Health Information Technology and Change

Health Information Technology and Change

T. Ray Ruffin (University of Phoenix, School of Advanced Studies (SAS), USA & Colorado Technical University, USA & University of Mount Olive, USA & Wake Technical Community College, USA)
DOI: 10.4018/978-1-4666-9494-1.ch012


Even in in health healthcare and health information technology change will not vanish or disperse. Technology, civilization, and creative thought will drive this force increasingly forward. Health care managers will continue being judged on their ability to efficiently and effectively manage (Patton & James, 2000). The pace of change has significantly increased since the days of the cave dweller who walked the earth until the “technology convergence” of using the ox and horse as tools. This article is to investigate the background, controversies, and problems surrounding Health Information Technology and change, and will include an overview of current changes. This will be coupled with solutions and recommendations, further research, and conclusion.
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One of the most widely discussed areas in the health care field is improving the quality of patient-centered care within Health Information Technology (HIT). HIT allows for the all-inclusive management of medical information and the protected exchange between health care consumers and providers (U.S. Department of Health & Human Services, 2008). Health care comprises of the use and management of a profusion of information that must be collected, managed, reviewed, processed, and mined (McHaney, n.d.). With this in mind, HIT is proclaimed to be the solution to improve patient-centered health care and quality, while reducing cost within the medical industry (Hersh & Wright, 2008). It was not until 1994; the United States healthcare industry established information systems capable of handling a universal delivery system (Accenture, 2001). These Information Technology Systems (ITS) operated along enterprise and system boundaries in the Health care Delivery System (HDS). However, they fragmented by the proprietary business benefits of large vendors that wanted to control patient information (Accenture, 2001). Practical tools, especially computers, continue to be created and rapidly placed in industry, the ability of organizations to accept, accommodate, and even embrace technology is moving at a varied pace (McHaney, n.d.). The health care industry has been one of the unhurried organizations to embrace the computer revolution in regards to patient care. However, health organizations have been using computers for years in business departments. Research has indicated that HITs represent tools or functions that help patients maintain their health through management of health information (Hudak & Sharkley, 2007). Even though HIT has the potential to transform the delivery of health care effectively and efficiently, health organizations continue to lack in this area.

A health organization has often been treated like a manufacturer who is advised that using cheaper materials can reduce manufacturing costs. The end result is that the manufacturer saves money on manufacturing costs but at the same time defects are accumulating and the results are subpar products. As we relate this to health organizations the ill effects of these short cuts are not externally evident, the health organization gives poor service or makes errors. Ultimately, health organizations fail in any of the countless ways in which organizations fail when they are poorly sustained (English, 1994). When health organizations operate inefficiently without proper funding, the odds become stacked against them.

Several other studies suggest that the adoption of HIT remains limited in certain functions (Poon et al., 2006). There have been limited studies conducted to determine which functionalities of HITs need implementation. Most studies concentrated on certain functionalities such as Computer Provider Order Entry (CPOE) or Electronic Health Record (EHR). CPOE is a set of clinical processes that incorporate technology to optimize physician ordering of medication and other required laboratory testing (Ormond, 2005). During a study by Minnesota Orthopedics Specialist, it was realized that vendor and local support during implementation was critical for success (O’Neill, 2007).

EHR is “related information on an individual that conforms to nationally recognized interoperability standards and that can be created, managed, and consulted by authorized clinicians and staff across more than one health care organization” (U.S. Department of Health and Human Services, 2008, p. 17). This definition has been updated to include a digital collection of patient health information compiled at one or more meetings in any care delivery setting and is often used to refer to the software platform that manages patient records maintained by a hospital or medical practice (Health IT News 2013).

Key Terms in this Chapter

Health Information Technology (HIT): The all-inclusive management of medical information and the protected exchange between health care consumers and providers.

Change Management: A multidisciplinary group activity to provide optimum solutions to change the process of how an organization does business to transform efficiently with organizational change ( Patton & James, 2000 ).

Informatics: “Studies the representation, processing, and communication of information in natural and engineered systems. It has computational, cognitive and social aspects. The central notion is the transformation of information whether by computation or communication, whether by organisms or artifacts” (University of Edinburgh Informatics, n.d. p. 1).

Health in All Policies: A policy or reform designed to secure healthier communities, by integrating public health actions with primary care and by pursuing healthy public policies across sectors (The World Health Report, 2008 AU119: The in-text citation "The World Health Report, 2008" is not in the reference list. Please correct the citation, add the reference to the list, or delete the citation. ).

Business Process Reengineering (BPR): Originated in the 1950s as large firms began to explore the potential impact of computers on the efficiency and effectiveness of their business processes. Different approaches, methods, and techniques have since appeared and constitute the foundations of BPR as it is presently known.

Electronic Health Record (EHR): Also known as Electronic Medical Records (EMR). Certification Commission for Healthcare Information Technology Commissioner meeting minutes of April 15, 2008 related that the work group addressing the terms EMR, EHR, and PHR would like to retire the term EMR and take the definition of EHR to present future vision (Certification Commission for Healthcare Information Technology, 2008 AU118: The in-text citation "Certification Commission for Healthcare Information Technology, 2008" is not in the reference list. Please correct the citation, add the reference to the list, or delete the citation. ).

Accountable Care Organizations (ACO): Groups of doctors, hospitals, and other health care providers, who come together voluntarily to give coordinated high quality care to their Medicare patients (Center for Medicine & Medicaid, n.d. para. 1).

Health Information Technology Interoperability: Defined as the “principal difference between an EHR, which can exchange information interoperably, and an EMR, which cannot” (U.S. Department of Health & Human Services, 2008, p. 14).

Health Service: Any service (i.e. not limited to medical or clinical services) intended to contribute to enhancement of health or to the diagnosis, treatment and rehabilitation of sick people ( World Health Organization, 1998 ).

Health Informatics: As defined by the U.S. National Library of Medicine, health informatics “is the interdisciplinary study of the design, development, adoption, and application of IT-based innovations in healthcare services delivery, management, and planning” ( Ong, 2014 para 1).

Health Sector Reform: An effort aimed at reconfiguring health services, dominant in the 90s in the framework of the New Public Management, typically including the following components: separating the roles of financing and provision and the possible introduction of a managed market; developing alternative financing mechanisms, particularly user charges and health insurance; decentralization; limiting the public sector and encouraging a greater role for the private sector; prioritizing the use of cost-effectiveness techniques ( Collins, Green, & Newell, 2002 ).

Health System Strengthening (HSS): Any range of initiatives and strategies that improves one or more of the functions of the health system and that leads to improved health through improvements in access, coverage, quality, or efficiency ( Islam, 2007 ).

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