Health Information Systems in Healthcare

Introduction

Health Information Systems are today considered an important aspect of healthcare systems through which care delivery can be processed and delivered in hospitals. Many forms of healthcare firms depend on these systems in their daily operations as they deliver healthcare services to their patients (Ismail et al., 2010). The significance of these information systems in healthcare come from their relevance in managing patient information, and data including information about patients, as well as, other comprehensive health records, including documented medical services which have been offered to patients, critical medical decisions, follow-up records or reports, treatment, diagnoses and investigation. Despite the benefits or potential benefits which can be seen from health information systems, the implementation of these systems in many developing countries is accompanies by many barriers and challenges as compared to those faced in developed states (Shortliffe and Cimino, 2006).

Aim of the Study

The aim of this study is thus to investigate the challenges and benefits of implementing Health Information Systems in Riyadh and Providing recommendations to improve the level and awareness in implementing Health Information Systems.

Objectives of the Study

1.To find out the willingness of and acceptance of Health Information Systems by healthcare professionals in Riyadh, Saudi Arabia

2.To determine the healthcare professional's perceptions concerning the challenges and benefits of Health Information Systems in different hospitals in Riyadh, Saudi Arabia

Research Questions

1.Are healthcare professionals willing to accept the use of Health Information Systems in care delivery in Riyadh, Saudi Arabia?

2.What are the perceptions of healthcare professionals about Health Information Systems concerning the challenges and benefits of implementing Health Information Systems in hospitals in Riyadh?

Literature Review

According to Sood et al. (2008), even though there are many potential benefits and advantages which are associated with the implementation of these Health Information Systems (HIS), many hospitals in developing states still experience a lot of barriers and challenges which are different from those that developed nations face. These individuals say that despite many visible benefits which can be sourced from these systems such as improved safety, quality and lower costs, the implementation of these health information systems in countries which are developing is still less successful. This claim is supported by Bah et al. (2011) who claim that in Saudi Arabia, the extent and level of application of heath information systems is poor mainly because of the delay in the technology’s adoption and implementation in hospitals as well as the lack of a countrywide HIS. Additionally, Altuwaijru (2011) claim that despite the many potential benefits that are associated with HIS, Saudi Arabia is still lagging behind because of the high failure rates in projects which are IT-related. Another research by Asangansi and Farri (2008) shows that one of the main reasons why implementing HIS in Saudi Arabia has been linked with delay is because of the problem of the system’s usability. These researchers say that in Saudi Arabia, most physicians do not have sufficient computer skills, a common case in developing countries, and as such, these healthcare professionals spend a lot of time learning the best ways to apply these systems in care delivery. Miller and Sim (2004) support this claim by stating that this extra time or the cost of initial time is a major barrier to ripping off the benefits of these technologies and add greater burdens on the time of physicians. As a result, these physicians become resistant to the use of these health information systems which lowers the possibility of effectively implementing them and achieving improved quality. According to Hoffman et al. (1999), although Saudi Arabia vendors are improving the usability of HIS, many of the vendors doubted if any of these newly developed/innovated technologies like, hand-held mobile devices, tablet computers and voice recognition would help simplify the use of HIS. These individuals claim that developing user friendly programs for knowledge and information professionals is a problem which spans the program or software sector beyond healthcare. This point is supported by McDonald (1997) who claim that weak integration and inadequate electronic information or data between the Saudi hospitals’ HIS modules and HIS systems as well as electronic systems also play a role in delaying the successful implementation of these systems. For instance, the lack of or inefficient integration of hospital HIS and clinical information systems as referral, radiology and lab systems. Working with the paper and electronic based systems simultaneously often force health practitioners to shift their tasks from either the two systems thus slowing their operations and need more time to enter data manually from other external systems. This additional work burden and slow workflow increase resistance to the implementation of HIS by healthcare professionals (McDonald, 1997).

According to Brynjolfsson and Hitt (2000), Saudi HIS often require more difficult complementary support and changes during the final tuning and customization processes. The information systems software and hardware for hospitals cannot be merely applied “out of the box”. Rather, healthcare professionals and physicians are needed to conduct time consuming and complex activities to adjust, complement as well as customise the hospital HIS products before they can generate benefits from their new technology. HIS also need much technical support from the different software, networking, service vendors and hardware when some technical challenges emerge, like slow computer networks and machines, poor user interfaces, difficult or problematic data entry and issues during data retrieval when hardware have become old (Brynjolfsson and Hitt, 2000). Additionally, Lorenz et al. (2009) says that generally, larger hospitals might implement HIS changes and get support from the technology vendors easier as compared to smaller hospitals because these larger hospitals have stronger resources like management experiences with their past changes, support staff for their information systems, leadership and financial resources. Other studies have attempted to look into the issue of the development and well as implementation of HIS in Saudi Arabia and other developing states, trying to elaborate about the unsuccessful implementation or delays of these systems and associate this issue to the resistance or acceptance of the technology by healthcare professions. For instance, Morton and Wiedenbeck (2010) state that the impact of the knowledge of information technology, the skills and experience which healthcare professionals have, the current status and extent of automation in health facilities and the attitude of professionals concerning their negative and positive beliefs with regard to information systems and computerised systems in healthcare environments are some of the main human challenges which hinder the successful implementation and application of HIS. This argument is supported by Ochieng and Hosoi (2006) who say that to ensure there is a successful development and implementation of this technologies, there is a need for the healthcare professionals to be trained to encourage a more positive attitude towards HIS as well as to build confidence concerning the benefits that might arise from the use of health information systems.

According to Dansky et al. (1999), strategies or plans for the successful HIS management regarding its implementation should engage physicians and all other healthcare professionals, where strong support from the organisation is offered to these professionals before as well as during the implementation of such technologies. Dansky et al. (1999) claim that these factors can help get rid of the major negative attitudes and resistance which are often seen and also increase the acceptance levels of HIS by healthcare professionals and physicians. According to Khudair (2008), physicians in Saudi Arabia spent more time with each patient, for months after the implementation of HIS. The increased effort and time consumed led to fewer patients served and longer workdays, majorly during the initial periods of the technology’s implementation. Khudair (2008) says that the technology therefore, added workload, slowed down the professionals’ performance and decreased productivity. Agha et al. (2010) claim that effective patient-physician interaction and communication is linked with better health outcomes, patient satisfaction and treatment adherence. In their study, these researchers measure the extent of keyboarding, healthcare professional’s computer screen gaze and their eye contact with the patients and their body lean. Agha et al. (2010) discovered that the use of HIS further complicated the patient-physician interaction during visiting hour, negatively impacting patient-centred communication. These researchers concluded in their study that the use of HIS can, not only undermine patient-centred care but can also led to poor physician and patient satisfaction.

According to Kalogriopoulos et al. (2009), while developed countries have undergone modernisation and the enhancement of their electronic medical data and records through the implementation of HIS, most developing states are still continuing with their paper-based systems as they slowly struggle to move to electronic systems. According to these researchers, those challenges which the developed world face in their health information systems are very different from those experienced in developing nations. The individuals say that the developing countries face various health crises which threaten millions of lives, where there is a lack of experienced and trained healthcare professionals as well as the lack of infrastructure. According to these researchers, these are the main challenges which affect the scaling up of treatment for illnesses and improving healthcare and is why these countries should manage challenges based on their list of priorities (Fraser et al., 2005).

Methodology

The approach that will be used in this study will be a qualitative research method, particularly with the use of questionnaires because it will involve interacting with people to study a real life phenomenon.

Design

This study will be a descriptive cross-sectional study to allow the examination of a real life scenario which is the critical analysis of the challenges and benefits of the implementation of health information systems in Riyadh hospitals.

Settings

The study will be conducted in KSMC hospitals in Riyadh Saudi Arabia which will represent major health facilities which have implemented and are still in the process of implementing health information records.

Sample

The target sample size and population will be healthcare professionals including technicians, pathologists, radiologists, nurses and physicians working at different settings in the health facilities. They will be classified either as implementers and non-implementers. Non-Implementers: Will includes professionals or facilities who have resisted implementing health information systems due to different challenges. At least 20 respondents will be evaluated during the study. Implementers: Will include health professionals or the health facilities who have implemented health information system and are benefiting from the technology. Here, at least 20 professionals in the health facilities will be evaluated as well.

Sampling method:--

Data Collection

This study will depend on the use of surveying technique, through the application and development of questionnaires to collect information or data directly from the above healthcare professionals’ categories including the administrative staff, technicians and doctors of the Riyadh hospitals. The study questionnaire will be designed to include at least four question sections. The first question section will about the participants, demonstrating demographic information to determine the possible relation between the challenges and benefits of implementing HIS and their experiences. The second section will be designed to gather data concerning the extent and type of the information system being implemented or that has been implemented. The third section will be designed to gather data concerning the experienced technical challenges linked to the computer software and hardware and the information technologies being implemented, which can contribute to the unsuccessful or delay to the implementation of the HIS, for instance, poor usability or interfaces, challenging data retrieval or entry and insufficient software or hardware concerning slow or old machines besides the lack of training and support. The last section will gather data concerning the human challenges which hamper the implementation of health information systems in Riyadh hospitals. The survey will collect information about the professional characteristics and demographic information of healthcare providers in Riyadh hospitals and their perceptions concerning the challenges and benefits of implementing information health systems and their resistance or willingness to use the technology. A Liker scale will be used on the questionnaires to find the benefits and challenges of implementing and using information health systems.

The process of data collection

A pilot study will be conducted with the help of preliminary questions and a small number of healthcare professionals from the hospitals to acquire their feedback on the used questions to help develop or formulate better and clearer questions which are relevant to the study and which are edited and rearranged following a clear sequence. The final developed questionnaire will be administered in languages, Arabic and English. Data will be gathered over at least six months starting from January 2020 to June 2020.

Data Analysis

Data will be analysed using a nonparametric statistical approach using the latest version of SPSS, version 19 or more. Here, descriptive statistics will be used to create the percentage and frequencies for different categorical variables and standard deviation and mean for various continuous variables. SPSS will help find the statistical relevance of the challenges and benefits of the implementation of HIS to determine the rank and order of the challenges and benefits. The Chi-Square test will also be used to measure the relationship between some variables. Moreover, Kruskal-Wallis test will be conducted to evaluate any existing substantial statistical difference between perceptions of the two categories of professionals. Between the variables, their statistical significance of p ≤ .05 will be employed

Ethics

An approval or consent from the ethics research committee in my university will be acquired and submitted to all the study areas to be visited.

Consent forms will also be provided to the participants requesting them to participate willingly.

The consent forms will also indicate to the participants that the data they will provide will be kept secure/confidential and no unwanted third party will access the information except my University and my supervisor as needed.

The participant’s name will be hidden or pseudonyms will be used to keep the participant’s identities secret and to protect their privacy.

Summary

In this research proposal, it has been demonstrated that Health Information Systems are today considered as an important aspect of healthcare systems through which care delivery can be processed in hospitals. Many forms of healthcare firms depend on these systems in their daily operations as they deliver healthcare services to their patients. The aim of the study has been outlined which is to investigate the challenges and benefits of implementing Health Information Systems in Riyadh, Saudi Arabia. It is clearly stated that the objective of the study is to find out the willingness of and acceptance of Health Information Systems by healthcare professionals in Riyadh, Saudi Arabia, to determine the healthcare professionals perceptions concerning the challenges and benefits of Health Information Systems in different hospitals in Riyadh, Saudi Arabia, to determine how healthcare professionals and facilities as well as how the patients are benefiting from Health Information Systems and to determine the challenges which are experienced by healthcare professionals and the facilities in implementing Health Information Systems. Different literatures have shown that there are many potential benefits and advantages which are associated with the implementation of these Health Information Systems, many hospitals in developing states like Saudi Arabia. With the help of questionnaires as a data collection method and SPPS data analysis tool, this research intends to determine the challenges and benefits of implementing information health systems in Riyadh.

References

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Dansky, K.H., Gamm, L.D., Vasey, J.J. & Barsukiewicz, C.K., 1999. Electronic medical records: are physicians ready? Journal of Healthcare Management, 44(6), pp.440-454.

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