Research Paper on Health Information Systems: Enhancing Quality & Efficiency in Healthcare

Introduction

Emerging technologies in healthcare aid nurses in realizing patient outcomes primarily through the ease of access to information and evidence. Health information systems (HIS) support decision making processes from the point of care to the organizational level. HIS affects clinical, financial, and administration outcomes targeted at improving high quality and efficient care. Some of the trends shaping the adoption of HIS include the accelerated motivation for healthcare provider communication and focus on treating chronic illnesses, the increased patient expectation of involvement in their care, market pressures for improved hospital and physician alignment, and advancements in technology easing system interoperability.

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Advantages and Disadvantages of a Health Information System

Usability is the extent to which a system can be used or is applicable. An example of an advantage of the usability of HIS is linked to their "simplicity in user experience, identifying problems in minimizing cognitive load, and unbiased information presentation" (Alshamari, 2016). According to Alshamari (2016), a disadvantage of usability is unavailability, and slow response time of HIS provides challenges for medical practitioners in providing patient care.

Interoperability involves the ability of a system to exchange and make use of information. The advantage of interoperable HIS is the reduction of errors through accurate reporting of data and trends. An example of a disadvantage of interoperability in HIS is vulnerability to cyberattacks due to universal connectivity of the system.

Scalability is the capacity of a system to be used or produce a range of capabilities. An advantage of the scalability of HIS is the integration of web-based or cloud-based applications built for scale and using massively-scaled networks in place. The disadvantage of scalability in HIS is that adding hardware resources diminishes returns and can also be costly for a large-scale organization.

Compatibility involves the capability of a system to work with another without a problem. The advantage of compatibility of HIS is the integration of computer and monitoring systems to reduce medical errors in patient assessment. The disadvantage of a system not being compatible includes privacy and security concerns where patient information can be leaked.

Patient Care and Documentation

A healthcare information system is designed to increase patient welfare. EMR, as an example of the HIS, improves the ability to diagnose diseases, and prevent medical errors. Another example of how the HIS affects patient care is the use of logs to monitor access to patient's information, thereby preserving the integrity of data, privacy, and security. Patients may not disclose their health records when they feel a system is not private and secure. To ensure patients put their trust in the HIS, the system will maintain accurate information of patients, make sure patients have a way to access their medical records with ease, ensure patient information is carefully handled and only visible to select parties to protect patient's privacy, and also make sure health documentation is accessible to authorized personnel when needed (ONCHIT, 2015). Some of the features that make patient care better include decision-making tools such as EMR that prevent adverse effects such as drug allergies. Imaging tools can be used to make early diagnoses and manage treatable conditions. Planning tools such as the CPOE helps in medicine administration facilitating efficient patient-centered care. Evaluation features can help nurses in conducting screenings and managing at-risk patients.

Health Insurance Portability and Accountability Act (HIPAA) lists federal guidelines for a patient's health information required of healthcare organizations. Some of the regulations include privacy rule that encompasses privacy of health information, security rule that documents standards for the protection of patient documentation, and breach notification rule, which mandate that health systems provide notification for breach of unsecured protected health data (ONCHIT, 2015). The HIPAA requires him to comply with its standards in conducting administrative and financial transactions for all healthcare providers that bill electronically. HIPAA privacy rule limits disclosure of patients' information. However, healthcare systems provide notice of privacy practices (NPP) and take note of individual rights and how patients can exercise these rights (ONCHIT, 2015). They also take note of their legal duties with regards to that information, and they include in patient's documentation whom the patients can contact for further information about the systems' privacy policy.

The system influences patient care and documentation by providing guidelines for patients' access to information. Patients will have the right to check and request copies of their health records. Patients also have a right to amend their data. The system will include an accounting of disclosures that detail names of entities that have patients' information such as insurance companies (ONCHIT, 2015). The system will be customized to restrict information. Individuals may wish for the health organization not to disclose their health plans to family or payment entities.

Quality and Delivery of Nursing Care and Patients Outcomes

HIS helps in the quality of nursing care by assisting nurses in obtaining crucial information from patients. For example, EMR is used by nurses to obtain patient history, thereby enabling better-coordinated patient care. The delivery of nursing care is made more effective through the integration of the Computerized Physician Order Entry (CPOE). The CPOE aids nurses in providing delivering the right medical care. Electronic Health Records (EHR) are developed from using HIS. "EHR is documentation that computes data useful in upholding patient safety, maximizing efficiency, assessing the quality of care, and analyzing staffing needs" (Lavin, Harper, & Barr, 2015). According to the American Health Information Association, EHR helps in the delivery of nursing care through prioritization of diagnoses and makes the nursing process more transparent (Lavin, Harper, & Barr, 2015). Access to health information in nursing is possible through nursing informatics. Nursing informatics involves the management of health information.

Patient outcomes are met through the application of clinical decision support systems. EMR provides biomedical and patient-specific information which are used in prioritization of diagnoses and making the nursing process transparent. Nursing informatics allows nurses to relay information to physicians, therapists, pharmacists, and other healthcare professionals, improving satisfaction for both nurses and patients. Access to information from the system improves patient care as they can access information that is useful and important to them when they need it.

HIS improves patient needs through the collection of patient history that is stored in electronic records. Modern nurses can access this information from the system and can effectively manage patients improving the quality of care. Systems document patient information automatically. Nurses can access patient records over time, which enables them to make better decisions about providing care. When nurses deliver seamless care, patient outcomes are achieved. The use of a system such as computerized physician order entry helps reduce medical errors. Patient safety is a paramount outcome for both nurses and patients. Using a system reduces errors. HIS provides information about possible dangers such as allergic reactions to certain medications. The majority of nurses agree that information is more likely to be shared when electronic systems are used. Fewer problems are experienced when discharging patients, fewer medical errors are experienced, and better-quality care is provided.

Ways QI Data Can Lead to Measurable Improvement

Information from HIS is aimed at facilitating quality improvement. One of the ways QI data can help in making improvements and the health status of target groups is through charting the insertion technique and removal of catheters in patients. Catheter-related infections (CAUTI) are the leading healthcare-associated infection globally (Mavin & Mills, 2015). Information on such infection is collected using EMR to assess the rate of infection and devise methods for quality improvement. Given the use of catheters often causes higher instances of urinary tract infections, nurses are required to follow the sterile techniques of inserting and removing catheters. This information is shared through the HIS systems. Nurses can also make assessments of whether a catheter should remain in place during their shifts to ensure patients do not get infections. Diagnosis of CAUTI is still a considerable challenge for medical staff as it is not evidence-based (Mavin & Mills, 2015). Quality improvement guidelines are developed among nations to help nurses assess patients to diagnose and prevent CAUTI in clinical practice. To measure quality improvement, the nurses will assess the catheter-related urinary tract infections identified in each targeted unit.

Another way quality improvement aids in making changes in healthcare and for target groups is the use of activity-based costing to inform decisions. Healthcare leaders recognize that the common way to address the threat to sustainability is through fully understanding and managing costs. Activity-based costing is a quality improvement measure used to deliver informed and usable data in the analytics environment. It supports service-line reporting, contract modeling, and clinical process improvement. Using this model aids in reducing costs and improving clinical outcomes in target departments such as surgical services, orthopedics, women's health, and cardiovascular. The improvement of costs also helps in making informed decisions that affect patient quality care and safety.

HITECH and HIPAA Security Standards and Regulations

For a HIS to meet HITECH and HIPAA standards of security, the system should put in place measures to safeguard information. Information security is achieved in two main ways; integrity of data storage and backing up data and recovery. The HIPAA security rule compliments privacy and requires organizations to protect a patient's private medical data (Moore & Frye, 2019). For the protection of data storage integrity, the system can have automatic safeguards such as logging out when there has been no activity on the system for a specified time limit. The system can also have a rule of setting complex passwords, which will be changed after several days. In preventing intrusions into the data storage, the system can lock out a user who tries logging in with too many failed attempts. HIPAA and HITECH policies also require healthcare organizations to limit access to information of patients for the people that do not need it, such as payment information. Other data storage information policies as mandated by HITECH/HIPAA include notification to patients about breach and release of their information, regular training, and educating the staff who access electronic records to internalize the updates and safeguarding information security (Moore & Frye, 2019). The entities also regulate policies regarding the handling of personal devices that contain personal healthcare information.

The HIPAA security rule and the HITECH act mandate that all medical practices, covered entities, and business associations related to healthcare should securely back up retrievable and similar copies of EHR. The system should restore data that may be lost. The system should have a...