Information systems with a practical utility for patient care or diagnostic procedures are relatively easily accepted, sometimes even without any scientific evidence of their value. However, systems that support the process of health care without being directly relevant to patient care are less easily accepted. Problems such as miscommunication, issues in trusting others professional, poor quality, medical errors, waiting times and high costs due to the insufficient access of the resources makes the situation more critical. Problems such as too many assessments, delays in making the decision to select the care packages, seeking placement and fund for the patients contribute to the delay transfer for In-Patients. It can be concluded, that the problem of delayed transfer of In-Patients are because of problems in information fragmentation. It is against this backdrop that In-Patients Information system is being designed to correct the problems using an integrative and system approach. The result was unprecedented and beats the expectations of the researcher as can be observed in the project report.
CHAPTER ONE
1.0 INTRODUCTION
Introducing an innovation into an organization will evoke changes. In some cases these changes will be minor ones that hardly affect the organization and the people working in it. In other cases, those having to use the innovation might experience major changes. Among health care professionals, new innovations are predominantly judged by their direct value for patient care.2 Patient care information systems include hospital information systems, computerized or electronic medical record systems, or nursing documentation systems. Information systems with a practical utility for patient care or diagnostic procedures are relatively easily accepted, sometimes even without any scientific evidence of their value.2,3 However, systems that support the process of health care without being directly relevant to patient care are less easily accepted. In particular, attempts to introduce health care information systems that require data entry by health care providers have not always been successful.4–6
But what is successful? Complete refusal of users to use a system is certainly a failure, but often success remains undefined. Clearly, the determination of success depends on the setting, the objectives, and the stakeholders. Only a thorough evaluation study can show whether or not a specific system was successful in a specific setting. A wide range of attributes has been measured in evaluations of patient care information systems. These attributes vary from purely technical factors to outcome measures such as quality of care and from end-user evaluation to extent of diffusion into the organization. Which criteria predict success or failure is unclear, but it is likely that no single criterion can account for success or failure of an information system. Furthermore, each evaluation criterion must be measured in an appropriate way.
In 1995 van der Loo conducted a literature review to classify evaluation studies of information systems in health care.7 The primary objective was to get an insight into the variety of evaluation methods applied. In all, 76 studies published between 1974 and 1995 were included in the review. Many different performance measures or success factors were applied in the studies reviewed. The review’s main conclusion was that the evaluation methods and effect measures depended on the characteristics of the information system under evaluation. However, the range of identified evaluation methods and effect variables was broad for every type of system. Among the effect variables were costs, changes in time spent by patients and health care personnel, changes in care process, database usage, performance of users or the system, patient outcomes, job satisfaction, and the number of medical tests ordered. Several authors have suggested approaches to evaluating information technology in health care.8–10 These approaches concerned assessment of technical, sociological, and organizational impacts.8,9,11 A literature review by Delone and McLean in the field of management information systems aimed at identifying determinants for system success.1 They presented a framework with six dimensions of success.
The purpose of our review was to analyze evaluation studies of inpatient patient care information systems requiring data entry and data retrieval by health care professionals, published between 1991 and May 2001, to determine the attributes that were used to assess the success of these systems and to categorize these attributes according to the Delone and McLean framework. We also examined how the attributes were measured and what methodologies were used in the evaluation studies.
1.1 Problem statement
The program for integrating social and health care have been started since the two entities have similarities in term of delivering the ‘care services’ which are improving their customers’ quality of life. In fact, the integration of these two entities has been put in the 2000 NHS plan for Nigeria for integrated care provided to a wide range of clients groups especially for elderly people (Mur-Veeman et al. 2008). Health and social care have to integrate due to several reasons, such as problem faced by single provider in supplying the demand from the patient especially with complex needs (Van Raak et al. 2005), high cost as well as discontinuities of care especially for elder people (Mur-Veeman et al. 2008).
There still have problems in integrating these two care sectors, such as the work is not efficient, cost becomes higher, conflicts between the social and healthcare professionals relating to their exact responsibilities, unsatisfied customer, as well as poor quality in delivering the services (Mur-Veeman et al., 2008). Problems such as miscommunication (Moret et al. 2008), issues in trusting others professional (Rummery and Coleman, 2003), poor quality, medical errors, waiting times and high costs due to the insufficient access of the resources (Grone and Barbero, 2001) makes the situation more critical. Bryan (2006) found problem such as too many assessment, delays in making the decision to select the care packages, seeking placement and fund for the patients contribute to the delay transfer for elderly people. It can be concluded, that the problem of delayed transfer of older people are because of problems in information fragmentation.
From the several studies by the academic researchers as well as the policy makers, it is proved that healthcare and social care are two different agencies that provided the ‘care services’ or ‘continuous care’ to the elderly. However, due to different systems between these two in care sector, they have problems in integrating and cooperating to each others.
Focussing in information system integrations, critical questions that can be raised here are about processes and flow provided to the same patient but in different systems, conditions, professionals, funding, policies, as well as fragmented information systems involved. Thus, the main research question is:
“How modelling can support information systems integration for inpatients health and social care?”
1.2 Aim and objectives of the study
The main aim for this study is:
“To develop information systems integration for inpatients health and social care”
To achieve the main aim, several objectives have drawn as follows;
a. To capture existing knowledge about health integration, real time integration model in care sectors and other fields as well as effort that have been put to improves current inpatient information systems in Ntasiobi ndinonafuff
b. To build a model of information systems integration for social care and inpatient health care
c. To test, evaluate, and redefine the model
d. To produce integration of information systems model for inpatient health and social care.
1.3 Purpose of the Study
A model of information systems integration for health and social care comprising all the stakeholders, such as policies, regulations, resources and other attributes will be adopt using modelling techniques. This integration model will be a standard model of integration between inpatient health and social care. Using the modelling techniques, government can develop their policies and adopt it in the real world. This is to make sure that, the investments that have been put in improving the care services is not a waste. As for academia and researchers, this integration model can be as guidelines or framework to integrate different system, working as one system.
1.4 Significance of the study
The significance of this study is that it will provide the institute with an opportunity to introduce this new technology, which will also serve as the basis for future research into the topic.
1.5 Scope of the Study
This research will only focus on integration between health and social care sectors, which focus on continuity care of inpatient in systems integration in Ntasiobi ndinonafuff in particular. When we talking about system integration, there many types of integration in systems integration. Parts of them are professional integration, types of care integration, services integration, funding integration, clinical integration, and so forth. Since the problems of this continuity of care involved the whole system, however, this research is focusing more on integration of information for the health and social care.
During the research process, some difficulties and limitations where encountered. They include;
1.7 Assumptions
There are several activities that the proponents assumed in the development of the proposed system and these are the following:
All the information obtained from the hospital are accurate
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