The Impact Of ICT On Workflow In Medical Records Department In A Hospital

Medical and Health Science Project and Seminar Material

The Impact Of ICT On Workflow In Medical Records Department In A Hospital


Abstract


This research work examines the impact of ICT on workflow in medical records department in a hospital; University Ilorin Teaching Hospital, Kwara State, Nigeria. Its specific objectives include: to examine the prior assessment made by the UITH Ilorin Hospital Management before the implementation of the system and to find out the challenges faced in use of information technology in health records management in UITH Ilorin, Kwara State, Nigeria, and also investigate the solutions on preservation and conservation of information technology in health records management in UITH Ilorin, Kwara State, Nigeria. Also, the paper utilizes simple percentage method that was computed by the authors to analyze data from 50 health/medical practitioners of the surveyed major departments/uints in UITH Ilorin, Kwara State, Nigeria. Its findings show that the major use of Information technology in health records management in University Ilorin Teaching Hospital, Kwara State, Nigeria.

Include: poor funding, inadequate computer and other ICT devices, poor skill and harsh environmental conditions. Through the findings from the survey, the research recommends that owners of health institutions should inject more financial resources into the organization in order to solve the problem of inadequate funding of the health records management, as money needed in acquiring the infrastructure development and acquisition of modern equipment that would facilitate and sustain the good health record of their patients. These could help in saving cost and manpower at the long run. Also, managers of the surveyed health institutions should intensify their efforts in encouraging their health workers to maintain good handling care of records.


Chapter One


Introduction

1.1 Background of the Study

Introducing computer databases to the healthcare field has improved the efficiency of record keeping. Computers have the ability to maintain central databases that healthcare professionals are able to use and access wherever and whenever.

Information and communications technologies (ICTs) for health can play a critical role in improving healthcare for individuals and communities. Through the development of databases and other applications, with ICT, it is easy to access a patient’s full medical history. ICT also provides the capacity to improve health system efficiencies and prevent medical errors.

Computers are an excellent means for storage of patient related data. It is very necessary to maintain detailed records of the medical history of patients. Computers enable the efficient storage of huge amounts of medical data. It reduces duplication of patient’s data as there is only a modification file, which means the file is constantly up to date and the issues of lost case note and lack of space in folder storage are eliminated, due to all the patient’s information stored in a single file in the computer system, it makes it more effective when retrieving medical records for the examination of possible trends and long term changes in the patient.

ICT represents a huge opportunity to improve patient care and health system operations.

The motive of creating and managing a paperless office would be more serving, going paperless will save time, money, and lives too. It will make the records department more efficient, save on space, and promote cleanliness and good organization.

The traditional paper medical record used in physicians’ offices, clinics, and hospitals no longer meets the needs of today’s healthcare industry and is therefore becoming extinct.

The way healthcare professionals store, access, and use medical information, as well as the requirements for the management of health-related information are transforming. ICT has the core tool in healthcare delivery, integrating all pertinent patient information into a single record, which can then be accessed by authorized interdisciplinary professionals at any time.

Using Information Technology to manage the administration of intricate information resources promises significant rewards, such as improved practices and cost savings. Several developments in IT implementation have taken place in healthcare organizations, with IT playing an increasingly significant role in its delivery. All these technological developments have been made in providing effectively functioning systems to healthcare organizations to improve record management services (Grimson, 2001).

Technology has introduced a new dimension to various fields of human endeavour. It is helpful in bridging information gap when essential and in creating information gap when needed (Van Hoof et al, 2006). Incorporating different information technologies (ITs) into the healthcare system of developing countries is not all about modernizing the health system but it is about saving life by facilitating communication, practicing evidence based decision, incorporating e-learning to remote health professionals, using it as a medium to access recent healthcare information, data handling and processing activities among staffs (ITU, 2012).

The art of preservation and management of health records is an issue that has generated series on concern overtime because it require abundant resources including skilled labour, technological, and financial means, all of which can be difficult to procure in low-income settings (World Health Organization, 2012). Therefore, the need to develop and organize new ways of providing efficient health record services has resulted in a dramatic increase in the Impact Of Ict On Workflow In Medical Records Department In a Hospital


1.2 Statement of the Problem:

It has been observed that to receive medical treatment in most of our hospitals, the patients queue up for several hours from one unit of the hospital to another starting from obtaining a new hospital folder, or retrieving an old one before consulting a doctor, to the laboratory unit for lab test then to the pharmacy to get the prescribed drugs and so on. With the manual processes involved in handling the patient most of them waste the whole day in the hospital. Very often, patients leave their homes very early in the morning in order to be among the first group to see the doctor. Otherwise, they may end up wasting the whole day without due attention. This situation is discouraging to most patients and sometimes forces them to turn to non-professionals or even resort to self-medication for quick recovery. (UDOFIA I. U. 2013)

The Health Record Management sector in Nigeria has not been able to tap into the full potential of modern information technology to improve on healthcare delivery (Hitachi Data Systems, 2012). The paper based method of keeping medical records of patients comes with a lot of challenges. With a huge number of registered patients, there arises the need for a lot of physical space to be able to keep and store the paper based medical records. Since these systems rely on the handwriting of individual professionals within the hospital (e.g. doctors, nurses, laboratory scientists e.t.c), there can arise the problem of illegibility of writing which can make it difficult to access information at some other times. Accesses to patients’ longitudinal records are often times difficult and cumbersome. The lack of proper access has cost the healthcare industry a huge fortune every year due to duplication and waste (Hitachi Data Systems, 2012).

Preservation and conservation of health documents and records has posed a serious problem. The deterioration of materials forms the basic problem of registries and gives rise to preservation and conservation of records. Some of the major challenges of incorporating information technology into health record management system in Nigeria are; finance, shortage of staff, shortage of materials, inadequate coordination of data flow, lack of feedback to peripheral data and huge backlog of unprocessed data. Other barriers hindering adoption of information technology into health record management in UITH Ilorin, Nigeria, and some African countries include the high cost of implementation, poor infrastructural development, and inadequate trained manpower (Ayo et al, 2008).
Information is vastly more useable if it is in electronic form. Electronic information can be viewed as the raw material, which can then be made available to end users through a range of platforms. Therefore in Nigeria there is a dire need to strengthen the health information system through by use of information technology on health record management through provision of appropriate infrastructure, and the establishment of mechanisms or procedures for collecting and analyzing health data to provide needed information (WHO, 2010).

Finally, the keeping of folder for each patient manually takes a lot of time and money and some of the information are redundant. All these have net effect of loss of lives and inefficiency on the part of management.


1.3 Broad Objective:

The general objective of this study is to examine the impact of ict on workflow in medical records department in a hospital.

1.3.1 Specific Objectives of the Study

The following were the specific objectives that guided this research. They include to:

  1. Examine the prior assessment made by the UITH Ilorin Hospital Management before the implementation of the system
  2. Find out the challenges faced in use of information technology in health records management in UITH Ilorin, Kwara State, Nigeria
  3. Investigate the solutions on preservation and conservation of information technology in health records management in UITH Ilorin, Kwara State, Nigeria

1.4 Justification of the Study:

Even though the potential of Information Technology for improving the health record delivering system is very compelling and increase the efficiency of health care delivery system. Using information technology will enhances the recording, delivery and exchange of timely information at the point-of-care. The system offers high mobility and flexibility with potential to save people’s lives. This study will contribute to the body of literature on preservation and management of medical records in Nigerian health institutions. It will also provide a more effective and reliable tool for improving the management of records in the hospitals. This study will help to know how information communication technology (ICT) can help to achieve a better health record management system within few years and how they can expand their reach. The studies will emphasis on Nigeria health record management and ways in which they need to improve through the use of ICT. The implementation of electronic health records (EHR) can help lessen patient sufferance due to medical errors and the inability of analysts to assess quality. EHR systems have the advantages of being able to connect to many electronic medical record systems. In the current global medical environment, patients are shopping for their procedures.


1.5 Research Questions:

The study sought to address the following research questions;

  1. What was the initial (preparation) assessment conducted prior to the acquisition and implementation of the EHR?
  2. What are the challenges being faced in use of information technology into health records management in UITH Ilorin, Kwara State, Nigeria?
  3. What are the probable measures of improving on the usage of information technology in UITH Ilorin, Kwara State, Nigeria?

1.6 Scope of Study:

This research work on Use of Information Technology in Health Record Management was limited to Health Information Managers, Nurses, Doctors and Others Health/Medical practitioners in major department/units, UITH Ilorin, Kwara State, Nigeria. Research was carried out between January and May, 2017. The independent variables were the socio demographic information such as respondent age, sex religion, marital status, and level of education while the dependent variables were Use of Information Technology in Health Record Management. The study excluded respondents who were not staff or staff relative in UITH Ilorin, Kwara State, Nigeria


1.7 Operational Definition of Terms:

Electronic Records (ER):

refer to records that are dependable on relevant machines for access or reading, which is computer hardware and software such as e-mails, database and word processing.

Electronic Medical Records (EMR):

Is The health-related information of an individual that is created, gathered, managed, and consulted by licensed clinicians and staff from a single organization who are involved in the individual’s health and care.

Electronic Health Record (EHR):

Is the aggregate or longitudinal electronic record of patient health information created and gathered cumulatively across more than one health care organization and is managed and consulted by licensed clinicians and staff involved in the individual’s health and care. Included in this information are patient demographics, progress notes, problems, medications, vital signs, past medical history, immunizations, laboratory data and radiology reports.

E-Health:

Is an amalgamation of healthcare system and Information Communication Technology (ICT) to enable better health and healthcare delivery.

Health Information Management (HIM):

Is an information system that is specifically designed to assist in the management and planning of health programs, as opposed to delivery of care.

Health Information Systems (HIS):

Is a system that deals with storing patient information which can be gotten from patient records, surveys, health plans, and a host of other data sources. It comprise the entire infrastructure, organization, workforce and components for the collection, processing, storage, transmission, display, dissemination and disposition of information in the healthcare industry.

Health Information Managers (HIM):

Strictly health information managers are professionals who design and manage health system to ensure they meet medical, legal and ethical standard (Medical and health service managers, 2016) but for the purpose of this research, health information managers are all those involved in retrieval, filing of case notes and who give appointment to patients. This is inclusive of all health records staff

Information Technology (IT):

Is a broad based term used generally to describe the techniques and technologies, methods and applications which support activities involving the creation, storage, manipulation and communication of information (Principally computing electronics and communications) together with their related methods, management and applications.

Personal Health Record (PHR):

Is an electronic application through which individuals can access, manage and share their health information, and that of others for whom they are authorized, in a private, secure, and confidential environment.


Chapter Five


Summary, Conclusion and Recommendations

5.1 Introduction

The rapid advance of IT in healthcare settings has accentuated the importance of addressing the shortcomings of current health record integration practices. This matter is made worse by the regulatory gap between implementing new and emerging ICT, and managing the security risk the latter represents. Other problems include poor data quality and fragmentation, budgetary constraints, irreconcilable systems architecture, a history of incompatible data standards, confusing privacy jurisdictions and a lack of access to proven evaluation results. This research argues that it is of crucial importance that technology innovation in health is associated with the incorporation of Information Technology (IT) for establishing secure health record integration.


5.2 Summary

The analysis of mechanism put in place for use of Information Technology (IT) in health records management in UITH, Ilorin revealed that care in handling hospital health records, confidentiality of health records, security of health records and avoidance of water contact/bad weather are major mechanism employed in the hospital. The major challenges faced in use of IT in health records managements in surveyed hospital are poor funding, inadequate computer and other ICT devices, poor skill in computing, harsh environmental conditions, lack of preservation and conservation policy.


5.3 Conclusion

Use of Information Technology (IT) in health records management is an integral part of medical/ healthcare service delivery as it goes a long way in enhancing better service delivery as well as serving as a basis for following patient health trend overtime. It also serves as a basis for effecting referral service. Hence effort should be made to ensure regular preservation and management of records in medical centers/hospital.

The knowledge and skill of IT should be used on the hospital staff through training and re-training, formulation of health record management policies, infrastructural development, proper funding, computer skill training, etc as these would help in ameliorating the problem of poor hospital record preservation and management and its attendant’s negative impact on health care delivery.


5.4 Recommendations

In view of the above findings, the following recommendations were made for management of the institutions and to the entire health institutions in kwara and Nigeria at large. The following aspects should be improved for better operation of health information management in the future:

  1. Management of health institutions should inject more financial resources into the organization in order to solve the problem of inadequate funding of the health records management. It takes real money to acquire and maintain good health records management.
  2. Capital should be injected into provision of infrastructure and acquisition of modern equipment that would facilitate and sustain the general health condition of their patients. These could help in saving cost and manpower on the long run.
  3. Management of health institutions should intensify their efforts in encouraging their health workers to maintain good handling care of records; while some of the paper based records should be microfilmed in order to sustain their durability.
  4. Management of the health institution need to training the health/medical practitioners

5.5 Limitation of the Study

During the processing of the project, the researcher faced with a lot of physical problems.

These problems includes:

The researcher seriously faced with the problem of data collection, which helps in building the manuscript. Because information is the tool of business for solid data collection or material. So, inability to get materials on time really set my project back. Actually, it took me more than five months to gather enough information needed for this project.

Also for collection of data from my case study a lot of money is spent on transportation (Ibadan to Ilorin and Ilorin to Ibadan). Hence for one to be effective in this project, money must be involved.

Finally, the major limitations of this study were time, financial constraints and poor response by some health/medical practitioners fearing that computers may take over the practice of medicine which in advance, they may lose their jobs. For this reason the researcher is recommending compulsory information technology training for all the medical practitioners to enable them cope with the current trend in information technology.


5.6 Area of Further Studies

It is recommended for further studies to examine country specific policies and its effect on the implementation of EHR especially in the context of developing countries such as Nigeria. This would help unearth the limitations and barriers created by national policies and regulations on ICT systems’ implementation in both developed and developing countries. It would also help to determine the national readiness for EHR in developing countries.
It is also recommended that future studies evaluate the impact of EHR from the patients’ perceptive. This would help reveal whether or not the intended benefits of the implemented EHRs to patients are actually realized.
From the identified limitations to the adopted study approach, it is recommended for further studies to adopt both quantitative and qualitative research approaches in similar studies to generate diversified responses from participants.


The Impact Of ICT On Workflow In Medical Records Department In A Hospital


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The Impact Of ICT On Workflow In Medical Records Department In A Hospital


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Frequently Asked Questions


What is the role of ICT in hospitals?

The fundamental use of ICT in Hospital is for electronic storage of medical data. This helps to retrieve the information easily. Through ICT the data can be transferred to the patient or to the Doctors for consultation. The patient can have medical records in hand which can be used anywhere, anytime.

How does ICT impact quality of care?

From Figure 1 and Figure 2, it depicts that out of 50 respondents, 28 (56%) of them agreed to the fact that ICT impact quality of care by providing quicker access to medical diagnoses, whereas others representing 13 (26%) strongly agreed, 5 (10%) disagreed to the assertion that ICT is an enabler in promoting quality health service delivery.

Does ICT enhance doctor-patient rapport and improve health care delivery?

The majority of respondents asserted that ICT enhances doctor-patient rapport and improves quality of health care delivery as shown in Figure 2.

What is the impact of healthcare information technology on healthcare?

Health information technology presents numerous opportunities for improving and transforming healthcare which includes; reducing human errors, improving clinical outcomes, facilitating care coordination, improving practice efficiencies, and tracking data over time. 

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