Utilizing Health Information Technology

Task:
A. Provide a literature review of five sources that discuss the implementation of one
of the health information technologies listed in the introduction.
B. Present a proposal of how to assess the effectiveness of your selected technology
by doing the following:

  1. Discuss how you would perform a needs assessment for the project.
  2. Discuss how you would formulate a research question.
  3. Explain how you would develop a hypothesis.
  4. Discuss the purpose of your research.
  5. Discuss what research method would best fit the situation.
  6. Explain what you would measure.
    a. Explain your measurement methods.
  7. Explain the benefit of one data collection tool or technique you would use.
  8. Discuss how you would analyze the data you gather.
  9. Discuss how you would draw conclusions.
    C. When you use sources, include all in-text citations and references in APA format.
    Note: When using sources to support ideas and elements in a paper or project, the
    submission MUST include APA formatted in-text citations with a corresponding
    reference list for any direct quotes or paraphrasing. It is not necessary to list
    sources that were consulted if they have not been quoted or paraphrased in the text
    of the paper or project.

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Note: No more than a combined total of 30% of a submission can be directly quoted
or closely paraphrased from sources, even if cited correctly.

Utilizing Health Information Technology

Table Of Contents

Table Of Contents 2
1.0 Introduction 3
2.0 Literature Review 3-5
3.0 Proposal On How To Asess The Effectiveness Of The System 4-9
3.1 Performing Needs Assessment 4-5
3.2 Formulating Research Question 6-7
3.3 Hypothesis Development 7
3.4 Research Purpose 7-8
3.5 Suitable Research Methodology 8-9
3.6 What To Measure 9
3.7 Measurement Methods 9-10
3.8 Benefits Of Face To Face Interviews Conclusions 10
3.9 Data Analysis 11-12
3.10 Drawing Conclusion 12-13
References 14
Appendix A 15

Utilizing Health Information Technology

1.0 Introduction

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Health information technology has gradually been assimilated in the medical
fraternity. Although most physicians are resistant to the change allied with computer
aided technology, they are progressively embracing digital documentation to meet
standards set by the Health Insurance Portability and Accountability Act (HIPAA).
Through computer assisted technology such as the implementation of electronic medical
record (EMR) system, medical staff improve on workflow through the user-friendly
screens for locating patient data, constant electronic data sets for every patient, and the
elimination of redundant information (Currim, Jung & Xiao, 2009). EMR systems help
the physicians to provide better care with the availability of electronic medical records;
there is so much information in medicine that the only way to keep up is by digitalizing
the available data. EMR systems provide details that the physicians might not remember;
they also provide information relating to drug interactions notifying the physicians of
potential problems.

2.0 Literature Review

Myriad studies have been spawned to demonstrate the significance of
implementing automated computer aided systems in the medical field. Nonetheless, cost
of implementing new system has been a major hurdle for IT system adoption rates.
Copious evidence points to the fact that cost is the biggest reason for low adoption rates.
Calvillo, I. Roman, S. Rivas, in their article titled Privilege Management Infrastructure
for Virtual Organizations in Healthcare Grids (2011). Point to the fact that the market is
ready for change but the cost of rolling out a new system is exorbitant causing many
health care providers to back off. For the most practitioners who have implemented
computer-aided systems such as EMR, they report a return on investment within six to

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one year period. A study carried by Health Affairs and the RAND Corporation revealed
that EMR systems help to minimize costs at several levels of organizational operations
(Benaloh, Chase, Horvitz, 2009).

Agrawal, G. & Johnson.C (2011) noted that in securing electronic health records
people are able to have ease in accessing information an element that enhances fast and
reliable decision making. The same concept is prominently supported by Calvillo, I.
Roman; S. Rivas (2009) who believes that the rights and privacy of the patients must be
properly catered for in the computer aided systems. Even though people are naturally
resistant to change, the EMR systems enhance information flow, helping the practitioners
to be more informed and proactive since they are able to access digital information
through the secure databases. Security is a very core concept in relation to the medical
field thus its imperative to make sure that the implemented system is a multi-tier structure
leaving a room for the system administrator to regulate on who has the right to access the
particular kind of information.

An EMR, notes Currim, E. Jung, X. Xiao (2009) changes the manner in which
operations take place in a working scenario. In order for an EMR to be implemented
successfully, the system developer should have an intimate physician participation in the
integration process. This according to Liang, M. Barua, R. Lu, X. (2012), helps to make
sure that all the needs of the end user are properly assimilated in the system. A new
system should be gradually introduced working parallel with the existing system to make
sure that the end users are not discouraged or alienated in the whole implementation
process. The system developer should go through phases before assimilating the system

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into the working milieu so that the physicians may feel comfortable with it and can
appreciate its merits over the manual data archiving system.

Benaloh, M. Chase, E. Horvitz, K (2009). Are keen to establish the kind of
records kept in the medical databases. Client’s information is very private and thus the
system should be exceedingly secure to make sure that the patient’s information does not
leak out to the third parties. Through EMR, information integrity is enhanced, as there are
different layers of security established through user privileges and access rights. The
databases are more secure than the menial filling system which imbibes on the available
space and it is cumbersome when storing or retrieving information. The introduction of
an EMR is a step further in ensuring that all the available data is stored securely and can
be retrieved or stored easily.

3.0 Proposal on How to Assess the Effectiveness Electronic Medical Record Systems
3.1 Performing needs assessment for the project

Professionals in the health sector have started giving more attention to adoption
and implementation of health information technology (HIT) to aid in improving
efficiency and productivity at work place. There are various EMR systems customized to
meet the specific needs of the intended organization, before implementing an EMR the
physicians should find out if the EMR system being purchased can smoothly interface
with the installed physician practice management (PPM) software (Liang & Barua 2012).
A system developer should establish all the capabilities that the proposed EMR can
handle organizational needs. A fully developed EMR should enable the staff to easily

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find information, create and complete tasks, write prescriptions, view labs, and create
patient notes (Benaloh, Chase & Horvitz, 2009).

Before an electronic medical record (EMR) system is implemented in the hospital
of my choice, I will have to evaluate and understand the needs of the end users to avoid
designing an obsolete or redundant system. For effective need assessment, I will foremost
work in consensus with the nurses who interact directly with the existing manual system.
This will help me understand how the manual system works so that I will be in a position
to propose the design of a parallel-automated system, which will be able to capture all the
components just like the manual system. Secondly, I will use oral interviews to establish
the kind of system that the end users would prefer. Through open-ended questions, I will
educe numerous views from the end users to ascertain the kind of system they would like
to be implemented at work place.
The upper management will also be interviewed so that the researcher can have a
comprehensive opinion on what all the user requirements. After obtaining the needs from
the end users I will design a prototype and present it to the end users so that they are able
to establish whether it fits all their needs accordingly, any proposed adjustments or
changes will be fitted in accordingly.
3.2Formulating a research question.
A research question is a yardstick guiding the researcher to remain objective in
his investigation. Through the research question all the aims of carrying out an
investigation are portrayed, it acts as a summative inquiry seeking to find a solution to an
identified problem. Thus is should be succinct but detailed capturing the core of the
undergoing research. In order to formulate a good research question I will have to

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establish the aim of the research, so as to strategically state what the investigation seeks
to uncover.
3.3 Developing hypothesis
Hypothesis is the premise or presupposition on the likely outcomes from the
research investigation. For instance, it is estimated that the implementation of electronic
medical record (EMR) would make data organization easy, an element that will improve
on quality of information archived. Moreover, the integrity of the data stored will be
increased so that the available information will be reliable for decision-making. This will
help the staff members to be able to readily access information necessary to make critical
decisions even in the absence of the expert physicians (Agrawal & Johnson, 2011). In
order to develop a succinct hypothesis I will brainstorm on the likely outcome of the
research investigation after which I will formulate proposition to form my hypothesis.
3.4 Research Purpose
The purpose of this research is to examine how electronic medical record (EMR)
systems can be implemented successfully in the health care organizations to make them
more effective and sufficient in service delivery. This research will illuminate into some
of the core advantages allied with the use of digital data archiving system as opposed to a
manual system. In order to implement a new digital system successfully, the researcher
will find out the core elements that should be blended with the new system to make sure
that it delivers value and quality to the end users.
Moreover, the research will seek to establish how the implementation of EMR
will be pivotal in ensuring smooth flow of the hospital processes (Currim, Jung & Xiao,
2009). Digital records are easy to access, modify and to use in decision-making; this

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research will also uncover some of the challenges allied with the transition from the old
manual system to the incorporation of the new digital system. The researcher will also
find out how change can be implemented smoothly in the working milieu without
injuring the staff morale and efficacy.
3.5 Suitable Research Methodology
Face To Face Interview
The interviewer will conduct the survey in a period of five weeks; the assessed
participants will be thirty in number. The interviewer will proceed to supply the
respondents with certificate of informed consent [See Appendix A] whereby the sampled
participants will be required to sign to ascertain that they will be offering their views
without being pressurized or intimidated. The researcher will utilize a multi-usage
stratified sampling method to obtain data and classify it. The responses will be obtained
through face-to-face interviews to enable the interviewer to make follow up. Face to face
interview will create a pedestal for the interviewer to have an interactive session with the
interviewees to clarify facts and get personalized ideas.
Prior to the survey, the interviewer will allocate specific time and date for every
interviewee to avoid inconveniencies. The researcher will have to extract factual
information on whether the physicians and the hospital staff support the implementation
of the EMR in their organization. Moreover, the researcher will particularly seek to find
out some of the core elements that the interviewees would prefer to be assimilated in the
system face-to-face interviews will be utilized in this investigation, because interviews
enable a researcher to delve deep into the situation in a way that most data gathering
methods cannot.

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Ethics and human subject issues
During the survey, rights of the respondents in relation to their anonymity and
confidentiality will be guaranteed to make sure that the privacy of the interview
participants is not breached. For this purpose, a statement of informed consent will be
administered to the respondents prior to the interview; the form will contain information
in relation to the nature of the study and ways in which the educed information will be
used.
3.6 What To Measure
The research will be based on a qualitative approach. The researcher will seek to
understand how the existing manual system works and how the physicians and the staff
would like it to be computerized to aid in improving workflow and processes. After
garnering this information, the researcher will further establish how the implementation
of EMR will augment the efficiency, reliability and the speed of the existing manual
system. This will involve the use of oral interviews as the survey tool; the interviews will
contain different scales of measurement including ordinal ratio, interval ratio and nominal
scales. Moreover, 30 employees working in the organization under will be under
investigation to make sure that before the new system is rolled out that it is able to meet
all the needs as stipulated by the end users.
3.7 Measurement Methods
To ensure that there is accurate representation of the relevant population, the
respondents will be chosen at different times and different days of the week. The research
will include variety of ranking techniques and tools to measure the attitudinal dispositions
of the respondents. Examples of such techniques include a 5-point Likert scale, ranking

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from “strongly disagree” to “strongly agree”. The oral interview questions will be
formulated using English for convenience to ensure that the response rate of the
participants is improved. The survey tool will comprise of two sessions, the first session
will focus on the demographic data of the respondents such as age and gender while the
second part will be made of different questions centering on the system dimensions. The
second session will comprise of open-ended questions to give room for the interviewer to
probe further into any ideas that are not clearly defined.
3.8 Benefit of Face-To-Face Interviews
The researcher will use qualitative data analysis approach since most of the
interview questions will not be rigidly structured, creating a leeway for the researcher to
personalize the interview. Through the semi-structured interviews, the researcher will
explore issues as they arise and at the same time provide initial framework for areas of
discussion. The researcher will be keen enough to take major points during the interview
process. The viability of the interview is that it will provide immediate response to the
questions at hand, allowing the interviewer to explore the meaning of every answer
provided to resolve any ambiguities (Kvale& Britmann, 2008). The interviews will be
tape recorded for future reference and the harnessed data will be coded for tabulations
and drawing conclusive findings. After the coding, the tapes of the interviewees will be
compared to each other to find similar patterns in their responses regarding the interview
questions.
3.9 Data Analysis
One of the most significant aspects of oral interview is the transcription of the
interview data. There are five standard main methods used for the analysis of the

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interviews. In this project, “meaning condensation” method will be used, because it
requires the researcher to identify key ideas that emerge in the interviews and organize
those themes into meaningful patterns or categories (Kvale& Britmann, 2008). The
condensation method gives the interviewer a chance to reduce the text of the interview
into brief but meaningful statements that reflect the key ideas introduced by the
interviewee.
The following steps will be taken in order to achieve credible findings:
i. The interview will first be transcribed and read by the interviewer to
understand the essence of the whole text, the message introduced by the
interviewee, and the emotions inherent to a particular situation.
ii. Several natural themes and patterns of the interview have to be
determined. Accordingly, the researcher will write notes in the margins of
the transcripts to grasp a sense of the meaning of the themes that emerge.
iii. More time will be spent identifying and condensing different key ideas,
concepts and short phrases in the text.
iv. Once all the concepts drawn from the interview are completed, it will be
necessary for the researcher to specify the information that the participants
have conveyed.
v. Respondents will therefore be grouped in accordance with the major role
that they play- as administrators, physicians or medical staff (Kvale &
Britmann, 2008). Through this, the researcher will be able to take note of
those areas where the participants share the same opinions on what has to
be implemented in the system; the researcher will also establish areas

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where the respondents differ.

Ten out of the 30 interviewees will form the pilot study, which will be carried out to
“test” the interview schedule and to gain a feel for the issues relating implementation of a
new computer aided system. The collected data will be analyzed using Nvivo software
package owing to glut of the information, which will be requiring study and analysis.
Nvivo stands out over the other packages chiefly because it has a special program
NUD.IST, which will help the researcher to determine minimum text units in advance of
the analysis. Nvivo is relatively simple to use and has an interface which allows the user
to import documents directly from a word processing package and code these documents
easily on screen. Coding stripes can be made visible in the margins of documents so that
the researcher can see, at a glance, which codes have been used and where they have been
used.
3.10 Drawing Conclusion

In order to draw conclusion for this project I will sum up all the gathered material
and organize them in a sequential order. I will go over the main points exploring how
EMR system can be utilized to garner maximum benefits to health care providers both in
saving their money and augmenting their work output. Moreover, I will also illuminate
into how patient safety is enhanced through improved processes and data accessibility.
As I warp up the proposal, I will also offer my conclusive remarks on why the
implementation of EMR is important and various ways in which a health care
organization can harness its potential by embarking on the implementation of a change,
which might be daunting at first but valuable in the end.

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References

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Agrawal, G. & Johnson.C (2011) Securing electronic health records without impeding the
flow of information. International Journal of Medical Informatics, Volume 76,
Issue 5, Pages 471-479.
Benaloh, M. Chase, E. Horvitz, K (2009) Patient Controlled Encryption: Ensuring
Privacy of Electronic Medical Records. CCSW’09, Nov. 2009.
Calvillo, I. Roman, S. Rivas, L (2011) Privilege Management Infrastructure for Virtual
Organizations in Healthcare Grids. Information Technology in Biomedicine,
IEEE Transactions on, Page(s): 316 – 323, 2011.
Currim, E. Jung, X. Xiao (2009) Privacy Policy Enforcement For Health Information
Data Access. In WiMD 2009.
Kvale, S., & Britmann, S. (2008). Interviewing: Learning the craft of qualitative
interviewing. London: SAGE.
Liang, M. Barua, R. Lu, X. (2012) HealthShare: Achieving Secure and Privacy-
preserving Health Information Sharing through Health Social Networks.
Computer Communications – special issue on Smart and Interactive Ubiquitous
Multimedia Services, 2012.

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APPENDIX A
Informed Consent

This survey requires the participant to describe how he/she would like an information
system to be implemented at work place. The participant would be able to complete the
entire survey in less than half an hour and he/she may refuse to answer any questions,
without giving a reason.

The responses shall be kept confidential, and the participant’s anonymity shall be
maintained throughout the study. No such records or information would be disclosed, that
can identify the participant in published documents.
The participation in this survey is completely voluntary. Refusal to participate would not
result in any fine. Furthermore, the participant may wish to terminate the consent without
any penalty to which he/she may otherwise be entitled. The participant may omit any
question during the participation and he/ she may continue with the rest of the survey.
In case of any questions or concerns about this study, the participant should contact
(name), phone: , address, university name or email: _. He/she may also
contact the instructor supervising this research: [Instructor’s name, designation, Address].
The participant has fully understood the above information and agrees to participate in
the survey described herein.


Signature of Participant Date


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