Information Management at the National Hospital Service - Coursework Example

Tables of Contents Introduction 2 Advantages of a Fully Integrated Package 2 Porter Analysis 3 Balance Scorecard 4 Using the Scorecard for Quality Improvement 8 Strategic Information System Planning (SISP) 8 CRM Solutions for Healthcare 9 (Niven 2002) Barriers to successful execution of Strategy 9 SWOT Analysis 10 Tools of Information Management within the National Hospital Service (NHS) 10 Conclusion 11 References 11 INTRODUCTION The Integrated healthcare systems can be defined as the product of a strategic alliance among the hospitals, healthcare plans and the medical specialists. This is the age of growing achievements in the medical science, and the concept of integrated healthcare offers the hope of optimising and ensuring seamless returns both for the patients and the medical fraternity. While fragmented systems slow the operations, effectively using technology The purpose behind introduction of the fully integrated Hospital Information Support System is to constitute a synchronised information management mechanism to progress from strategic planning to performance measurement and management. These steps will help the NHS revamp its system of care, manage the strategic priorities, while centralising services for exercising better control and improved accessibility. The principal object of integrated healthcare management is to secure introduction of strategy to optimise performance management. This can be done by classifying, tabulating and removing the irritants to develop one best way of doing the job. The trouble is many of the organisations are yet to include strategic goals in their respective performance management processes. Over the years, many hospitals have allowed their systems to grow piecemeal, adding new equipment or software as the need arises. This often leads to a confused mix of incompatible and inefficient systems. Again, in a fragmented healthcare system sometimes different wings, such as cardiac and Dental, each enter the same or related data separately, duplicating effort. Separate information "silos" can each hold some information - but bringing it together to get the whole picture can be difficult. This can cause confusion or frustration for both the doctors and the customers, besides the suppliers and other employees. Integrated health care system with strategic goals in place is the answer to these troubles. Once this is achieved, it will help the organisation harmonise and facilitate the working of the organisation, and develop system objectives. Essentially, the objective would allow selection of best work measures to ensure that the organisation’s efforts are coincident with the efforts of other wings, and keeping all activities in perspective with regard to the overall aims of the organisation. Integrating systems help sharing of the medical histories, create interdisciplinary medical teams, and update doctors on the latest medical research findings that can actually trim healthcare costs while improving patient care. These business strategies have been used in the world of healthcare to meet patient needs and manage overall performance. ADVANTAGES OF A FULLY INTEGRATED PACKAGE The advantages of such an integrated systems are manifold. Comprehensive databases of information on patient’s health that can be accessed ands used by a group of hospitals simultaneously will not only cut real time operations but also smoothen and qualitatively enhance the delivery mechanism. This is indeed very important, as the beneficiaries would include human lives. The integrated system ensures improved efficiency and reduction of errors. Besides, Better access to information means you can offer a more responsive service and develop better relationships with customers and suppliers. The Systems also grows with the operations rather than needing to be replaced. In addition to this, it helps the organisations ensure better use of staff time and greater job satisfaction for employees, besides the cost reduction benefits. Since data entry is updated immediately across the system, the integrated system provides complete data retrieval, and provides 'real-time' information. Besides, the integrated system would be time effective also save money in input costs by automating the update of health related information. Overall, it will also ensure consistency and accuracy of performances because the operating doctors may have all possible feedbacks he would need while treating a patient. This will be possible because the doctors would gather tremendous operational; speed thanks to the critically crucial data that he would have at his disposal. Indeed, this perfectly jells with the fast changing and on the move healthcare system where the need of the hour is to make crucial and complex decisions at different levels. The integrated healthcare mechanism can also create a structure that will facilitate and stimulate timely transmission of necessary information. Under these circumstances, the managers, administrators and consultants must be flexible to the changes while transforming performance within the organisation. Effective change management can help an organization view change as an opportunity to strengthen its performance while, at the same time, provide guidance in creating and maintaining the necessary cultural and operational adaptation. One way that Integrated Systems manage costs is through holistic disease management programs, in which trained health professionals take over many of the duties formerly performed by doctors. For example, the job of helping a patient manage his or her diabetes can be handled by a team of medical professionals including nurses, educators, and nutritionists who can provide lifestyle coaching, mentoring, and routine checkups—things that previously a doctor did at a much higher cost. Despite the need to initially pump in sizeable funds to let the integrated healthcare system functional, the professionals have understood that it would help them reap significant benefits, including committed consumer base and increased market share while simultaneously ensuring quality of life to the patients. Besides, the Integrated healthcare systems can always be are more cost effective, efficient, and there are is less possibility of human error since most of the feedbacks are automated with sufficient checks and balances in place In fact, more and more consumers are willing to get enrolled to the integrated healthcare because they often have all the answers at one window, instead of the multiple contracts with a number of physicians and hospitals. The physicians and the managers associated with the integrated healthcare systems also derive professional satisfaction by providing top quality and synchronised care to patients. PORTER ANALYSIS Michael E. Porter developed the analysis in 1979. Porter, a specialist in competition and strategy at Harvard Business School, was of the opinion that the doctors must coordinate their operations to improve their collective performance, and to ensure fixing the national health system Using concepts of industries, Porter had derived 5 forces that determine the competitive intensity and therefore attractiveness of a market. According to porter, the healthcare system is should not deliver "21st-century technology with a 19th-century system. Medical care, he added, is "the only sector in our economy that has not undergone reconfiguration seen everywhere else." (www.boston.com/.../washington/articles/2007/03/14/harvard_economist_proposes_team_approach_on_healthcare/ -) In the context of hospital management, Provincial priorities signal future areas of focus for the health system. Consideration of the provincial perspective ensures that the organization’s strategy is in alignment with public policy No organization can be successful without considering the needs of its customer base. The hospital must be informed of the needs of the patients, community and population so that any gaps with programs and services can be assessed The NHS integrated system, however, will suit porter analysis. This is because it will ensure that a patient undergoing treatment for breast cancer does not have to take multiple appointments with different doctors and specialists on different days. The integrated model would ensure that the patient could meet various specialists while located in one building. Besides, the hospital will have a mechanism in place that will allow these specialists to consult with one another. BALANCE SCORECARD Balance Scorecard is a method to estimate an organisation’s activities in terms of its goals and plans. This helps the planners comprehensively assess the performance of the organisation. Balanced Scorecard is also known as the translation of an organisations strategy into a comprehensive set of performance measures that provides the framework for a strategic measurement and management system. The scorecard allows the patient care department a better understanding of how the patients evaluated the hospital's service, thus enabling the hospital to achieve its primary goals and objectives. The important performance metrics that drive success for the hospital are measured, and can be linked to the institution's strategic objectives. The traditional balanced scorecard measures organizational performance from four perspectives: finance, customers, internal business processes, and learning and growth. The balanced scorecard is founded on the mission, vision and strategy of the organization, and is thus, a vital part of a strategic management system. It can help to reinforce and communicate the organisation’s strategic objectives throughout the organisation, and will assist in setting indicator targets, aligning strategic initiatives, and will allow the organisation to measure its success in achieving its goals. The scorecard works as a framing tool to help an organisation draw attention to the processes that are most critical to achieving high quality performance for customers and stakeholders and the outcomes that define high quality performance for these target groups. Scorecards can help communicate short- and long-range goals, set performance targets, evaluate hospital responses to physician needs and track process improvement efforts. Introduced in 1993 by Drs. Kaplan and Norton, the scorecard can articulate what the hospital must do to satisfy its patients so as to achieve its financial objectives. To answer this question, the hospital management can assess the link between the firm's target market, its performance and the tangible results in terms of patient care objectives. The measures/indicators are linked with a cause-and-effect relationship. For example, reduction in service delay may increase customer satisfaction. This in fact perfectly jells with NHS decision to introduce a fully integrated Hospital Information Support System. Today's the NHS is more focusing to reduce the costs, improve the quality of care and meet stringent guidelines. And, this is possible using best-in-class solutions for healthcare quality using the patient management scorecard. The measures chosen for this scorecard focus on the achievements of the hospital in reaching and satisfying its target market. The scorecard's measurement and management system provides the following potential benefits to healthcare organizations: * It aligns the organization around a more market-oriented, customer-focused strategy * It facilitates, monitors, and assesses the implementation of the strategy * It provides a communication and collaboration mechanism * It assigns accountability for performance at all levels of the organization * It provides continual feedback on the strategy and promotes adjustments to marketplace and regulatory changes Table 1: Template for a Patient Management Scorecard  Patient Care Objectives Measures  Values Targets Color Code Initiatives                                     Aravind Eye Care System, India's and the world's largest eye care service provider for the last 30 years, successfully implemented a patient management scorecard in its Eye Hospital in Coimbatore, India. As a response to the changing business environment, the NHS in its integrated Avatar would be wise implement patient management scorecards, a modern management tool to help solve problems and improve performance regarding patient services. The technology scorecard also plays a vital role and needs to be aligned with patient strategy in order to make good business decisions. Eventually the healthcare profession will fully involve the other three perspectives – financial, internal, and learning and growth – by building an all-inclusive balanced scorecard. Using the Scorecard for Quality Improvement Performance measures can be used in two ways. The first is to identify areas for potential improvement, often part of the internal scans that facilitates the identification of strategic goals for the hospital. Once priorities are established, the hospital should be identifying quality improvement initiatives that will enable the organization to succeed in achieving goals and objectives. Once a quality improvement initiative has been implemented, the scorecard indicators can be used to monitor progress on a quarterly and annual basis. However, other measures are needed to monitor progress on specific projects on a daily, weekly and monthly basis. STRATEGIC INFORMATION SYSTEM PLANNING (SISP) Strategy fundamentally reflects how you will achieve your mission and vision, through articulation of goals and objectives that will guide activities to fulfil the aims. Strategy reflects what you intend to do and serves as a reference for identifying what you should not be doing. Strategic Information System Planning (SISP) is a type of Information System that is aligned with business strategy and structure. The alignment increases the capability to respond faster to environmental changes and thus creates a competitive advantage. SISP is a process for developing a strategy and plans for aligning information systems with the business strategies of an organisation There is significant opportunity for health service providers to gain competitive advantage through the innovative use of strategic information systems. Such systems provide sophisticated tools and services to capture, classify, and operationalise accurate healthcare data. And accurate data is essential because it drives an organization's ability to manage revenue and resources, comply with regulations, and ultimately, to improve the quality of patient care. Healthcare organizations, especially the ones like the NHS which is going to adopt a fully integrated system can use information technology to achieve better operational performance and strengthen their market position. CRM SOLUTIONS FOR HEALTHCARE CRM is a broad term that covers concepts used by organizations to manage their relationships with customers, including collecting, storing and analysing customer information. CRP helps the managers develop databases and predictive scoring that can identify health needs and status and even predict future medical needs. Using that information, we create and track single and multi-channel campaigns to help you reach the most appropriate individuals with the right messages and services at precisely the right time. In fact, no other industry has more direct impact on the lives of its consumers as healthcare. Besides, the CRM in the healthcare field is also the need of the hour since as the quality of other goods and services improves, consumers of healthcare are no-longer willing to tolerate the levels of service once deemed acceptable. This generates demand for CRM systems in healthcare that ensures overall customer experience. Healthcare payers face unprecedented pressure to improve its delivery mechanism that is defined in terms of lowering medical costs, decreasing administrative waste, and improving the medical outcomes of the members they serve. The CRM will ensure consolidated and customer-focused operation to boost overall success rate, and make the healthcare system attain higher satisfaction quotients. Many companies in the healthcare industry are embracing CRM as a great way to better manage their relationships with patients and other healthcare providers. Pharmaceutical and medical device firms are great examples of companies effectively using CRM strategies and applications to more efficiently build relationships with doctors and health facilities. Various ‘elective surgical’ facilities are utilizing CRM applications to effectively market, sale, and support their patient base. (NIVEN 2002) BARRIERS TO SUCCESSFUL EXECUTION OF STRATEGY Since successful execution is one of the greatest challenges, senior leadership will be critical to the implementation of the performance management system. Without the leadership and commitment of at least one senior leader, preferably the President/Chief Executive Officer, any attempts to apply a strategy-based approach to measuring and managing performance will most likely fail. It requires effective communication throughout the entire process. Communication is paramount to implementation and uptake, requiring key players at all levels to be on board and to understand how their work and involvement contributes to achieving the Goals of the organization. In other words, to be successful, this approach requires buy-in and uptake by all individuals within and across different levels of the organization working together to achieve desired outcomes. SWOT ANALYSIS SWOT (Strengths, Weaknesses, Opportunities, and Threats) is a tool used to provide a general or detailed snapshot of a company's health. This is an objective analysis of an organisation’s competitive position in the marketplace. It provides an effective feedback to the organisation that would help it determine the core areas where more efforts are required. Besides, it would allow the company to allocate resources in such a way as to maintain any dominant positions it may have. IN fact, SWOT has assumed special significance in the field of healthcare because the medical organisations require making strategic in view of the heightened expectations and the need to make quick decisions. In this backdrop, SWOT analysis would help the healthcare organisations assess is its strengths, weakness, opportunities and threats. This would let the healthcare system identify, diagnose and assess the real challenges. The SWOT analysis can also serve as a business-strategy tool for the healthcare system to devise and introduce fresh opportunities like e-health systems and initiatives program to support the overall strategic objectives. TOOLS OF INFORMATION MANAGEMENT AT NATIONAL HOSPITAL SERVICE (NHS) It includes a clinical information system (CIS), which is a comprehensive, integrated information system aimed at achieving the best possible support of patient care and administration by electronic data processing. As an area of medical informatics, it can be composed of one or few software components with specialty specific extensions as well as of a large variety of sub-systems in medical specialties. Similarly, Evidence Based Medicine (EBM) is an approach to patient care that ensures that potential advances in health care must be tested and proven to do more good than harm before they are incorporated into medical practice. Electronic access to information sources from the user’s normal work place is the only feasible way to bring EBM into everyday practice. Again, the Results Reporting System (RRS) is one of the systems containing patient data that has been developed to run in the ward environment. It is widely used and is mainly designed to enable clinical staff to send laboratory test requests and receive laboratory test results. The computerised RRS has considerably reduced the delays for clinicians accessing test results. The system holds important clinical data that can be consulted at any time, day or night, by clinicians. The RRS is a good example of a patient based information system which clinicians use regularly in the course of their work on hospital wards. CONCLUSION Having patient data and reference data available together in the hospital work place can provide the perfect work environment and an effective tool for all who can access it. The challenge is for IT system developers and those willing to have an integrated healthcare system in place is to provide usable interfaces which afford an environment that enables clinicians and other ward based staff to make effective use of such systems. Work being done at the Royal Hallamshire Hospital, a 700 bed acute hospital in Sheffield UK, aims to provide a system where all the reference and patient data are available within a single user interface - the web. Having created a hospital wide network that provides clinical information to the various departments, it is important to take the next step in the direction of creating a reference point for non-patient specific information available to doctors on that same network. Similarly, the integrated healthcare system will provide medical staff with the opportunity to access large amounts of information quickly. This means that it can be used for reference before treatment delivery or to increase their knowledge in a particular medical field. A carefully planned intranet seems ideal for this job as it combines both internal and external information sources, providing patient data and adequate reference data together. Thanks to the integrated system, the access to different journals and medical databases has been increasing substantially. The NHS that aims to integrate patient and reference information to support clinical decision making is also stands to gain because the doctors will have a better, more effective and quicker method of accessing reference data. This system will also facilitate collaborative working among healthcare professionals. REFERENCES Cobbold, I. and Lawrie, G. (2002a). “The Development of the Balanced Scorecard as a Strategic Management Tool”. Performance Measurement Association 2002 Cobbold, I and Lawrie, G (2002b). “Classification of Balanced Scorecards based on their effectiveness as strategic control or management control tools”. Performance Measurement Association 2002. Kaplan R S and Norton D P (1992) "The balanced scorecard: measures that drive performance", Harvard Business Review Jan – Feb pp71-80. Kaplan R S and Norton D P (1993) "Putting the Balanced Scorecard to Work", Harvard Business Review Sep – Oct pp2-16. Kaplan R S and Norton D P (1996) "Using the balanced scorecard as a strategic management system", Harvard Business Review Jan – Feb pp75-85. Kaplan R S and Norton D P (1996) “Balanced Scorecard: Translating Strategy into Action” Harvard Business School Press Niven, Paul R. (2006) "Balanced Scorecard. Step-by-step. Maximizing Performance and Maintaining Results Andrews K (1980). The Concept of Corporate Strategy, 2nd Edition. Dow-Jones Irwin. As cited by Nickols F (2000). 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