A Patient-Centered Health System and Designing of Information Systems - Assignment Example

Name: Professor: Course: Date of Submission: Question 2: A Patient Centered Health System and Designing of Information Systems and Documentation to Support the Model A patient-center health system implies that the entire operations of the health system evolve around responding to patients’ needs, preferences, and values1. The concept of patient-centered health system denounces operations on the principle business as in the case in some health care facilities. Patient-centered health systems operate within the concept of patient engagement in care including ongoing, routine patient feedback and maintenance of publicly available information on practices. The demands of a patient-centered health system are accomplished through reforms in the planning, delivery of health services and evaluation. In this form of system, both the healthcare practitioners and patients are guaranteed of access to different information sources within the facility. The concept requires clinicians and the healthcare delivery centers to become more collaborative in order to meet the expectations and needs of the patients. Attempts to increase efficiency and effectiveness of the services delivered forms a crucial part of implementing patient-centered health systems. Healthcare practitioners and the organizations must strive to offer timely care and reduce the waiting time. Time taken to deliver a given healthcare service plays a critical role in influencing satisfaction in the service offered as well as the ability to intervene in critical conditions2. Other factors considered in delivering patient-centered services include the quality of service offered in which the healthcare providers and organizations focus on ensuring that the high quality services are delivered to the clients or patients. Patient-centered health systems generally focus on providing safe, timely, upholding patients’ values, effectiveness, efficiency and equality in the delivery of all services. Health information systems and documentation in health-centered systems can be designed in a manner that promotes enhanced access to health information to both the patients and clinicians. The system design should be designed in a manner that allows increased participation of participation of patients in the process of service delivery. The system design should integrate information sharing avenues such as emails, the various social networks, and direct call lines between patient and service givers. The participation of patients through such information sharing avenues play a critical role in promoting implementation of the patient centered concept in health care systems3. This kind of information design system provides patient-centered health care systems with means of assessing patients’ expectations as well as ensuring significant continuity and improved access to health services by patients. The information systems should also provide online access to health related information posted by health care providers. This design guarantees improved continuity in healthcare service delivery and enhanced involvement of patients in the process of delivering health care services. Establishment of a patient record system further provides a reliable way of tracking all and organizing all patients’ information. Proper documentation of patients’ information is crucial in promoting continuity in the delivery of services. Automated information gathering and storage is important in ensuring that patients get quality services from the providers as well as enhancing ease in the delivery of effective and efficient services. Question 3: Case Study One of the key system issues raised in the case study revolves around patient’s information handling and process. As noted from the case study, Mr. D. was admitted with due to complaints over epigastric discomfort, and different healthcare providers were involved in the investigation of his condition. The first steps involved proper exchange of information between the practitioners but a communication breakdown emerged in the process of delivering the healthcare services. The fact that the patient was discharged with an incomplete discharge plan that omitted the need to undergo the Endoscopic Retrograde Cholangiopancreotography (ERCP) and biopsy translates to improper handling of the patient’s information. This opens an avenue for emergence of an adverse event in the process of delivery the health service to the patient due to incomplete procedure. The system lacked proper linkage of all information for a given patient in the processing of attending to the patient. The health practitioner discharging the patient has done so due to scattered information and lack of proper coordination in the system. The other issue arising in this case study in addition to poor coordination in the delivery of the health service is the lack of continuity. From the surgical outpatient clinic, it is clear that there is lack of coordination and continuity in attending to the patient after the surgeon dictates a letter for medical hard copy allowing the patient to undergo the endoscopic procedure. The inconsistency is evident in the manner in which he or she handles the medical record leading to delays in treating the patient since no notes from the surgeon were recorded. After treatment, the doctor further advices against a follow up on the patient, a decision that may have contributed to his death later. Recommendations to Address the Issues Identified The most crucial step in preventing occurrence of a similar incident is the implantation of a computerized information system to allow better management of patients’ information. The system requires implementation of an electronic medical records and patient information tracking systems from the time of admission to the time of discharge. This system would lead to improvement in the accuracy and availability of all medical information to ensure effective and delivery of the health services. The system would boost the processing of the patient’s information to allow full intervention. The system should have alert pointers especially on the surgical interventions to avoid medical errors that may be tragic. The plan should also have standardized patient follow up requirements to avoid a scenario where the practitioners are given the mandate to decide the necessity of such an important step in ensuring effectiveness of the health services offered. The system further requires an effective monitoring procedure to ensure that all its services are well coordinated and the health practitioners attend to their patients professionally. The case in question not only identifies failures in the system but also a significant lapses on the part of the health practitioners to uphold their professional requirements in their specific roles. The proposed system can ensure continuity in both the medical information and services as depicted through the experiences of Mr. D. Question Four: Role of Improved Information Systems and Proper Handling And Processing Of Clinical Information On Avoiding Adverse Effects The increased number of adverse events affecting patients in the healthcare systems can be attributed to lack of efficient as well as dysfunctional information technology system among other failures in proper patients’ information handling4. In this case, the improvement of information systems and better clinical information handling provides important steps towards limiting or avoiding reported harmful incidences. Information technology plays a critical role in the process of healthcare delivery through providing clinicians with adequate information for decision making, especially in interventions presenting significant ethical dilemma. Improved information systems would therefore empower health practitioners with more knowledge to facilitate selection of more effective services with ease as well as aid in avoiding occurrence of adverse events as they deliver their services to the patient. Installation of a computerized patient record system can assist in augmenting proper healthcare guidelines with the patients’ information leading to better healthcare service delivery. The patient record system can also facilitate information flow within the healthcare facility translating to minimized errors and response to patients’ queries. In addition, designing of a computerized patient information record can also play a critical role in avoiding emergence of adverse events in the delivery of healthcare services to patients. This is because the computerized information record would lead to better clinical information handling and processing. Improved information systems provide healthcare practitioners with more complete and accurate information at the point of need to assist in effective decision making. Enhancement of information flow and availability through improved information systems has the potential of leading to improved patient outcomes thereby reducing the case of adverse events5. Improved information systems can be important in avoiding occurrence of adverse events that affect patients through ensuring continuity of care benefits. Through the improved information system, clinicians can easily combine background information with patient’s signs and symptoms, test results and physical findings to come up with the most effective course of treatment. Masso suggested that adverse events experienced in various healthcare centers can be averted through introduction of an incident reporting system across all healthcare institutions6. This would form part of the improved information system, which would go a long way in ensuring the tracking of all previous adverse events and the corrective measures undertaken to avoid repeat of similar anomalies at all costs. The incident reporting system is particularly important in keeping the clinicians on the lookout to avoid repeating blunders committed by their colleagues in previous incidences. The healthcare commission can also provide standard guidelines on the way to handle similar cases in order to avoid occurrence of similar errors or potentially harmful blunders by the clinicians. Previous cases can be provided through the incident reporting system to act as reference points at the point of care as well as during healthcare practitioners’ skills appraisals and enhancement. The manner in which adverse event cases are handled has potential implications on the ability to avert potential repeat of similar events in the process of delivering similar healthcare services7. Proper handling of information provided on certain events is critical in enabling the authorities involved in dealing with occurrence of such incidents set out proper guidelines as to what measures should be implemented to prevent similar unsatisfactory client handling. Proper handling of the clinical information may imply ensuring putting in place measures to ensure all adverse events are reported; and well analyzed by the relevant authorities. This is because unreported incidents may keep on recurring thereby exposing more lives of innocent people at greater risks. Question 5: Open Disclosure The legal framework provides patients with right to be informed about issues and events that affect their care in the process of receiving healthcare services from any healthcare organization. Open disclosure implies that healthcare providers and systems have an obligation to obey the legal requirements to let patient’s know about everything that surrounds their wellbeing8. Health practitioners should be ready to discuss and help their patients know what affects their systems especially if errors or other adverse events occur during any healthcare interventions. Every patient has the right to transparency and full communication of health information collected during the treatment process. The open disclosure is particularly important if adverse events occur in order to allow the patient to make informed decision about their health. At times, the medical intervention process may result into unexpected effects on the patient, a phenomenon that amounts to adverse events that require full disclosure to the affected patients. However, under circumstances where the patient is not in position to receive the information and make informed decisions about their care, the legal framework surrounding open disclosure require disclosure of such events to the next of kin or the person whose name appears on the patient’s admission card9. Adverse effects do not necessarily imply errors committed by the health practitioners but also inclusive of other events that translate to negative or harm to the patient whether ascertained or not ascertained. Some of the common events categorized under adverse events in health delivery include ascertained risk of a procedure such as complications of a surgery or side effects, administration of wrong medicine, or dosage and discovery of a wrongly prescribed drug. Other adverse events that practitioners ought to inform their patients include know drug side effects and potential infections during healthcare intervention and any disease risk that a patient may be predisposed to either through undergoing a given diagnostic or treatment procedure or by factors beyond the patients understanding. Under the state’s open disclosure policy, healthcare practitioners or providers as well as the health systems are obliged to inform their patients of any harm that occur during the intervention process. For example, if in the event of performing a caesarian procedure the reproduction system is unintentionally affected negatively by the procedure, then the patient should be professionally informed of the harm and proper counseling undertaken. After receiving an adverse event or harm information from the concerned healthcare practitioner, the patient can take up the matter with necessary healthcare system or authority if not contented with the explanations provided. In many healthcare facilities, there is a systemic way of handling complaints that should be followed in order to ensure patient satisfaction or justice. In case, the complaint management process within a given health care facility cannot amicably resolve complaints, the Health Service Commission (HSM) provides an alternative avenue to take the complaints further through an external process where all patients and families dissatisfied with the services can be addressed. Since communication of some medical information may have adverse effects on the patients and the families, the commission standardizes the open disclosure process in which timelines, how people receive the information, where, and the extent of disclosure are stipulated. Bibliography Durbar, J., Reddy, P., Beresford, B., Ramsey, W. and Lord, R. “In the Wake of Hospital inquiries: Impact on Staff and Safety.” The Medical Journal of Australia 186 (2007): 81-83. Victoria Department of Health. (2011), Open Disclosure for Victorian Health Services- a Guidebook. http://docs.health.vic.gov.au/docs/doc/Open-disclosure-for-Victorian-health-services---A-guidebook Wolff, A. and Taylor, S. Enhancing patient care. Sydney, NWS: Australian Medical Publishing Company, 2009. Masso, M. “Peer Review of Adverse Events- a Perspective on Macarthur.” Australian Health Review 28, no.1 (2004) 26-33. Joseph, A. and Hunyor, S. “The Royal North Shore Hospital Inquiry: An Analysis of the Recommendations and the Implications for Quality and Safety in Austrian Public Hospitals. The Medical Journal of Australia 188, no. 8 (2008):469-473. Read More