Issues which Limit Informaticians
What problems or issues limit
health informaticians' abilities to evaluate health information
infrastructures; why?
An
information infrastructure is defined as a combination of communication
networks, databases, and procedures etc. that are combined to meet the
initiatives of the organization (Zwass, 2017). For healthcare this is a complex
network of disparate systems, policies, and procedures put in place to
accomplish a common goal to improve quality of care. The disparity in
technology being used in healthcare is what I perceive as one of the major
challenges faced in healthcare today by informaticians. The goal is to
eventually achieve interoperability. Other common issues seem to be the impact
technology has on workflow, and our lack of understanding the correlation
between technology and the patient’s ability to use the technology (Jackson et
al., 2011).
Interoperability
Technology
in healthcare today has emerged as a plethora of heterogenous information
systems that lack interconnectivity. Iroju et al. (2013) identified the
complexity of healthcare domains, misinterpretation of standardization
requirements, and the use of legacy systems to be some of the key challenges in
becoming fully interoperable. These key challenges have an upstream effect on
continuum of care, implementation, and the overall bottom line. With regards to
implementation the challenge would be in vendor selection and the philosophy of
a best of bread model or single-source. Although, both models may work well in
certain circumstances. When trying to leverage legacy software to avoid
additional costs. The challenge you will be faced with is integration not only
within the four walls but external as well (Cambridge Healthtech Institute,
2013). Moreover, this disconnect can lead to negative effects on patient care
and unnecessary services being provided that would impact the organization and
patient costs.
Workflow
Understanding
how workflow is impacted by certain technologies may also pose as a barrier in
evaluating health information infrastructures. In many organizations’ workflow
can be siloed and not known across the multiple divisions. Moreover, the
informatician may not be privy to these workflows. The impact this has is with
regards to modifications or changes to technology causing an upstream effect
that may impact the workflow of certain departments. Being that technology can
be used by multiple departments for different purposes. It is important to have
a sort of statement of work that assists the informatician when evaluating a
health information infrastructure. I have seen this personally as a challenge
in a working environment I have been in. In my case a system that was being
used by one department for a specific reason was modified and caused the entire
department to create entirely new processes to complete their duties. These
sort of impacts cost money and take time to mitigate. Jackson et al. (2011),
identifies this as a common issue and barrier to determining the impact of
health IT. The example provided is in regard to the expanded use of secure
messaging between the physician and the patient. With a lean
towards better communication between physicians and patients. Adding an
additional task without comprehending the current workflow of a physician may
cause many upstream problems and dissatisfaction.
Patient Use
The lesser evaluated topic is the
correlation between the technology and the patient’s ability to use the
technology. A common challenge in patient intervention is the patient’s ability
to use healthcare technology. Whether it be a wearable device or simply
accessing the patient medical record (PMH). A patient depending on technology
literacy, socioeconomic factors, or even age will impact the whether or not the
technology is being used as intended (Jackson et al., 2011). In many cases this
can be a negative or positive effect but does require additional evaluation by
the informatician in order to understand the patient’s direct needs.
The three primary limitations as
stated are interoperability, impact on workflow, and understanding the patient
ability to use the technology. Interoperability consists of a heterogenous method
of developing health information technology which has caused issues with
interconnectivity amongst health systems. Workflow issues stem from technology
changes causing upstream effect on departments with siloed workflows. The lack
of understanding the patient’s capabilities to use technology essentially leads
to challenges in patient care. Although there are solutions that can mitigate
risk of these challenges. I believe they still pose the biggest risk for
informaticians in evaluating a health information infrastructure.
References:
Cambridge
Healthtech Institute (2013). Battle Between Best-of-Breed and
Single-Source Philosophy Continues. Digital healthcare and
Productivity. Retrieved June 20, 2014
from http://www.bio-itworld.com/DigitalHealthCare_Article.aspx?id=37974.
Iroju,
O., Soriyan, A., Gambo, I., & Olaleke, J. (2013). Interoperability in
healthcare: benefits, challenges and resolutions. International Journal of
Innovation and Applied Studies, 3(1), 262-270.
Jackson,
G., Krein, S., Alverson, D., Darkins, A., Gunnar, W., Harada, N., . . .
Bosworth, H. (2011). Defining core issues in utilizing information technology
to improve access: Evaluation and research agenda. Journal of General Internal
Medicine, 26(0), 623-627. doi:10.1007/s11606-011-1789-3.
Zwass,
V. (2017). Information system. In Encyclopedia Britannica. Retrieved from:
https://www.britannica.com/topic/information-system/Information-system-infrastructure-and-architecture