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Introduction
As computer generation quickly grows, many institutions should comply with it for easy running. The main component attracting attention for these institutions has been the use of Information Communication and Technology (ICT) sometimes referred to as information technology (IT).
Hospitals handle extremely sensitive issues concerning people’s health. One way to fulfill has been health record keeping of their patients (Van der Meijden 238). However, most of the hospitals have been using the paper-based health records that are not fully secure in some instances. As a result, there has been a suggestion of computer-based heath recording to replace the previous system that is tedious also physical in handling many records. Hospitals across the United States have decided to computerize their health recording to alleviate these problems. Uses of ICT and Electronic Health Records (EHR) have been on the rise given the benefits accrued to utilization of these technologies (Badger et al. 1).
However, adoption of these technologies has not been easy in these hospitals as various stakeholders in hospitals expressed different opinions on computerization of some functions in the hospital (William 1). This study will address how these stakeholders differently perceive computerization in hospitals.
Background Information and Research Problem Definition
The United Stated has been using the paper-based health recording for many years until when the Katrina Hurricanes strike the United States gulf coast in 2005. Paper medical records faced massive destruction, which made tracking of health records hard. More so, this disaster devastated many health care providers. Activities in most of these health facilities almost came to a standstill but the U. S. Secretary of the Department of Health and Human Services had to acts quickly to resolve the situation. As a result, the department had to develop better methods to secure health records in the future. The major way to this utilization, of Electronic Health Records to facilitate quick retrieval of patient’s information under any circumstance.
No sooner had the department aired their plans than various health care providers raised concern on the implementation of these EHR. This has led to a difference in attitudes among them hence; there have been acceptance and resistance to this move by these health care providers. Therefore, this paper investigated the factors that might have contributed to either acceptance or resistance toward computerization of hospitals.
Research Questions
From the introduction and background information, the following were questions that this research sought to answer:
- What are the advantages and disadvantages of computerization in hospitals?
- What drives resistance among the concerned stakeholders in the hospitals toward computerization?
- What are the possible computer applications used in a successful computerization and their area of interest in hospitals?
- Could there be any correlation between the advantages of computerization and acceptance of the technology?
- What is the responsibility of SAS data analysis in bioinformatics, in a hospital setup?
Research Scope
Use of computerized functions has been on strong demand in most institutions given the benefits. However, not all the stakeholders have warmly welcomed such paradigm shift because of reasons either known to them or revealed by research. Therefore, this research study concentrated on the hospital setup where peoples’ health is paramount, and everything always ensured working all the time to alleviate any disruption in handling patients. Computerization of some functions has been the primary method to facilitate this situation, but there are issues surrounding this health care in adopting this initiative, especially the EHR. The research study narrowed down to examine the reasons health care providers have either accepted or rejected computerization. In addition, factors fueling either of these opinions helped in analyzing their validity and contributions.
Research Limitations and Ethics Consideration
Limitations in many researches are unavoidable because they occur without even the researcher’s knowledge or the prevailing conditions. However, the researcher should be aware of these limitations as well as applying the research ethics to handle some of these limitations. Therefore, these were significant limitations faced during this research.
- There was insufficient time and resources to facilitate the whole research period. Time allocated to carry out the investigation was inadequate to investigate all the issues contributing to variation attitudes toward computerization. In addition, there was little financial support to collect primary data, which is especially valuable.
- Not all issues affecting the difference in attitudes could be present in the context by the end of the research because of inadequate information in some questions.
- Lack of basic information led to use of secondary data only. Most of these secondary sources were outdated thus, affecting their validity and reliability.
The ethics considered during the research process were:
- All the quoted or paraphrased data had a reference to give credit to researchers in other previous studies on the same topic.
- Data analysis ensured no modification to maintain its validity and reliability. Any alteration could have led to biasing of the outcome to fit an opinion, which could have undermined the importance of the research.
- Time allocated for research was used properly to avoid lateness and avoidance of some areas required for learning. The results acquisition was in time and the results presented in this paper are data got from the literature reviewed.
Research Methodology
Data collection and analysis from secondary sources utilized both inductive and deductive research approaches because of their complement in data acquisition. Data collected were mainly through a qualitative research method. Unlike the quantitative research method, data collected through qualitative approach are immeasurable using numerical standards. Instead, the figures reflected the perceptions, opinions, emotional, and obscure information expressed in percentages or probabilities.
The research had to get information to address difference opinions expressed by various health care providers. There were no defined answers to questions asked to them hence; measurement of percentage could have been difficult. Therefore, the research used a qualitative approach.
Data required for this research could have been either from secondary or primary sources. Primary data results from primary sources using different methods such as interviews, surveys, case study, focus groups, among others. Data from these sources forms the basic research because the data offer firsthand information from the population studied. However, collection of primary data is expensive because these methods consume many expenses in planning and the activity.
On the other hand, secondary data were acquired from secondary sources such as journals, online sources, publications, newspapers, among others. The advantage over the primary data is the inexpensiveness in acquiring them. Acquiring these data is less expensive because they are readily available from these sources. Therefore, this study used the secondary data only to meet the research question.
This research was possible through a conducting an in-depth literature review on the topic from previous work published by other researchers. The literature review addressed various aspects of the research topic in which answering of various research questions was possible. The researcher formulated some recommendations as well as making conclusions on the topic after answering these questions.
Literature Review
Computerization in hospitals has contributed too many benefits in the United States and the rest of the world. However, agreements among different health providers have ranged from positive to negative attitudes. These differences in attitudes triggered research into this issue to know what the contributing factors to these divisions in perceptions are. As a result, various researchers, academicians, health providers, and scholars have showed interest in this issue. Many researchers have been done on the question by individual researchers who came up with different perspectives to this topic. This continually has expanded the knowledge base of computerization in hospitals and differences in opinions.
This have led to development of information on how computerization in hospitals has received acceptance or if the level of rejection is declining or increasing. This research conducted an in-depth literature review of the previous work to create a decision on the research topic.
According to William (1), knowledge in ICT has been of enormous importance to nurses in their line of duty. ICT has enabled nurses to improve health care service delivery to their patients. It is advisable for nurses to accept ICT progress in their jobs because patients care is essential. ICT will be of much help to nurses in making wise decisions when taking charge and managing their patients.
Attitudes toward ICT phenomenon have been a determinant in adoption of computerization. This situation has slowed efforts by some hospitals toward paperless systems.
Factors Influencing Attitudes toward Computerization
Before introducing computerized services, addressing the attitudes exhibited by the health workers is important. The attitudes by the workers initially determined computerization. Computerization is achievable if only the nurse managers have a positive attitude. Difference in computer skills levels among the health workers in hospitals might be one major determinant to acceptance or rejection of computerization in hospitals. Health workers with excellent skills in computers easily accepted computerization because it could reduce their work. However, lack of computer skills among the workers can be a hindrance to computerization because the health workers are not used to computer operations.
Efforts to establish computerized functions can be discouraging to these workers because it can be a way of eliminating them from the system. In case the low skilled workers accept computerization, it takes a long time to learn all the requirements, which may affect their work output and effectiveness.
Ngin and Simms (55) revealed that variation in skills level could help in dealing with them based on their capability to operate at different levels. Appreciation of workers both skilled and non-skilled in computers can create a basis of motivating the low skilled workers. As a result, they can take computerization after getting little duration training in computers use. However, sidelining the low skilled workers could lead to rejection of computerization in hospitals.
A positive attitude among health workers toward the use of computers is significant because computer use in both academic and practical setup (Mcbride and Nagle 164).
Kivuti and Chepchirchir (1) cited various factors that have influenced agreement or rejection of computerization as age, experience in computer use and educational preparations. However, there might be other factors influencing attitudes toward computerization hence; more research is helpful in to coming up with more factors. Various researchers have investigated age factor toward opinion attached to computerization (Krampf and Robinson 32).
Previous studies revealed that young health workers were more positive to computerization than elders were. However, recent studies have disqualified the age factor as a determinant as the acceptance of computerization has increased in all ages categories (Parker and Abbot 1015). This means that age factors currently is invalid in determining the attitude toward computerization.
The present generation has been exposed to computer use, unlike in the past, when remarkably few people had experience in using computers. Studies have revealed a continued acceptance of computerization in hospital among the workers. The positive attitude has been on an increase, but a struggle to computerization has a negative attitude toward computerization is still evident in hospitals.
Simpson and Martins (39) have attributed the opposition to lack of knowledge in operating computers to the nature of work and applicability of computers currently and in future (McBride and Nagle 170).
Nurses with high education preparedness to computerization had a positive attitude. According to Henderson et al. (30), the relationship between working experience and consent of computerization are being inconsistent. However, Henderson, and others were in the opinion that work experience was a determinant, but Ash, and others denied such claims.
A short-term training session in computer use among health workers was a determinant toward adherence to computerization. Trained workers were more favorable to computer use. According to Braude (150), attitudes toward computerization depended on the area of work. For instance, nurses in pediatrics can take computer use more easily compared to nurses in medical surgical. More so, workers in health recording should be the most suited for computerized functions with the use of electronic health recording.
Interaction with computers in the hospital determined the attitude toward computerization. Workers regularly handling computers in the service area were more likely to accept computerization than those who rarely sit next to a computer (Chan 59).
Use of computers in hospitals has been a significant challenge to physicians and health workers (Mandell 316). This has separated the experienced and non-skilled in computer usage. However, technology has been in a progressive development enormous even to the skilled personnel. Evolution in technology has also separated between the proficient and tertiary health workers in the technological field. Some hospitals have advanced in new technology integration into all the institutions. Nowadays, there is software loaded into a computer for data computation, data review among other significant functions. This software has been on demand from the hospitals to manage their patients in a better manner.
As noted earlier, bioinformatics remain one major constituent in hospitals, especially in health recordings. Some software such as SAS has been essential in statistical data analysis. SAS among other software have eased duties allocated to health workers. Some software is capable of analyzing data after computation through data entry. The results from this analysis have been of much significance in making a decision on patients.
Perceptions by Non-Health Workers to Computerization
Most of The researches have ignored the attitudes of the patients and their affiliated families and friends toward computerization. Computerization had a tremendous support from people outside the hospital setup such as patients, other workers, and the civilians. Computerization has eased patient-hospital relationship as patients have expressed their satisfaction for services currently delivered by different hospitals. Patients spend less time in making enquiries in hospital as observed before. Use of software to monitor the heath status closely for patients involved in emergency cases saved many lives (Braude 150).
Computerization has helped the patients in knowing their health standards through data access to perform a review of health tips, recommendations, and so on. For example, information on body weight and height submitted to a computer to verify health fitness of a person. The results may recommend physical exercise, and change of diet.
Advantages of Computerization Ion Hospitals
Regardless of differences the attitudes among different stakeholders, computerization has several advantages.
Making the work easier
Use of the computer has saved the workers much time that might have been wasted in physical activities. Workers should submit information to a computer, after which the computers have software to perform analysis. This has eased the previously work done by former workers.
Improvement of accuracy in health records
Use of the computer has led to accurateness of patient’s health information. As long as you enter the right information about the patient, the data store in the computer remains constant unless outside forces vary. Alteration may be through hacking processes done by malicious people. However, hospitals can avoid such occurrences through powerful data encrypting methods as well as securing their website by firewalls (Lorenzi and Robert 117).
Quick retrieval of patients records
Unlike the paper-base health recording, computerization has enabled quick access of patients’ health information on a request. Only few clicks done to gain access to the information in retrieving information. Previously, some minutes or even hours became wastage in retrieving a patient’s heath record.
Disadvantages of Computerization in Hospitals
Computerization has its better and the worse part. Therefore, the following are the obstacle associated with computerization in hospitals.
High costs of establishing a computer system and purchases of software
It is expensive to buy computers, especially if the hospital targets to receive fast and efficient computers. The cost of buying original software is even higher unless the hospital settles on locally developed software.
Lack of computer experts in hospitals
Computers like any other machine require regular maintenance to maintain their functionality. Software loading into computers makes them more susceptible to virus infection. This may hinder functioning of these computers to avoid further destruction of data stored in as a computer
Laying off some hospital workers
Computerization leads to ease of service in hospital because one computer can supply different departments simultaneously. Therefore, adoption of computerization in hospital might lead to laying of some workers because computers replace them.
Conclusions and Recommendations
From the above in-depth literature review, various issues were open to the research conducted. The division in attitude toward hospitalization has continually taken different dimensions as time goes on. One factor might have led to either acceptance or rejection of computerization at one time, but with time, it became less determinant, for example, age.
The investigation revealed age, level of experience, preparedness to work, among other factors as a determinant to either positive or negative attitude toward hospitalization. However, there were deficits in researching for more factors as revealed by many researchers.
There was a correlation between the advantages of computerization and the amount of compliance in the hospitals. Most of the involved stakeholders accepted computerization based on the benefits it had to patients. On the other hand, rejection of computerization had little to do with disadvantages of computerization. Instead, those rejecting computerization had a personal problem to it or the conditions they worked suppressed efforts to incorporate computerization.
Evolution in technology has improved service delivery in hospitals as new software are aiding in the proper handling of patients. However, problem in latest and improved software has proven hard for many people (Lorenzi 204). As computerization in hospitals become a reality, there are opinion divide among the associated stakeholders such as doctors, clinicians, nurses, registrars, among others. The move to switch from manual activities to electronic and digitalized functions has not been easy. Some of the directly affected stakeholders warmly have accepted this initiative, but there is yet another group still criticizing such action. Therefore, more researchers have shown interest on this issue to determine the potential drivers to either acceptance or hostility toward computerization in hospitals. An exciting showdown may emerge as the computer-based health records replace the paper-based health records.
There were challenges faced in the completion of this research study. For instance, there was no in-depth data analysis in most of the literature review. Therefore, this research came up with different recommendations.
- There is a need to do more research studies on this topic because the already documented data have not been consistent. There is unclear trend in the factors influencing the attitudes toward computerization.
- Hospitals in the United States should conduct a research before computerizing the functions in their institutions to avoid rejection by their workers. This may suspend the functions of the hospitals, something that avoidable by consulting the workers on the suitability of such proposal (Ash et al. 234).
- Patients should request for more computerization ensure fit bodies. Leaving decisions to computerization to health workers might not produce any fruits as the exhibit different attitudes.
- A formal strategic plan execution should promote a more welcoming response to computerization. Rejection should distance from personal interest. Instead, addressing the factors leading to dismissal could enable a smooth transition from paper-base systems to electronic-based systems.
Works Cited
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Badger, Stephen, Ryan Bosch, and Praveen Toteja. CEO Leadership: Seven Strategies for Leading Successful EHR Implementations. San Diego, CA: HIMSS 2006 Annual Conference and Exhibit, 2006. Print.
Braude, Robert. “People and Organizational Issues in Health Informatics.” Journal of the American Medical Informatics Association 4.2 (1997): 150-51. Print.
Chan, Mariachi. “Factors affecting knowledge, attitudes, and skills levels for nursing staff toward the clinical management system in Hong Kong.” Computers, Informatics Nursing 27.1 (2009): 57-65. Print.
Henderson, Richards, Peter Deane, and Johnstone Ward. “Occupational differences in -related anxiety: implications for the implementation of a computerized patient management information system.” Behavior & Information Technology 14.1 (1995): 23-31. Print.
Kivuti, Lucy, and Angelina Chepchirchir. “Computerization readiness.” Online Journal of Nursing Informatics (OJNI) 5.1 (2011):1. Web. 19 Feb. 2012.
Krampf, Scholes, and Steve Robinson. “Managing nurses’ attitudes toward computers.” Nursing Management 15.1 (1984): 29-34. Print.
Lorenzi, Nancy. “The Cornerstones of Medical Informatics.” Journal of the American Medical Informatics Association 7.2 (2000): 204. Print.
Lorenzi, Nancy, and Riley Robert. “Managing Change: An Overview.” Journal of the American Medical Informatics Association 7.2 (2000): 116-24. Print
Mandell, Steven. “Resistance to computerization: An examination of the relationship between resistance and the cognitive style of the clinician.” Journal of Medical Systems 11.4 (2011): 311-318. Print.
McBride, Samuel, and Livingstone Nagle. “Attitudes toward computers: A test of construct validity.” Computers in Nursing 3.1 (1996): 164-170. Print.
Ngin, Patel, and Lamina Simms. “Computer use for work accomplishment: A comparison between nurse managers and staff nurses.” The Journal of Nursing Administration 26.3 (1996): 47-55. Print.
Parker, Jones, and Phillips Abbott. “The new millennium brings nursing informatics.” AORN Journal 72.1 (2000): 1011-1017. Print.
Simpson, Gerald, and Kendrick Martins. “Nurses’ attitudes toward computerization in clinical practice in British General Hospital.” Computer Nursing Journal 15.1 (1997): 37-42. Print.
Van der Meijden, Miloscav. “Determinants of Success of Inpatient Clinical Information Systems: A Literature Review.” Journal of the American Medical Informatics Association 10.3 (2003): 235-43. Print.
William, Schecter. “Resistance to change and hospital physicians’ use of electronic medical records: A multidimensional perspective.” Journal of the American Society for Information Science and Technology Jan. 2012:1. Print
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