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Health care facilities, being providers of core human needs, often face challenges in the process of providing sufficient, high quality and readily available services to persons that depend on them. There are various challenges that face healthcare facilities, but administrative and financial challenges can be argued to be the topmost and most prevalent challenges. Specifically, electronic health records and informed consent and electronic health records are the emerging challenges that have become prevalent in the recent past (Sittig & Singh, 2011; Nijhawan, et al., 2013). So as to understand the nature and the extent of financial and administration challenges that are experienced by healthcare facilities, there is need to analyze the nature of the administration or financial problems encountered, evaluate the decisions made to combat the problem, as well as the results that were obtained from the implementation of the decisions that were made in terms of the effectiveness of the decisions.
Organization Information
NHS Betahealth (real name withheld) is an organization that consists of a union of three health care facilities that have established roots in the region and won the trust of the people residing in the locality. The organization, measured by the size of the three healthcare facilities, has a 1660 bed capacity, with the three hospitals having 492, 535 and 633-bed capacities. The organization is responsible for providing services to approximately 652,230 people in an area of approximately 4,732 miles. NHS Betahealth is a government agency and is owned by the government but controlled by a board of governors who are appointed by the Cabinet Secretary of the government’s Health Ministry. Founded in 2004, the organization has been in existence for 14 years, although one of the hospitals under the organization has been in existence for close to 100 years now. The organization is located in a city that occupies approximately 57.9 square miles but serves a whole county which occupies around 4,732 square kilometers. Although there are no similar organizations in the municipality, similar organizations exist in the country but are smaller in size compared to NHS Betacare.
Gist of the Problem
The essence of the problems that steered the hospital administration to take the action of attempting to solve the problems was majorly explained by the extent of damage that the problems had caused. The jeopardy that was involved with informed consent, being one of the problems, had caused conflicts with patients who felt like their consent had not been obtained as well as mistrust from the public who thought that the hospital did not give much regard for patients’ consents during medical procedures. Challenges with the implementation of electronic health records, on the other hand, were evident in the sense that the security and confidentiality of electronic health records had been jeopardized and the finances involved when maintaining the flow, storage and retrieval of electronic health records were high.
Description: The Problem
Background
Despite electronic health records being a major revolution in the health sector, the drawbacks of implementing and managing electronic health records have been an issue for medical personnel. Electronic health records are subject to being accessed by unauthorized and malicious third parties, and to ensure the security of patient data, high costs of maintenance have to be incurred. Similarly, informed consent has been argued to cause dilemmas amongst doctors when performing medical care to patients, and such dilemmas have caused law suits, mistrust, and conflicts between the medical fraternity and patients.
Evolving complexity of the situation
In NHS Betahealth, the predicament became evident in the day to day activities in one of the hospitals under the organization. One incidence on informed consent became evident when one patient reported the facility for negligence by the physician who was in charge of her delivery, and the patient claimed that the doctor did not disclose all the risks that were involved with natural birth before letting her decide between natural birth and caesarean section. The organization’s reputation was ruined as a result. The challenge with electronic health records became evident when one of the hospitals was reported to have lost some of its data to malicious parties, and to repair the situation, the organization had to incur extremely high costs to retrieve and secure patient data. Furthermore, the costs became repetitive and continuous.
Persons or groups involved and their roles
The groups involved in the scandal were the hospitals from the organization who were directly affected by the problems and the organization itself. Other parties involved include the hospital personnel such as doctors who provided medical care to the patients involved, the personnel from the information technology who were responsible for managing electronic health records, the lawyers who helped to handle legal issues linked to the problems and the employees from the financial department who were involved in disbursing funds to repair the EHS leakage problems and other financial challenges in the context. The last group involved were the patients who were affected by the problems.
Local or historical factors contributing to the situation
The situation that involved the challenges that arose from the informed consent dispute were contributed by the conflicting nature of doctors’ professional obligations and patients’ rights to make decisions regarding the interventions. In this case, the doctor was in a dilemma but saw informed consent as inapplicable to the situation. In the situation involved with electronic health records, lack of advanced and affordable technologies to secure patient data was a key contributing factor. Given the data breach that occurred, the hospital had no option but to increase the financial investments in securing data and tracking the accessors of patient data. Despite the security measures taken, it was not a complete guarantee that the data would be secured, hence causing a problem that had not been solved completely.
Other appropriate data inherent in the case problem
The other relevant factors that were involved in the problems that NHS Betacare faced included the law suits that were being dealt with in the court and the government’s involvement. The patient who claimed that her decision was not steered by divulgement of all the facts involving the birth of her child filed a case against the hospital, hence the involvement of the courts in the problem. The government, which is in charge of the organization, was responsible for the control and release of finances that were used when researching on and tackling the problem.
Administrative/ Financial Management Division
Although decisions were made for both problems, the nature of the solutions that were reached was different. To solve the dispute that was involved with informed consent to the patient, the administration resorted to having an intermediary (the court) to solve the dispute with the patient. The court, exercising its power, judged that the patient was to be compensated for the damage caused to her by the doctor. To prevent such challenges, the organization aimed at ensuring that doctors were well informed about the situations involved with obtaining informed consent from the patient and prioritization of patients’ opinions. The alternative considered was to settle with the patient, but the option was rendered impossible by the patient’s reluctance to solve the issue with the organization in a settlement meeting. The main obstacle encountered when arriving at the situation was the difficulty in finding a consistent definition of situations whereby informed consent is relevant.
For the issue regarding electronic health records, the organization agreed to heighten the security of patient data stored electronically by hiring more personnel and spending more finances in software technology to encrypt the files. The organization also agreed to create a portal which allows physicians to log in and view patient data only from specific, authorized devices and locations, while also tracking the individual who viewed patient data. The administration considered the creation of an all-new electronic storage system whereby the old system was to be formatted after transferring information, but this option was more costly for the organization despite increasing the risk of data loss, hence this option was ruled out. The main obstacle experienced in this problem-solving process was insufficient financial and labor support to efficiently and entirely implement the solutions that were arrived at.
The Results
After making the decisions is essential to track the results of the decisions made in an effort to test the ability of the decisions to yield positive results and repair the damages caused by the problems (Blenko, Mankins, & Rogers, 2010). A week after settling the issue involving the informed consent dispute, the organization decided to observe public opinion on their confidence on the services provided by the hospital through a quick questionnaire over a period of one month. According to the case reporter, the hospital that had faced the problem managed to receive a positive from the patients that visited the hospital, although the patients who were admitted to the maternity ward were more cautious and provided a rather neutral feedback on their confidence in the health facility.
The decisions made concerning electronic health records were also tracked in an effort to test the ability of the implementations to yield positive change in the organization. Immediately after implementing the changes, the organization began to monitor the level of security of patient information and the ability of the organization to track the recorders and accessors of patient information over a period of six months. The organization also hired software experts to test the ability of the electronic systems to detect and prevent malicious parties from accessing patient information. According to the case reporter, after testing the systems, the organization noted that their systems were more secure than they were before, and it was highly unlikely that any unauthorized parties could access the information. This also meant that the costs of implementing the systems provided a return on the investments.
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