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1 Evaluating Information Technology Systems for Health Information Management (HIM) Amelia Brown Strayer Health Information Systems Donna Levesque 08-07-2023
2 Evaluating Information Technology Systems for Health Information Management (HIM) Health Information Management (HIM) reflects the systemic utilization of digital Big Healthcare data coupled with health information technology. The primary context is through the acquisition, safekeeping, analysis, and conveyance of specific health information to various healthcare stakeholders such as patients, multidisciplinary collaborative care teams, and health insurance companies (Zhao et al., 2020). One advantage of HIM involves the steering of patient engagements to improve their involvement in their healthcare process. Another advantage centers on the improved aptitude of HIM to steer evidence-based clinical decision-making within multidisciplinary collaborative care teams. Another merit centers on the generated aptitude for facilitating robust insights for forecasting illness trends and evaluating the efficacy of pertinent treatment interventions (Zhao et al., 2020). Selecting an Information Technology System that utilizes Health Information Management (HIM) for Facilitating Improved Patient Safety Clinical Decision Support Systems (CDSS) mirror an example of an Information Technology system that utilizes Health Information Technology for elevating patient safety. A Clinical Decision Support System (CDSS) is reflective of an Information Technology framework that oversees the analysis of Big Patient Health Information for helping multidisciplinary collaborative care teams make informed patient-centered decision-making (Han et al., 2023). The reason for selecting Clinical Decision Support Systems is founded on its aptitude for placing patients at the forefront of their care which improves the attainability of individualization of their care process. On this note, the CDSS system steers Health Information Management (HIM) via a
3 comprehensive leveraging of patient-unique digital healthcare data that is also informed by the use of scientific evidence for a continuum of quality healthcare outcomes (Han et al., 2023). Clinical Decision Support Systems necessitate computable-founded biomedical awareness, individual-unique healthcare information, and a logical thinking framework. The elements amalgamate evidence-based clinical awareness with Big Healthcare Information (Han et al., 2023). The framework in turn helps create while at the same time conveying quality, validated, and error-free patient-specific healthcare data to multidisciplinary collaborative care teams as the healthcare process is ongoing. The individual-specific healthcare data, through the CDSS framework, undergoes comprehensive filtration, management, and conveyance which helps improve the ongoing care process (Han et al., 2023). As a result, there is the generated aptitude for prompt evidence-based decision-making that is considerate of all the patient’s needs for person-centeredness. Organizational Needs for the Requirements of a Clinical Decision Support System Various organizational needs amalgamate three phases that will highlight the requirements for the Clinical Decision Support System. The initial phase is the evaluation of the necessity for quality improvement through the use of Health Information Management. On this note, there is the highlighting of the specific healthcare challenge that should be tackled to attain accessible, cost-effective, quality, and safe person-centered healthcare outcomes (Tun & Madanian, 2023). The next Phase involves generating a consensus and selecting the Clinical Decision Support System that helps tackle the healthcare challenge. The next phase involves carrying out the implementation approach, infrastructure needs, and training on Health Information Management of the CDSS framework that also appraises its
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4 continuous life cycle, performance outcomes, and room for improvement. Consequently, there should be the selection of effective communication approaches for facilitating the implementation of the CDSS system. Another context involves the selection of effective leadership strategies such as transformational leadership for inspiring the organization's personnel to buy into the quality change initiative per the underlying organizational culture (Tun & Madanian, 2023). The element requirements are shown in the figure below.
5 Software Development Life Cycle (SDLC) Impact on Organizational Needs The Software Development Life Cycle (SDLC) is utilized for highlighting specific development phases within the health information system that will facilitate Health Information Management within the healthcare organization for improved patient safety and patient- centeredness (Hamza et al., 2022). The initial phase, “Analysis”, will be central to acquiring unique needs for all the involved stakeholders, especially patients, to understanding the nature of their needs and how to tackle them. Additionally, the analysis phase will help evaluate the organizational business needs and probable threats for integrating the health information technology system (Hamza et al., 2022). The second phase, “Planning”, will be central to highlighting the pertinent scope of the healthcare challenge and pinpointing possible counteractive measures. On this note, there will be the underlying various organizational needs such as infrastructure, finances, and timeframe for project implementation (Hamza et al., 2022). The third phase, “Architecture & Design” will encompass the High-Level Design (HLD) and Low-Level Design (LLD) sub-phases. The HLD sub-phase will be significant for underlining the long-term architectural aspects of the health information technology system. On the other hand, the LLD sub-phase will be central to highlighting the architectural elements that should oversee improved patient safety (Hamza et al., 2022). The fourth phase, "Development", encompasses the actual development of the specific Clinical Decision Support System. Clinical Decision Support Systems typically amalgamate three-layer frameworks that enable their overall success within an organizational context (Hamza et al., 2022). The primary layer is the “Data Management Layer” which integrates the evidence-
6 based clinical database for acquiring, curating, analyzing, and conveying healthcare Big Data (AltexSoft, 2020). Healthcare Big Data may be in the form of patient-unique healthcare information, illness trends, and laboratory findings. The “Data Management Layer” acts as the knowledge level that constitutes the "If-Then” protocol for machine learning (altexsoft, 2020). The second layer is the "Inference Engine" which is utilized for applying standardization (algorithms) coupled with data within the knowledge base for the availability of patient-unique healthcare information. The outcomes are conveyed and revealed within the uppermost layer, the "User Interface Layer" (altexsoft, 2020). The User interface layer constitutes various applications that may be in hardware or software form. Examples of elements within the User Interface Layer include smartphones, smartwatches, desktop applications, mobile text alerts, and an Electronic Healthcare Records framework (altexsoft, 2020). The fifth phase, "Testing" will enable actual testing of the Clinical Decision Support System to prove its efficacy for improved patient safety and person-centeredness. The sixth phase, "Maintenance", will encompass routine performance appraisal for ascertaining the need for improvements and better performance (Hamza et al., 2022).
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7 Data and Security Breach Vulnerabilities for Clinical Decision Support Systems and Counteractive Measures A possible data and security breach vulnerability for the Clinical Decision Support System that is utilized within Health Information Management is Shadow IT. Shadow IT mirrors the utilization of unofficial third-party software, apps, or even internet services with the CDSS system and is usually not identified by the Information Technology personnel (Tariq et al., 2023). Shadow IT may generate challenges such as the unwarranted sharing of patients' private and confidential information without their approval. A significant approach for countering Shadow IT involves facilitating a continuum of open-ended communications between all the healthcare organization’s personnel to comprehend secure technological ethical and compliance adherence. Additionally, there can be integration of Data Loss Prevention (DLP) apparatuses that halt known or unknown integration of Shadow IT within the Clinical Decision Support System (Tariq et al., 2023). Phishing coupled with social engineering is another data and security breach vulnerability for the Clinical Decision Support System. Phishing and social engineering mirrors when the IT technology system users tend to be hoodwinked into facilitating a harmful online activity such as giving away patients’ personal information. Phishing and social engineering can be tackled by installing antivirus software that is regularly updated as newer attacks are developed each second (Tariq et al., 2023). Additionally, health information technology personnel are necessitated to be routinely trained on how to stay vigilant to prevent possible phishing and social engineering via the CDSS system.
8 Physical theft of the healthcare organization’s software or hardware information technology apparatuses is another data and security breach vulnerability for the Clinical Decision Support System. The challenge can either be faced while working within the organization’s premises or remotely (Tariq et al., 2023). The challenge can be countered by using encryption that prevents unauthorized access to the given apparatuses. Another option involves integrating a “Remote Wipe Out” option for the apparatuses whenever an apparatus is misplaced or deemed stolen which prevents unauthorized access to sensitive healthcare information (Tariq et al., 2023). A Synthesis of How Analysis Outcomes by SDLC on Clinical Decision Support Systems Improves Patient Quality of Care Using the Software Development Life Cycle (SDLC) to analyze the Clinical Decision Support System (CDSS) enables the generation of a comprehensively functioning healthcare information technology system. On this note, there is the enabled aptitude for generating a health IT system that meets all the involved stakeholders’, especially patients’, needs through the in- depth capability for analyzing healthcare Big Data to steer evidence-based decision-making (Salsabila et al., 2021). Additionally, there is an improved aptitude for improved facilitation of Healthcare Information Management (HIM) for person-centeredness of care. Another context involves the generated aptitude for reducing possible threats to the system's functioning, which helps the organization stay on track with the defined organizational culture for high-end patient safety (Salsabila et al., 2021).
9 References altexsoft. (2020, May 28). Clinical decision support systems: How they improve care and cut costs . AltexSoft. https://www.altexsoft.com/blog/clinical-decision-support- systems/#:~:text=A%20typical%20CDSS%20contains%20three,typical%20clinical %20decision%20support%20system.&text=a%20knowledge%20base%20in%20the,rules %20or%20machine%20learning%20models. Hamza , M., Akbar , M. A., & Alsanad , A. A. (2022). Decision-Making Framework of Require- ment Engineering Barriers in the Domain of Global Healthcare Information Systems. Mathematical Problems in Engineering , 2022 (8276662). https://doi.org/https://doi.org/10.1155/2022/8276662 Han, X., Wan, D., & Yin, Z. (2023). Verification of a clinical decision support system for the di- agnosis of headache disorders based on patient–computer interactions: a multi-center study. The Journal of Headache and Pain , 24 (57). https://doi.org/https://doi.org/10.1186/s10194-023-01586-1 Salsabila , R. N., Arif, Y. W. T., & Listyorini, P. I. (2021). Patient Clinical Data Integration in In- tegrated Electronic Medical Record System using System Development Life Cycle (SDLC). 2021: PROCEEDING OF THE 2ND INTERNATIONAL CONFERENCE HEALTH, SCIENCE AND TECHNOLOGY (ICOHETECH) / . https://doi.org/https://doi.org/10.47701/icohetech.v1i1.1073
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10 Tariq, U., Ahmed, I., & Bashir, A. K. (2023). A Critical Cybersecurity Analysis and Future Re- search Directions for the Internet of Things: A Comprehensive Review. Sensors , 23 (8), 4117. https://doi.org/ https://doi.org/10.3390/s23084117 Tun, S. Y. Y., & Madanian , S. (2023). Clinical information system (CIS) implementation in de- veloping countries: requirements, success factors, and recommendations. Journal of the American Medical Informatics Association , 30 (4), 761–774. https://doi.org/https://doi.org/10.1093/jamia/ocad011 Zhao, Y., Liu, L., & Liu, Y. (2020). Evaluation and design of public health information manage- ment system for primary health care units based on medical and health information. Jour- nal of Infection and Public Health , 13 (4), 41–496. https://doi.org/https://doi.org/10.1016/j.jiph.2019.11.004