Discuss about the N.H.S Patient Database Management System.
In this report document, the author has identified several intellectual concepts of database management system in context with N.H.S administration mentioned in the case study. The presented report below is to understand the concept of database or information management system in the selected working environment in this case it is N.H.S hospital in United Kingdom. The overall idea of this document is to understand N.H.S managing information system in the workplace and the capabilities of database management system and difference between the traditional database management system and non-traditional database management system. The aim of this report is to understand the overall working concept of database management system in the selected organization.
The researcher has taken the case study as N.H.S Patient Management System associated with the country United Kingdom. In a relevant case study, the perfect use of database management has been clearly stated and highlighted (Asabe et al. 2013). The main motive of reflecting the case study is to make distinguish the concept of database management system and its uses; to make transformation in the manual way of searching, manipulating, sorting, and accessing medical patient information files in the form of electronic medical record.
2.1 Capabilities of N.H.S Patient Database System
According to (Kuperman 2013), a database is a well structured collection of information or data. It is the collection of tables, queries, views, schemas, reports and other objects. On the other hand as per (Mazurek 2014), a DMBS (Database management system) is an application that interacts with the customers or user and with other software applications and the database itself collect, capture and analyzes the information or data. The table below showcase the difference in relationship database management system and traditional system that is mentioned in the below table.
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Traditional Database |
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DBMS has to be persistent. DMBS should provide uniform procedure or methods independent of a particular application for accessing the data which is stored. DBMS does not put any security or constraints with respect to data manipulation. Normalization procedure is not present in traditional database DBMS only supports single user. DBMS internally treats data as files DBMS needs low hardware and software requirements. It has no concept of relationship. |
RDBMS is completely based on relationship model. RDBMS describes the integrity constraint. In RDBMS a normalization procedure or process is present which evaluates the database table. It helps in backup of the database in case of lost information or data. RBMS is utilized to establish the concept of relationship among with database. It does support more than one user. It treats data as tables. The hardware and software requirement is high. |
Table 1: Difference between Traditional Database and Relational Database Management System
(Source: Mazurek 2014, pp-531)
The database management system is a computer application which is utilized to interact with others applications and users and where the database itself collect and analyze the data. The basic functionality of database management system is to allow the data to be well organized in a system to be analyzed or utilized as per the user requirement (Mazurek 2014). In this case, the patient or N.H.S hospital management data or information is collected is stored in the database management system and it is been utilized by the hospital management as per requirement.
The concept of non-relationship database management system is to provide a technique or process for storing and retrieving of information or data which is modeled other than the tabular relations used in RDBMS. They are generally used in real time web application or big data and they are also known as NoSQL which generally refers to “Non SQL”. The concept of Non-Relational Database System in N.H.S Patient Database System is a form of database that does not incorporate with the key/ table model that generally RDBMS promotes (Mazurek 2014). This kind of database management system does not require SQL programming; rather than it requires manipulation of data technique while maintaining patient data and records.
Figure 1: N.H.S database management system
(Source: Waterson 2014, pp-154)
Cloud computing has been a latest trend and quickly developing technology in the area of health care. Universally, it is on demand where it can access the data virtually to endless resources. The utilization of cloud computing in the field of healthcare has provided various benefits in terms of economically and technically. The cloud computing is generally used in “OMICS-Context” for example it is been used in proteomics, genomics, and molecular medicines. The cloud computing concept can be very handy to a hospital management system where it provides worldwide access to the hospital resources to help the patient serve better with a better management system as well as management.
Figure 2: Diagram of N.H.S Management Database System
(Source: Kaur and Bhambri 2015, pp-60)
3.1 Challenges of N.H.S Patient Database System
The document has presented severe challenges in context with N.H.S administration database management system. As mentioned above, that the need and benefits of database management system is very necessary for every management organization. There are various challenges that affect the efficiency of N.H.S administration. The author has highlighted various upcoming challenges of database management system which include delivering enhance performance, issues of information integration, lack of patient resources, securing personal information and growth of high information volume growth (Haux 2013).
Maintaining cost – As the maintenance cost is high because of the growth and size of the database.
Training cost – A database management system is a critical and complex system and the employees or individuals who ever is going to use it has to be know more about its functionality, so they need to understand the database management system properly and how to use it.
Security Issue– The security needs for a database management system is high and typically need to improve security functionalities and features which are costly.
3.2 Benefits of Database Management System at N.H.S
Data Access – The N.H.S database management system basically has a centralized database which allows the end users to operate and access the database without any programmer or any application program creator (Xu et al. 2014). The main benefits are that the data are crafted well in an organized manner and the data structures or records can be access easily whenever required.
Expandability – The database expandability is one of the major benefits of this database management system where a new applications or sections like new department or employee interface can be created without any interfering with already created database or working applications in the N.H.S database management system.
Backup and Recovery – In most of the case in systems, the entire database might get corrupted or might get lost but the database management system provides a backup and recovery options which gives N.H.S database management system a better advantage to prevent the patient and hospital data loss in case of viral attack or any other disaster situation.
The concept of knowledge based system implies a system program that utilizes advance knowledge to solve critical and difficult problems. In the base of database management system, there is a need of emergence in improving the concept of knowledge based system. According to Holsapple (2013), the concept of knowledge based system is a generic term that is used in knowledge organization for classification schemes, topic maps and etc.; whereas as per Hislop (2013), the base of knowledge management is a concept in which an organization organize and gathers its social knowledge in terms of documents and resources.
Managing the knowledge in N.H.S organization to support the clinical decision making needs changing information into actionable intelligence and which can be translated by various functional working employees in N.H.S.
Figure 3: Intelligent Data Support System in N.H.S
(Source: Mital and Monga 2015, pp-45)
The concept of Intelligent Data Support System makes extensive use of artificial intelligence techniques (Lavrac et al. 2012). The IDSS does provide by a system that helps in making the decision by providing an evidence based understanding with regards to patient data. It helps in making decisions by showcasing of intelligent behavior which might include reasoning and learning. This can be achieved by implementing neural network or knowledge based or rule based expert systems. Based on the relevant case study of N.H.S Patient Database Management System there are varieties of intelligent data support system.
Today hospital or a healthcare organization is generated huge amount of data from their respective departments. Even though the data is huge but the information which it carries is very less. So in such case the business intelligence will be much useful to N.H.S hospital where the raw data are transformed into meaningful information to ensure that the decision which is made is accurate. The database holds a very important concept in an overall N.H.S patient management system (Barone et al. 2012). It provides the current, past and predictive views of the hospital operations mostly by utilizing the data which has been gathered in the database during the hospital operation. Various kinds of information and report might be required by the N.H.S hospital staff or doctors so the BI helps in making decision faster and its improved efficiency.
There are generally six elements in Business Intelligence Environment in context with N.H.S Patient database Management system (Kirchner et al. 2013). It has been identified that it as data from the N.H.S environment which is critical because the BI is depended in the raw data which is gathered by the hospital management system, business intelligent infrastructure, N.H.S Patient database analytics toolset, delivery platform and user interface of a N.H.S Patient Database system.
5.1 Ethical Issues in N.H.S Patient Database System
The researcher has manifested several ethical, issues regarding the ethical issues prevailing in the N.H.S administration management which include: avoiding conflicts of interest, balancing profit with patients and providing the benefits of charity care, VIP treatments for patients and for donors v/s wrestling with equal treatment (Strack et al. 2014), managing and manipulating geriatric and pediatric patients who has not the capacity for decision making and addressing moral distress nurses with minimal benefit.
Based on the relevant case study, the researcher has manipulated some legal issue which includes: lawsuits against the mandate to purchase health insurance, data breaches and HIPAA, issue of antitrust, false claims and suits of whistle blower, physician N.H.S issues and anti kickback, impact of stark law on social N.H.S relationships and recovery of audit contractors.
The technical issues in case of N.H.S administration management system are reflected by the researcher itself which generally include: physician alignment, decreasing fees of technical, N.H.S owned practices, storage of physician, maintain ace of patient safety, emerging of energy standards and errors of medication (Cresswell and Sheikh 2013).
6.1 Analysis tool for making improvement in decision making in N.H.S Patient Database System
Constructive environment: It is very important to create a constructive base environment in N.H.S database management system. Various decisions are becoming complex when it starts affecting peoples to weight up several intellectual options (Mikkonen et al. 2016). Conduction of stakeholder analysis, and following up decision model may help to improve the base of decision making.
Situation Investigation: It is very essential to make a clear understanding regarding the situation. It may be that the objectives can be approached in initializing the isolation factors in a number of intellectual belongings. Changes in one department in N.H.S administration make the counter-productive.
Generation of good alternatives: The better will be the options the wider will be the final decision in a N.H.S administration (Mital and Monga 2015). Generating varieties of options with forces of alternatives helps to dig out the issue from different angles.
Building up knowledge management into career path: The N.H.S administration built several processes of knowledge management into career paths in order to integrate the requirement of work flow for moving up the N.H.S (Borghoff and Pareschi 2013). Each individual group will contribute the appropriate level for its job.
Tracking of useful metrics: The N.H.S administration tracked knowledge and measure the value of metrics to prioritize the areas of upcoming future knowledge (Strack et al. 2014). They usually see knowledge as a living system that requires to be weakened as the management changes.
Conclusion
This research paper concludes with the broad concept of database management system in context with N.H.S based patient management system. The researcher has discussed several intellectual concepts based on which several strategies have also been illustrated with respect to database management system in the case study. The report discusses about the database management system capabilities in the selected case study, in this case its N.H.S. The document also discuss about the challenges and benefits of data management systems and some critical technical, legal and ethical evaluation is been done by considering the case study.
References
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Strack, B., DeShazo, J.P., Gennings, C., Olmo, J.L., Ventura, S., Cios, K.J. and Clore, J.N., 2014. Impact of HbA1c measurement on N.H.S readmission rates: analysis of 70,000 clinical database patient records. BioMed research international, 2014.
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