There are two major developments in America right now. The first one is an epoch changing and history defining revolution due to advancements in technology. The start of this revolution can be traced back to the work of Thomas Edison, followed by the breakthrough in travel made possible by the Wright brothers and summing up the early years is the contribution of Henry Ford for changing the concept of mobility for the ordinary person.
America is always in the forefront of discovering and inventing cutting edge technology.Recently, the most important development is in the area of computers, software, networking and the Internet. The second major development is the rising costs of healthcare. Both of these issues are very important and shaping the lives of Americans in profound ways.
For instance, advancements in the design of electronics like microchips and progress in software design has put a lot of pressure to alter American way of living. The individual must learn what to make of “high-tech” for there is no way to ignore it. It must be embraced or transformed; it has to be met head on and there is no turning around it.
With regards to the issue of rising healthcare costs the number of uninsured people in America is rising. Surely there is something wrong with the system and surely there is a way to chip away at the problem piece by piece for Americans to solve it. Recently, the people of Indianapolis decided to confront both issues. For them there is a way of embracing technology so that they will not be overwhelmed by it. By doing so, they make technology as an ally to combat a known problem which is healthcare. By using this kind of thinking the community was able to hit two birds with one stone, so to speak.
Indianapolis and the surrounding area was able to establish a working model for a Medical Information System that now has become the envy of other states who wanted to use technology in creating a more efficient medical profession and delivery of healthcare services. The basic component of this system is the creation of Electronic Medical Records. Simply put, these are records of patients that were converted into digital form or electronic form. This component is then used as a cornerstone to building a shared Information System that can be accessed by member hospitals, clinics, medical personnel etc.
https://healtheappointments.com/health-care-system-in-india-essays/This study looks at the viability of creating a Medical Information System that will be incorporated into a larger context which is a network of databases that allow sharing of patient information to facilitate and speed up healthcare services. This study also looks at the problems faced by the developer of such a system and their continued struggle to create a better model that then ca be copied by other medical communities that comprises the U. S. healthcare system. This means looking at problems related to the use of advanced technology colliding with decades old traditions of how to take care of the sick and dying.The analysis of the problems and possible solutions can be done by using a systems thinking approach and applying basic knowledge of systems theory. Electronic Data and Networking Generally, the discussion is about the technological breakthroughs in technology experienced by the world in general and America in particular.
And the specific sphere of study is on the digital revolution and the use of computers, software, networking capabilities that when put together creates another amazing phenomenon called the Internet.With regards to the case study what is in focus is the study of converting information – raw data taken from interviews with the patients and observable data written by medical personnel – into digital or electronic form. This then called generically as Electronic Medical Records or EMR. Now, since the data is electronic then it means there is no need to carry around a whole stack of papers and instead the data can be stored in a computer or any device that can store digital information.
The next implication of this is that it will only take a few seconds or even less to copy the data into another device.Thus, copies of medical records can be had without taking up precious man hours. In the olden days it will require a clerk to type all of this for hours and days. It is a full time job as the paper work mounts up. Another implication of this is that information is very portable. Several gigabytes of data when reconverted into hard data on paper can easily equal to a ton of paper material. This solves the problem of storage. Another characteristic of EMR is its ability of the data to be subdivided into different parts.
If someone wants to know the demographics of all the patients in the hospital for the last five years, a computer software can scan through a roomful of information in minutes and then comes back with an answer. In the “dark ages” of filing cabinets and dark storage rooms, an employee has to sort through all this stuff, opening up the boxes and going through every single file. Computer software specifically designed for this purpose can create a classification of data more efficiently. What are the Benefits of Using EMR? As shown in the details of the case study Electronic Medical Records serves two purposes.The first one is the easy storage of data.
This means there is no more need for a full time employee to create copies as back-up. This again translates to saving storage space and quick duplication of data for sharing to other authorized personnel. EMR’s does not only function as storage device.
When incorporated to a system i. e. Medical Information System, the data from EMR can be shared and made available to a community hooked into the system. The best illustration was given in the case study when Dr. John T. Finnel was faced with an emergency situation.The routine when having this kind of emergency calls for the giving of a drug to temporarily stop breathing so that a breathing apparatus can be inserted to her esophagus. Then the doctor will try to revive her while a nurse will get a blood sample for analysis.
Since the medical personnel had no clue as to her medical history they will have either to wait for the paperwork and lab work to finish which will take up some considerable time or wait for her family to look for her. At any rate this will take up so much time and will cost more.Fortunately, in that hospital where Finnel worked there a Medical Information System is in use, used – the first working prototype. Dr.
Finnel accessed the system and in less than a minute was able to have crucial information that saved the day. The patient does not have to endure all the standard operating procedures to isolate her condition because there are many factors that contribute to losing consciousness. Imagine for a second if this is an allergic reaction that is life threatening. Think again if this is a case where a patient is taking another medicine that does not go well with other medications.What are the Challeges of Building a Medical Information System? The information found in the case study described the following problems faced by the Indianapolis medical community: a) cost; b) conflicting interests; c) privacy and security concerns; d) varying degrees of computer sophistication and literacy for some users; and finally, e) sustainability. There is no question that creating something new, something that does not exist before will cost money. The price becomes subjective, meaning a project can be viewed as very expensive when the people that are paying for it are not convinced on its practicality.The proponents for such a venture must be able to convince the power that be, in the potential of the system to save lives, save time, effort and most of all money.
The projected saving in healthcare costs must be enough of an incentive for the project to start. With regards to conflicting interests, this is a tricky problem to solve. Politicking inside an organization is very difficult to read.
Vested interests are hidden from plain and would easily frustrate any project manager. An understanding of systems theory will come in handy at this stage of development.Privacy and security concerns are potential headaches that must be solved immediately. This can stop the project dead on its tracks without as professionals from other fields would come in and muddle the issue. Lawyers and politicians who may not have a clue as to how important a rapid response or rapid information flow – as seen earlier in Dr. Finnel’s experience – can save lives, will attack the proposal on the basis of some human rights violation.
The project manager must be able to demonstrate that technology has reached a certain level wherein it is very difficult to hack into the system.Also, the design of the system can be such that sensitive information can be withheld by the patient or by the doctor and therefore it could not be seen by anyone who has access. And besides there is nothing to hide and the exceptions are celebrities, VIP’s and some cases where the patients have terminal illness. For these cases the patients and their physicians can exercise their rights not to put those data inside the database. On the issue of convenience as pointed out in the case study, the challenge is to increase levels of computer literacy for some older medical personnel who have survived many decades without the use of computers.A compromise can be reached like in Indianapolis, a computer printout or hard copy of the data was also made available for some doctors who hated to log on to their computers every time they want to study to study a particular patients case.
The last stage of the development process is sustainability. This is very important because even though Indianapolis was able to create the first working model it still has not reached the stage where the Medical Information System can pay for itself. How to Establish a Viable Medical Information System? In order to create something so urgent and yet so complex requires systems thinking.
This is what theorists and scientists like J. Gharajedaghi and William Covington are advocating. If one only focuses on one aspect and gets narrow-minded then the project manager will just get frustrated and give up. Whereas, when the project manager acknowledges these tensions and conflicts he/she can be able to change his /her mindset and create new frameworks for creating solutions. In the book entitled, “Systems Thinking: Managing Chaos and Complexity Gharajedaghi (2000) pointed out to two very important concepts about systems: Openness and Multidimensionality.With regards to the concept of “Openness” in relation to systems theory, this what Gharajedaghi tried to say, “Openness means that the behavior of living (open) systems can be understood only in the context of their environment” (Gharajedaghi, 2000) This can be understood that in the design of a viable model for a Medical Information system, the project manager must realize that it is not simply a creation of a storage device or a database system that can be accessed by authorized personnel. There is much more to that. What is involved here is an interrelationship between physicians, patients, hospitals, clinics and the community in general.
This is about making known and available information about the very important information regarding a person’s medical history. Gharajedaghi asserts that there is “Multidimensionality” in systems that leaves many perplexed and usually leaves a project dead in the water for there seems no way to go forward. The author describes this as being forced to choose between two difficult choices and he remarked: It seems as though we live in an age of paradoxes […] the dilemma with the observation that some are afraid of freedom, seeing always behind it the specter of anarchy […] Furthermore, consider the relationship between security and freedom.One cannot be free if one is not secure; one will not be secure if one is not free. Maybe freedom, justice, and security are three aspects of the same thing and were not meant to be separated in the first place. Certainly, treating them in isolation has been problematic.
(Gharajedaghi, 2000). Applying Gharajedaghi insight into the creation of the medical information system will provide solutions. His ideas must guide the project manager that it is not right to separate some aspects of the system and focus on them in isolation.These aspects such as access to information versus privacy must be treated as part of the whole. The woman saved by Dr.
Finnel has no time to discuss about privacy rights. Access was given because it is the correct compromise between the tension existing between privacy, rapid response to an emergency, efficient service, and costs of healthcare. William Covington (1998) asserts that it is not enough to know systems theory to solve this kind of problems. There is also a need for thinking creatively and not just thinking about systems.Covington proposes the use of creativity in applying the principles of creating systems process such as: 1. Processes between inputs and outputs – With regards to the Medical Information System there is a need to find creative ways in getting raw material that can be transformed into useful outputs. This does not only mean a better way of coaxing hospitals and medical personnel to share their data but also a creative way of financing the system.
This can mean getting sponsors or asking companies like Blue Cross and Blue Shield to share the cost of creating such system since it promises to lower healthcare costs.2. Adjustment process – the project manager must know how to handle the strains inevitable in such endeavor. 3. Evolutionary processes – the project manager must have hope that people and situations can change and that improvements to the system is feasible because opposition to changes can die down. 4.
Growth cohesiveness and integration – since technology and healthcare is integrated in this system, development in one can help the other. As technology becomes better in the future, more and more people will accept the idea of a community or state Medical Information System. (see Covington, 1998) ConclusionThe model shown by Indianapolis in the creation of a system that allows sharing of data that in turn translates to saving lives, time, money and effort is a great scheme worthy to be emulated.
The problems and challenges that a project manager will face are inevitable. But this must not concern him/her. There are solutions to those problems and it starts with doing systems thinking. Moreover, the acceptance of such a system is not really determined by a good design or a charismatic project manager but it will be developed, spurned on by the great need to reduce costs and the creation of the system that will save lives.References Covington, W.
(1998). Creativity and General Systems Theory. Universal Publisher Gharajedaghi, J. (2000). Systems Thinking: Managing Chaos and Complexity.
Burlington, MA: Elsevier Science. Haines, S. (1998). The Manger’s Pocket Guide to Systems Thinking. Amherst, MA: HRD Press. Ragsdell et al. (2002).
Systems Theory and Practice in the Knowledge Age. New York: Plenum Publishers. Skyttner, L. (2001).
General Systems Theory. New Jersey: World Scientific.