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Assignment is all about implementation of I.T in healthcare , specially on Nursing Practices.

Home, - Importance of healthcare information technology and its impact on nursing.

Introduction

The field of healthcare has improved considerably on the incorporation of information technology (IT). IT ensures the delivery of high quality and safe healthcare services while promising enhanced profit margins for the organization. However, there exist several barriers in the process of incorporation of IT within the healthcare sector; namely high cost of information systems, complexity in the functioning of the same and a significant change in the organizational value and culture. In order to address these issues associated with IT, the need for health information technologists in constantly on the rise. This implies a high job security of individuals with this profession.

The person, LN, interviewed was working as a radiology technician.During that time, the field of healthcare technology is undergoing rapid changes. LN felt that there was a strong job security in Information Technology combined with high demand while working in healthcare setting, LN decide decided to pursue his career choice in Bachelors in Information Technology (IT). He needed a clear specialized understandingof the working of healthcare organizations along with the functioning of Electronic health records within these organizations.

Major duties and responsibilities of Healthcare Technologist

The healthcare industry deals with the sensitive and critical data elated to the medical records of the patients. The vital role of the healthcare information technologist is to manage the information system and technological aspect of medical information. Healthcare information technologistroles include implementing and building information system while managing the availability, integrity and security of the medical records stored in the database and implementing the information system functionality. The information system contains highly sensitive and critical data therefore it is crucial for maintaining privacy and security of computer vulnerabilities. Their responsibility also includes compliance with the private, federal and state laws and insurance guidelines.

LN also train physicians, nurses, case managers, chief financial officers, and others how to use EHR software. He also responsible fro maintaining and updating softwares.

Education and Training

For the “healthcare information technologist” the education often requires bachelor’s degree, postgraduate degree or associates degree in the field of “health information technology”.

The organization and its culture (pls paraphrase)

A moral environment in healthcare is a result of the hard work of all the Hospitals staff. bedside care nurses must abide by certain ethics associated with EHRs. The ANA Scope and Standards of Practice for Nursing Administration (2009) emphasizes that nursing practices must be in accordance to the Code of Ethics (ANA, 2015). The ANA Scope and Standards of Practice for Nursing Administration (2009) illustrates the various duties and responsibilities of nurses who are in involved in leadership and managerial roles. The nurses have to put forward their practices  as per the  servant leadership frameworks in order to achieve effective communication (ANA, 2009, p. 8) effective communication in turn helps in identification of the various problems in healthcare and incorporate several ethical provisions to address these issues. The prime responsibility of nurses in administrative roles is to promote, a organizational culture based on  safety within the settings including the reduction in the complications arising from not paying adequate attention to the EHR design (ANA, 2009).

Challenges

Two major challenges for incorporation of information technology in order to deliver quality patient care is that the healthcare organizations might not be able to apply information technology in a way that would improve the quality of care and for nurses to  provide quality patient care in accordance to the policies of the healthcare organization standards of care. Constant monitoring, training is critical.  Nurses make use of information technology in order to prevent errors in medication, delay in treatment procedures, etc. Green found the adverse unintended consequences of technologycannot be predicted beforehand.

Ethical dilemma  encountered working in this role (Pls paraphrase)

Most of the healthcare professionals are well aware of the Code of ethics and obligations associated with their role as a nurse. However, personal or emotional barriers may interfere with their motivation to act accordinly.  In other words institutional barriers hampers an individuals motivation or perseverance to do the right thing.  (Grace, Robinson, Jurchak, Zollfrank, & Lee, 2014, p. 14). As opined by Wolf et al. (2016) nurses face significant moral distress whenever they are not capable of  meeting their role obligations and provide safe and provide safe and high quality patient care within the hospital environments. Sometimes the nurses experience considerable moral dilemma, as they are not capable of abiding by the code of ethics. The hospital authorities have a huge role to pay in this. Most hospital authorities emphasize on maintaining proper medical records rather than providing proper patient care.

 According to The Code of Ethics the Patients’ rights are of prime importance in any  decision-making process of the healthcare organizations. The confidentiality of the personal information of both the patient and the organization must be maintained. These legislation concerning  privacy and confidentiality of is applicable to any  information  that is being transmitted or communicated (ANA, 2015, p. 10). A typical ethical issue is that institutional priorities are often given more importance over patient-centric nursing care practice.  The nursing care practices are based on  decision-support, templates, and are in accordance to the clinical practice guidelines that have been provided (Lown& Rodriguez, 2012; McBride, Tietze, Hanley, & Thomas, 2015; Sulmasy, López, &Horwitch, 2017). However the most critical nursing ethical issue is the deteriortaion of the patient’s relationship with the nurse(de Ruiter, Liaschenko, & Angus, 2016; Rathert, Mittler, Banerjee, & McDaniel, 2016).

Apart from stem cells, transplants, and nanomedicine, the use of computers and communication technologies will affect the general lifestyle of the people in 21st significantly(Goodman, 2015). Although there are a variety of  healthcare professionals who are responsible for documentation of medical information, (O'Brien, Weaver, Settergren, Hook, & Ivory, 2015) nurses are ones who are responsible for delivering safe and high quality patient centric care along with maintaining electronic records of the medical information.

Proper use of the EHR involves a significant number of ethical and legal challenges. A Nurse must be able to face these challenges, understand the code of ethics and thereby counteract the challenges by developing appropriate solutions that abide by the code o ethics. The nurses must also abide by the workplace policies, obligations of the profession and state and federal law. Researchers have  revealed that nurses spend much more time  documenting medical information in the EHR, than providing high quality patient care (Kim, 2006).  The standards of practice for registered nurses in the United Nations have been established by The Scope and Standards of Nursing Practice (ANA, 2015).

Documentation do not abide by the code of ethics interfere with the quality of care provided to the patients and the success of the healthcare organization (ANA, 2015). Medical information documented by the nurses can be some used in legal proceedings id needed under certain circumstances. Registered Nurses must be competent in maintaining the code of ethics while documenting medical information so that these information could later be used in other purposes (Larsen, 2012). Auto-population of lab results or other critical information is done by EHR systems that are designed as templates or ‘fill-in’ instruments (Sittig& Singh, 2011). At times, the nurse might not have an idea of the unintentional documentation that results from auto-fill function. (Sittig& Singh, 2011). Once a medical record has been made an recorded, the nurse is held accountable for the information these records provide.

The ‘copy and paste’ policies for documenting in the EHR have been implemented by a vast a majority of healthcare organizations. This feature allows data to be the copied, pasted, cloned, auto-filled, carrying forwarded, replicated and reused rom one section to another within a single EHR (Scruth, 2014). However this feature has caused significant. While some argue that this feature enhances the efficiency of EHR, others say that it hampers the security and reliability of data (Harrington, 2017). This feature might result in reliance of the healthcare organization  on outdated or inaccurate information that aren’t relevant clinically. Such unintentional reliance might lead to disruption in the as treatment plan such as diagnostic biases; incorrect information and distracted notes; pertaining to a particular patient visit; and symptoms and assessments of expired patient (Scruth, 2014; Weis & Levy, 2014).  Further such malpractices might lead to  timeliness issues in the maintenance of medical records.

It has been seen that EHRs simplify  order entry and reduce errors in prescription (Scruth, 2014). These systems have significant role in improving the delivery of healthcare services provided to the patient. However, a major challenge in this context is to balance the time for patient care with documentation of medical information (McBride et al., 2017; Wolf et al., 2016). Previously charting in nursing would be decreased by charting by exception (de Ruiter et al., 2016). Moreover, it was believed that the nursing standards of care were met unless documented otherwise. The introduction of the EHR, in recent times imply that complete documentation of medical information is much more time consuming and elaborate(de Ruiter et al., 2016).

In recent times nurses have reportedly been intentionally entering false information to reduce the workload concerning  EHR systems as a result of time constraints and usability issues (McBride &Tietze, 2017). The three major challenges of EHR include privacy, security, and the issue of  false entries, work-arounds, or system bypasses also needs considerable attention (Ayatollahi, Mirani, &Haghani, 2014; CMPA, 2015).

A false entry into an EHR might have significant negative consequences. Although, the patient is unaware of the false entries, it would be difficult for the hospital authorities to avail health or life insurance coverage for the patient. This is because the patient might be denied insurance coverage if they become aware of the false entries.

Role of information systems.

Following the incorporation of information systems within the healthcare system, Masters prepared nurses have to identify the factors that affects the quality of patient care and the delivery of services. According to many, the incorporation of information technology enhances the quality of care by simplifying the collection of information, which can then be accessed using the health information systems (HIS) (Laudon&Laudon, 2016). The several characteristics of health care industries include payment systems and fragmented delivery of care act as barriers to the successful utilization of information systems within the healthcare industries. It has been seen that the ease of gathering information and the class of HIS used is closely associated with the timely delivery of appropriate services, reduction of the risks of nosocomial infections and significant simplification of the administrative operations(Stair & Reynolds, 2013). However, merely gathering information making use of information systems does not serve any purpose. Adding value to information converts it into useful data that can be use in the decision-making and problem solving procedures. Since the functioning of the healthcare industry is slowly becoming dependent on the amount of data collected and stored, the importance of securing such large volumes of information has also risen. The exponential increase in the amount of data in healthcare industries implies a significant dependence of this industry on the use of computer applications (Patil&Seshadri,  2014, June).

The information gathered making use of information systems is highly functional in addition to being presented in a sophisticated manner. However, a large volume of data does not always ensure a high quality of the same. This in turn indicates that a high quality of data is important in order to deliver services of high quality. According to several research works the quality of information is judged based on a variety of parameters; namely it completeness, validity, accuracy, reliability and relevance. Information systems used in healthcare primarily emphasize on the validity, reliability and timelines of data. The healthcare industry is based on the promptness of treatment procedure and hence the shorter the timelines, the better is the information system for the healthcare industry. The information, which have greater sensitivity, require longer timeliness as compared to general information whose sensitivity is less.

how healthcare technology impact professional nursing practice

Privacy of information is one of the most important issues associated with the healthcare industry. Using information systems that comply with the Health Insurance Portability and Accountability Act (HIPAA) must be used by the healthcare organizations. HIPAA has provided several guidelines in order to protect data that concerns the personal details of the patient, their medical history, current health conditions and the confidential information of the healthcare organizations (Hsu, Lee & Su, 2013). HIPAA violations can result to legal and financial liabilities for hospitals and employees. Electronic health records that contain information regarding the personal details of patient are highly confidential documents and thus referred to as Protected Health Information (PHI). However, complete confidentiality of this information is difficult to maintain, as some employees of the healthcare organization has to gain access to this information, in order to ensure delivery of high quality patient care. Such access to

The standards to follow when the nurses care for patients may be based on written procedures protocols, hospital or employer policies (Raposo, 2015). Masters prepared nurses have a role in developing strategies to reduce legal risk and liability (Taft &Nanna, 2008) which may include about healthcare informatics and technology. This includes implementing various management policies and procedures (for example, those related to data management, personnel management, and clinical documentation improvement). The healthcare industry takes very seriously the need to enhance the ability of EHRs to increase patient safety. MSNs are expected to recognize the importance of looking for opportunities to identify and reduce any potential risks associated with the application of EHRs (Taft &Nanna, 2008). MSNs have opportunities to better design and improve performance of employess, better training for the EHR users and to define protocols and guidelines  for delivery of EHR (Staff Development Weekly, 2005).

Organization policies to insure compliance safeguarding personal health information with HIPPA standards or requirements?  How does this influence your work?

Privacy of information in healthcare organizations is usually maintained by following the set of strict guidelines provided by the HIPAA. As per these guidelines, the employees performing administrative tasks in the healthcare organization are trained to handle PHI carefully and maintain the confidentiality of the same. The hospital authorities never share confidential information of the patient, without their authorization or permission from their family members (Weaver et al., 2016). Moreover, PHI is protected in a manner that it prevents unwanted access of the same. Even the hospital authorities avoid accessing the PHI, unless it is a necessity. The hospital authorities must be careful to close all the computer programs that contain patient information, when they are not in use. In this regard, the hospital authorities might consider incorporating use of computer applications that have provisions for automatic timeout. Following the guidelines provided by the HIPAA, emphasis must be laid on role-based security. The employees of the organization must be trained in accordance to the HIPAA guidelines periodically.

Discuss the most important element of healthcare technology learned during this interview

This assignment emphasized on the importance of privacy in the context of healthcare technology. Maintaining privacy of patient’s information ensures a healthy relationship between the patient and the physician and the other healthcare professionals. Although patients are required to share personal details and their medical history with their physician in order to ensure proper diagnosis and appropriate treatment method, it is the responsibility of the hospital authorities to maintain confidentiality of the same. This is particularly important because there exists social stigmas concerning mental health issues and sexual health issue, which makes the patient uncomfortable in sharing such information. The patient’s identity must also be kept confidential. Although the personal details of the patient might have to be shared with the physicians, doctors and sometimes with insurance companies, it is regarded as the protected health information.

PHI needs to be secured well by the healthcare organizations by making use of secure information systems that would be locked by passwords.   The hospitals use a patient ID to address them instead of addressing them with their names in order to maintain confidentiality of their identity (Caine &Hanania, 2012).  The physicians discuss the medical information concerning the patient in private settings to ensure that unwanted parties do not get any access to the same. PHIs are never shared with any third parties not even with the insurance companies without the permission of the patient or their family members.   The information systems used to store the patients information must be free from the risk of data loss and security breaches. The high confidentiality of the patient’s information is important as it protects the patient from unwanted attention and interest of third parties. Finally, they are able to establish a healthy connection with the healthcare organization as it feels that their privacy is being respected and valued.


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