Health Information System Failures and Prevention

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Table of Contents

Factors Contributing to Failure
The reaction of Leadership Team to Failure
Developing a Custom Application or Proprietary System
Best Practices to Avoid Failures in Future
Various Metrics and Portfolio Management to Enhance Organizational Performance
Governmental Intervention to Ensure Security of Information
References

Nowadays, information technology is an essential element that ensures a sufficient flow of information in a hospital and organizes its processes and activities. Nonetheless, relying on IT systems solely is not always effective, as their failure may lead to adverse consequences. For example, one of the technological incidents took place with Martin Health System located in Stuart, Florida (McCann, 2014). This hardware glitch negatively affected several MHS entities, as it took two days to restore the system and eliminate outage (McCann, 2014). Nonetheless, it was unclear whether the issues with hardware were the central causes of the problem since a similar failure of Epic EMR occurred in North Carolina while being caused by malfunction of software and network (McCann, 2014). Consequently, it could be said that the primary goal of the paper is to analyze the case mentioned above and understand driving forces, actions of the management, and potential solutions to this issue. At the same time, it is essential to describe best practices that can be actively used to avoid similar failures, propose different approaches to using metrics to maintain system efficiency at a sufficient level, and discuss the role of governmental intervention in information security.

Factors Contributing to Failure

In the first place, it is essential to understand the primary reasons for failure. The management of the organization indicated that the problems with hardware were believed to be the main causes of the system downtime (McCann, 2014). In this case, ineffective maintenance and lack of planning and scheduling for check-ups could be viewed as critical factors driving to the malfunction of hardware. Underestimating the importance of the procedures mentioned above will hurt the company’s operations, financial performance, and quality of the provided care.

Apart from the fact that the management claimed that ensuring the appropriate use of the Epic EMR system was their priority, another potential cause of failure might be referred to as the insufficient functioning of software (McCann, 2014). In this instance, there might be several factors that were the main drivers for the development of these problems. For example, lack of training and knowledge could be considered as one of the matters since improper use of the system will lead to glitches and failures. Furthermore, underestimating the significance of IT management and check-ups could also be discovered as crucial factors, as without these procedures, it would be impossible to understand the actual condition of the system.

In this instance, it remains apparent that the incidents mentioned above had a critical impact on the functioning of the organization and its patients. In the first place, these technological failures hurt the profitability of these medical institutions. At the same time, these issues questioned the ability of these medical facilities to ensure the safety of patients. For example, in North Carolina, electronic health records were unavailable for 24-hours while some information about the patients was permanently deleted (McCann, 2014). Overall, it could be said that these failures hurt both patients and organizations since they damaged the images of the medical institutions and increased the possibility of medical errors.

The reaction of Leadership Team to Failure

When discovering the cases mentioned above, it is vital to evaluate the actions of the managerial team to these issues. In the first place, it is necessary to describe the sequence of steps taken to find a solution to this problem. The managerial team highlighted that it is vital to ensure a continuous flow of information and processes while disregarding the failure of the system. In this case, it was necessary to use manual documentation to record important information about the patients (McCann, 2014). At the same time, it was vital to restore the system and data and contact different IT specialists to increase the speed of recovery (McCann, 2014). The subsequent stages included dealing with various stakeholder groups and finding causes of the failure. It could be said that the actions of the leadership team were logical since prioritizing the maintenance of the hospital helped them avoid panic and misunderstandings and minimize the number of medical errors.

Speaking of the measures to deal with different stakeholder groups, informing the employees about the failure and providing them instructions were sufficient. As it was mentioned earlier, it helped avoid panic and minimized the percentage of medical errors. Informing staff about the failure decreased financial loss, as the hospital continued maintaining its back and front office activities. At the same time, applying these measures was also beneficial for patients, as their needs were satisfied. It helped the company ensure that only high-quality services were provided while complying with the concepts of patient-centered care. Nonetheless, these actions were only temporary measures, and contacting the support team and IT department to restore Epic ERM was the next sufficient step. As for other stakeholder groups such as community, government, and NGOs to avoid misunderstandings and conflicts, the organization reported this situation to different media sources, and this action showed that the management of the hospital was able to cater the needs of patients continuously even in the case of crisis and technical failure. Overall, a combination of the measures mentioned could be discovered as sufficient, as it helped maintain the company’s image and provide a rationale that the organization would continue working effectively in stressful situations.

Developing a Custom Application or Proprietary System

In the previous sections, it was mentioned that the company used the Epic EMR system to store and maintain medical records while making them available to personnel of the organization (McCann, 2014). This aspect underlines the fact that the company was using a proprietary system in the recent past, and the inability to adjust it and its lack of flexibility could be discovered as the major causes of failure. Consequently, in this case, developing a custom application can be viewed as one of the solutions to the issue. One of the benefits of this approach is the fact that using this method can help medical institutions focus on the drawbacks of the previous proprietary system and design new software that will be able to take into account the limitations of the previous one. Consequently, utilizing this strategy can help the company avoid similar glitches and failures in the future, as the regularity of the automated system check-ups can be agreed with the system developers.

As it was mentioned earlier, one of the major issues was the fact that information about prescribed medication and treatment was unavailable to nursing practitioners and physicians for 24-48 hours (McCann, 2014). To avoid similar problems in the future and ensure data integrity, the organization has to include cloud storage as one of the essential elements in a new customs system. This method allows storing large volumes of data and ensures its rapid retrieval in case of an emergency such as network glitch (Griebel et al., 2015). Consequently, underlining the essence of this element to the software developer will not only help design application that ensures fast access to this information but also have a beneficial impact on the flow of information and its accuracy during technological failures and system glitches. Nonetheless, before designing new software, it is necessary to conduct a sufficient analysis of Epic ERM and determine critical reasons for failure. This aspect will contribute to effective and rational decision-making, as, now, the causes of failure are still unclear.

Best Practices to Avoid Failures in Future

Apart from the need to switch to custom applications. It is essential to improve the functioning of the company from a managerial perspective. In this case, introducing universal best practices that can be applied to avoid similar technological failures is important. In the first place, the management of the medical institution has to understand the value of integrity, as the organization consists out of interdependent departments and components that have to work in unison to provide high-quality services to patients. Applying a principle of “collective mindfulness” can be discovered as one of the best practices that have a direct connection with organizational integrity (Chassin & Loeb, 2013, p. 461). Taking advantage of this model will help prevent system failures since each employee will be responsible for reporting any malfunction or misuse of software. Nonetheless, to be able to spot the cases of technical errors, providing additional training will be essential. This concept can be discovered as the second-best practice. Developing effective training programs will not only improve the quality of the provided services but also enhance organizational performance and help report errors promptly (Chassin & Loeb, 2013).

Furthermore, one cannot underestimate the significance of continuous assessment of performance and frequent check-ups since these strategies are actively employed by highly reliable organizations (Chassin & Loeb, 2013). This matter has to be discovered as the main prevention strategy that helps minimize the frequency of failures. Apart from regular reports of the employees, professional assistance is required. Prioritizing this method will help detect the lifecycle phase of the software and hardware and signify whether it has to be replaced. Nonetheless, despite a substantial significance of the last best practice, all strategies indicated in this section have to be considered of paramount importance, as using them as a combination will help enhance performance and ensure that regular back-up of information takes place.

Various Metrics and Portfolio Management to Enhance Organizational Performance

Along with the best practices highlighted above, it is essential to consider various measures and portfolio management techniques. Introducing different KPIs (Key Performance Indicators) will ease the assessment procedure. In this case, the company can employ metrics such as data safety, data integrity, confidentiality, system performance, and flexibility to evaluate the performance of IT system, as using them will help avoid system failures and data corruption and spot the malfunction of software and hardware at its initial stage. Alternatively, to assess the compliance of the company with healthcare standards, benchmarking and customer satisfaction surveys can be used. For instance, organizing a short interview after the screening will help reveal the aspects that have to be improved.

Alternatively, to determine the cost-effectiveness of interventions, the principles of value-based purchasing can be applied (Lighter, 2015). For example, it will help evaluate the necessity of particular procedures such as audiology in rural areas. In turn, this paradigm can also be used in different contexts such as portfolio management. It will assist in evaluating software and hardware options, contribute to discovering the benefits of custom applications, and determine the existence of an extended number of alternatives to Epic ERM. The metrics to evaluate the technical performance mentioned above can be used to select the most suitable option.

Governmental Intervention to Ensure Security of Information

Lastly, one cannot underestimate the role of government when ensuring the safety and confidentiality of patient records. One of the positive examples of governmental intervention is introducing EHR (electronic health records) to ensure data integrity (Bowman, 2013). This matter helped increase the availability of information in case of emergencies such as system failure or network glitch since it is safely stored on reliable servers. At the same time, making patient records digitalized required the authorities to introduce well-developed confidentiality and safety standards to avoid the leakage of data (Bowman, 2013). In this instance, following these guidelines helps not only ensure the confidentiality of information mentioned in EHR but also underlines the need to conduct frequent check-ups to identify malfunction or stop cyber-attacks at their initial stage. This example highlights that governmental intervention is essential in this context since it establishes safety regulations that have a positive impact on the overall organizational and financial performance of medical institutions. Based on the arguments mentioned above, it could be said that the role of government in this process cannot be underestimated since the authorities can take into account the needs and preferences of different stakeholders of the medical industry and develop effective policies and guidelines that have to be followed.

References

Bowman, S. (2013). Impact of electronic health record systems on information integrity: Quality and safety implications. Online Research Journal: Perspectives in Information Management, 10(1), 1-12.

Chassin, M., & Loeb, J. (2013). High-reliability healthcare: Getting there from here. The Milbank Quarterly, 91(3), 459-490.

Griebel, L., Proskoch, H., Kopche, F., Toddenroth, D., Christoph, J., Leb, I.,… Sedlmayer, M. (2015). A scoping review of cloud computing in healthcare. Medical Informatics & Decision-Making, 15(1), 1-16.

Lighter, D. (2015). How (and why) do quality improvement professionals measure performance? International Journal of Pediatrics and Adolescent Medicine, 2(1), 7-11.

McCann, E. (2014). Network glitch brings down Epic EMR. Healthcare IT News. Web.

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