Leveraging Health Information Technology -Myassignmenthelp.Com

Question: Discuss About The Leveraging Health Information Technology? Answer: Introduction The implementation of the IT system projects requires the deployment of the improved activities for listing the functional and professional development models (Ford et al., 2016). The various IT projects are related with the inclusion of the developing effective communication medium for the users. The deployment of the improved operations for the users with complete system development is resulted due to the use of the advanced technology. However, the deployment of the information system for the patients had impacted the exhaustion of more money than expected from the project. It was expected that the project would be completed in the estimated time duration and accumulated budget. The alignment of the operations had resulted in forming the supportive deployment of the successive development factors. The assignment has been developed for forming the development of the report for listing the issues faced in the scenario of the Abandoned NHS IT systemproject. The alignment of the operations had formed the deployment of the effective report for the development of the final reports (McKeigue, 2017). The various resources present in the project had been formed for listing the various issues of deploying the improved operations. The issues listed in the project would show the prospects of cost value analysis of the issues in the project. Key issues of the project The deployment of the new and centralised IMT strategy for management the information related to patients treatment procedure (Haddad, Muhammad Wickramasinghe, 2016). The key issues of the project were based on the formation of the specific issues and alignment of the profound system development of the activities. The various issues of the project were ignorance of core issues, implementation of radical change in trust, and infiltration of privacy. The government had been sleazy about the implementation of the integrated system for the patient record keeping system. The adjustment of the programme management system would tend to form the issues in deployment of the techniques for management. Ignorance of core issues The NHS IT project had been doomed for failure as the major project operation included the deployment of the changes in information processing and storing with the help of IT system development (Eason, 2016). The use of the IT system development was the major factor that would be required for forming the support to the database management. However, proper integration of technology and alignment of the activities had been ignored during the project. The lack of communication among the government officials and the health department had been a major concern for the development of the improved project activities. The successive development of the project plan was not well communicated among the project stakeholders. The allowance of the effective communication methodology would have helped them in aligning their activities with the primary requirements of the stakeholders (Audet, Squires Doty, 2014). The avoidance of the core issues of the project was the main reason in forming the majo r issue in forming the issue in NHS IT project. The addressing of the issues ate core was not being undertaken into the project. Implementation of radical change in Trust The policies developed for the NHS IT project was based on the development of the IT infrastructure of IT for the deployment of the effective operations (England, 2016). The system would ensure that the information related to the patients and their medical records would be kept securely for the development of the effective and improved operation development. The development of the information system for patients health record would help in listing the probability of effective development methods. The development of the activities would allow the formation of the improved data management for the users. The unwillingness of the Trusts board for investing successfully in the NHS IT projects were the main reasons behind the failure of delivering the integrate systems. The project required the converge inclusion of the IT strategy and principles for the formation of the improved functional and operational activities. The government were influenced by the interim report for the NHS funding written by Derek Wanless, Natwest banker. They decided to opt for more centralized strategy focusing on combating the piecemeal uptake of IT. The NHS hospitals operate differently and they require unique sets of data for the patients as they have little or no choice as per the services they provide (Johnson, 2014). The centralized arrangements of the NHS IT system development were not able to fit with the healthcare needs of the professional grounds. Infiltration of privacy The privacy consideration for the NHS project was a major factor for concern as all the data and information related to the development of effective information processing (England, 2016). The effective deployment of the information system for NHS was employed for listing the development of the operations for the organization. The ambitious healthcare information system projects were of high risk and high gain feature and the policymakers had the clear intention of undertaking some policies that would be suitable for the IT system development projects. The government did not take the confidentiality of the information seriously for the implication of the NHS IT projects. The alignment of the privacy activities were a major part of the IT implementation factor. However, the implementation of the 2001 Health and Social Care Act had made it possible for collecting and using personal health data in all possible identifiable form (England, 2016). It had give rise to the probability of the occurrence of the privacy infiltration to the health records. Analysis of Control System The control system of the NPfIT considered various factors such as cost, schedule, quality and schedule (Cooper, 2016). Control system implementing cost is a means of assessing and reducing the expenses met by the organization so as to increase its profits. The initial state of cost control is budgeting. It compares the budget expectation to the actual results and analyses the cost of implementation (Haddad, Muhammad Wickramasinghe, 2016). The cost of implementation of the project was comparatively low initially. Then after, there was a substantial increment in the investment. The cost of the project was incremented from about AU $3.9 billion to AU $4.8 billion, and this represented approximately 3 per cent of the total NHS budgeting (Eason, 2016). However, the amount that would be spent was low and the Prime Minister committed to increase the NHS spending amount. This also assisted the Chancellor to make significant approval of the funding scheme. Thus, this implied that funding wa s not the serious issue to be considered however, it created a major problem as a detailed cost benefit analysis was lacking. Thus, due to this reason the expenditure of the programme was not justified. However auditing of such funds was done for ensuring that the requirement is met and the fund is not directed towards other purposes. The other control system used was schedule and the plan was to take control over the resource management and performance management. It provided an appraisal for the various procurement approaches (Waterson, 2014). The plan then after assessed the option that was greatly preferred. The subsequent processes included outsourcing major program components. Then at the national level some program components were delivered. Following that some standards were also set for the local use. While planning for the NSP plan, an outcome based specification that was an integrated electronic health record system was also in progression. After the launch of the NSP plan the health department published a consultation draft that was largely concerned to draw in documents from other procurements. The NSP plan then after permitted only a specified amount of time for the major activities taken up in Phase1 of the plan. Then, in the subsequent years all the clinicians and the supporting staffs were provide d with broadband access. The plan also proposed to implement the National Booking Scheme as well as to implement full heath record nationally. The upcoming phases such as phase2 and phase3 were planned to work for the subsequent years. It was proposed to deliver the entire functions for the remaining components of NPfIT. The other control measure considered in the NPfIT plan was quality control. In the process plan some suppliers lacked specific capabilities to meet the required target or the respective objectives (Audet, Squires Doty, 2014). Furthermore, lack of focus of the employees further led to the downfall of the plan. On the other hand, the hurried timescales in procurement led to the further downfall of the plan. Furthermore, the complexity of the project undertaken was underestimated hence; the officials were unable to marketing the plan as a complete success. However, the implementation of the plan featured success with the programme elements executing on the required schedule. The functioning of the program also proved to be a success. The other aspects of the plan were also running behind the schedule. The delay in the schedule made it tougher for people to trust towards the Information Technology. Scope was considered as the major unit of control system. The NPfIT plan considered huge scope for further development and enhancement in the near future. The plan was planned to be implemented nationally. The scope was to incorporate the entire health care unit under Information Technology (Clarke, 2015). It also had a scope of training programmes for enhancement of skills. Furthermore, medical coding would also be implemented so as to provide accurate data. Analysis of schedule and cost overrun The project of NHS IT system development took much leap of time and exhaustion of resources for the operations. The costs of the project were escalating without any proper showing of the budget benefits even after 7 years of running project. The schedule of the project had been unclear and the project team members role in the project was vague and no clear responsibilities were set for the team members. NHS CIO Connelly had been defining a confusing goal for delivering the conspicuously lacking probability. The setback of the project had been largely based on the issues of the cost factors. The financial crisis of 2007-08 and recession had affected the budget of the project severely. The project had seen many change in project budgets that ultimately tended with exhaustion of Au$ 17.7 billion. The project was entitled to save a major amount of Au$ 1.25 billion by allowing the trusts for selecting their systems from plural supplier base. The NHS structure had included the spine, NHSma il, N3 network, picture archiving and secondary uses services, choose and book, and communication services for forming the essential infrastructure. The elements had included the amount of Au$ 3.74 billion worth of programme expenditure. The contract settlement of the projects took a toll of Au$ 100 million and Au $ 350 million advance payments were made to CSC month before expending Au$ 427 million by Lorenzo (Awwad, 2014). The new agreements between CSC and Health Department were done for ensuring that effective operations would be implied and it took over Au$ 1 billion for forming the new contract agreement. By the end of 2010, BT had delivered the systems to five of the Trusts hospitals with similar negotiation. The amount saved from the Au$ 1.8 billion contract with Ambulance service was only Au$ 130 million. The project had expected to deliver a benefit of Au$ 19.7 billion worth and the overall cost of the project was Au$ 17.5 billon (England, N.H.S. Improvement, 2016). Analysis of Project Execution Team The major IT reformation of the NHS project has been proposed by the Parliamentary Under-Secretary of State in the department of Health on 12 June 2002 ("Forbes Welcome", 2018). According to the proposal announced for NHS, a governance structure for the whole set up of the project plan had been proposed which included an involvement of a ministerial taskforce, while the senior director of Health Department had been given the responsibility. Sir John Pattison had been the head of the Health department, and the senior officer-in-charge of the project. Nigel Crisp was appointed as the permanent secretary of the health department. Lord hunt had been given the responsibility of the chief executive of the NHS project. The senior responsible officer would be directly reporting to the Chief Executive and Permanent Secretary of Health Department. The structure has been consistent with the Department setting policy for 28 Strategic Health Authorities (SHAs). It had been worked in the field of supervising strategies of the Primary Care Trusts (PCTs) and other NHS Trusts, which were providing the different health care services like primary, secondary and community service in their respective localities. The project had three of Local Standard Plans (LSP), and the core IT partner was iSoft as well as Accenture ("Final Results | iSoft Group PLC (IOT) | RNS Company Announcements | Equities | FE Trustnet", 2018). The project of NHS IT had acquired a powerful management team, which consisted of the following personalities. However, the management team has been observed as one of the reasons of the failure of the project. Richard Granger, an eminent management consultant of Britain who had worked as a consultant in Deloitte, Accenture and Andersen Consulting and also had been a part of successfully implemented London congestion charge scheme, had been appointed as the director general of IT department in the NHS project in the year of 2002 ("Forbes Welcome", 2018). Gordon Hextall was the chief operating officer of NHS. Richard Jeavons was appointed as the owner of service and Harry Cayton had been worked as the chief of the Care Record Development Board. The procurement process of the project had ended in the hand of Granger, who was appointed in the project with the responsibility of both its procurement and proper implementation. Richard Granger incorporated a new approach in the management by to shift away the procurement from local implementation with national standard. It is also said that the primary view of this shifting of procurement approach had come from Sir John Pattison. However, Pattison had suggested a new model with newly added levels in the procurement process to support the new technological implications in an efficient way with comprehensive charge management. The new level would work as a prime service provider working with Health Department and SHAs. However, Granger mainly took an instrumental step towards the innovative private sector approaches by adopting the service-oriented strategy. Since the optimized timeline that had suggested at the time of the proposal was not realistically achievable, the forceful st rong leadership of procurement by strongman Richard Granger made it complete. However, the focus was not more on the precise specification of the project and supplier recruitment was mainly based on their general aptitude, which later affected on the overall quality. Moreover, the risk transfer method for which Granger was so proud, did not work properly in the particular Government project. Richard Granger quitted the job and left the program in the year of 2008. After his departure, Gordon Hextall had taken the responsibility of the whole program. However, it had been noted that Richard Grangers departure had told upon the whole project in a significant way. Analysis of relationship between overrun and the stakeholders The primary, secondary and key stakeholders of any healthcare system generally consist of the different fields. The major stakeholders of the NHS that can be broadly pointed out, are Government, Healthcare providers, Public, Administrator and different non-governmental organizations. In the context of the NHS, it has been observed that the stakeholder landscape is constantly changing and hence is affecting the cost of overrun of the whole project (Nancy, Currie Whitley, 2016). While the plan did not include any detail of the methods of the involvement of the key stakeholders of the company, with the growing time it reflected the control system and throughout cost. In the beginning years, the authority of NHS IT program declared a review report mentioning the formal arrangement for the more involvement of health professionals, clinicians, patients and other stakeholders including the policy advisors and managers of NHS in the wide project of electronic health system implementation. It had been found that the requirement of the stakeholders has a direct impact in the production of OBS. In the year of 2002, the review published from the authority of NHS named Gate Zero Review had emphasised on the engagement of stakeholders, though the improvement in the involvement did not take place in an expected manner (Presser, Hruskova, Rowbottom, Kancir, 2015). Chief Executive of the NHS, David Nicholson, announced in 2007 that the creation of the NHS Local Ownership Program that the decision of the production of OBS depends on local people related to healthcare service, NHS staff, boards of NHS organizations and authority, have not involved themselves th at much which were expected by the program. However, the engagement of more stakeholders in the core project program became tougher and started to tell upon the control system when Lord Hunt, the Chief executive of the project had resigned from the Government in 2003, followed by the exit of the senior responsible owner Sir Pattison at the end of the same year. This was a fatal loss for the project. Again, in the year of 2004 the Deputy Chief medical officer who was promoted to the post of Sir Pattison, Dr. Aidan Halligan also had a quit from the project. Mr. Alan Burns who replaced the post of Dr. Halligan again departed after only six months. In March 2006, Sir Nigel Crisp also retired from the Department of health of NHS (Campion-Awwad, Hayton, Smith, Vuaran, 2014). This constant change and alteration in the senior managerial post affected the whole project in the aspect of corporate leadership followed by a time overrun in the next year. The main IT partner of the project, iSoft faced a gradual financial degradation in 2006 and the loss was clearly reflected by the profit warnings, which were issued in January and June in the same year followed by the announcement of the great financial loss in August ("Final Results | iSoft Group PLC (IOT) | RNS Company Announcements | Equities | FE Trustnet", 2018). This became a big reason of cost overrun in the project (Andriof, Waddock, Husted Rahman, 2017). Nevertheless, in the same year, Accenture, another IT partner of the program made an allowance for AS$450 Million of future losses related to NHS IT project that included the problems occurred by the delay in iSofts development ("Accenture's Annual Report", 2018). In October 2006, Accenture announced that it is departing from the partnership of NHS. The main face of the whole program, Mr. Richard Granger left NHS in 2008 February, which affected the overall project in a large scale. Richard Grangers strong and crude leadership policies were criticised and admired at the same time and the cost overrun of the whole project had been influenced by his sole leadership. However, after his departure, in 2009, the Public Accounts committee described that the future of the project is uncertain ("Forbes Welcome", 2018). Nevertheless, the credentials of Granger were highly questions and certain health preservation campaigner had also commented that the whole scheme was nothing but a gross waste of money. Possible actions for success The major drawback of the implementation of the Information Technology in the NPfIT plan was the infiltration of privacy. The patients records are of utmost importance and require the urgent attention of the officials in maintaining the privacy. The plan would lead to success if a medical IT system would be implemented. However, clarity and precision should be maintained by the officials in entering of the datas. Moreover, proper security measures should be taken so as to prevent the leakage of data. However, the data on the network is never completely safe and secure (Lyon et al., 2016). It is also not reliable as it is vulnerable to data breaches by the criminal hackers who generally exploit the insecure internet connections. Implementation of smart cards could have been beneficial. The patients record and essential datas are stored. It could be incorporated as a part of a properly designed system (Dranove et al., 2014). Such cards could be stored with pin numbers that should be carefully stored and should not be disclosed to any other person. Moreover, the authorization of the officials should be done so as to prevent the unauthorized access of the datas. Another major drawback that led to the failure of the NPfIT is lack of trust and confidence of the people in the Information Technology systems. Loss of the trust of people in the government officials also set a major setback to the NPfIT plan. Strict supervision should be implemented such that the misuse of the personal data stored in the repository is banned. The easiest way to gain trust of the public is to generate respect for their privacy. Furthermore, the source code for the medical coding for the NHS should be kept open and available for general inspection (Ford, 2016). The patients should be provided with the complete information and the advantages should also be communicated to them. This would help in gaining the confidence and trust of the people. The usage of pseudonyms should also be facilitated. The existing and commission research should be effectively used in to the socio technical aspects of the Information Technology systems as the EPR systems. Conclusion Thus, with the above discussion it can be concluded that the NPfIT plan was primarily focused on implementing better data storage records in the health care units. It incorporated the implementation of Information Technology in health service. However, the plan suffered a great failure due to various reasons such as the qualities of deliverables were not satisfiable for the users as well as no provision for privacy was considered. Moreover, the plan was delayed according to the schedule. The plan included various control measures such as cost, schedule, quality and scope. Moreover, the plan was not appropriately implemented as there was tremendous delay in the execution of the plans. The officials thought plan did not execute properly because they hastily made decisions and proper attention was not given to minute details. However, various strategies should have been implemented to provide information security to the users. Additionally, provisions should also be made to keep the dat a of the users secure. The project execution team had an influence on overall project. Richard granger, the eminent managerial personality has left a lot of impact on the procurement procedure of the program. The report gives an overall analysis on the relationship of the stakeholders and the cost overrun. The departure of managerial personalities, the fluctuation in the market of the IT partners and the follies of the internal strategies can be held responsible for the cost overrun and the failure of the project. References: Accenture's Annual Report. (2018).Accenture.com. Retrieved 6 February 2018, from https://www.accenture.com/us-en/company-annual-report America's Highest Paid CEOs. (2018).Forbes. Retrieved 6 February 2018, from https://www.forbes.com/lists/2011/12/ceo-compensation-11_land.html Andriof, J., Waddock, S., Husted, B., Rahman, S. S. (2017).Unfolding stakeholder thinking: theory, responsibility and engagement. Routledge. Audet, A. M., Squires, D., Doty, M. M. (2014). Where are we on the diffusion curve? Trends and drivers of primary care physicians' use of health information technology.Health services research,49(1pt2), 347-360. Awwad, O., Hayton, A., Smith, L. Vuaran, M. (2014).The National Programme for IT in the NHS. [ebook] Cambridge: University of Cambridge, pp.35-47. Available at: https://www.cl.cam.ac.uk/~rja14/Papers/npfit-mpp-2014-case-history.pdf [Accessed 6 Feb. 2018]. Campion-Awwad, O., Hayton, A., Smith, L., Vuaran, M. (2014). The National Programme for IT in the NHS.A case history. Clarke, A. L. (2015).Using socio-technical thinking to explore the implementation of Electronic Patient Records into NHS secondary care organisations(Doctoral dissertation, University of York). Cooper, M. (2016). Ten Minute Briefing the Digital Healthcare Challenge.ITNOW,58(4), 38-39. Cresswell, K. M., Bates, D. W., Sheikh, A. (2016). Ten key considerations for the successful optimization of large-scale health information technology.Journal of the American Medical Informatics Association,24(1), 182-187. Dranove, D., Forman, C., Goldfarb, A., Greenstein, S. (2014). The trillion dollar conundrum: Complementarities and health information technology.American Economic Journal: Economic Policy,6(4), 239-70. Eason, K. (2016, August). How to Fail When Introducing Electronic Technologies into Organisations. InDevelopments in eSystems Engineering (DeSE), 2016 9th International Conference on(pp. 3-6). IEEE. Engl, N.H.S. Improvement, N.H.S., 2016. NHS operational planning and contracting guidance 20172019.NHS England and NHS Improvement, Leeds,22. England, N. H. S. (2016). Implementing the five year forward view for mental health.London: NHS England. England, N.H.S., 2016. NHS ENGLAND.Evidence review: pasireotide for acromegaly as third-line treatment (adults). Dost?p: https://www. engage. england. nhs. uk/consultation/clinical-commissioningwave4/user_uploads/a03x11-pasiretd-evidnc-rep. pdf (28.12. 2016). Final Results | iSoft Group PLC (IOT) | RNS Company Announcements | Equities | FE Trustnet. (2018).Trustnet.com. Retrieved 6 February 2018, from https://www.trustnet.com/Investments/Article.aspx?id=200708010701382761B Forbes Welcome. (2018).Forbes.com. Retrieved 6 February 2018, from https://www.forbes.com/profile/jim-pattison/ Ford, E., Carroll, J., Smith, H., Davies, K., Koeling, R., Petersen, I., ... Cassell, J. (2016). What evidence is there for a delay in diagnostic coding of RA in UK general practice records? An observational study of free text.BMJ open,6(6), e010393. Haddad, P., Muhammad, I., Wickramasinghe, N. (2016). Assessing the Business Value of Australias National e-health Solution. Hefford, R. (2011).Why the NHS National Programme for IT didn't work. [online] cio.co.uk. Available at: https://www.cio.co.uk/it-strategy/why-nhs-national-programme-for-it-didnt-work-3431723/ [Accessed 6 Feb. 2018]. Johnson, C. (2014).Case Studies in the Failure of Healthcare Information Systems. [ebook] Glasgow: University of Glasgow, pp.1-18. Available at: https://www.dcs.gla.ac.uk/~johnson/papers/AHRQ/case_study.pdf [Accessed 6 Feb. 2018]. Jones, S. S., Rudin, R. S., Perry, T., Shekelle, P. G. (2014). Health information psychology: an updated systematic review with a focus on meaningful use. Annals of internal medicine, 160(1), 48-54. Kayser, L., Kushniruk, A., Osborne, R. H., Norgaard, O., Turner, P. (2015). Enhancing the effectiveness of consumer-focused health information technology systems through eHealth literacy: a framework for understanding users' needs.JMIR human factors,2(1). Loveday, H.P., Wilson, J., Pratt, R.J., Golsorkhi, M., Tingle, A., Bak, A., Browne, J., Prieto, J. Wilcox, M., 2014. epic3: national evidence-based guidelines for preventing healthcare-associated infections in NHS hospitals in England.Journal of Hospital Infection,86, pp.S1-S70. Lyon, A. R., Wasse, J. K., Ludwig, K., Zachry, M., Bruns, E. J., Untzer, J., McCauley, E. (2016). The contextualized technology adaptation process (CTAP): Optimizing health information technology to improve mental health systems.Administration and Policy in Mental Health and Mental Health Services Research,43(3), 394-409. Martin, D. (2018).NHS computer system is scrapped... and it's all YOUR money that Labour poured down the drain. [online] dailymail.co.uk. Available at: https://www.dailymail.co.uk/news/article-2040259/NHS-IT-project-failure-Labours-12bn-scheme-scrapped.html#ixzz56JZZpK00 [Accessed 6 Feb. 2018]. McKeigue, P., 2017. A critical look at methods for protection of privacy in the 2015 Charter for Safe Havens in Scotland for handling unconsented data from NHS patient records to support research. Mid Staffordshire, N.H.S., 2016. Foundation Trust Public Inquiry (2013) Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry: Executive Summary.The Stationery Office, London. Nancy, P., Currie, W., Whitley, E. A. (2016). Entangled Stakeholder Roles and Perceptions in Health Information Systems: A Longitudinal Study of the UK NHS N3 Network.Journal of the Association for Information Systems,17(2), 1. Presser, L., Hruskova, M., Rowbottom, H., Kancir, J. (2015). Care. data and access to UK health records: patient privacy and public trust.Technology Science,2015081103. Sheikh, A., Sood, H. S., Bates, D. W. (2015). Leveraging health information technology to achieve the triple aim of healthcare reform.Journal of the American Medical Informatics Association,22(4), 849-856. The Guardian view on the NHS crisis: its not just the flu | Editorial. (2018).the Guardian. Retrieved 6 February 2018, from https://www.theguardian.com/commentisfree/2018/jan/11/guardian-view-nhs-crisis-not-just-the-flu Waterson, P. (2014). Health information technology and sociotechnical systems: A progress report on recent developments within the UK National Health Service (NHS).Applied Ergonomics,45(2), 150-161.