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Information systems designed for specific objectives. Today, lots of information systems are designed to help the health care industry. One of the main systems is Health Information System, which has designed for collecting, storing, managing and providing available patient information important to the healthcare delivery system.
One field of health information systems is hospital information system. This system records the patient related data and update the data and make it available for clinical staff for monitoring the patient and diagnosis and also to make treatment decisions by hospital professions.
Information technology has already changed the ways of services in hospitals, and become one of the important considerations in modern hospitals, but often bad designed IT solutions may have problems to communicate with the staff.
The main objective of System Design is to make a technical solution that fulfills the functional demands for the system. There are several challenges to design a good IT system; organizations in any healthcare units can improve the implementation process by using the following five elements:
Comprehensive Business Plan: Defines the reason for taking the responsibility for the project and the expected results.
Demand administrative Commitment and Leadership: Achieving success needs brave leadership and a full commitment. When the go-forward decision is made, those who responsible for the care of the design process must stand behind the leadership.
Set Realistic Expectations: keep away from searching for the extreme solution and trying to carry out all aspects of the system at once. The selection may focus on a sequence of expectations concerning software performance, with fulfilling the clinical goals within a reasonable budget.
Secure Operational Ownership of the Project: the supplier has experience; customers have to define their own vision and demands. The timetable of process and method of use among customers could be different in an extreme manner.
Lead the Implementation: The pilot site idea allows the supplier, clinical and IT staffs to study procedures, define future state workflows, and develop guidelines and procedures.
The absence of any essential element may leads to physician disappointment and less adoption with the system. the system itself also must satisfy following demands:
- Make connection between care professions and patients and also their relatives.
- It must be useful to keep the patent data not only for diagnosis but also for prevention and maintaining health.
- Easy enough to use by clinical staff.
- IT must have interconnection between other health care systems in other hospitals and care centers.
- The system must be learnable enough and has no considerable errors in sending and receiving data.
The evaluation begins during program development and can be divided into veriï¬cation, validation, assessment of human factors and clinical assessment of clinical effect (Engelbrecht et al. 1995; Ohmann & Belenky 1995; Ohmann et al. 1998; see also Van Bemmel & Musen 1997).,
Verification checks development of the system according to its speciï¬cation and conï¬rms consistency, completeness and correctness of the system. Validation checks that the system performs the tasks for which it has been designed in the real working environment. Evaluation of human factors is the next phase of system evaluation. Even if a system has been veriï¬ed and validated, it may be so clumsily designed that it cannot be used in real life, because using the system is either too inconvenient or consumes too much time.
In this part the main consideration must be how to evaluate the system continuously to make sure that the system is efficient enough as in care delivery or cost. It means that the system should not impact the patient data, because any change in patient data may cause bad diagnosis and incorrect care delivery, and the system must be in budget. One important factor in evaluation is to define correct evaluation goals. Without proper goals the evaluation has no sense. The main purposes of evaluation are user-based evaluation for design feedback, which checks whether users can carry out their jobs through the system or not and makes a feedback to system, and User-based evaluation for metrics .
Resistance of hospitals’ staff arises when they cannot adopt IT applications easily, so challenge in design is to integrate the ICT into their workflow. Staff members may be afraid to learn new technology, or they may be afraid that the system will eliminate their job, so they insist to keep working in traditional paper-base system. Moreover, physicians assign many reasons why they can’t adopt ICT systems. Some mention about difficulty, or they are not well enough in typing. There are also interested in making eye contact with patients. Making connection between hospital staff and their colleagues who are currently using ICT systems, will illustrate that the system increase physician-patient relationship and also the system does not eliminate hospital staff jobs however it may cause changes in their workflow.
In order to train the staff, system supplier must develop training materials, training plan and also lead the proper training program for staff, i.e. perform annual workshops to improve the computer and IT knowledge of staff continuously. Hospital training department can assist supplier in developing and performing the program and can ensure participation of all users in training sessions. The training department also should perform computerized training programs for both new arrived nurses and physicians to make them ready for the system that hospital is working with. By this process It is likely hospital will have a favorable response in convincing the staff.
Advantages and disadvantages with Ehealth system:
After implementation an Ehealth system some advantages and disadvantages may identified when comparing the system to paper-based documentation.
Ehealth system advantages:
- reduces staff stress.
- makes an efficient and accessible patient record.
- Time saving and reducing indirect works, that leads to more direct care delivery.
- Causes keeping staff in their possession and attracting them.
Ehealth system disadvantages:
- changes communication processes with staff.
- training of staff is quite time-consuming.
In conclusion, a good Ehealth information system must concentrate on providing information and services to guarantee the best outcome for the patient care. There is a strong demand for employing personnel with health informatics skills to supervise this process and to keep the management part of the hospital in a high standard level because these personnel will play an important role in the system design, system implementation and evaluation of the system.
Development and Evaluation of Information Systems for Shared Homecare(ISABELLA SCANDURRA)
 J. K. H. Tan, Health Management information Systems; Methods and practical Applications. 2001.
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