Information Governance

INFORMATION GOVERNANCE 10

Abstract

The application of technology in medical centers and a vast majorityof hospitals has been on the rise. The use of technology in theprovision of healthcare is aimed at enhancing service delivery andreduce the cost of healthcare provision. One of the main technologythat has been on the rise in the health sector is the use ofelectronic health records (EHR). This is a technological system thatmanages all the health records which include patient information,medical history, as well as prescriptions (Busch, 2013). Experts inthe Information Technology sector have pointed that the health sectorhas been lagging in terms of adopting new technology in itsoperations. Other sectors such as manufacturing and banking have madehuge strides towards adopting new technologies in their operations.

The American government has offered to give incentives to hospitalsthat adopt electronic health records. This is aimed at encouragingthe adoption of technology by majority of hospitals. As this researchpaper will indicate, the United Kingdom was one of the first nationsto adopt the technology in its health sector. Unfortunately, thesystem that had been hoped to enhance service delivery and reducehealthcare provision costs failed (Busch, 2013). Equally, otherhospitals have had instances where their technology systems havefailed. One major example is the Sutter hospital based in California.The electronic health record system in the hospital failed on august2013, rendering the system inaccessible for an entire day. Thisresearch paper seeks to address the causes, effects and themanagement’s reaction to the failure.

Where as other sectors such as the banking and manufacturing havealready adopted information technology in their operations, thehealth sector has been regarded as being left behind with over tenyears in its bid to incorporate technology in its operations. As aconsequence, the US government has given assurance of financialincentives to medical centers and hospitals that will adopttechnology in their operations. The electronic health records havebeen the major form of technology that a vast majority of hospitalsand medical centers have adopted as a means of ensuring that theydeliver high quality services and that they reduce the cost ofmedication (Geisler et al., 2013).

The electronic health records (EHRs) have been adopted in majorhospitals where they have been backed by the government. The UnitedKingdom was one of the pioneers of incorporating informationtechnology in their health sector (McCann, 2013). However, more oftenthan not, the technology that the medical centers focus on, has beena colossal failure such as the United Kingdom one, which failedcompletely. This is just a single case among many others. Thisresearch paper will focus on technology failure at 24-hospitalSutter, which rendered the one billion dollar electronic healthrecord system inaccessible to nurses and other staff in all Sutterlocations (Busch, 2013). It is imperative to point out that thesystem that failed at the California based hospital had tremendouseffects. This is in consideration that enormous patient informationincluding their history and medication prescriptions were managedthrough the EHR system (Integracon, 2013).

The key factors contributing to the technology failure

The technology failure, which was experienced at various branches ofthe Sutter hospitals has been said to have been caused by Citrixglitch (McCann, 2013). This is a problem that relates to the networkof the system, which was thought of having failed. However, themanagement of the hospital was quick to deny this. The failure in theelectronic health record system was caused by a failure in thesoftware that manages the system. This rendered the systeminaccessible to nurses and other medical practitioners in the varioushospitals affiliated to Sutter (McCann, 2013). As a consequence, thenurses and other medics at the hospitals were unable to accesspatient information, as well as medication details hence putting thehealth of the patients at a great risk (McCann, 2013). Research hasalso indicated that the system at the hospital had been reported ashaving the potential to fail. Prior to the august 26th2013 EHR failure, the nurses at the hospital had complained about thesystem. According to the California association of nurses, the systemwas only aimed at collecting payments and enhancing profits, but notenhancing healthcare provision. It is also critical to note that thesystem had gone down for eight hours just two days before the Mondaymorning incident.

Effects of the technology failure on operations and patientinformation protection and privacy

The EHR failure at the Sutter hospitals had tremendous effects onthe operations of the hospitals. During the downtime, patientinformation in regard to their historical data was not available.Equally, nurses and other medics at the hospitals were in completedarkness in regard to the type of medication that each patient at thehospital was to receive (McCann, 2013). The situation was worsened bythe failure of the management to intervene and provide a quicksolution to the problem. Patients at the various hospitals went awhole day without medication. Research has found out that families ofthe patients at these hospitals were extremely worried about theirloved ones’ health. There were also cases of delayed surgery atlabor that were reported at Alta Bates Berkeley facility by thenurses. This resulted in delays in delivery at this particularhospital.

Although there were no reported cases of patient informationleakage, it is evident that such a technology failure puts thepatient information at risk. Since the cause of the electronic healthrecord system failure was disputed, there could be a possibility thatthe failure could have been as a result of hacking. This is anextremely worrying assumption in regard to the patient informationprotection and privacy (CAN, 2013). The technology failure, whichlasted for almost an entire day, could have led to the leakage ofpatient information to third parties. It can be authoritatively beargued that the entire hospital fraternity, as well as the patientsand their families cannot have any faith in the system to protect theprivacy of patient information in future (CAN, 2013).

The reaction by the leadership team to the failure

Reports from nurses at the various Sutter hospitals indicate thatthe leadership of the hospital offered little or no help to them inregard to handling the technology failure. Whereas the registerednurses at California had raised issues with the new system, themanagement of the hospital is said to have ignored the calls by theregistered nurses (CAN, 2013). Therefore, it is clearly evident thatthe management could have ignored the nurses cry during the systemfailure. Nurses all across the Sutter affiliated hospitals such asAlta Bates Summit Medical Center facilities in Berkeley and Oakland,Eden Medical Center facilities in Castro Valley and Sutter Tracy andSutter Modesto reported that the management offered little supportand direction during the failure (McCann, 2013). The registerednurses also argue that the management of the hospital could be seenmoving all over the hospitals an indication that they did not knowwhat to do in regard to the failure.

Whereas the nurses may have viewed the leadership team as havingfailed to offer adequate support during the system downtime, expertsin technology have suggested that the management did whatever itcould to ensure that the system was restored within the same day(CAN, 2013). Although the hospital management issued a statementregretting for the inconveniences caused by the technology failure,critics and stakeholders have argued that the management of thehospital took too long to respond. However, other readers such asAnish Arora, who had worked at the hospital argued that the stepstaken by the management to patch the software were quick, swift andeffective (McCann, 2013). According to Anish Arora, who is thefounder of healthcare IT firm Afyatech, the leadership team at thehospital did everything possible to restore the system back to normaloperational state (McCann, 2013). The management had fallen out withthe California nurses association over the lack of involvement of theregistered nurses in the implementation of the E Epic EHR system. TheCAN was no satisfied with the explanation given by the management ofthe Sutter hospital.

Custom application versus proprietary system

Sutter hospital requires to adopt a system or an application thatwill meet the demands of the hospital. The hospital requires a systemor an application that is sustainable and that offers the servicesneeded by the hospital (Busch, 2013). Whereas the proprietary systemshave copyrights and are owned by individuals or companies, whatSutter hospital requires is a custom made application for its healthneeds. The custom made application is designed to meet the specificneeds of the customer. As a consequence, the custom made applicationfor Sutter will provide the services and support that the hospitalneeds in the healthcare sector (CAN, 2013). Since a custom madeapplication is normally developed stage by stage, it is evident thatsome of the any hidden dangers or issues will be noted and rectified.A vast majority of the large companies in the United States usescustom made applications to manage their records. Such applicationshave proved to be successful. Therefore, Sutter should shun theproprietary system and adopt the custom made application in order toavoid failures in future. This will also ensure that the applicationmeets the specific demands of the hospital, which might not be met bythe proprietary systems.

Strategies by organizations to avoid technology failure

The success of any technological advancement depends on the historyof such a technology, as well as the presence of backup plan. Whereasit might be extremely hard to totally eliminate the possibility of atechnology failure in an organization, it is imperative to have abackup plan, which would suffice the functions of the system in caseof a failure (Geisler, 2013). It is also vital for any organizationto have frequent checks and maintenance services for technologyequipment and software. This should be coupled with intensive testsof the applications to ensure that they can withstand pressure fromthe functions it will be subjected to (Geisler, 2013). Testing thesoftware would ensure that the management of the organization isfully satisfied with the ability of the software to handle thevarious functions it is intended for.

As the case of Sutter hospital indicates, the failure of thetechnology was partly associated with the lack of incorporating thenurses in the implementation of the application (CAN, 2013). In thisregard, it is clearly evident that there is the need involve all thestakeholders of an organization when implementing a new form oftechnology. This would ensure that all the stakeholders are satisfiedand have approved of the system.

It is also imperative for any organization to carry out backgroundcheck in regard to the system the organization wants to adopt. Thiswould ensure that the organization has enough knowledge of theoperation and the frequency of downtimes by the software. Suchknowledge on the effectiveness of a system will ensure that theorganization goes for the system that is extremely stable and doesnot breakdown easily. Finally, it is imperative for any organizationto train its employees on the use of any new form of technology.Research has indicated that employees can tamper with the softwareand render it ineffective.

Use of project metrics and portfolio management healthcare leaders

Project metrics can be applied or used in the healthcare informationtechnology sector to assess the success or failure of such atechnology. Project metrics collects data in regard to certainInformation Technology projects. Healthcare leaders can use projectmetrics to assess the state of their IT projects to ensure thattechnology failures are avoided. When project metrics measures theresources, processes and activities of an IT project, it will enablethe management of healthcare sectors to take preventive steps, whichwill avoid technology failures. Portfolio management, which ensures acentralized management and control of all processes and systems canbe used in healthcare setting to control the activities of thehospital (Busch, 2013). This would ensure that the management is incontrol of the IT systems and would therefore be in apposition toprevent any potential failure since they will have an opportunity toread the signs.

Government intervention in healthcare sector

It is role of the government to ensure that the patient informationheld medical centers and hospitals is safe and private. Thegovernment has the responsibility of putting rules and regulations inplace to ensure that data is safe and private. The government mustprovide the healthcare leaders with a list of the government approvedhealth information technology service providers. In a bid to ensurethe safety and privacy of patient information, the government mustcome in and regulate the digitization of healthcare provision. Theintervention of the government to regulate the use and application ofinformation technology in the health sector is critically vital sinceit will ensure that technology failures are minimal and patients’information is secure.

Conclusion

The rate at technology projects that cost huge sums of money arefailing is alarming. The failure of EHR system at Sutter hospital foran entire day in august 2013 was shocking. Stringent measures must beput in place by the government to avoid such incidences in future.Research has indicated that the failure was as result of negligenceby the management to take measures of enhancing the effectiveness ofthe technology (McCann, 2013). It is imperative to note that thehealth sector deals with a critical aspect of human life, which ishealth. In this regard, it goes without saying that the servicesprovides by the technology must be accurate since there is no roomfor error. The agony and suffering that patients and relatives wentthrough as a result of the system breakdown at Sutter hospitals wasunheard of. It is critically important to ensure that technologysupports the functions of a human being, but it is not a failure.

References

Busch, R. S. (2013). Electronic health records: An audit andinternal control guide. Hoboken, N.J: Wiley.

California Nurses Association (CNA) (2013). Sutter’s $1 BillionBoondoggle-New Electronic Records System Goes Dark. Open healthnews. Retrieved from: http://www.openhealthnews.com/content/sutter%E2%80%99s-1-billion-boondoggle- new-electronic-records-system-goes-dark

Geisler, E., In Krabbendam, K., &amp In Schuring, R. (2013).Technology, health care, and management in the hospital of thefuture. Westport, CT: Praeger.

Integracon (2013). Failure in EHR Backup Plan. Retrieved from: http://blog.integracon.com/category/disaster-recovery/

McCann, E. (2013). What to do (and what not to do) when your $1Bsystem-wide EHR fails. Health care IT news. Retrieved from:http://www.healthcareitnews.com/news/what-to- do-when-your-$1B-EHR-system-fails-lessons-learned-sutter-ehr-software