Saturday, October 17, 2009
Barriers on IS/IT implementation
A barrier is an obstacle that prevents the coming-into-force of a particular measure, or causes delays in its implementation. Barriers can be rigid or flexible, the latter being able to be overcome given sufficient time or resources. Land use measures tend to face more rigid barriers than, say, management or information measures.
Barriers can be either positive or negative. A positive barrier arises when one of the objectives of the strategy restricts the ability of a measure to achieve other objectives. Environmental constraints are examples, and their imposition could well improve the measure or its performance. By contrast, a negative barrier, such as inadequate legislation, may cause delays and excess costs in the implementation of the measure.
In NekenFab Incorporated, as our adopted Company, since they are in construction field, they are not totally focus on their information system. In fact, the one who made the company’s system is the owner of the company which is not a programmer graduate or any related programming course. The one who made their system is a civil engineer. But, our interviewee said that the system they used now is useful in the company even it’s not so good in performance. I can tell that that their system is not so good in performance because there back-up files in case there system will crash is still on the print out paper. They need to re-encode all the data that the company’s file. Aside from that, when they send their data or files to other offices, they used flash through mailing address, or there is a person who bring those flash drive to the other office. In this case, there is a big possibility that they lost the data that they need, in just a blink. Or maybe the person who bring those things, change all the data that encoded on the file.
The following are the barriers on implementing information system.
Implementing IS/IT costs money and is expensive.When implementing new Information system, the company needs to buy the software and also need to hire someone who can manage the system.
Organizational Culture Barriers• Culture of physical/paper records
- Workflow is designed for paper.
- Paper provides provider a sense of security.
- Paper provides proof of action.
- Paper provides proof of ownership.
- Paper is readily available (cheap).
• Culture of ownership of data and not sharing it
- Exchange of information between organizations is not universally accepted as appropriate.
- Negative repercussions are feared if organization becomes more transparent by sharing information.
- A negative impact on “bottom line” is feared if organization shares information.
- Data of patients from underrepresented facilities/groups may be used inappropriately.
• Culture of actions based on risk aversion/comfort rather than standards
- Exchange of information between organizations is not universally accepted as appropriate.
- A negative impact on “bottom line” is feared if organizations shares information based on network standards rather than internal risk assessment.
• Culture of market competition
- A negative impact on “bottom line” is feared if organization shares information based on network standards rather than market analysis.
- An open exchange of information may reduce competitive edge between providers and/or facilities.
• Culture of organization type, with variations due to public vs. private.
- Protections to sensitive situations and information vary from organization type to organization type.
- Protections against stigmas or other negative repercussions on patients vary from organization type to organization type.
- Populations served vary from organization type to organization type.
• Culture of diminished value of staff continuing education
- Staff education lacks priority in organizational plans.
- Cheaper staff can be hired (recent grads); reduces organization obligation.
Technology and Standards Barriers• There is a technical challenge to assure user authentication and successful use of system
- There are many different technical methods available to authenticate users. A universal standard would have to be adopted in order to ensure interoperability between sites and users.
- The different technical methods that exist to handle user authentication can be difficult to implement for health care providers with limited IT resources.
- Current methods for strong authentication are difficult for consumers to use. Strong passwords are difficult for consumers but encryption keys are even more challenging.
- The interface for retrieving records would have to be standardized so that providers would not be trying to learn each individual system.
- The electronic signature for an information system can be a problem.
- There are far more users of information system than there are technical assistants available to address technical issues.
- Technical documentation for information system is usually long and not user friendly.
- Staff may occasionally use other log-on ID’s for information system.
- Staff may not sign out of information system properly.
- Staff may not receive proper training in user authentication and system use.
•There are no national requirements for information system interoperability
- This lack of an enforced standard has driven the complexity of creating and maintaining interfaces up. Most providers do not have the IT resources available and rely solely on the vendors for this service. This has driven the cost of interfaces up substantially and can render them financially impractical.
- The electronic health record is still new.
- Technology advancements are much greater than the speed of learners for many of the users.
- New systems will be as disconnected as current systems.
•There are insufficient standards for data elements
- There are currently multiple standard sets, with some variation in definitions.
- There are emerging data elements (new items needed).
•There is no standardization in security protocols and interfaces
- There are numerous standards for secure communication but one will need to be selected for the specific purpose of security protocols and interfaces.
- There are delays from security/standards groups.
- There is competition among software vendors.
- There is massive data in huge legacy systems that must be considered.
•Organizations lack adequate infrastructure and role delineation for the development and enforcement of security, privacy, and information management policies and
procedures.
- Security, Privacy, Policy, and Procedures are interrelated.
- There is no consistency of how security and privacy management should be handled in an institution (power issue).
Knowledge about the new IS/IT•There is a lack of ways to share educational materials
- Some educational materials may be proprietary.
- There are ways of sharing educational material, but a lack of information/leadership to execute.
•There is a lack of standardized educational materials that have been developed for sufficient evaluation of effectiveness
- Educational needs vary by organization, individuals, geographic, and available resources.
- No specific group has been identified as the industry authority to consult regarding educational material for health information management.
- Those who have developed educational material for health information management have not been asked to share information with others.
- There is resistance to use information for education in health information management that is developed by others.
In-house Resources for Information Management Barriers•There are variations between shifts in both practices and available resources
- Shift variation in practice is related to the educational barrier listed previously. All staff needs to be educated on appropriateness of information, procedures for access and security of the records.
- The majority of healthcare resources are on the first shift, consistent with normal business hours.
•There are insufficient resources for language diversity to assure provision of information, and comprehension of information given
•There are variations in resource availability from organization to organization
- Providers without the appropriate resources will not be able to participate in the shared record. These resources could be defined as monetary or technical.
- There is a lack of funds and/or resources in some organizations.
- Resources are limited in rural areas.
- Resources are limited in poor communities.
•There are variations in information technology development from organization to organization
- Some organizations do not have any form of electronic data in which to interface.
- There is a lack of funds for across the board information technology development.
- Some organizations lack the ability to attract professional resources due to geographic.
Global Market Barriers•Competitive market forces in software development complicate standardized information exchange solutions
- Competitive market forces in software development will add costs to the participation of the provider in the electronic record
reference
www.idph.state.il.us/hispc2/resources/Appendix8-Barriers.pdf
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