A long term care and nursing information system is created with a purpose of creating ways that to be sued in treatment of patients in long term facilities more efficiently. This has led to a revolution in the industry as they help in the creation of units that work across the board in the long term care situations. This allows the clinicians an option of flexibility that will be used in decisions that are used in caring for people. Due to the efficiency in operation that is brought about by the information systems, the use of these systems is slowly becoming an integral part of nursing home and in delivery of the long term care. Today most of the facilities that are in operation tend to develop some kind of operating system that is used in the running of the day-to-day processes (Singh, 2009).
According to Evashwick (2005), in using these systems, the software gives leverage for efficiency in the clinical process that was never previously possible. Some of the facilities like the electronic patient record are normally integrated with the financial process hence making the process of transmission of services in the case of inquiries by the insurance service providers. In doing this, it gives an edge by the ability of capturing service delivery through an electronic process. This creates a central point that will allow the creation of an infrastructure that is efficient enough for efficiency to the service providers. This system is created in a manner that it will combine all the financial and administrative information that is needed in running a complete nursing home like a company. Most of the information that is used in this case can be gathered from the charts that are used and fed into the system.
Significance of the system
The use of these information systems has not been adequately realised in most of the nursing homes. The integration of the records of the patients along with collaboration can assist in driving the efficiency that is achieved in the electronic process and transfer the same efficiency to the delivery of the clinical process. This is because more time will be spent between patients and care givers unlike in situations where more time is spent in the review of records. This is because as patients are moved from one section to another so will the records that exists about them. The electronic system that is a hand held computer device entailing all the guides to be used by home care clinicians and shortens the entire clinical process. The clinicians will hence use the structured guides to note the records and in doing this as the system will assist in automating the report (Stone, 2000).
The most fundamental aspect in the trying to set up the long term care and nursing home systems is the implementation that relates to patient treatment process that becomes flexible. By controlling the costs that are incurred by the nursing home and skilled nursing facilities is reduced and in the process this creates a responsive ability towards the changing conditions of the patient. In supporting the flexibility of the systems, the home is able to manage the patients at a lower cost and this also spurs a rapid growth of the electronic patient records. The markets for these systems had reached about $250 million in 2009 and it is expected to double in the next decade (Bayley et al, 2005).
Basic Components of the System
The system should have the ability to support the healthcare information that is put into charts and allow its exchange in the medium that has been set up; in this case most likely a local network. The system should have the ability to improve the processes being done at the centre and this shall include both the business aspect and clinical setting as it facilitates easy retrieval and clearance of records. This will assist in the integration of with the existing information that is available. Besides the information system should facilitate an easy access and delivery of information those who need it at any time the day for the facilitation of various actions. The system if possible should include some specific applications that may be needed in the long term care provision.
The system should also increase the ability to conduct an end-to-end business processes that will be carried out in the organization. The system must also have the capability of optimizing integration with other existing IT departments and infrastructure that is already in place. In order to achieve a better health, information outcome should enforce the access and delivery of information. The model that is created should be in a manner that it can support the growth and development that will occur in future by allowing the space for expansion of it (WHO, 2000).
Saben (2011), states that in trying to design these systems, they do not just arise from a vacuum, hence there are factors that come into consideration and need to be considered. In the design some of the factors that need to be integrated include the current services that are offered along with the health and social services. The first step that needs to be taken include fragmentation of the existing service programs as this will assist in the better use of the new resources that will be availed. There are three main models that are applied in the instituting the long term care information systems.
The first combines all community based and institutional care into a single a sole purpose agency that will govern and monitor everything. In such a system all the long term costs and expenditure are integrated into one budget and allows the proper allocation of resources. Another model is one that uses an umbrella agency which will shift some of the internal responsibilities and in the process increase coordination among the various agencies in the health facility. The third model that has been applied is one that retains the independency the various agencies in the facility possess but sets an interagency committee that will foresee the integration of all the other agencies on a supervisory mode.
The information that needs to be provided in the system includes all medical records that will be relayed electronically unlike the current situation. This will assist in the running of the various information statuses that include discharge summary that is made available. Other types of information are complexity of the patient, any acuity on the patient and the time pressures. In doing this it helps in making the service delivery more efficient in comparison to other instances (Saben, 2011).
Issues to Consider When Availing the Information needed
The first action that is needed is that each patient needs to have an adequate amount of medical history especially any pre-existing conditions that may require some form of care in the process. This is followed by stating of the sources of the information to ensure whether they are credible enough to be sued in the actual setting. This is followed by how comprehensive the instructions given are and if there will be adverse effects in the case of breaching. The communication channels that are available in the case or need for check up. In this case in the event for need to contact the family what are the available options? All these queries that may be needed to be answered will also depend on the condition of the patient that shall involve whether there is a complexity, specific treatment type needed or acuity (Pratt, 2009).
Information Provided by the System
According to Kovner & Knickman (2008), the older people who are normally admitted need to contact various local agencies as they try to find the service packages and the resources needed for funding. The entry in this case must be centralized in a manner that makes it less fragmented and in the process from the view of the older people who are in need of the care shall assist in costs of the program. This centralization will allow the client to be assessed, pre-admission screening to be carried out, and management of the cases to ensure the key components that will allow access to the care programs.
This comes in handy in the cases of patients who have been transferred from hospital and should continue with their medication. The medication in this case has to be strictly stated including the time intervals that need to be followed and the contra-indications in the case there is need to see any of them (Justice et al, 1988).
This is the study that is carried out in trying to determine the physical ability of the person in relation to the conduction of the daily activities. The results that become obtained from these tests will be used in the determination of whether the person has been impaired enough in order to need the care of the long term programs. The results that become obtained from such results are easily stored in the electronic data system to ensure the condition of the person can be determined at the time of arrival (Gardner, 2006).
Pre-Admission Screening Process
Every person before they enter the clinical setup of the ward needs to undergo screening to determine any conditions that may be present warranting further care and measures that will be needed. This will determine if the person to be cared for needs a full-time by the bed service or is ok and needs periodical checks. Besides putting into fact that most elderly people may not prefer this option, the discussion on the best way forward can also be considered. The data from such reviews must be recorded about the patient and all the necessary information made available whenever it is needed for other uses.
According to the WHO (2000), this is the most central of information about an individual in the entire community care system. The service provider has a different criterion that is used in management of the whether one qualifies for the service. In addition, all cases’ previous records for treatment or any other procedure must be easily accessible to the physicians or patient that may be needed in such situations. In addition to this, the information that is available also helps in finding out the services that are subscribed to an individual according to the service provider that has been selected.
This can be used in the ensuring the plan that is offered to an individual does not bring too much cost to the nursing home. Some of the main services provided in such situations include housekeeping, preparation of meals, and assistance in activities like bathing, dressing and other daily activities. However there is need of flexibility in terms of how things are done especially in cases of need of public support that consists of creation of programs tailored for individuals.
This will be indicated to help the administration in dealing with some issues that may arise of demanding extra funding. Besides no single individual plan is likely to fully satisfy all that may be required. This shall also include the daily benefit amount that the client is entitled to including the options that are available in the case of extension of the services that are available to them. If this arises the service provider has to indicate the amount it is willing to contribute like the insurance company.
Besides this, another issue that comes into play is the benefit period. In this period it should indicate how long the care that is to be given to the individual will last in order to get the full day care. In the case of the service being provided spending lesser than expected, the period is expected to last longer in comparison to a situation where this would have spent more hence shortening the period.
Justice et al 1988 states that in the case of a person having stayed beyond the time period that is set by the service provider there is the minimum number of days that they will have to put up before this comes into effect. This may last from 20-100 days. Hence in such an event the person will have to pay for the services during this period before the service provider comes back in to lend a hand. The policy that the individual creates in the service provider must also cater for issues that relate to the provision of services. In this the service provider has to guarantee that the service to be offered will not be affected by economic issues like inflation but will remain consistent. This is because it puts into consideration the fact that the policy may be implemented up to thirty years later. In order to give such a protection their service provider has to give a certain increment to the benefit to be awarded on a yearly basis.
Barriers that may arise in Planning and Implementation
The main problems may arise in the issue failures in the transfer of medical information. This will bring a dilemma as some of the missing parts may end up being the crucial parts and in the process the system physicians ay become limited in the steps that can be taken. Such problems may arise in the case of wrong admission orders or when they were not completely filled. If a patient or client has been transferred from hospital and the discharge medication does not provide adequate information, the process becomes tricky and may hinder the service given due to inability to judge whether some other medication should be administered. This will result in a gap in the information that is fed into the system. Poor communication is another factor that can result in this as it will proper transfer or in other cases the information transferred may be erroneous leading to impaired action or treatment because of the information’s lack of accuracy.
The other issue that does arise has to do with the financial conditions. Installing such a project in an institution can be quite costly and putting into consideration the fact that most of the software’s used in the information system are quite costly. This is made worse by the fact that the financial conditions are changing; this includes the high rate of declining reimbursements, rising costs in operations and labour shortage which is in most cases very costly. This when put together gives little room for navigation in terms of expenditure and budget flexibility (Pratt, 2009).
Factors to Consider In Design
There is the need to assess the risk that is involved hence this will include the cost, the actual amount of time and resources that are available for the design. In the same process the amount of resources that are available must be considered because it is important that it is within the budget of the organization. In addition to this, the design that is being considered has to be effective, efficient and have a low maintenance cost. In this the ability to perform the allocated tasks is of utmost importance implying that it has to be able to integrate the various types of records and information of health and financial data on a patient easily. The design that is being implemented has to ensure that it is easy to use and does not require any specialization due to the fact that it will be used by all staff at the facility; this including both the medical and administrative staff.
External development that may impede the Implementation
Some of the issues that impede the implementation process of the project include the policies in place. Some of the current policies include a grant from the state government that assists in the running of the facility. This however due to cuts in state spending may be withdrawn resulting in a huge deficit in the budget of the centre. If the funds to be sued may have come from such grants the cuts can interfere with the process. In addition the availability of the equipment that is needed may be unavailable resulting in delays in implementation. The market changes can also play hand in this as prices and economy lapses can result in prices rising sharply of some of the equipment to be used resulting in increased spending.
The long term care information system can be an important advancement in an organization not only due to the ease of access of information but it will improve the service delivery. This can be attributed to the fact that more time will be spent in trying to meet the needs of the patients rather than going through records. The coordination also makes it easier for diagnosis of any ailments due to the easy access of medical history. The interconnection also means every service can be conducted at a single port due to access to all information. However there are constraints that may arise due to cost and efficiency that the design created shall bring to the table.