Chapter 2 IT and Information Management

1. Chapter 2IT and Information Management Yung-Fu Chen, Ph.D. Department of Health Services Management, China Medical University

2. Outline • IT has the potential to transform healthcare delivery by providing information in a timely fashion, when and where it is needed. It also has the ability to reduce errors, costs, duplication and waste. This chapter discusses health IT and its use in the collection, storage, retrieval and transfer of clinical, administrative and financial health information electronically.

3. Computer technology enables activity that would otherwise not be economically feasible, but at the same time it is difficult to cost-justify in advance or to show value in hindsight. Too little investment leads to project management problems, continued local inefficiencies, incompatibility, and wasted time and effort. Too much investment discourages end-user investment and involvement that may result in unused capacity and accusations of waste. A modern health system cannot function effectively with information locked in professional or organizational silos, nor can it be managed without computer systems because of the enormous amount of data that are generated IOM and others indicate that fragmented, disorganized, and inaccessible clinical information adversely affects the quality of healthcare and compromises patient safety. Introduction

4. Introduction • Heathcare is an information-rich environment and all health workers have a responsibility to ensure the quality and reliability of health information. • IT can refocus healthcare into a truly consumer centric model • Consumers already access vast amounts of online health information and some present to their provider with these as a basis on which to discuss their health issue. • The huge increase in the use of IT systems and the substantial investment in information management infrastructure is evident of a strong belief that information management systems will provide patient care and deliver quality health outcomes

5. Information as a dominant health resource • As healthcare grows more complex, and the boundaries between the professions and various health sectors become increasingly blurred, the ability to communicate effectively about patient care is paramount • The inherent characteristics of information make it unique, crucial and invaluable resource • There are limits to the growth of knowledge in healthcare because of the restrictions on the time that clinicians can devote to refining information

6. IT in practice • There is evidence to support the use of IT to improve the safety and quality of care and support the decision-making • Despite growing evidence for the effectiveness of IT, clinicians remain sceptical • The literature reports many instance of the unsuccessful introduction of health IT, with failures in both networks and computer system reported • IT is pervasive. In the community nurses use handheld computers and mobil phone connections for emails, note-taking, caseload management, allocating resources, and tracking travel and visit times. • It is difficult to imagine what business and industry would be without computers and automation as they are so irrevocably entwined

7. Managing health information • Security • Authentification • Access • containment • Access control • Standards • Timely access to quality data • Interoperability and integration

8. Workforce issues • There are many related social and work factors involved in the implementation of IT into workplaces, such as a largely unprepared workforce and uncharted workflows • Workflow issues are critical in the implementation of IT, because without careful planning, the implementations meant to improve practice might have the opposite effect.