Naval hospital Jacksonville in Florida had been in need to improve its service delivery to its patients and improve on its operations which it has achieved by the implementation of Hospital Information System. The Hospital Information system is able to support both inpatients and outpatients; it shall address issues of improved access of patient’s records, eliminate duplication of records, improve on billing the systems and makes the treatment process much faster by saving a lot of time in processing medical records. The implementation involved a feasibility study which indentified what needs to be addressed by the system, the requirements obtained from the current users of the existing system was analyzed so as to understand the type of Information System which would be able to serve the hospital. The findings of the analysis were documented then passed over for design of the systems; the system was designed to address issues which were addressed in the analysis stage. The system was later coded, tested and was ready for implementation.
The main reason why implementation of Hospital Information system was chosen was to address the limitations which were with the previous system. The system was supposed to automate operations of the hospital. Automated operations are much more efficient and eliminate errors as well as make the process much less costly and faster. The system was as well expected to address computation challenges and manage clinical, financial and administration aspect of the hospital (Wager and Wickham, 2005). The system was also expected to stimulate use of Information and Communication Technology (ICT) in health care.
After the system was successfully tested and proved that it shall address issues indentified, it was ready for implementation. An implementation team was constituted which was in charge of implementation, to ensure that it is done successfully. The implementation team which was formed was all inclusive and consisted of a project / implementation manager who was the overall leader of the implementation team. The implementation manager was an Information Technology expatriate. There was a team of clinical expertise and medical group who were advising of how the hospital operates and any medical operations which other stake holders would need to understand about the hospital. The medical group and clinical expertise were also the end users of the system which was being implemented and were the one using the one which shall be replaced so they played the role of actually putting the system in to use. Project management expertise formed also the team whose role was to advice the hospital management and the Information technology expertise on how they should plan the project to be successful. Information technology expertise actually did the technical part of carrying on a feasibility study, analyzing finding, designing the system, coded and tested the system for implementation.
The team agreed on an implementation process as they were advised by the project management expatriates. A top down framework of implementation was agreed upon; the hospital management was made to understand that the implementation process would transform operations of the hospital. Such a transformation do not come without resistance form the users hence, it was important first to sensitize all stakeholders the need for the implementation of a hospital Information system and make them understand how it shall benefit them so that they would own up the project for it to be successful. The implementation of the system was done on phases, the system was broken down to modules and each module was implemented at time. For example we have the finance module and medical record modules each of this was implemented at a time once one is successfully implemented the other module is implemented. These ensured that the project was divided to manageable potion at any given time and it was easer to train the users and manage the implementation process.
Implementation of the system on phases was beneficial to the implementers and the users as it was less strenuous on resources needed at any given time. There was good resource planning such as the budget allocated and skilled manpower per module being implemented. The patients are the main beneficially of the system because the hospital is set to offer services to them. They had realized both tangible and non tangible benefits; the system eased congestions in the hospital by making the treatment procedure much shorter and fast by introduction of electronic health record system. The system ensured that records of the patients are easily retrievable and accessible to all medical practitioners this eliminated passing over of medical files which were time consuming.
It also ensured that records of the patients are well kept and secure which eliminated chances of missing files. Patients who are visiting the hospital for a follow up of the previous treatment their particulars are well kept and doctors medical practitioners would be able to have an essay access of the patient’s ailment history and be able to address it effectively. The system also improved on the billing process by consolidating all services which are offered to the patients which is able to generate the bills at the accounts office on all services which had been offered in different sections of the hospital this has eliminated partial billing for each service offered. The system has as well eliminated duplications of records which would be contradicting hence, leading to wrong medication or even mix up of samples and misfiling which would as well lead to the same.
The implementation and organization was really successful and the team delivered its objectives to implement a system which addressed administration and medical issues for the benefit of the hospital and its patients. The team which was formed was highly functional and worked toward the success of the system implementation. The team was well constituted with all players on board and their duties were well stipulated for an effective organization in the team. There were good communication channels which were set among the implementation team and the management which improved on sharing of information and quick feedback for action. Dividing the project into phases of manageable modules was a noble idea which made it much more manageable for a successful implementation. Many of the project team members were the end users of the system who provided a close link between the impacts of the decision made by the team and the decisions themselves.
The biggest challenges which the implementation team went through were dealing with the three myths of system implementation which were deep rooted in the majority of the hospital staff. Implementation of the Hospital Information system was a transformational move which would change operations of the hospital. During the implementation of the technology it would transform the hospital. Such mutual transformation encountered resistance from some management and junior staff. If this is unforeseen before the inception of implementation and be addressed by sensitization all stakeholders the system implementation would face a lot of resistance such that it would be difficult to implement it or the implementation would fail to take place. Hence it is very important that during such system implementation it should only be done if it has fully support of the management of the hospital and the end users (Berg, 2001).
Balancing between implementation of the Hospital Information System and organizational change by seeing the system as a changing agent without pre specifying and controlling the process was a challenge. It was quit hard for the implementation team to convince the users that the changes which they shall experience would only inconvenience them for a short time but it shall be beneficial to them in long run. Maintaining the systems implementation process in the budget was quit challenging this arose because there was an unforeseen revision which was supposed to be done on the system so that it would be fully customizable to meet the intended use of the hospital. The users requested for many amendments to be done which took much longer than anticipated but they were addressed. This delay lead to another challenge of delivering the project in the set time frame the implementation process took longer to implement a factor which was also attributed to a longer period which was spent to train the user than it had been anticipated.
Despite of all this challenges the system was successfully implemented. The staff attributes the success of the implementation to their proposed amendments being incorporated in the system. The system is highly customized to meet almost all operational needs by the staff. The staffs were involved in the implementation of the system from its inception this gave them a good understanding of the system which was being implemented and their contributions were incorporated in the system (Follen, et al. 2007). These built a sense of ownership on the system being implemented which made them more encouraged to participate its implementation.
The problems which the staff indentified when testing the systems were communicated to the designer who rectified them without delay. Keenness of the staff when testing the system and boldness of requesting anomalies to be rectified and proposing honestly on what they would need addressed by the system has enabled the implementation team to successfully implement a system which is error free and functional to meet the requirements of the hospital.
The staff had undergone a successful training before the implementation of the system was done. All the staffs that ware using the system were trained thoroughly before the system was put into use. This also enabled them indentify most errors and need for additional features because the understood the system. The training was also done as a post implementation measure to ensure that they optimize their efficiency and effectiveness.
However, the success of the implementation of the system from inception to its conclusion and its post implementation plan is attributed to the visionary implementation team which was well constituted. I would also recommend that any health care institutions which are planning to implement a successful information system to invest more on setting up a functional team which shall steer head the implementation process. Most of the computerization projects like this one do not end up being successful like this one.
Wager, A and Wickham, F. (2005). Managing Health Care Information Systems: A Practical Approach for Health Care Executives. York: Jossey Bass Willy
Berg, M. (2001). Implementing information systems in health care organizations: myths and challenges. International Journal of Medicine Information. 64(3): 143-56.
Follen, M., Mikelson, M., Johnson, D and Wilson, A. (2007). Implementing Health Information Technology to Improve the Process of Health Care Delivery. Disease Management. 10 (4): 208-215