health care provider can operate in more than one country.
Most importantly, the research will offer World Health Organization (WHO) and other international health agencies an insight into the possibility of developing a worldwide health information system that can track and control all infections, epidemiology, and outbreak of other human diseases. This could provide a powerful health care tool for the global prevention of all epidemics such as Ebola, anthrax and SARs. These international agencies can further establish the global patters of various diseases and infections and in turn develop policies to manage them (diseases and infections).
The particular research will also enlighten the general public on the numerous benefits of the Health Information Systems to the end users (patients). The technological awareness will enable patients know the electronic health records can minimize the chances of medical errors by a significant percentage, reduce the cost of health since many unnecessary clinical procedures are bypassed, guarantee accuracy and constant updating of the patients’ health records, and ensure data security of the patient information. Subsequently, the general public will fully embrace the concept and application of the electronic health records.
The findings of this research will equally important to researchers drawn across fields of technology and health care. These experts would be able to conduct further research into how information technology can be used to enhance quality of health care other through the use information management. The possible areas these researcher might show interest is the new area of telemedicine where these two categories of experts can jointly work together to produce a wonderful online health care solution to larger populations of patients across the world.
1.6 Research scope
The research study will be carried out in different mainstream health care facilities, insurers, government health are agencies in different states/countries and international health agencies. The study will be conducted in different institutions of health care to ensure that all classes of health care providers are adequately represented in the research. The study will then narrow down its research undertaking on the benefits of the Health Information Technology (HIT) in its agenda of transforming healthcare.
1.7 Definition of key terms
Health Information Technology (HIT) – According to W. Health Information refers to the systems of computer program software and physical hardware components that systematically function to process, store, retrieve, use, and share healthcare knowledge, data, and information for the purposes of the communication within the healthcare system.
Data- It refers to organized information within the healthcare system.
Electronic Health Record (EHR) - This is the systematic gathering and storage of an individual patient’s electronic health information within the systems of Health Information Technology .
Ebola and SARs- Both are contagious and very deadly viral disease in human beings.
Anthrax- It is a contagious deadly bacterial disease in human beings.
Clinical Information System (CIS) - It refers to a collection of records that contain information regarding medication and drugs dispensed to patients at the healthcare facility.
Hospital Information System (HIS) - This refers to a collection of patients’ particulars by a particular health facility for their internal use.
This chapter discusses the literature review of the study. Literature review helps in identifying the relevant theories addressing the research problem. This study reviewed literature on the benefits of Health Information Technology (HIT) in its transformation of the health care industry. The reviewed literature will be obtained from reference materials such as journals, periodicals, working papers, reports and books.
2.2 Theoretical Review
According to W., Health Information Technology (HIT) refers to the systems of computer program software and physical hardware components that systematically function to process, store, retrieve, use, and share healthcare knowledge, data, and information for the purposes of the communication within the healthcare system. In his empirical studies, explains that the use of computers to process, store and retrieve patient information within the health care system forms the basis of HIT. The interconnectivity between users, insurers, health care providers, health care facilities, medical practitioners through the central computerized systems makes the exchange of health information a reality between these health care provides across the areas of their operation.
According to W., there are basic features of the Health Information Technology that must be put into consideration in the development of various healthcare programs. First of all, software programs of the HIT must be user friendly in the sense that all categories of the healthcare practitioners and service providers must find these programs easy to learn and use. This quality will ensure that the HIT programs and the subsequent computerization of the healthcare information is realized considering that all the healthcare providers fully embrace its applications in the management of health information. Secondly, the HIT must indiscriminatively integrate all areas of health care operations into its systems for the purposes of universality. In this way, the HIT will comprehensively satisfy all the needs within the healthcare systems.
The Office of the National Coordinator of National Health Information Technology (ONCHIT) defines Health Information Technology as the use of information technology by the health care providers to manage patient care through secure use and sharing of health information”. The ONCHIT positively identifies the use of electronic health records (EHRs) rather than the traditional paper work in maintaining patients’ health information within the health care industry.
The ONCHIT highlights several benefits that are accrued from the use of Electronic Health Records (EHR) in the health care sector. Most importantly, the EHR increases the administrative efficiency of the health care providers because they can easily retrieve information from the system without relying on the traditional methods of the file storage system.
2.3 Empirical Literature
The benefits of HIT in promoting quality of health care: HIT has greatly transformed the health care industry. The availability of the accurate and elaborate patients’ health information through Electronic Health Record enables the medical health care givers offer excellent care to patients without any delay during an emergency such as sicknesses or regular check ups. Any incidences of medical error that could be experienced with the conventional systems of data storage are completely eliminated with the introduction of Electronic Health Record.
The benefit of HIT in reducing the cost of healthcare: Various medical and Information Technology experts have managed to use information technology to enhance quality of health care other through the use information management. The development and subsequent introduction of the telemedicine by the two categories of experts can jointly work together to produce a wonderful online health care solution to larger populations of patients across the world. Telemedicine has greatly reduced the cost of health care because doctors can conduct diagnosis and dispense treatment online.
As observed by W., the availability of telemedicine has drastically reduced the cost of health care by more than 16% because there is no redundancy of medical test since the electronic health records is capable of providing medical and clinical history with high precision. As the author put it, telemedicine is the only way of making health care services more accessible and affordable to larger numbers of patients across the world without any element of restriction.
RESEARCH DESIGN AND METHODOLOGY
This chapter discusses the research design and methodology that will be used throughout the study. It explicitly explains the sample design, study population, sampling methods and techniques, sampling procedures, data collection methods and techniques and the data collection instruments. To avoid any error during the data collection and analysis stages, the study will involve the direct participation of the experts to during these critical stages of the research exercise.
3.2 Research Design
The study will use a descriptive research design that is commonly used to obtain information concerning the current status of the phenomena to describe what exists, with respect to variables or conditions in a situation. Descriptive research aims at gathering data without any manipulation of the research context and it is non-intrusive and deals with naturally occurring phenomena, where the researcher has got no control over the variables.
3.3 Target Population
A target population is the total collection of elements about which one wishes to make some inferences . The researchers will target the representative drawn across the health care industry namely patients, medical practitioners, insurers, and government representatives in the healthcare industry. The population was drawn from key segments of the industry. This kind of a perfect sampling will ensure that all players of the healthcare industry are accurately represented during the research study. During this study, a target population of respondents is 1000 (one thousand individuals). The target population will be as follows:
3.4 Sampling Design
A sample of 250 respondents will be chosen for the study using stratified random sampling technique. Under this technique, the respondents will be obtained from various sub-groups using 25% of the target population.
3.4.1 Sampling Method and Techniques
The study will apply a Probability sampling method whereby stratified random sampling technique will be used to select respondents from the target population. Stratified random sampling method serves the useful purpose of ensuring that all the respondents from the target population are entitled to an equal chance of participating in the study without any bias. The target population will be divided further into smaller sub-groups and respondents get picked randomly from each of the distinct sub-groups.
3.4.2 Sampling Procedures
The study will apply stratified random sampling procedures throughout the study. This procedure entails dividing the larger target population into their respective strata or cohorts. These sub-groups are then divided into half (50%) and further into quarter (25%) so as to come up with a smaller population that is a perfect representative of the target population. In cases where the target population is extremely large, the sub-division conducted further beyond 25% into 12.5%, 6.25%, and 3.125% respectively.
Stratified sampling procedures will be appropriate since the researcher will be at liberty to sub-divide the population of concern into sub-groups called strata for the purposes of convenience during the study. The essence of sampling is to reduce the bigger target population into smaller manageable sample that would give the accurate characteristic or representation of the whole population.
3.5 Data Collection
The researchers will gather all the relevant information they need for this particular research study. Data collection will be conducted in all key areas of concern through a number of tools and data collection techniques. Some of the methods and techniques that will be used during the data collection phase of this research study are discussed in sections 3.5.1 and 3.5.2 below.
3.5.1 Data Collection Method and Techniques
Data collection method will be mainly done through questionnaires. The researchers will prepare elaborate structured and unstructured questionnaires to solicit for all the required information from the respondents. In technical fields of the healthcare industry that are served by experts, open ended and closed ended questionnaires will be used to help collect sensitive data for the purposes of comprehensive information. Nevertheless, the structure and unstructured on one hand and open and closed ended questionnaires could also be used in combination depending on the level and qualifications of the respondent.
3.5.2 Data collection Procedures
This presents the actual data that will be obtained for the purpose of the research study. The primary data could be obtained directly from answered questionnaires, recorded interviews and direct observation of facts. Primary data will be collected and analyzed to help in answering of the research questions. The research will rely so much on the primary data as the main source of information. In fact, 75% of the information required by the research study will be obtained directly from the primary data (as given by respondents).
The collection of secondary data will be obtained through desk or library research. Relevant literature related to the research subject, either from internal or external sources, will be used to provide the information that cannot be provided by the primary data such historical aspect of the Health Information Technology. The sources of the secondary data include journals, publications, books, concept papers, reports and working papers. It is most notable that the secondary data has been extensively used in the literature review of this research study.
3.6 Data Analysis and Reporting
The data gathered during the data collection stage of this research will be evaluated, assessed and comparison made so as to select the most accurate and quality information from the feedback given by various respondents. The acquired data will be analyzed through the use of statistical software such as Statistical Packages for Social Sciences (SPSS), STRATA, and Microsoft Excel that will also be used to present data using charts.
After the data analysis, the research findings will be presented in graphs, pictures, charts, and captions. All these could then be presented in publications, healthcare journals, magazines, research magazines, government press printings, and active websites.
3.7 Limitation of the Study
Cases of uncooperative respondents are likely to be experienced and this may affect the much desired achievement of a high response rate. As a result of this non-responsiveness, the researchers and field workers are likely to gather inadequate data which might not portray the true characteristic of the research problem. The researchers will hence engage the respondents in a brief interview before issuing them with the questionnaires as a strategy to avoid lack of cooperation.
Confidentiality and sensitivity of the health related study might make most of the respondents refuse to give information about their actual feelings on the quality of healthcare services in their respective localities. Most of the respondents, especially the employees of the healthcare service providers, might not give accurate information in fear that the study will be used against their jobs in their respective workplaces.
Most of the healthcare institutions such as insurer, hospitals, government and international health agencies have prohibitive confidentiality policies that do not allow care giving and medical personnel to expose organization confidential matters and operational secrets. For this reason, the research study will most likely fail to acquire key information on the challenges or loopholes these healthcare institutions experience in regard to the management of their health information. Suffice it to say, most of the respondents will not reveal their shortfalls in the storage of their health records for an imminent fear of negative reputation.
3.8 Ethical issues
To ensure that all ethical issues are observed, permission to conduct the study will be sought from the public administrations and other institutional authorities. Full disclosure of the exact purpose(s) of the research study will be explained to the local, institutional, and metropolitan authorities and the study respondents. This authorization will give the researchers freedom to move from one place to another in search of study respondents. All the respondents will be further informed that the research findings will strictly be used for academic purposes but not any public administration or government agency.
Data privacy and confidentiality will be maintained throughout the study period. In this case, case the researcher will explain to all healthcare institutional authorities and the respondents that any information they give will be treated with a lot of confidentiality. To help reduce this anxiety, the respondents will never be asked to reveal their personal information but they will be assigned reference numbers upon which the volunteered information will be tagged. The guarantee respondents of their privacy, the research study will be conducted in private places and at the discretion of respondents.
An introduction letter will be acquired from the University detailing the purpose and intention of the study. This will help the respondent confirm that the research study is purely academic in nature. As such, their rate of response will be elevated above average.
3.9 Expected outcome
The study is expected to determine the benefits of the Health Information Technology in transforming the healthcare. The study respondents are expected to give much information on how the use of Health Information Technology (Electronic Health Record for this matter) is has transformed health care in terms of prevention of medical errors, reduction in the paper work, reduction in the general cost of healthcare, enhanced quality of health care, enhanced efficiencies, and expanded services to the provision of affordable health care.