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Evaluation of the Integrated Elderly Patient Record System

This paper aims to critically evaluate the integrated elderly patient record system (IEPRS), which is an innovative health informatics technology. The IEPRS focuses on the storage of all health or medical information about the elderly patients aged 65 years and above, and operates on the principle of the Electronic Health Record system. The paper accomplishes this goal by employing the model to evaluate the system, explaining how the system will improve health or patient care outcomes, and stating the benefits associated with the introduction of the technology. The paper then concludes identifying the risks for users, patients, and healthcare organisations of the new information system. These goals are accomplished in the headings below:

Evaluation of the IEPRS System Using the Model

Many health care organisations across the globe are focusing on the development and implementation of health information systems (HIS), with the aim of improving the quality and efficiency of health care (). As such, adequate comprehension of the level at which the system can fulfill its objectives, processes, strategies, and ultimate outcomes of its introduction, especially its impact on the efficiency and quality of health care, is essential for the acceptance and use of the system by the purposed users and attainment of the anticipated outcomes. As such, the evaluation of the outcomes and processes associated with the introduction of the health care information system in health care organisations is considered a significant area of health informatics study.  () assert that assessing HIS happens to be a complex matter that has plagued HIS researchers for a long period. Since different stakeholders possess various interests in the assessment study, the types and nature of queries to be raised can be quite dissimilar considering the differences in sizes, organisational culture, management, and power structure of various health can organisations. Nevertheless, it is significant to note that there exists no one-size-fits-all remedy. Moreover, various issues may arise at different phases of the system introduction, which in turn may account for the significant variation in HIS evaluation approaches and methods. In relation to this, the Unified Theory of Acceptance and Use of Technology (UTAUT) framework is employed in the evaluation of the IEPRS.

() assert that technology acceptance models such as the UTAUT attempt to illustrate the magnitude of acceptance of the employment of information technology. () add that these theories analyse whether user will manage to embrace the novel technologies, and the ability of the users to deal with such technologies. As such, the technology acceptance framework assists decision makers and managers to evaluate the success of the development and implementation of technology to the organisation, and encourage users to embrace the systems. According to (), researchers and many academic institutions have employed UTUAT to address the questions concerning user’s perceptions towards the acceptance of ICT (Information and Communication Technology) solution. UTUAT takes into consideration four primary concepts including effort expectancy (EF), performance expectancy (PE), facilitating conditions (FC), and social influence (SI). The four principal concepts are independent variables influencing the dependent variables, usage, and behavioral factors. As such, the use of age, gender, experience, and system volunteers have influence the dependent variables through the four key concepts in an indirect manner. It is also vital to note that behavioural intention is perceived as a critical technology use predictor (). Figure I below shows the image of the UTUAT model:

Figure I: The Unified Theory of Acceptance and Use of Technology (UTAUT) framework

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Table I: Summary of the Four Concepts Involved in the UTUAT Model

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The employment of the four primary concepts of the UTUAT model in evaluating IEPRS is provided below: 

Effort Expectancy (EF)

According to Black et al., (2011), effort expectancy (EF) is the magnitude of ease involved in the employment of the system. Berweck et al., (2007) define effort expectancy as a person’s view that the use of an information technology (IT) system will be effort free. As such, effort expectancy contributes to the moderation of the influence of experience, age, and gender on behavioural intention. IEPRS provides for ease of access of medical data on the elderly patient, provided the patient’s information is stored in the system. The organisation of this information also allows for clarity as is focuses on issues of gender, age, past illness among other factors as in the case of an Electronic Health Record (EHR). The presence of a search engine along with the provision of patient’s medical health profiles enhances the user’s ability to identify pertinent data on the elderly patient’s health history or status. In addition, the system allows for smoothness of interaction with the elderly patient’s medical data, as data is arranged in a manner that can be identified easily by the user. As such, the IEPRS satisfies the guidelines to be met by an HIS under the concept of effort expectancy.    

Performance Expectancy (PE)

Black et al., (2011) define performance expectancy (PE) as the magnitude at which a person believes that the employment of the system will enable such an individual to accomplish gains within job performance. In this dimension, some of the areas against which the HIS system should be assessed are system’s effectiveness, improvement of productivity, improvement of work, better regulation of work, and chance to acquire transferability skills. IEPRS is extremely effective relative to the employment of paper-based patient information data storage method. This system allows for the storage of enormous volume of information in a secure manner. The system also contributes significantly to the improvement of productivity in healthcare in terms of search, access and retrieval of medical or health data on the elderly patient. According to Brandao (2009), the access and retrieval of patient information from paper-based is often accompanied by long duration of search, especially when significant data volumes are involved. Such an undertaking often slows the performance of work, which in turn impacts the execution of health care organisation’s tasks associated with the access and retrieval of patient data. IEPRS enhances work performance by facilitating the storage, access, and retrieval of patient data. Since the IEPRS contributes to time-saving and easy access and retrieval, it can be argued that it plays an essential role in enhancing organisational productivity. In addition, the system allows for better regulation of the task of storing and safeguarding data on the elderly patients. IEPRS ensures that enormous data volumes can be stored and accessed easily, and that the user does not have to handle large volumes of papers employed in storing data. This system also contributes largely to the transfer or acquisition of data security and storage skills among health care personnel. Thus, it can be argued that IEPRS effectively meets the standards needed for the aspect of performance expectancy to be accomplished.          

Facilitating Conditions (FC)

According to Brandao (2009), facilitating conditions refer to the level at which a person believes that technical and organisational infrastructure are available to support the employment of the system. Thus, facilitating conditions are a person’s view of how difficult or easy it will be to execute the target behaviour or the quantity of regulation that an individual possesses over executing the behaviour. The concept of facilitating conditions focuses on issues such as comprehensiveness of training or manual session, ability to imagine the system’s application to execute tasks, mention of the search criteria’s extensiveness, provision of logical steps for employment, application, and recall, and coverage of all essentials required to execute tasks and overcome complexity. The use of IEPRS does not require much training, as it only serves to store medical data on the elderly patients aged 65 years and above. As such, organisational users only require trainings on data storage, protection, access, and retrieval. IEPRS is also suited to store large volumes of elderly patients’ information, which makes the system applicable for such task. The system also ensures the process of searching for patient’s medical details is enhanced by the presence of a search engine, where a unique code assigned to the patient is keyed in. In this manner, only patients whose medical details are captured by the system can be identified, and this enhances the validity or authenticity of the system. IEPRS provides logical steps that can be employed by the user to access the elderly patient’s data. Issues such as patient’s code, age, and sex among others are employed to guide the user on the specific, medical details of clients sought. As such, the user can overcome several complexities encountered in the use of integrated systems of patient medical information. These issues emphasise the system’s adherence to the requirements of the concept of facilitating conditions.           

Social Influence (SI)

 Brandao (2009) defines social influence (SI) as the magnitude at which a person perceives that significant others believe she or he should employ the novel system. Some of the areas addressed by this concept are organisational encouragement, organisational need for change, management involvement in the process of change and communication, experience of a demonstration beforehand, and presence of an open door regulation to discuss elements related to change. The IEPRS possesses a significant potential to motivate organisational employees and management to embrace it. The system eliminates the burden of a health care organisation have to store large volumes of documents and shortens the time required to access and retrieve elderly patient’s information. The system also enhances the safety of information, as opposed to a paper-based system. Damschroder et al., (2009) assert that technology is a key component of health care success, and many organisations are moving towards the embracement of novel information and communication technologies with the aim of having a competitive edge over their rivals. In relation to this, it can be noted that there is a significant need for healthcare organisations to embrace IEPRS, which plays a vital role in the secure storage of elderly patients’ medical data. Since the system operates on the principle of an electronic health record system, many organisational employees will not encounter major problems when it comes to learning how to use it. Thus, it can be noted that IEPRS meets the guidelines outlined in the concept of social influence for HIS.  

How the System will Improve Patient Care and Health Outcomes

According to Black et al., (2011), the development and implementation of HIS should be guided by the gaps in healthcare organisations and the system’s its ability to fill the existing gaps. Organisations are moving from the use of paper-based information storage methods to information technologies, as a mechanism of enhancing the quality of service delivery to clients. The adoption of the IEPRS will contribute largely to positive patient care and health outcomes. This system ensures that the medical information of the elderly patients is stored in a secure manner. Thus, issues associated with loss of critical patient information are avoided, which in turn ensures that appropriate treatment is provided to patients based on their past health information. In this manner, the quality of care is improved. Besides, the system ensures that health care information about the elderly patient is stored in a precise manner, which in turn ensures that suitable diagnosis and treatment is done to patients, thereby leading to improved health outcomes. The system also ensures that information on the elderly patient can be accessed quickly and retrieved easily, which in turn contributes to time saving and hence improve care delivery process. As a result, the quality of care provision for elderly patient will improved.    

Benefits Associated with the Introduction of IEPRS in Healthcare

DesRoches et al., (2008) and Häyrinen et al., (2008) assert that the organisational motivation to embrace a novel HIS is influenced by the system’s ability to grant an organisation a competitive benefit over its competitors. Embracing and implementing the IEPRS will presents several benefits to organisations. First, the system will ensure that data is store in an accurate and safe manner, which will in turn ensure that issues such as loss of key patient information and errors of omission are avoided. Second, storage of patient information in a precise manner will ensure that issues related to poor diagnosis and inappropriate administration of treatment is avoided, thereby rescuing organisations from incurring the legal costs arising from such matters. Third, the system ensures that information retrieval is easy and data access is quick, which contributes significantly to time-saving and reduction of costs resulting from events such as time wastage. Fourth, IEPRS ensures that patient data is stored in a small space relative to paper-based method of storage. While the system depends on hard disk and cloud-based backups for preserving patient information, paper-based method relies on documents and huge files that consume large volumes of space. As such, the IEPRS will save health care organisations from incurring the extra costs arising from securing additional storage volumes for files or documents containing elderly patients’ health information.   

Risks for Users, Patients, and Healthcare Organisations

The development and implementation of HIS is often accompanied by certain risks, which might affect users, patients, or health care organisations (Peffers et al., 2008; Porter, 2010). The IEPRS does not present any significant threat to patients since the information is stored at the health care organisation, which is in charge of its storage. The elderly patient can access such health details when they visit the healthcare organisation with which they are registered using a unique code. However, this system presents certain threats to users or organisation employees and health care organisations. Users face the risk of employing complex passwords that cannot be remembered easily. The employment of such passwords might hinder them from login into the system to retrieve patient information. Addressing this issue will require that user employ combination of passwords that they can remember easily such as incorporating their years or dates of birth into their passwords. The key threat presented to health care organisations is the possible loss of key patient information via hacking or damaging of critical IT infrastructure. Health care organisations will address this issue by securing their systems using three layered systems and employing robust passwords to safeguard their systems from malicious hackers. Lluch (2011) proposes the backing up of critical information on the cloud to ensure that such information is recovered when lost through hacking or damage of critical IT components by fire. These organisations should also focus on training their employees on good practice when it comes to the use or handling of patient information. Embracing these measures will ensure that health care organisations address the risk presented by IEPRS in an effective manner.

In conclusion, health information technology assessment continues to be a significant component of success of health care organisations, which aim to implement new health care information systems. The assessment of the IEPRS has indicated that this innovation will gain immense acceptance from health care organisations considering the benefits it presents to patients and organisations. IEPRS will contribute to the reduction of cost incurred due to inaccurate storage or loss of elderly patient information and costs used to secure spaces for storing large volumes of documents or files. This system will also ensure time-saving in terms of quick retrieval and easy access of elderly patient data. In this manner, the quality of health care provision and health outcomes will improve significantly. As such, health care organisations should consider implementing the IEPRS.