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Health care information systems (HCIS) are systems, which are designed for health care institutions. Their success or failure in most cases depends on their matching/mismatching with reality. Moreover, every HCIS should be regularly updated, so that it can match reality better.
In most of cases, failures in HCIS depend happen on various reasons:
- HCIS, which are designed for one reality, practically meets other behavioral models.
- If HCIS designed for private sector are used at public health care organizations.
- If HCIS developed in an industrialized country are transferred to a developing country.
Reality gaps influence much on success or failure of a health care information system. Therefore, in the process of designing a HCIS there is much need to consider details. For example, it is better to design its own HCIS for every health care organization, either private or public.
There are more ways that can be adopted by any organization to avoid failures of HCIS. Such practices can be implemented by every health care organization, in order to improve quality of their service.
In order to improve HCIS and guarantee its success, management of the company should:
- Legitimize and map organizational reality. Every HCIS should match current events. The most important task of management in every health care organization is to reduce the gaps between HCIS and reality. The best way to achieve this is to make a prototype of a system before its designing or implementation. It is possible to do with third party observation in a way of exposing and mapping the conception of a system in context of current realities. By vivid exposing and mapping, it is possible to find out how users will use this system practically.
- Using reality-supporting applications. In many cases, HCIS failure is caused by different realities. For example, if HCIS is designed for the given realities, practically they fail as in every health care organization there are different realities. The way out is to design special applications, which can help to implement the entire HCIS.
- Customization. In some cases, HCIS fails, because there is a preference of ready-made solutions in a health care organization. The better solution is to use customized version of a HCIS, which will satisfy every customer’s needs. For example, every HCIS should have options to be set in a custom way. For example, the software should be developed, considering different options, like customized versions for every sector, public or private organization, and in-home solution.
- Hire the best developers. In order to develop a good HCIS, much skills are required. So, it is better to hire experienced developers only who are ready to make a well-designed and functional system, so that there may be not many mismatching with realities.
- Change managers. Every health-care organization has IT-department, which is in most of cases is the central point. Sometimes IT-departments are staffed with inexperienced or too much “experienced” managers who are not able to face with new problems and meet new realities. It is better to hire young highly educated IT-professionals who are able to try their best to improve HCIS, set it properly, customize it meeting customer’s and staff’s needs.
Richard Heeks proposes more practices, related to successful implementation of HCIS, such as “end-user development”, “participation”, “hybridization”, “incrementalism”, “freezing dimensions of change” etc. (Heeks etc. 1999).
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How to Facilitate IM/IT Governance
IM/IT governance in every health care organization totally depends on management of these departments. They should be decisible and responsible, so that to solve the problems perfectly, face with current realities and events. There are some other aspects on which successful implementation of HCIS and information governance depends. These are:
- Communication. If leaders of a health care organization want that HCIS will succeed, they should hire a team of professional managers and developers who will do their best to reach the goals and deliver the best results in short terms. Communication is an integral part of every working strategy. IM/IT department should work as a united team, and every person should be ready to help each other.
- Develop the best kinds of software, buy appropriate hardware. Health care organization should use software, already developed by the other companies. Alternatively, it is better to develop unique software, which would match the needs of this organization. Developing unique software matters much, especially if IM/IT department of an organization does not want to rely on the third-party developers, which can supply the developed software with spying programs and viruses.
- People personal security and physical security of products.
In one of his researches, Yuen Ip points out that in modern realities, when all the people have to deal with information technologies, it is very important to store confidential information carefully. At the same time, the access to the public information is guaranteed to every citizen by law. Therefore, every organization should provide it. That is why in the main important way of information governance is to provide the access to public information and prevent confidential information from using it by the third parties (Ip 2009).
This list of ways of facilitating IM/IT governance of a health care organization is far from being complete. Every organization can face with new problems that can be solved in unique way. In any case, good experienced managers are always able to face with current realities and problems and find the best solutions.
Government Intervention into Health Care System
In our opinion, US Government has immensely high influence on the health on the public health care system. There are two main ways to do this – by controlling prices and providing health care organizations with medicine which quality is under the dispute.
Jeremiah R. Grosse in his article “Government Intervention into the Health Care Industry” points out: “The American people want quality medical service at a fair price. Physicians want to offer that quality service; however, the prices are not under their control for those who choose to remain beholden to third party providers. The options are few and the choices are very clear. Unless something is done to change and improve the health care system as we know it things will only get worse. Looking at the Canadian model or even the model currently offered by the Commonwealth of Massachusetts provides evidence that the universal health care idea is not the way to go.” Therefore, if the prices are for medical service is controlled by the government, it decreases the profit of health care organizations. Moreover, the problem is it influences the quality of service.
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Additionally, there is another citation, which proves the negative influence of the USA Government on health care system by means of government intervention to it: “there’s a glaring problem with Gov. Perry’s recent criticism. On February 2, 2007, he issued an executive order requiring that all Texas schoolgirls receive a questionable vaccine, Gardasil, to prevent a sexually transmitted disease known as HPV. The effort would have cost $60 million for the state’s 170,000 eligible girls.” (Mackowiak 2009).This citation is related to Texas Public Policy Foundation, Gov. Rick Perry’s actions. It proves once more that government intervention into health care system can lead to negative influence on it.
In this research paper, the primary causes of information technology project failures were critically discussed and analyzed. In most cases, the cause lies in vivid mismatching between HCIS and current realities. The failure of the project may be caused by implementation it under developing countries’ circumstances, while it was designed for industrialized countries’ realities.
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There are such practices that can be adopted in health care organizations to avoid HCIS failures:
- Legitimize and map organizational reality.
- Using reality-supporting applications.
- Hire the best developers.
- Change managers.
There are some aspects on which successful implementation of HCIS and information governance depends. These are:
- The role of information.
- Developing the best kinds of software, buy appropriate hardware.
- Develop the best kinds of software, buy appropriate hardware.
The significant part of the paper is dedicated to the role of government intervention into health care business. In most cases, this role has negative influence on the development of the modern technologies. Sometimes government by price and service control can decrease the quality of medical service. It matters much, especially for retired people, who need medical help of the best quality, due to their age.
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