A1. Advantages and Disadvantages of a System  

Health information systems (HIS) usability is the consistency and satisfaction that individual users attain when using a network to execute tasks in a particular environment (Khajouei, Zahiri Esfahani & Jahani, 2017). The main advantage is that the physician’s ease of documentation and understanding of technical components. Usability’s disadvantage is the subjectivity and reliance on the user’s expertise or experience.

Interoperability details two or more HIS’s ability to exchange information across organisational boundaries to advance individuals and communities’ health status and deliver care effectively (Bouamrane, Tao & Sarkar, 2015). Its advantage is transactional sharing that allows instructions and results to be shared through care environments. The disadvantage is that the amount of data available can be overwhelming, mainly if it is not portrayed in a readable and tangible format.

Compatibility is the software’s ability to operate on or with other devices, such as different software versions that work with a particular computer (Kahouei, Zadeh & Roghani, 2015). Compatibility’s advantage is reducing the risk of error in data entry as users can minimise data entries. A disadvantage of compatibility requires regular updating of the same software, which can be costly and could result in performance issues if different versions are running concurrently.

Scalability measures the system’s ability to upsurge or reduce output and cost in response to application and system processing demands changes (Yang, Troup & Ho, 2017).  An illustration would be how HIS system executes tasks when the number of users is amplified, increased number of queries or how the software operates on different hardware. Scalability’s advantage is reducing task repetition among healthcare professionals, improving communication between teams, and physicians get real-time access to patient information; there is better regulatory compliance (Yang, Troup & Ho, 2017). The disadvantage of scalability is the cost of integration. Integrating numerous systems across regions causes a lot of duplicative effort, culminating in cost increase, thereby delaying interoperability benefits.

A2. Patient Care and Documentation

An integrated health information system is integral in patient care and documentation as it reduces errors in documentation due to minimised data entries (Institute of Medicine, 2004). For instance, when a patient goes for a lab test, the results are documented in the lab system and shared with the HIS and stored in one location. The information remains accessible to all authorised users. It is protected from distortion compared to situations where the nurse has to enter the report into the system after receiving it. The second scenario is for a hypertension patient that has regular clinic visits either virtually or physically. Absence of HIS forces the nurses to gather and document patient information on every visit, increasing inaccuracy risks due to perhaps change of attending nurses. However, after HIS implementation, the nurse will only update patient information in the system, thereby making documentation easy and accurate, eliminating possible mishaps (Rupp, 2014).

Enhancing patient safety demands more than event analysing and reporting systems; errors must be prevented from occurring. HIS will provide tools that can assist eliminate or avert adverse events attributable to poor documentation (Institute of Medicine, 2004). For instance, the clinical decision support system for medication order entry helps in preventing documentation errors. The alert system makes it easier to adhere to medical protocols and provide prompt access to clinical data such as laboratory and radiology samples, reducing duplication and better reporting. HIS also has data collection capabilities and user interfaces that meet health data standards, data storage and clinical case shows. Excellent user interface features contribute to gathering accurate patient information, thereby ensuring precise documentation (Rupp, 2014). Well documented data is stored on data repositories will enable ease of access if the healthcare provider needs the information for use or update. In this regard, the health information system will ensure comprehensive and standards-based access to clinical data and documentation to avert errors.

A3. Quality and Delivery of Nursing Care and Patient Outcomes 

HIS improves patient care quality through improved documentation, reduced medical errors, and improved coordination of care. Contemporary nursing is propelled by personalised care and data collected, organised and stored in electronic patient records. Physicians can coordinate treatment more effectively and, as a result, improve the quality of care by recording the condition of the patient and sharing information electronically (Rupp, 2014). The primary concern of any health care provider is patient safety; the system can help keep patients healthy by avoiding misdiagnosis, drug errors, and other issues.

HIS enhances the delivery of care, especially in coordinated settings. Nurses in most healthcare facilities also monitor their patients’ care by providing input from physicians, nurses, pharmacies, billing offices and other sources, both before and after treatment (Rupp, 2014). The lack of accurate and valid data could jeopardise patient care. HIS enhances this information’s coordination and allows caregivers to furnish their patients with all information relevant to improving outcomes and satisfaction with care.

B1. Ways QI Data Can Lead to Measurable Improvement  

HIS has improved healthcare services in general. It has the power to deliver the right information to the right partners at the right time, to provide patient services and to promote robust safety management systems in the case of near misses or adverse outcomes (Institute of Medicine, 2004). Nurses who have access to electronic health records claim less challenge in getting patients ready for discharge, causing fewer prescription errors, and providing better care. Also, a decline in preventable medical errors culminates in reduced healthcare costs and enhances nurse productivity.

The system will be tuned to standardise care, improve communication, and promote opportune access to information at the point of care to tackle hospital-acquired infections (Pageler et al., 2014). HIS can facilitate compliance through a worksheet enhanced by electronic medical records and a unit-wide console with an evidence-based, paediatric-specific catheter care package and decrease central line-associated bloodstream infections (CLABSI).

B2. HITECH and HIPAA Security Standards and Regulations

HIPAA aims to safeguard the patient’s privacy and their security of patient health information. The facility will comply with HIPAA requirements by preserving the veracity, discretion, and accessibility of health data in its systems (Office for Civil Rights, 2013). HITECH dictates how HIS must have safeguards to keep patient data safe from misappropriation through proper storage, backup, and recovery of data from systems.

The health facility will comply with HITECH and HIPAA’s requirements by ensuring the data stored is backed up regularly, encrypted, stored off-site and recoverable (Chen & Benusa, 2017). Enforcement will be done by introducing a data backup policy, a disaster management plan, an emergency working plan, reporting and revision procedures, and a critical analysis of software and data.

B3. Protection of Patient Privacy

Besides improving care delivery, health information systems are designed to enhance patient privacy by averting data breaches intrinsically. Standard features include the ONC-ATCB Certification, Audit trails, password protection and data encryption.

B4. Organisational Efficiency and Productivity  

HIS assist in the standardisation of clinical document design, mark-up language, and comprehensive clinical terminology. Standardisation of all clinical document architecture helps homogenise clinical reports and enable sharing of information across different systems (Institute of Medicine, 2004). For instance, if discharge summaries have a standardised design, these reports’ preparation becomes effortless and errors reduced, thereby increasing system efficiency and functionality.

Preventable medical errors are among the leading contributors to the wastage of healthcare resources. However, HIS’s adoption provides nurses with alerts to avoid mistakes and assist in the automation of specific tasks, such as creating doctor note templates, thereby refining nurse productivity, reducing resource wastage, and precluding healthcare costs.

Finally, HIS’s adoption will impact the healthcare team’s composition as some positions will be removed, and others created. Non-physicist care professionals that can use skilled decision-making techniques to handle basic diagnostics and treatments can play a more significant role. They will now play different positions in the realms of public health, medical safety and patient care. New personnel will receive training.

1. Interdisciplinary Team Identification  

1. Plan for Evaluating Success of Implementing a System 

The evaluation of HIS implementation will be based on HIPAA and AHIMA’s security rule standard. The HIPAA security rule requires fitting organisational technical and physical defences to protect protected health information confidentiality (Miaoulis, 2018). Similarly, the AHIMA security standard rule mandates all organisations to safeguard the confidentiality of personally identifiable information by ensuring the creation, receiving, storage and transmission of electronic information is secure.

The implementation of HIS will be a success when minimum acceptable standards are established. Compliance involves assigning security responsibilities, ensuring personnel access information appropriate for their jobs, and implementing procedures authorising access to ePHI (Miaoulis, 2021).

References

Bouamrane, M. M., Tao, C., & Sarkar, I. N. (2015). Managing interoperability and complexity in health systems. Methods of information in medicine, 54(1), 1-4.

Chen, J., & Benusa, A. (2017). HIPAA security compliance challenges: The case for small healthcare providers. International Journal Of Healthcare Management, 10(2), 135-146. https://doi.org/10.1080/20479700.2016.1270875

Institute of Medicine. (2004). Patient Safety. Patient Safety: Achieving A New Standard For Care.. https://doi.org/10.17226/10863

Khajouei, R., Zahiri Esfahani, M., & Jahani, Y. (2017). Comparison of heuristic and cognitive walkthrough usability evaluation methods for evaluating health information systems. Journal of the American Medical Informatics Association, 24(e1), e55-e60.

Kahouei, M., Zadeh, J. M., & Roghani, P. S. (2015). The evaluation of the compatibility of electronic patient record (EPR) system with nurses’ management needs in a developing country. International journal of medical informatics, 84(4), 263-270.

Miaoulis, W. (2021). HIPAA Security Overview – Retired. Library.ahima.org. Retrieved 28 February 2021, from https://library.ahima.org/PB/HIPAASecurityRule#.YDuiqFUzaM8.

Miaoulis, W. (2018). Information Security—An Overview (2014 update). Bok.ahima.org. Retrieved 28 February 2021, from https://bok.ahima.org/PB/InformationSecurity#.YDuhe1UzaM8.

Office for Civil Rights. (2013). Summary of the HIPAA Security Rule. HHS.gov. Retrieved 28 February 2021, from https://www.hhs.gov/hipaa/for-professionals/security/laws-regulations/index.html.

RUPP, S. (2014). How Nurses Are Using Health Informatics to Improve Patient Care – Electronic Health Reporter. Electronichealthreporter.com. Retrieved 28 February 2021, from https://electronichealthreporter.com/nurses-using-health-informatics-improve-patient-care/.

Yang, A., Troup, M., & Ho, J. W. (2017). Scalability and validation of big data bioinformatics software. Computational and structural biotechnology journal, 15, 379-386.