Leadership And Change Management In Healthcare: Evaluating Health Information Technology System

Key historical events

The United States has a vast history of health information management (HIM). The health information industry has been in existence officially from 1928 when the American College of Surgeons (ACOS) wanted to improve the standards of records created in clinical settings. HIM trends continue to make news today thanks to the new implementation of electronic health records (Brooks, 2015).

Paper records were utilized until the 1960s/1970s when technological innovations such as the use of computers led to the beginning of new approaches to HIM. This lead to the standardization and sharing of medical records. By 1965, approximately 73 hospitals and clinical information projects and 28 projects for the storage and retrieval of medical documents and other clinical information were underway, according to HIMSS. By the late 1960’s some hospital information systems include patient diagnoses and additional patient information, and care plans based on physician and nursing orders (Saba, Johnson, & Simpson, 1994).

To operationalize point of care data capture PDAs, start to appear in hospitals by 1995. Congress primary passed the Health Insurance Portability and Accountability Act (HIPAA) in 1996, and the rules for privacy provisions for HIPAA finalized in 2002. American Health Informatics Consortium (AHIC) also got established in 2005.

Health Information Technology Standards Panel (HITSP) responsible for designating standards that will use in the structure and transmission of healthcare information, standards that will affect how nursing and others document care, including the nursing and other healthcare terminologies that will be acceptable (Sewell & Thede).

Currently, in the healthcare system, information technology is the grounds of the future. Healthcare transformation is best pictured if we compare how we were thirty years ago and where we are today. The need for improvement was the motivating power that pushed the evolution of computers in healthcare. The significant part of the past thirty years of technological expansion on computer programs used for administrative intention while the past decade has seen an emphasis on the clinical process (Cassano, 2017). Patient care is the primary focus in the development of new concepts and knowledge in healthcare technology.

Technological development in clinical applications is the current trend in healthcare, and it will continue to play a significant role for years to come (Cassano, 2017). Looking into the past technology has kept a dynamic form which seems to evolve to solve problems. In 1987 Health Level Seven (HL7) began to develop a wide range of message format standards for patient registration, orders, and observations reporting and published its first version in October of that year. The healthcare delivery system today uses many different information systems from different vendors, both within a single organization and across multiple organizations. For example, a hospital may have three different vendors, a laboratory system from one vendor, a pharmacy system from a different vendor, and a patient care documentation system from a third vendor.

Due to the recent violation of several government regulations regarding the use of technology the staff of Featherfall should be re-trained and the technology been use updated. The two main concern will be the clinic staff and Administrative staff within the organization. As data and classification systems evolve, the clinic and administrative staff play an invaluable role to the interpretation and conversion of healthcare data related to many uses, including patient data, organizational effectiveness and efficiency, policy making, and reimbursement systems. For example, the initiation of ICD-10-CM/PCS and other terminology systems such as SNOMED CT will help understand how data are collected, analyzed, and reported to ensure information is understandable and useable.

Guidelines for technology use

Technology has allowed doctors to use e-mail, texts, videos, and conference facilities to consult colleagues from all over the world. This practice, identified as telemedicine, is especially useful for doctors and patients in rural and under-developed areas. Externally relocating patients, doctors can ask specialists from all over the world to diagnose, operate, and study conditions without needing access to a sophisticated hospital (Krueger, 2010). Telemedicine was used effectively after the 2010 Haiti earthquake.

Technology has made patient care harmless and more stable than before. Featherfall staff cross board interact with technology daily especially the HIM team, clinic staff and the administrative staff. Nurses and doctors use computers to record a patient’s medical history and check that they are administering the correct treatment. Results of lab tests, records of vital signs, and medicine orders are all electronically put in.

Successful implementation of HIT requires a deep understanding of current processes that deliver a function, willingness to map these processes and change them to adapt to the new systems and to make the time and space required for the key stakeholders to have the conversations that adjust possible (Jaén, 2011). Clinical and administrative staff at Featherfall have issues with record-keeping and training in general. With these issues present a new electronic health record is extremely advised. A very modern system needs evaluation to know it is going help eradicate the current problem. The evaluation process will start with;

1.    Assess how secure the technology could be used. Ease of use applies to the administrative department, as much as it does to the physician; hence it is essential that the support staff can use it more efficiently, providing the patients a better experience (Jaén, 2011).
2.    Check how easy it is to retrieve insurance details.
3.    Compatibility and extensibility for the practice at Featherfall.
4.    Will check if EHR solution is certified, and it should include in the contract that the vendor should ensure that the product will be updated with the latest releases promptly without any significant cost to the practice Featherfall.

With all the process as mentioned earlier, one major thing to look at is the how compliant the new system is with government regulations. The Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy, Security, and Breach Notification Rules are first Federal laws that protect health information. The Privacy Rule gives you rights concerning health information. The Privacy Rule indicates the limitation on how health information can be used and shared with others. All the process mentioned above, and regulation would be used to evaluate the new health information technology system.

Patients must be guaranteed that the health information they share with healthcare professionals will remain private. Without such assurance, patients may withhold critical information that could affect the quality, safety, and outcome of care (Hofman & Rose, 2013).

The HIPAA privacy rule became effective April 14, 2003, and established criteria for information disclosure including what constitutes a valid authorization. HIPAA applies to covered entities, defined by the rule to include health plans, healthcare clearinghouses, and healthcare providers that communicate specific information electronically. The HIPAA Enforcement Rule provides different penalties for each of four levels of culpability:

The table provides an overview of the penalty amounts for HIPAA violations.

Intent	Minimum Per Incident	Annual Cap for All Violations
Did Not Know or Could Not Have Known	$100 – $50,000	$1.5 million
Reasonable Cause and Not Willful Neglect	$10,000 – $50,000	$1.5 million
Willful Neglect, but Corrected Within 30 Days	$10,000 – $50,000	$1.5 million
Willful Neglect and Not Corrected Within 30 Days	$50,000	$1.5 million

Featherfall clinical and administrative staff will cause the company to lose a lot of money if attention is not placed on training staff about HIPPA rules the violations. From the table above, it could be deduced that it could the company as high as $1.5 million. Example:

The U.S. Department of Health and Human Services’ (HHS) Office for Civil Rights (OCR) has issued a Notice of Final Determination finding that a covered entity, Cignet Health of Prince George’s County, MD (Cignet), violated the Privacy Rule of the Health Insurance Portability and Accountability Act of 1996 (HIPAA).  HHS has imposed a civil money penalty (CMP) of $4.3 million for the violations, representing the first CMP issued by the Department for violations of the HIPAA Privacy Rule. The CMP is based on the violation categories and increased penalty amounts authorized by Section 13410(d) of the Health Information Technology for Economic and Clinical Health (HITECH) Act.

Standard Technologies currently used

Daily operations of Featherfall includes the following but not limited to providing pre and post operation care, monitoring and administering medication, booking and checking in patients, writing records, etc. One major thing that needs to be factored in when going through processes and task of the day is ensuring policies and regulations upheld. Violating health regulation regarding technology can have an impact on staffing. An example is if Featherfall loses a provider due to a violation, can affect patient inflow and increased patient wait time. If it happens at the front desk patients cannot be processed fast due to low manning.

Healthcare data security is an essential element of Health Insurance Portability and Accountability Act Rules. The HIPAA Security Rule requires covered entities to assess data security controls by conducting a risk assessment and implement a risk management program to address any vulnerabilities that are identified. Violating health regulations and law regarding technology will impact the security of Featherfall patient information. In areas like record-keeping clinical staff lack training on the system. This is crucial when it comes to security because instances where patient information is faxed there are PII procedures that need to be followed like faxing the Privacy Act Page first for the receiver to know that the document coming in contains patient information.  

The Featherfall Medical Center technology system is vastly out of date. The clinical staff who are responsible for entering information into the system lacks training and hence there is a major need to bring new technical functions within the system in order to meet the current needs within the center. The new use of information technology within the medical center would be useful in order to improve the functions within the system and thus bring efficiency within the system. New systems have incorporated features that meet HIPPA standard and will help Featherfall stay compliant to government regulations.

The new health information system, which would be implemented within the systems, should abide by the regulations and laws related to the health within the country. Advanced form of the networks of communication could be helpful in enabling the process of data sharing. The process of electronic billing and administration systems could be helpful in reducing administrative costs related to the healthcare sector (Jones et al., 2014).

Upon close analysis of the two technologies I would recommend Intel for Featherfall Medical Center because of the following reasons:

• Intel has been in operative for past three decades and has been able to stand through all the changes healthcare information technology has gone through.
• The number hospitals that uses the Intel system is 364 indicating a larger number hospital that Featherfall can share data with issues.
• Intel has a standard authentication and authorization feature which will limit the people who will have access to classified patient information.
• With the introduction of Intel technology staff members will have a user friendly system to work which will generate list of patients by physician and by unit.
• Intel system reads bar-code a very important feature which makes patient identification at both check in and at bedside easier and save time because it pulls all the patient data.

Ethical based health research and protection related privacy would be helpful in providing valuable benefits for the society. The research within the sector of health is crucial for the improvement within the healthcare sector in order to preserve the rights of the individuals, which would be essential for the conduction of ethical based research.

The healthcare organizations should be able to understand the basic benefits of using the technological systems within the industry. They should recognize the long term financial benefits, which would be acquired by the proper use of the information technology within the sector. The increased investments by the government of the respective countries would be highly needed in order to gain huge benefits from the use of the information technology. Hence, the Featherfall Medical Center should invest on the use of information technology systems for the use and betterment of the healthcare systems (Cresswell & Sheikh, 2013).

 Featherfall can invest in the software of Intel by adding other feature such as automated verification of insurance which will help the work of billing department. Other investment opportunity will be to invest in biometric capability of the Intel system which will serve as the primary feature to identify patients.

The implementation and usage of the new systems would prove to be a major help for the Featherfall Medical Center. This is why there would be the need for a high level of management and monitoring within the systems. The clinicians, doctors and staff should be made aware of the site systems monitor from Intel. The administrative system should ensure that the adoption of the newer technological system be well understood by the existing staff. There should be properly trained staff that would be able to view the functioning of the system (Baig & Gholamhosseini, 2013).

The investment of time for the development of the health information system is essential for the benefit and growth of the system. This would also help in serving and catering to the various needs for the process of development and installation of the entire system (Nguyen, Bellucci & Nguyen, 2014). The organization could organize weekly workshop to train staff who are struggling with the new system. If the issue gets better it could be reduced to a monthly workshop. It will be best to suggest that Featherfall Medical Center also invest time into refresher training for the entire staff yearly to keep them updated of any changes.