Information or knowledge management in health care refers to the organization of and easy access to important know-how, whenever and wherever it is required (Pasupathy, 2006). Experts in both health care as well as IT predict an ever increasing use of information systems in the health care profession, for the simple reason that medical science is founded on accurate and timely information – something that today’s information systems are absolutely capable of handling (Meadows, 2002).
The Personal Digital Assistant (PDA) seems to be doing a perfect job of helping health care organizations and medical professionals manage information in the palm of their hands. No wonder, the health care industry has emerged as a leader in adopting the PDA, which is an application of mobile and wireless technology to manage tremendous amount of data within hospitals and clinics (Havenstein, 2005).
Yet another example of technological development in the area of information in health care is nursing informatics, defined as the “use of information technologies in relation to those functions within the purview of nursing, and that are carried out by nurses when performing their duties. Therefore, any use of information technologies by nurses in relation to the care of their patients, the administration of health care facilities, or the educational preparation of individuals to practice the discipline is considered nursing informatics (Turley, 1999).”
Even the PDA, if employed by all nurses in a health care facility, is considered nursing informatics. Regardless of its name or function, however, a modern technological tool in the hands of the health care manager or provider is a blessing to be shared among all health care organizations. Thus, it is essential for health care professional organizations, health care executives and politicians alike to consider the importance of technological developments and promote them.
Clinical Information Systems
Clinical Information Systems are known as efficient technological tools for high quality care as these systems allow for swift retrieval of information as well as efficient management of data. Nevertheless, research has revealed that there is a tremendous amount of user resistance as far as these efficient tools for health care quality management are concerned. Hence, it is necessary to enhance our understanding of the successful implementation of Clinical Information Systems (Palm et al., 2006).
By comprehending the factors that inhibit the use of Clinical Information Systems, health care management teams would be in a better position to increase the use of these systems. Moreover, it is equally important to gather the factors that encourage the use of Clinical Information Systems. After all, health care professional organizations would be in a better position to help improve the health of America by understanding both the factors that inhibit and those that promote the use of new technological systems in health care.
Palm et al. have published a study that defines the determiners of user satisfaction with Clinical Information Systems. Using an electronic survey instrument designed on the basis of two theoretical models, the research was built on a hypothesis that identified several dimensions that were believed to have an impact on user satisfaction. These dimensions included the characteristics of users, the use of a Clinical Information System, the quality of the system, its usefulness, in addition to the quality of service provided with the system in place. The survey questionnaire was administered to medical secretaries, nurses and physicians of the Georges Pompidou European University Hospital in Paris.
The findings of the research suggested that all users of the Clinical Information System are generally satisfied with this technological tool for retrieving and managing information. In other words, all users were of the opinion that Clinical Information Systems are more efficient than paper-based information systems. What is more, although medical secretaries, nurses and physicians were all using the several components of the Clinical Information System at the Georges Pompidou European University Hospital, satisfaction was greater among the group of medical secretaries. Lastly, the overall satisfaction of the users of the Clinical Information System at the Georges Pompidou European University Hospital was significantly connected with the quality of the system, apart from its use as well as service quality (Palm et al.).
In the following sections of the paper, we will explore the implications of the above mentioned study.
Increasing Physician Use of Clinical Information Systems
Grant et al. (2006) have published a research which was conducted in the year 2004 to determine the prevalence of non-electronic health record information technology use among a sample of 1,662 physicians in the United States. All of the physicians were engaged in direct patient care. The research findings provided evidence that most of the physicians in the U.S. are not using information technology tools in clinical practice. This evidence confirms the research findings of Palm et al. that physicians are not using Clinical Information Systems as often as medical secretaries.
All the same, it is essential to encourage physicians to make use of Clinical Information Systems in their practice. Hum & Parshoram (2006) have published a study that provides evidence of the usefulness of Clinical Information Systems in medical practice. In this study, inappropriate administration of calcium was checked by a Clinical Information System. According to the authors:
Calcium infusion therapy is relatively common in critically ill children. We found that clinical monitoring is incomplete. Specifically, phosphate measurements were performed infrequently, and patients received calcium infusions despite high CPP. Information technology helped process the large amount of data and reveal these trends. Inappropriate calcium administration may be prevented by the successful application of a real-time clinical alert system including reminders to check calcium and phosphate levels in patients at risk, and providing alerts about inappropriate calcium administration at the time of order writing and during infusion (Hum & Parshoram, p. 959).
In order to increase physician use of Clinical Information Systems, findings of relevant studies outlining the importance of these systems in medical practice must be distributed among physicians. The findings of the research conducted by Hum & Parshoram provide an excellent example of the practical use of Clinical Information Systems in checking medical errors. By distributing such research findings among physicians, health care institutions and health care professional organizations could certainly help the entire nation experience an improvement in the quality of health care.
Improving the Quality of Clinical Information Systems and their Service Quality
The findings of the research conducted by Palm et al. suggest that health care institutions must consistently work at improving the quality of their Clinical Information Systems. In addition, the quality of service provided with the Clinical Information Systems in place must be improved. This includes the quality of training provided for use of Clinical Information Systems, as well as the availability of a support hotline, and speed of repair. The study of Palm et al. shows that nurses and physicians are both using Clinical Information Systems less often than medical secretaries.
While it is understandable that medical secretaries enjoy the use of Clinical Information Systems because their work had traditionally involved a high amount of paper work, it is equally important to encourage physicians and nurses to increase their use of Clinical Information Systems. Since the use of Clinical Information Systems is significantly connected with the quality of the systems in addition to service quality, it is necessary to improve quality of the systems and service quality to promote the use of these systems among physicians and nurses.
With a PDA, a medical practitioner or nurse has access to all of the patient information that he or she would need at any given time. Besides, doctors and nurses may download onto their PDA’s all of the medical knowledge they would ever require, for example, the downloadable American Academy of Pediatrics asthma guidelines. The information in the palm of the medical practitioner’s hand today may further consist of medical journals and encyclopedias downloaded onto the PDA.
Another important piece of downloadable data is billing information about inpatients and outpatients (Torre & Wright, 2003). In short, the PDA is the answer to the prayer of every medical professional. It is a lightweight, durable, safe to use, low power equipment, that does not interfere with other medical equipment in use by a doctor or nurse. In addition, the PDA does not involve any monthly charges. It is like a personal computer that any medical doctor may own (“PDA Causing Medical Revolution,” 2007).
On a similar note, Clinical Information Systems are highly efficient not only for speedy retrieval of information and management of data, but also for checking medical errors. Needless to say, all of the advantages proffered by these systems should encourage their use among medical secretaries, nurses and physicians. Even so, research shows that physicians and nurses are not using Clinical Information Systems as often as medical secretaries.
In order to promote the use of Clinical Information Systems among physicians, therefore, it is advisable to distribute research findings that relate the importance of Clinical Information Systems in medical practice. The fact that these systems are able to check inappropriate administration of calcium is enough to encourage physicians to use Clinical Information Systems more often than they do at present. At the same time, however, physicians must be able to gather more advantages of Clinical Information Systems in medical practice so as to increase their use of these efficient systems.
Lastly, it is important to improve the quality of Clinical Information Systems as well as their service quality to encourage their use among physicians and nurses. Undoubtedly, the quality of these systems is associated with their use. In order to increase user satisfaction of Clinical Information Systems, quality improvement is necessary. Health care institutions are expected to experience increased benefits of these systems if physicians and nurses begin to use them as often as medical secretaries. Most importantly, perhaps, it is the health care professional organization as well as the politician that would have to take equal interest in the promotion and improvement of technological tools that can significantly improve the health of America in the twenty first century.
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