Harnett County Public Health IT Department

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Healthcare has reached a very high level of development around the world and in the Unites States, in particular. The quality of medical treatment has improved significantly, as evident in the advances in the stem cell research, human genome, targeted cancer therapies, laparoscopic surgery of minimal invasion, and lots of others. However, while the treatment procedures have improved, a lot of other ingredients of a positive experience, such as the service provision, customer education, record upkeep, staff and interprofessional communication, remain severely ineffective, inefficient, and unintuitive, especially when compared to the advances of other customer-oriented industries in these areas.

For this paper, an interview was conducted with Chris Strahan, a member of Harnett County Public Health IT Department. He provided insight on the process of integration of new technologies that had been selected for his institution, what was the difficulties that were faced when implementing them, and talked about his involvement with the process.

Strahan discussed his experiences with an application called PDQ, which allowed them to transfer software to their workers remotely. The software was easily installed on a server and they had it integrated into their active directory. This, in turn allowed them to push whatever software they needed on a worker’s computer. According to Strahan: “It was an easy install and an easy tie in to our network” (personal communication, July 22, 2016).

As part of the interview, he was asked how the process occurred, and what happened. Strahan explained that the decision to purchase PDQ came from the need to update specific pieces of software, or remotely update the software on their employee’s software in a more efficient manner. Visiting each workstation was time consuming and not productive. They began researching ways in which they could “push” the software out to their workers from a server. Several products were available, but after researching costs, features and compatibility, PDQ became our choice of software.

Considering the often recognized difficulties of integrating such systems into the workflow, a part of the interview attempted to determine whether the interviewee would be willing to undergo this process of innovation again. Chris indeed confirmed that in this case the experience had been worthwhile, and that PDQ has been a great choice of software for his company’s needs. He does note that the initial process of software integration and learning how to use it had presented difficulties. In particular, they did not know how to use some of the custom software packages that came with the system in order for PDQ to successfully deploy, but it was “a minor hiccup at best”, and once they got a handle of it, the problems seized (C. Strahan, personal communication, July 22, 2016).

The interview shows that while technical innovation has the potential to improve the workflow of a healthcare business. However, the interview also showed that the lack of familiarity with the software can result in hold-ups and slowdowns of work. It also makes sense that the lack of experience with important software, like the Electronic Healthcare Systems, can similarly lead to a slew of issues, with medical errors being the most damaging ones. Due to the lack of innovation geared towards improving efficiency, medical errors lead to numerous complications in healthcare, with a 2016 study showing that they have become the third leading cause of death in the US (Makary & Daniel, 2016). This issue persists, despite the intensive growth of expenditures on medicine.

In this situation only truly innovative solutions can help resolve the situation. Innovation is needed in almost every aspect of healthcare, from client service, to technology, to its business model (Herzlinger, 2006).

US Government is aware of these realities and is investing heavily into medical research and development, but a lot of initiatives fail, resulting in even more sunk costs. A common reason, to which such failures are attributed, is that the innovations are pushed by outsiders, and their perceptions of what is needed in the industry. Often such perceptions are based purely on statistics and popular trends, with little to no input from the stakeholders themselves.

The introduction of Electronic Health Records was supposed to simplify the aggregation of such vital medical data as the daily charting, medical administration, assessments of patient physical state, past medical history, various related data, and the nursing care plans. The projected benefits of these systems were their completeness, accuracy, and organization of data, leading to improved accuracy in the documentation by health care professions (Hayrinen, Saranto, & Nykanen, 2007).

And, indeed, these systems have showed the benefits of computer-organized information, and were much desired in hospitals as early as in the 80s-90s, in order to replace the overabundance of paperwork that plagued patient care, both official, in form of reports, prescriptions, medical history, etc, and informal, which included various nurse and physician notes. EHRs promised to simplify the bookkeeping process and streamline the data collection and analysis process (McDonald, 1997).

Obviously, all of this makes the implementation of EHRs seem like a very good idea. However, studies which followed the implementation of EHRs in the late 2000s, discovered that integration ran into a number of severe obstacles, with the primary issue being that they were designed with the right specific goals in mind, but with little regard to the needs of the users. The systems remain as separated from one another, as the traditional health record systems have been in McDonald’s report, with numerous digital systems which rarely work together.

Functionality differs greatly from system to system, which makes it very difficult to provide appropriate training to the health practitioners. The lack of interoperability not only does not make healthcare more transparent, but arguably makes it less. Lack of widespread understanding of these technologies means that EHRs use is often time consuming, meaning that time is taken out of actual patient care.

Finally, since few financially viable EHR systems have been designed with actual commentary from physicians and nurses, these tools often force the stakeholders to painfully readjust to new ways of doing things, which increases the risk of errors and decreases the overall appreciation (Patel, 2015).

The only solution that has actively proven to be effective is presence of experienced IT experts in the hospitals and clinics, who understand the systems, are able to adjust to their use, and train others. By providing adequate coaching and ensuring the presence of a developed IT support for the medical practitioners, a lot of issues with the innovative systems can be resolved. Also, if the IT and system developers work closely in conjunction with the medical staff, a better understanding of the latter’s needs can be achieved, and, consequently, more effective systems will be produced.

References

Hayrinen, K., Saranto, K., & Nykanen, P. (2008). Definition, structure, content, use and impacts of electronic health records: A review of the research literature. International Journal of Medical Informatics, 77(5), 291-304. Web.

Herzlinger, R. E. (2006). Why Innovation in Health Care Is So Hard. Web.

Mcdonald, C. J. (1997). The Barriers to Electronic Medical Record Systems and How to Overcome Them. Journal of the American Medical Informatics Association, 4(3), 213-221. Web.

Makary, M. A., & Daniel, M. (2016). Medical error—the third leading cause of death in the US. Bmj, I2139. Web.

Patel, K. (2015). Electronic Health Records, Part 1: Challenges. Web.

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Harnett County Public Health IT Department

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