The chaotic nature of healthcare information systems: The need for transdisciplinary collaboration

Copyright @ 2013 EMCIS.This paper demonstrates one of the challenges of the healthcare information systems development, namely the chaotic nature of healthcare systems. Although the reliable evidence demonstrating the positive effects of health information systems on safety and quality remains inconclusive (a growing body of research revealing the unintended consequences and potentially error producing effects of health information systems’ implementation. Different arguments from the literature concerning the chaotic nature of healthcare, including but not limited to the nature of patients and disease have been presented. The requirements of new ways of systems design and the need for transdisciplinary dynamic teams within the requirements engineering phase as a start has been discussed. These arguments have been investigated in the context of an exploratory case addressing one of the advanced oncology centres in the US. This paper concludes that there is an important need to rethink healthcare information systems development method, which has to be in a dynamic ongoing manner for some major issues

Design of Information Systems in Health Services Hospitals Gandaria

Today\u27s progress has touched all aspects of life, including aspects of health care. Inorder to provide good health services, and the sooner it is not wrong if it is acomputerized system should be applied. At the hospital Gandaria currently using thesystem as the elderly, which in addition to the registration section in charge ofseeking patient data is also required to make patient data for new patients, then thedata is given to the receptionis to be given the serial numb er checks. However, whenrelatively few patients is not a problem, but problems arise when total patientincreases, so that the registration is required to give fast service and BAUK. For thisKKP writing this writer hope to give a picture of the health service and to helpcomputerize the task dari registration section

Using System Analysis and Personas for e-Health Interaction Design

Today, designers obtain more central roles in product and service development (Perks, Cooper, & Jones, 2005). They have to deal with increasingly complicated problems, like integrating the needs of various stakeholders while taking care about social, ethical and ecological consequences of their designs. To deal with this demanding design situation, they need to apply new methods to organize the available information and to negotiate the stakeholder’s perspectives. This paper describes how systems analysis supports the design process in a complex environment. In a case study, we demonstrate how this method enables designers to describe user requirements for complex design environments while considering the perspectives of various stakeholders. We present a design research project applying cybernetic systems analysis using the software ''System-Tools'' (Vester, 2002). Results from the analysis were taken to inform the design of an electronic patient record (EPR), considering the particularities of the German health care system. Based on the analysis, we developed a set of requirements for every stakeholder group, detailing the patients' perspective with persona descriptions. We then picked a main persona as reference for the EPR design. We describe the resulting design sketch and discuss the value of cybernetic systems analysis as a tool to deal with complex social environments. The result shows how the method helps designers to structure and organize information about the context and identify fruitful intervention opportunities for design. Keywords: E-Health; System Analysis, Cybernetics; Personas.</p

Health insurance in Zaire

This study of health insurance systems in Zaire was carried out as part of a larger program of initiatives designed to improve the sustainability of health care systems and increase the health status of the Zairian population. This paper presents the objectives of the study and a discussion of the economic aspects of health insurance, background information about the health sector and health financing systems in Zaire and highlights of previous related work. The major motivations for this study were: (a) to provide information for the ongoing social sector adjustment dialogue in Zaire; and (b) to serve as a case study in the World Bank's Region Study of Health Finance. Specifically, the study sought to document different types of insurance systems in Zaire, and to conduct in-depth case studies of several schemes. The in-depth case studies presented in this report evaluate the design, management operational efficiency of four health insurance programs from both rural and urban areas. The case studies also attempt to analyze the effects of insurance on equity of access, utilization of health care services, and mobilization of financial resources for the health sector. From these analyses, the report draws conclusions about the advantages and disadvantages of health insurance programs as a means of financing health care services in Zaire, and suggests avenues for future research, policy, and programming initiatives.Health Monitoring&Evaluation,Insurance Law,Health Economics&Finance,Insurance&Risk Mitigation,Health Systems Development&Reform

Institutionalizing Information Systems for Universal Health Coverage in Primary Healthcare and the Need for New Forms of Institutional Work

Today, many countries around the world focus on ensuring that all people can access health services of sufficient quality without experiencing financial hardship (i.e., universal health coverage). To measure progress towards this goal, countries need to build robust health information systems. Because countries need to root universal health coverage in primary healthcare, they also needs to sensitively anchor health information systems that support universal health coverage in existing routine health information systems. However, doing so involves significant challenges, which we study via empirically analyzing an Indian state\u27s effort to implement a universal health coverage health information system in primary healthcare. Using a theoretical lens informed by institutional theory, we seek to answer the question: “What is required to develop institutions that support the use of new technologies and associated work processes that universal health coverage entails?”. We identify the contradictions that emerge when new systems clash with existing ones, and we discuss what implications such contradictions have in terms of system design, work processes, and institutions. We contribute to the literature by explaining inherent complexities in universal health coverage health information system design and implementation and providing system design guidelines

Interpreting the management of information systems security

The management of adverse events within organisations has become a pressing issue as the perceptions of risk continue to heighten. However the basic need for developing secure information systems has remained unfulfilled. This is because the focus has been on the means of delivery of information, i.e. the technology, rather than on the various contextual factors related to information processing. The overall aim of this research is to increase understanding of the issues and concerns in the management of information systems security. The study is conducted by reviewing the analysis, design and management of computer based information in two large organisations - A British national Health Service Hospital Trust and a Borough Council. The research methodology adopts an interpretive mode of inquiry. The management of information systems security is evaluated in terms of the business environment, organisational culture, expectations and obligations of different roles, meanings of different actions and the related patterns of behaviour. Findings from the two case studies show that an inappropriate analysis, design and management of computer based information systems affects the integrity and wholeness of an organisation. As a result, the probability of occurrence of adverse events increases. In such an environment there is a strong likelihood that security measures may either be ignored or are inappropriate to the real needs of an organisation. Therefore what is needed is coherence between the computer based information systems and the business environment in which they are embedded. In conclusion, this study shows that to resolve the problem of managing information systems security, we need to understand the deep seated pragmatic aspects of an organisation. Solutions to the problem of security can be provided by interpreting the behavioural patterns of the people involved

Analysing regulatory systems in mixed public-private health systems: a new assessment tool and its application in India

Health systems in many low- and middle-income countries (LMICs) in the Asia-Pacific region can be characterised as mixed public-private systems, with common features such as blurred boundaries between public and private sectors, low government investment in public services and ineffectual policies and institutions for regulating health care.As a result, they encounter a range of performance issues, including poor quality and inequitable coverage of health services, health providers who exploit their market position for personal gain and high out-of-pocket expenditure for users, particularly the poor.Such problems reflect failures in the regulation of health care providers. However, in LMICs there is often little information on the specific nature of these failures or their causes to guide national and sub-national authorities in strengthening the regulation of their health systems.The Nossal Institute for Global Health and the Public Health Foundation of India collaborated in the development of a structured assessment tool that can be used to describe and assess regulatory systems and organisations and to identify gaps in the design, and failures in the implementation, of regulatory systems. The tool was then tested by assessing the regulatory systems at two sites in India with very different demographics and health care systems: Madhya Pradesh and Delhi.&nbsp