Introduction
The world’s health care system has changed dramatically during the past two decades (, 1992). Medical technology is now widely used to provide solutions for the demands and needs of patients in medical sector. Medical technology refers to the procedures, equipment and processes that are used by the medical sector to improve their services for the patients (, 2007). The use of Information Technology (IT) particularly the use of Internet will greatly affect the flow of data and information in the medical sector. Because of the continuous change in medical technology, Doctor’s offices and hospitals, now notoriously paper-dependent, would need to go digital ( n.d.). The days of the filing cabinet and folders is coming to its end. There are many external and internal forces that will push the health care systems to consider the need for changes. A health care system is the totality of services offered by all health disciplines. The healthcare professions all involve life and death situations (, . and , . 1998). In these situations, quality and quantity of medical services is irrelevant. Clinical governance provides a framework for a coherent, local program of quality improvement and an opportunity to share best practice. For the healthcare professionals, clinical governance will be about connecting and building upon the activities that they are already involved in, which help to promote and improve standards of patient care.
Background of the Company
Curbishley Hospital is a small hospital that provides short-term care for minor illnesses. It has 120 beds with and all of the patient can stay in the hospital for maximum days of three. The company is offering service of minor operations at short notice for their wealthy clients. Overall, the company has twelve consultants and physicians, twenty-five nurses and twenty administrative staff.
Purpose of the Study
This study will show the solutions that can be applied to improve the Curbishley Royal Hospital currents systems. This paper aims to provide creative analysis regarding the given situation. The management of the hospital is planning to apply IT to handle the two areas of the hospital processes; the initial patient contact and the Tele-home healthcare. The initial patient contact involves all the early processes of the hospital such as: the patients’ self-care and patients’ record checking. Tele-home care will deal with the remote consultation. It will offer services like medical consultations, nutritional and emotional support and other social services. Due to different factors and events that are now happening in the medical sector such as the cost of the overall resources of the hospital, Curbishley Royal Hospital management decided and planned to use IT to control and lower down the medical cost. On the other hand, it is very important to study and take a look at all the possible change and impact of the said technology to all of the entities involve in the hospital.
Methods of Enquiry
Enquiry for the participatory assessment involves a process of listening, information gathering and interactive analysis. The use of different methods will help to obtain various perspectives on the study and to gather complementary information ( n.d.).
Method 1 Participatory observation and spot checks
Participatory observation is a way of looking at the situation or behavior of people. It also presents a good opportunity to ask questions to the people that are concern about how they use certain service ( n.d.). This will be helpful to gather information on how do the staffs and the patients handle the current system of the Curbishley Royal Hospital. The problem with this method is that it will only focus on the observation of the researcher. This will cause bias because the researcher may only look on the aspects of the system that he/she wanted to see.
Method 2 Inductive-consensual (agreement)
The concept of this approach is to identify individual ideas and facts for each low level problem. It will also help to generalize low level ideas and facts and induce it to a higher level proposition. The advantage of this method is that it will encourage group participation and will refine the single solution by multiple rounds and maintain anonymity of responses during the process ( n.d.). This will be helpful to know the impact of introduction of the IT by automating the initial contact process of the hospital.
Method 3 Analytic-deductive (the World as a formula)
Analytic-deductive is a bottom-up approach. This will provide views of various solutions to the low level problems and issues. It will also consolidate low level solutions and deduce a higher level proposition and will deliver a single solution by critical reasoning ( n.d.). This will be helpful in studying the impact of introduction of telemedicine to the patient.
Objectives
The main objective of this study is to apply IT to the processes and transactions of the Curbishley Royal Hospital to ensure quality and security. This will also help the said hospital to use different technologies and computerized systems to improve their current systems. This will also focus on the benefits of the staffs and the patients. This will also help to lessen the work and task of the staffs and will give comfort to the patients.
External Factors Affecting Application of It to Curbishley Royal Hospital
Fig 1 Political, Economic, Social and Technological (PERT) Chart
Political Factors
Economic Factors
1. Change in government, law and policy
1. Cost of the computerized system and all the gadgets, hardware and software that are needed to install.
Social Factors
Technological Factors
1.Patients’ interest and demand
2.Patients’ needs
1. Change in Technology
2. Technological enhancement
3. Maturity of Technology
4. Short life cycle of technology
There are lots of external factors that will affect the decision-making of the Curbishley Royal Hospital management. Those factors are group into four: political, economic, social and technological factors.
Like other medical institutions, Curbishley Royal Hospital is affected by government rules and regulations that are created to protect the rights and security of the patients. This only means the management of the said hospital must deploy and implement systems that will meet and follow the standards and rules set by the government.
Another factor is the economic; it involves the cost of the total installation of the computerized systems. It involves hardware and software part of the system.
Social factor deals with the satisfaction of the patients. It will focus to the patients’ need, interest and demands such as fast and user-friendly transaction and processing, convenience and informative systems.
Technology is the main factor that will affect the decision-making process of the management. The fast change in technology, technological enhancement that will greatly affect the speed of transactions, technological maturity that will cause high maintenance to the part of the hardware and software of the system and the short life of different technological product such as desktop computers, server and laptop are also major factors that will affect the decision of the management.
Information Technology in the Healthcare Industry
Today, information technology is considered as a strategic necessity by world class organizations. As competition increases, the use of more sophisticated IT tools and techniques, such as the use of Internet. This technology is imperative in order for organizations to obtain a competitive advantage. The healthcare industry, with its shifting regulation, is not that immune from this escalation competitiveness (, 2000). Because of this advantage, IT has become an increasingly large portion of the total capital spending allocated by healthcare organizations and is expected to account for up to a third of the increase in new spending during the next few years (, 2003).
Because of the growing demand of the hospital for a computerized system to improve their performance and processing time, the hospital decided to implement various systems applying the IT. The whole health care system will include:
Expected Project Results
Electronic Patient Record System
This system will save and process all the personal information and details about the patient that will be helpful for his/her medication. Information and data like name of the patient, his and her address and contact number etc. This information will be encoded and save by the hospital staff and will be passed to the clinicians and medical practitioners for further analysis. This will lessen the work of the hospital staff by easiness of retrieval of data. The users of the system only have to look at the database and the entire patient’s information will be available. This system will improve the hospital’s quality of healthcare and efficiency of its work flow (, 2002).
Electronic Health Record System (EHRS)
This system is controlled by doctors or hospitals, it keep track of the record of the care given to patients in the clinical setting ( n.d.). It is a longitudinal electronic record of patient health information generated by one or more encounters in any care delivery setting. Included in this information are patient demographics, progress noted, problems, medications, vital signs, past medical history, immunizations, laboratory data and radiology reports. The EHR automates and streamlines the clinician’s workflow. It has the ability to generate a complete record of clinical patient encounter – as well as supporting other care-related activities directly or indirectly via interface – including evidence-based decision support, quality management and outcomes reporting ( n.d.).
Computerized Physician Order Entry (CPOE)
Medical errors and adverse drug events are common, costly and clinically important problems ( and , 2001). According to a study, half of the medication errors occur at the stage of drug ordering, and at the administration stage (, 1986; , 1996). CPOE will help reduce the prescription and other related errors. This system will keep track of physicians’ orders, partly to ensure that bad handwriting doesn’t contribute to medical errors ( n.d.). CPOE is a variety of computer-based systems of ordering medications, which share the common features of automating the medication ordering process. It will ensures standardized, legible and complete orders by only accepting typed orders in a standard and complete format. Basic clinical decision support may include suggestion for drug doses, routes and frequencies ( and , 2001).
Clinical Decision Support System (CDSS)
CDSS is a computer-based algorithm that assists a clinician with one or more component steps of the diagnostic process (, 1998). It is a software that integrates information on the characteristics of individual patients with a computerized knowledge base for the purpose of generating patient-specific assessments or recommendations design to aid clinicians in making clinical decisions (., 2001) .This system will perform drug allergy checking, drug-laboratory value checking, drug-drug interaction checking. It will also provide reminders about corollary orders and drug guidelines to the physician at the time of drug ordering ( and , 2001).
Bar Coded Medication Management
Bar coded medication allows a clinician to verify a patient identity and validate proper medication against active orders that leads to improved patient care and safety and a more medication process for the hospital. Bar code medication reduces the risk of medication error by ensuring that the “five rights” of medication are administered. There are five rights of medication safety to be followed by nurses and healthcare professionals dispensing medications to patients: these five rights are: the right medication, the right dose, the right time, the right route, and the right patient (, 1993). Once a patient check-in the hospital, they are given a bar code with all the information required for the nurse in-charge in giving the patient the necessary medical attention required by the patient. This barcode contains information about the patient’s symptoms, the proper medication he needs, the proper dosage, etc. This will eliminate medical-related errors.
Telemedicine
Clinicians, health services researchers and others have been investigating about the advance use of telecommunications to improve health care for more than 30 years. At the intersection of many of these efforts lies telemedicine – the combination of innovative and mainstream technologies. Telemedicine is the use of electronic information and communications technologies to provide and support health care when distance separates the participants (, 1996). The World Health Organization (WHO) defines Telemedicine as the practice of healthcare using interactive audio, visual and data communications. This includes healthcare delivery, diagnosis, consultation and treatment as well as education and transfer of medical data (, 2003). In short, Telemedicine is medicine practice at distance (, 2002).
Telemedicine is the delivery of health care and the exchange of health-care information across distances ( and , 2006). This system will be helpful to those patients who want to avail the services of the physician without getting out of their respective houses.
Physician and Room Scheduling System
This system will cater to the scheduling needs of the hospital. With the use of this system, the staff will no longer have to look at the manual schedule system to check the schedule of the physicians and the rooms. This will prevent chaos by overlapping the schedule of a physician or scheduling the room to two or more patients.
Project Beneficiaries
Impact of Internet to the Medical Sector
Medical Sector plays a major role in its commitment to address a variety of health care problems ( and , 1997). The use and application of IT and Internet is a critical supplement to improve the processes and transaction of the medical establishments. The Internet is promising to increase efficiency across all industry, thereby improving quality and increasing productivity (, 1997). Because of the technology of Internet, it will be easy for the medical sector to improve their services to meet the demand of growing health conscious people. This technology will also help to speed up the processes of the medical establishments for the benefits of the patients. The use of this technology will also lessen medical error.
Impact of Internet in Patients
The use of the Internet and other computerized systems will, people will be pushed to be more health conscious minus the hassles and the errors.
Impact of Internet in the Medical Professionals and Staffs
The Internet and other computerized system will help the hospital’s staff and other professional employee lessen their task. This will also help them to prevent errors in their transactions like prescriptions and medications.
Impact of Internet in Curbishley Royal Hospital
With the use of Internet and other systems that was mention in this study, Curbishley Royal Hospital will have an edge against their competitor. This will also help them to gain confidence from the client. This technology will also help them to cater their patients and their respective family faster. This will help the hospital to improve their care quality, increased patient safety and reduced cost.
Soft System Methodology
Based on the prior discussion, Curbishley Royal Hospital’s key resources is the integration of Internet to other computerized systems. The said technologies will serve as a supplement to the service of the people, finances and material assets. The use of IT, Internet and other innovation will help the Curbishley Royal to improve and develop their service delivery as well as their internal business processes and external service implementation.
In developing the plan of innovation, it is better to build a report that is ideal for a specific need then to make a report based on a predefined concession between several users. The shaped information will have value and increases insight into information needs and the way the business is looked at. Adding more and more information to the system and solving the problems as they occur will eventually lead to a system as mentioned. In fact, that is the way any functional Information System is developed. Having an experienced team helping you take the first steps and educating the teaching staff in the first period can make all the difference.
Stage 1-The Problem Unstructured StageThe definition of the problems and flaws of the current systems of the Curbishley Royal Hospital will be define and analyze during this system. The persons that will be involved in this stage are the patients, the hospital staffs and other employees that are connected or involved in the entire process of the system.
Stage 2 – The Problematic Situation expressed
During this stage, all the necessary information that will be helpful to the system’s development of the Curbishley Royal Hospital will be gathered. This information will include the problematic situations of the patients, the physicians and the staffs.
The main purpose of a rich picture is to help the analyst gain an appreciation of the problem situation ( n.d). As it is understood in SSM, rich picture are used as means to represent the situation of concern and include elements which influence the problem but which would not perhaps be picked up using more formal methods (, 1994)
The main problem of the Curbishley Royal Hospital is the speed of time that the management is spending to serve their patients. This has become the biggest problem because of the increasing demand for healthcare services. This issue has become hard to set aside and the issue of application of IT to their current systems. The problem of the hospital is presented using the rich picture.
Adopted from: Couprie et al, 2004
Fig 2
The Rich Picture of Distribution of Medical Services of Curbishley Royal Hospital
Fig 2 shows the factors and the entities that are involved in the processes of the Curbishley Royal Hospital. These ate the factors that are affecting the speed of the delivery of the medical services of the organization.
Stage 3 – Root definitions of Related SystemsRoot definitions are formulated in this stage. Root definitions state the heart of the functions of some focused action structure. Furthermore, a root definition is expressed as a transformation process that takes some entity as input, changes or transforms that entity, and produces a new form of the entity as output.
The first related system would be the personnel hiring system. It is because the first issue in Curbishley Royal is the lack of time by administrators and the staff to distribute the services and accept inquiries. Since head administrators have minimum knowledge regarding IT systems (e.g. most of staff are health specialist with no IT background) there is a need to find additional personnel who will perform these tasks and handle the corresponding responsibilities. There is a need for the manager to find the personnel who have the required skills and / or capabilities to perform the tasks and handler the responsibilities. In order for the newly hired personnel to effectively perform his tasks and / or responsibilities, there is a need for the personnel to be trained on the tasks and responsibilities that he has to accomplish. The manager must evaluate the performance of the personnel as well as the improvements (s) in the performance of Curbishley Royal in order to determine if the personnel has addressed the problem situation.
Table 1 The CATWOE Analysis
The Root Definition of Personnel Hiring System
Customer
The Curbishley Royal and the patients
Actor
The Curbishley Royal Management
Transformation
Employment of new staffs of the hospital
Weltanschauung
New employees and staff will speed up the service of the hospital
Owner
The Hospital Administrator
Environmental Constraint
Cost of additional labour cost
The second system will be use to broaden and improve the hospital’s scope of services. Innovation of services and offerings will help Curbishley Royal Hospital to survive the growing competition in medical sector. This will help them to provide more of the patients’ demand. But those services must undergo a trial to check if it can cater to the demand and needs of the client. This innovation process will help the organization to add service or services to their current variety of their offerings. This will give them edge against their competitor by giving their patient/ client the satisfaction that they want.
Table 2 The CATWOE Analysis
The Root Definition of Organisation’s Services
Customer
The Curbishley Royal Management and the patients
Actor
The administrator
Transformation
Innovation that will lead to a greater edge for competition and will be useful in meeting the needs and demands of the patients.
Weltanschauung
Innovation will bring new and wide variety of services to the patients that will meet their demands and needs.
Owner
The administrator
Environmental Constraint
Capital for the new services and the needs and demands of the patients
Stage 4 – Conceptual Models
Stage four will deal with the presentation of conceptual model. A conceptual model is the representation of the system expertise using information and knowledge ( and , 1997).
Table 1 shows a continuous process. This will all start from selecting and hiring employees but will also in great need of maintenance such as trainings and seminars. This process will be applied to the future services and development of the processes of the organizations. The management must make sure that they are hiring the right personnel well as deploying the right training to ensure that each employee is knowledgeable enough to handle a part of the entire system and to ensure the quality of their human resources.
Table 2 also shows a continuous process. In this stage, the management of the hospital must analyze the variety of services that they are offering and must think of new and improved innovation that will help them to target a new and larger market. This process will also enable them to analyze the needs of their patient that will lead to creation of service that will add to their offerings. This process will start from analyzing the problematic situation of the patients and ends with a solution by creating more improved services.
Stage 5 – Identification of feasible and desirable changesThe feasibility and desirable changes of the organization based on the evaluation of the problematic situations will be identified in this stage. The changes that can be done are: changes in structure, changes in procedure and changes in the attitude within the organisation.
To solve the problem of the Curbishley Royal with regards to its time of distributing medical services, the hospital must consider to hire more employees that will be involved in different areas and part of the system’s transactions. The change in the flow and processing of the data and information will also enhance the speed of the hospital’s system. The management must also take advantage of technologies that will surely help the hospital’s staffs and medical professionals to speed up their operations and to maintain safe and secured appointment with the patients. The division of labour will also help the employees to focus on a specific task only, and will lead to a high quality and patient’s friendly services.
Conclusion
Among the four mode of enquiry, using the Multiple Realities Enquiry system will suit Curbishley Royal Hospital in IT implementation, because this enquiry system will give consideration to all the problems and issues in IT implementation, formulating solutions and alternative solutions as well. Problems will be well-analyzed, formulating an appropriate solution for each problem, and an alternate solution to back-up the initial solution. Managing healthcare institutes can be a problem, which is why it is important to adopt IT in a systematic approach, and formulate a methodology that will determine and identify system boundaries and system activities. Using soft system methodology can be an aid to dram the system boundaries and identifying the system activities. The long term aims are to examine the effects of soft system methodology in system acceptability and to provide the analyst and managers with assistance in strategies for healthcare.
Healthcare industry needs to reorganize the way they conduct business. Information technology has its effects when it alters how people come together and communicate with each other. Organizations should be mindful and considerable to the limitations of technology and should have a thorough understanding of the behavior of their target audience in searching for information, and not just adopt and invest in new technologies. The core and main aspect of health care must never be forgotten even though the healthcare industry is pressing on to leverage with information technology to improve patient care and services.
Bibliography
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