Implementation of Health Care Information System

This paper discusses about the implementation of healthcare information system using EIA framework. Various types of EIA framework are discussed along with their advantages and drawbacks. The proposed framework has been designed in order to eliminate the drawbacks of these models. The various sections in the proposed system is discussed. Certain challenges present in the system are taken into account. At the end the final conclusion along with the recommendations are provided.

IMPLEMENTATION OF HEALTH CARE INFORMEATION SYSTEM
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IMPLEMENTATION OF HEALTH CARE INFORMEATION SYSTEM
Executive Summery
Health care information system is the electronic record, where the health providers can keep
the information regarding patients. That information can be shared among the other health
care providers if it is needed. The main aim of the health care information management system
is to provide the structured information of the patients to the health care providers. This paper
discusses about the implementation of healthcare information system using EIA framework.
Various types of EIA framework are discussed along with their advantages and drawbacks. The
proposed framework has been designed in order to eliminate the drawbacks of these models.
The various sections in the proposed system is discussed. Certain challenges present in the
system are taken into account. At the end the final conclusion along with the recommendations
are provided.
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Table of Contents
1.0 Introduction...............................................................................................................................3
2.0 Enterprise Information Architecture:........................................................................................3
2.1 Enterprise Information Model:..............................................................................................3
2.2 Conceptual framework:.........................................................................................................4
3.0 Data Integration and Information Management:......................................................................6
3.2 Challenges regarding data integration and data management:...........................................7
3.3 Strategies for managing the challenges:...............................................................................8
4.0 Conclusion..................................................................................................................................8
5.0 Recommendation......................................................................................................................9
Bibliography...................................................................................................................................10
Table of Figures
Figure 1: Conceptual Block Diagram of the proposed e-Health Record.........................................4
(Source: Created by Author)............................................................................................................4
Figure 2 : Overview of architecture of the health care information system...................................6
(Source: Vogel 2014 )......................................................................................................................6
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1.0 Introduction
The advancement of the information technology has opens up the option of accessing
various services through internet. In order to improvise the services the government has
taken the internet to make the services available to the people through internet. This
facility is called e-governance. The implementation of e-governance in the health
monitoring is regarded as ‘Health Information Technology for Economic and Clinical Health
Act, 2009’ (Datascience.nih.gov 2018). He healthcare provides have to maintain a record in
this system. These records can be shared between the other health care providers, if
needed. This system will help to provide the integration of data. The proposed systems have
to be developed within 2014. It can be said that this electronic health record will helpful to
the people. In the development of the health care information system, the Enterprise
Information Architecture (EIA) will be used. EIA is a framework which provides the logical
implementation process of designing the framework of electronic health record (Degoulet,
Luna and de Quiros 2017). The solution provided by the framework is realistic and risk
assessment is also done during the implementation.
2.0 Enterprise Information Architecture:
2.1 Enterprise Information Model:
There are various models of enterprise information architecture. These are-
 Federal Enterprise Architecture Model
 Zachman architecture model.
 Department of defense architecture model
 Open group model
In case of Zachman architecture there are various ideas which are farmed within the
five row and six columns. With the help of Zachman model interoperability problem can be
solved. There are some advantages and disadvantages regarding this model. The main
advantage of this model is it describes the ‘enterprise business requirements’ in the
information field (Fernandes and Fragoso 2017). One of the disadvantages of this model is that
in the case of architectural structure, no procedure id followed. Federal enterprise model
clearly defines the mission and vision of the organization but fails to maintain any suitable
framework for the system. In order to modify the existing system Open group model is useful.
The major advantage of the health information system is that the records it holds all the
information about the patients and this information can be shared between the health
providers. Some advantages of the health information system are-
 Accessibility: The data from the health record can be accessed from anywhere. The
access of the data can be done any time of the day.
 Integration of Data: Integration of data is the main advantage of the electronic health
record. The data recorded by the health providers will help to synchronize the data and
the data can be shared between the other health providers. In case, if the patient
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forgets about his or her past health record, the information can be retrieved from this
record. The records are stored digitally, so there is no chance of misplacement of these
records.
 Cost effective: EIA framework for the ‘Health Information Technology’ (HIS) is cost
effective. The initial implementation of the HIS using the EIA framework may requires
cost and time and planning, but after the implementation it servers various purpose I a
cost effective way.
 E-Health interoperability elimination: Interoperability is the essential attribute of the
HIS. Using ` EIA framework can reduce the chances of interoperability of the HIS. This
causes the better flow of information the system.
2.2 Conceptual framework:
From the conceptual level of understanding the health information system, the e-Health
record is similar to the conventional health record. In case of conventional health record the
information are recorded manually in the record. In the e-health record system the information
are stored electronically. While developing the e-health system, using EIA, the main aim should
be the elimination of disadvantages of the Zachman model.
Figure 1: Conceptual Block Diagram of the proposed e-Health Record
(Source: Created by Author)
In the figure 1 the block diagram of the proposed framework is given. There are two main
section of the proposed health care record are-
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Patient Information
Database
ELECTRONIC
HEALTH RECORD

IMPLEMENTATION OF HEALTH CARE INFORMEATION SYSTEM
 Patient Care Information: The patient care information holds all the information
regarding the patient. This section is generally maintained by the health care provider.
There are two sun domains in this section. One is clinical information of the patient,
another is general information regarding the patient (Singh 2018). The clinical
information contains all the medical details of the patient and the past health records
and conditions of the patient (Jonkers and Quartel 2016). The patient information
section holds the information about the policies of the patient regarding health care
facilities, which can be a medical insurance or policy (health 2018). Both these two
section are accessible to the patients and can be shared between the other health
providers if it is necessary.
 Management Level Information: Management information system holds all the
information from managerial aspects (Weaver et al. 2016). This section includes the
data regarding the current situations of the health policies of the patients. The
managerial data contains all the necessary information from the patient care section
and clinical section. This data is stored in the central database.
The main database acts like a master storage and has centralized control.
Implementation of the HIS using EIA framework should provide right information to the
patients and the health providers. This can be achieved by the ‘Service Oriented
Enterprise Information Integration’.
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Figure 2 : Overview of architecture of the health care information system
(Source: Vogel 2014 )
3.0 Data Integration and Information Management:
Data integration and managing the information is the essential feature of the robust
health information management system. These sections will analysis the different sub sections
of the health care information system
3.1 Functional Components:
There are five components of the e-Health care management from the functional point
of view. They are-
 Billing and Patient management
 Managing the Department
 Documentation of the clinical data and delivery of care
 Decision making
 Management of resources.
Billing and patient management:
This section has two functions- billing and tracking the care facilities of the patients. The
billing includes all the financial transaction made by the hospital and health care provider
regarding the treatment of the patients. ‘Master patient index’ are being used by the hospital in
order to keep the information regarding the patient (Iyamu 2018). This ‘master patient index’
helps in the synchronization between the database maintained by the health care information
system and hospital database.
The register ID of the patient works as a reference in the billing and tracking the
information about the patients. The registration number is often called the patient
identification number. Patient identification number often helps as a reference to keep the
track of information about laboratory reports, referring the medicines (Farooq et al.2015). All
these data are stored in the central database and, from the central database the information
cannot be accessed without authorized ID. The duplicate set of same database is used by the
hospitals and the health care providers. This is done because, in case if any data is missing, the
data can be retrieved from the central database. It can be seen that the registration
information of the patient is connected with all the processes in the health care information
system.
This section also involves with the scheduling process. The scheduling of the healthcare
includes admitting the patient and giving care to the patient maintaining the availability of the
space in the clinics and the hospitals. It is complex process, as the number of availability of the
slot dedicated for providing services to the individual may vary from day to day (Romero and
Vernadat 2016). Scheduling should be done in strategic way (Vargas et al.2016) . Another
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challenge, faced by this section is the resource management which is associated with the
scheduling process. Patient tracking application is provided in order to track the progress in
caring the patient.
Managing the department:
This section of the health care management system serves the information which is
required by the clinics. This information can be of various types, which includes automatically
generated pathology reports, radiology reports. There are two main functions performed by
this section-firstly to provide information from the ancillary department which are essential for
the functions of the various departments. Secondly, to generate online reports, this can be
accessed by patients. These medical reports can be accessed by the health provider by giving
the right user registration ID.
Documentation of clinical data and delivery of care:
This section in the health care information system deals with the after treatment care of
the patients. The functions of this section are – ordering the entry and reporting the result. The
automated system implied in this area helps to eliminate the misplaced slips and transcripts
error are removed by the regular update. All the patient information along with the reports
form ancillary department are stored in this section (Wang et al.2016). The detailed clinical data
is published after merging of the additional information collected by the health care experts
after conducting the interviews of the patients. Clinical data can be available from the health
care information system, in case if the patient is admitted in the hospital or a clinic.
Decision making:
Here decision making refers to the clinical decision making. The decision making process
includes the analysis of the clinical data of the patient. It helps to determine the further steps of
the treatment for the patients. In order to make the strategic decisions, the required data is
fetched from the different sections of the health care information system (Julia, Kurt and Ulf
2017). In order to fetch the right set of data from the other departments of the health care
information system, the patient’ registration ID is used as reference. The sub domain of this
section is ‘Physician Order Entry’ which enable the doctors and health providers to keep track
of the food and drug allergies of the individual patients. This entry helps the doctors to choose
the right combination of drug for the patient.
Management of resource:
This section deals with the management of the resources. The resource is connected to
the resource billing. The main objective of this section is informing patients about the current
status of their medical policies. Through this section the patients can transact the money to the
health care providers (Jones et al. 2014) . In order to calculate the total bill, the raw data is
fetched form the different sections of the departments. The registration number of the patient
ID also plays the reference in this section (Rosenbaum et al. 2017). The third party involvement
such as payment by the insurance companies is also handled through this section.
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3.2 Challenges regarding data integration and data management:
There are certain challenges associated with the data integration and data management
in health care information system. The main aim is to strategic handling of these challenges
through EIA framework. These challenges includes-
 Security: Security is an important issue for any system. In the health care management
system, the security is regarding the protection of information about the patients. The
medical data of the patients are confidential. The main challenge is to maintain the
confidentiality of the data in the system. The data can be accessed by the patient and
the health care provider after the mutual understanding (Yuehong et al. 2016). This
information can be shared among the other health care providers with the permission
of the users. Another security concern is about the safety in the transaction of the
billing amount. The payment of the bill should be done through a secured electronic
gateway.
 Availability and Flexibility: The proposed system needs to be flexible so that it can adopt
any environmental change and the change in the process. The flexibility of the system
depends on the capacity of the adoptability of the system to the certain change
(Nguyen, Bellucci and Nguyen 2014). The availability of the system refers that the
system is available to the health care providers and the users in any time of the day. The
availability of the system is the main attribute the health care information system.
 Data Management: The main aim of the health care information system is to serve the
important information to the heath care service providers and the patients. In order to
do this management and synchronization of data between the various section of the
health care information system is needed. In order to manage the data various
techniques can be taken into account.
3.3 Strategies for managing the challenges:
In order to manage the challenges, the identification of the challenges is needed to be
done. Here, the main challenge is to provide a secured system and managing the information
within the system correctly. In order to maintain the security, different security protocol has
been engaged in the different sections of the system (Andersen, Rasmussen and Frøkjær 2017).
Application of the firewall will prevent the unnecessary traffic to access the system. On the
other hand using the payment gateway which is secured by the network protocol will help the
transaction of the money in a secured way. In certain places, the use of username along with
the password section is needed to be provided as it will help to prevent the unauthorized
access to the system. In order to store the data in the database, SQL server can be used (Shahn
et al. 2016). The dedicate server is needed to be required as the system should be available to
the users and the health care provider for all time of the day.
4.0 Conclusion
The above discussion concludes the effective strategies for implementation of the
health care information system can be done through the EIA framework. There are several
models of EIA those can be used to implement this system. However, there are certain
limitations of each model. The proposed framework of implementation of the health care
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information system is inspired from the different models but it also tries to eliminate the
drawbacks of those models. It can be said that the proposed model will server its purpose by
providing health care information services with robust information management. There are
challenges associated with this framework which can be handled through the implementation
of different strategies. The right implementation of the system will be helpful for both the
health care provider and the patients.
5.0 Recommendation
Certain recommendations can be made in order to improve the system.
 The system needs to be user friendly.
 In order to cleat the doubts and queries of the users, a dedicated support team can be
maintained.
 The users of the system need to be aware of the security issues regarding the system.
 The selection of the EIA methods and the security protocol are needed to be selected
carefully.
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