Information Governance (Essay Sample)

Information Governance
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Introduction
While the acceptance of Electronic Health Record (EHR) frameworks in the healthcare sector guarantees various significant advantages, negatively impacting outcomes from the usage of these systems have developed. Poorly designed EHR systems and inappropriate use can bring about EHR-related lapses that jeopardize the reliability of data in the EHR. As a result, it causes errors that imperil thesafety of patients or cause deterioration of the care quality. Thisinvoluntaryoutcomemay further cause an increase in abuse and fraud, thus cause immense legal implications. Martin Health System in Stuart, for instance, is an IT system failure that rendered Epic Electronic Medical Record system inaccessible. According to the healthcare team, the outage lasted more than a day.
Indeed, the three-hospital Martin Health System underwent a system malfunction that resulted in unanticipated downtime for the Epic EMR as well as other entity applications. The system failure greatly impacted the healthcare facilities. A downtime of more than 24 hours is never anticipated, and its occurrence caused numerous misfortunes for the organization.
Key factors contributing to the failure in question
Improper and poor usability of the system is one of the major factors contributing to the system failure at the Martin Healthcare organization. In addition to the design specifications of the EHR and the tasks contributing to the sub-standard quality of healthcare, errors may originate from unsuitable system utilization. The errors resulting from usability problem happen due to the complexity of the system, absence of functionality that is user-friendly or even user limitations. Indeed, functionality that is faulty may mislead medical practitioners in case of a confusing display. Moreover, malfunctioning of the system may emanate from programming bugs, which converts from one system measurement to another incorrectly, for instance, kilograms to pounds. Another form of error that may occur is the adjacency error, where the clinician selects an item adjacent to the intended item in a particular menu, including wrong medication or patient.
Additionally, inconsistencies between data field may result in errors, for example, when a structured data file free text area are uneven. An example of the structured data field is the indication that two tablets need to be taken twice each day. However, free text area indicates one tablet should be consumed in the morning and two of the same pills in the evening. Moreover, the inconsistent dosage of medication information contributes to the list of errors likely to be undertaken.
Regrettably, Sittig& Dean indicates that clinicians share complex processes control with computer systems such that in some instances, they make an assumption of a higher level omission role and permit computers to reach routine decisions and execute necessary actions. An example of such situation is anautomatic generation of laboratory order when certain medications orders are made. Indeed, this technology is so complex that clinicians are not able to comprehend computations made and thus are unable to carry out competent human intercession (Sittig, Dean F. &Hardeep Singh, 2011).
Incorrect records capture also contributes to the occurrence of the healthcare system in question. Vendors of EHR frequently make additional functionalities aid in the documentation, including copy and paste, standard phrase use, templates and insertion of objects automatically. Such object insertion comprises of medical values imported from additional sections of the electronic record. These features have numerous benefits, and they comprise of boosting theefficiency of capturing data, legibility and timelines, extensiveness and consistency of data documentation. Nonetheless, when these functionalities are used inappropriately without sound control and education, these features may result in thewrong documentation and may potentially lead to allegations of fraud and medical errors.
Leadership team’s reaction to the failure
As many healthcare organizations system migrates from paperwork to digital functionalities, the level of impact of unanticipated failure on patientscares systems is often highly complicated and pronounced. The 24 hour Martin Healthcare system in Stuart reported system failure as erratic and impacting to the organization’s operation. Furthermore, the recording of a two-daydowntime worsened the situation. According to the leadership team, the failure led to thesignificant compromise of patient’s care. Additionally, even the backup framework went down, and this is attributed to the nurses’ inability to use the system’s Pyxis management framework to print information about the patients. The data was reportedly registering outdated for the entire forty-eight hours.
The team also highlighted the fact that majority of the families became concerned and restless since patients did not receive their prescribed medications for the better part of the day. Indeed, themajority of patients were not given medicine for the entire day owing to the failure of the EHR since the onset of the day.

Martin Healthcare system should develop a custom application
Importantly, no single vendor can meet the entire needs of all customers in the application field. The implementation of a surrounding of standard protocols and API will permit continuous integration of the best third-party hardware and software solutions. The healthcare system will liberate and thus they will have the freedom of choosing the best application that meets her exclusive needs, regardless of the vendor. Evidently, the organization will not be locked into a particular vendor who makes used of proprietary protocols and APIs, holding them hostage and might charge them a huge sum of money.
Moreover, use of custom application facilitates ease of internal and external system integration. According to Sullivan, June M. (2007), making use of standard APIs and protocols will ensure the organization’s ease of integrating applications, both with external as well as internal applications. The ease is owed to the standard API and protocols used in all application. The organization will also enjoy aminimal total cost of proprietorship. Regardless of the vendor, when organizations have the freedom of choosing a certain application that suit their needs, the cost of both development and integration will particularly reduce. Extensive integrations services, for example, will be of no essence. Also, for vendors running custom applications, they will be tasked to maintain clients to participate in an open field competition. Evidently, the vendor will not have the freedom of holding the organization hostage for the services they offer(Sullivan, June M., 2007).
When using custom applications, migrating from one vendor to another is easier and seamless. In case of integration services, they will be kept at minimal. Using custom applications will further create superior solution resiliency. Use of standard protocols and API ensures that quality assurance and testing have been undertaken to ascertain compliance with the standards. This quality check means application resiliency and stability have been certified. In addition to the advantages of using custom applications as discussed above, non-proprietor applications encourage innovation. Innovation is articulated to the completion that increases with enactment of internationally accepted standards of APIs and protocols.
Best practices that any organization could adopt to avoid such a failure in the future
Any health organization that does not desire failure of their systems ought to improve theusability of the system and articulate proper use of the same. Eradication and prevention of medical errors are not only the design of EHR system that is significant but its execution as well. Furthermore, how the system is amalgamated into medical processes and the manner end users make use of it in their routine basis is equally important. Moreover, there is aneedto assess systematically patient harm risks associated with particular applications as well as safety and quality procedures that are comparative to the recognized clinical perils (Institute of Medicine, Committee on Patient Safety and Health Information Technology, 2011).
The present approach towards EHR certification and standardization do minimal to address usability, implementation or information integrity by the clinicians, which comprise of full integration with workflows. To begin with, there is aneed for EHR certification to define what vendor applications are not permitted to do in addition to the intended mandate. Moreover, healthcare organizations, as well as other providers, need to be tasked with developing and implementing procedures and policies referring to theproper use of EHR. Healthcare organizations should further certify all intended users undergo proper, and thorough training on the use of the system developed. Training also needs to include the provider’s anticipations with regards to the use of the framework.
For every application developed, quality, as well as safety processes that are steady with the level of safety peril related with particular application and frameworks, should be embraced. In addition to establishing safety processes, an internal system to identify problems internally using EHR and related errors should be developed in healthcare organizations and other healthcare providers.
According to the American Health Information Management Association (2012), Healthcare organizations should further work towards minimizing errors emanating from clinical and medical decision support frameworks. While risks may not be eliminated, the target should be to enact proce...