Technology and Decision Making Essay Example

an organization's mission statement, applicable to various entities like health care organizations, churches, and schools.

The local public health department's mission is to promote health, prevent illness, and control communicable disease by providing quality services, health education, and environmental services for the community.

Computer systems can have multiple purposes and are often classified according to their purpose. By selecting a purpose that everyone within the organization agrees upon, a system can be chosen. It is crucial to involve all users of the system in identifying its purpose.

Functions refer to the activities that a system carries out to achieve its purpose. To identify each function and how it will be performed, a list of functional specifications must be written when choosing a computer system. Systems are structured in a way that allows these functions to be carried out effectively. Examples of structured systems include the nursing department, where the nurse in charge assigns patients to staff nurses with the purpose of providing care.

The charge nurse ensures that the team functions properly to provide the necessary and deserved care to the patients. There are two models that can be used to visualize the structure of a system: hierarchical and web.

The hierarchical model includes a local area network (LANA) connected to a wide area network (WAN) and a mainframe computer system. The mainframe acts as the leader of the system. In contrast, the web model operates like a spider-web, allowing information to be transmitted to various departments for different purposes. For instance, laboratory results can be sent to the pharmacy for medication dosage calculations, and patient vitals can be sent to another department for review and

use. According to Manageable ;Nelson (2002), a system combines elements from both the web and hierarchical models. Change is a constant state for all entities, whether living or nonliving. Understanding the change process involves six concepts: dynamic homeostasis, entropy, engagement, specialization, reverberation, and equability. Dynamic homeostasis focuses on maintaining balance within the system but increased stress can disrupt this balance and pose challenges to the organization. A healthcare informatics specialist's role is to reduce stress and restore equilibrium within the organization. Entropy refers to the natural tendency for systems to deteriorate over time. Eventually, all systems reach a point where they cannot be repaired and must be replaced.Engagement is the opposite of entropy and can be best described as the system's ability to multiply and become more complex.

As the healthcare industry expands, so does the size of healthcare information systems. Information technology has the potential to streamline healthcare and decrease the possibility of human error. However, there is evidence suggesting that inadequate system design can actually increase the chance of error in the complex interaction between clinician and machine in healthcare (Brick, E. Skunking, A., Breeder, J., 2010, p.714).

The term "information" has multiple meanings, and there are various theories related to information theory. The two common theoretical models are Shannon and Weaver's information-communication model and Plum's model (Manageable ; Nelson, 2002, p.10). The concept of information theory was formally introduced in 1948 through Claude Shannon's publication titled "A Mathematical Theory of Communication". In this theory, the sender is the original source of the message, which then gets encoded into a code. The code can be a number, symbol, letters, or words.

The decoder

then converts the message back into a recognizable format for the receiver.Shannon, a telephone engineer, explained the theory that the decoder converts sound waves into a message that the receiver can understand. Warren Weaver from the Sloan-Kettering Institute for Cancer Research provided insight into understanding the semantic meaning of messages. He used Shannon's works to explain how individuals perceive communication differently.

Various circumstances can cause a message to be interpreted incorrectly. For instance, if a patient cannot understand medical terminology used by a physician, there is a communication problem. Similarly, if the patient is unable to hear due to a malfunctioning ear, another type of communication problem arises. The message must convey meaning and achieve the intended result.

Bruce L. Blue categorized health care computing applications into three types according to his model, called Plum's Model. These applications are grouped as data, information, or knowledge. Data refers to attributes like height, weight, age, and name. Information refers to processed data, and knowledge represents the relationship between data and information. By using these concepts, it becomes possible to identify different levels of computing and automated systems.The DICK (Data, Information, and Knowledge) model is used in healthcare informatics to explain the relationship between these three elements. Data serves as the foundation, representing facts and observations. However, without context, data is irrelevant. Once data is validated or manipulated, it becomes information, which is the result of data processing. Ultimately, the combination of data and information leads to evidence-based knowledge. Critics argue that too much emphasis on data limits the scientific approach in medicine, as it becomes driven by statistics. However, these same critics still utilize the hierarchy of data, information,

and knowledge when treating patients. For example, when a patient develops a fever after hip surgery, the fever alone does not provide significant information. However, when combined with knowledge of the recent surgery, a physician can further investigate for signs of infection. This highlights the importance of viewing informatics through the DICK model as a comprehensive process.

The accuracy of the data is crucial in ensuring the accuracy of the information. The saying "dirty in, dirty out" applies to this model. Therefore, it is important to input clean data into the system in order to produce clean data and information. This, in turn, substantiates the knowledge and evidence produced. Just like clinical decisions rely on evidence, the DICK model, along with scientific information, is used to build evidence-based medicine.

Health informatics plays a role in spreading and distributing information, which is just one part of the multifaceted process of generating knowledge (Georgia, 2002). In nursing care and medicine, decisions that impact patient care and treatment are made on a daily basis by professionals who may not be experts in all areas. Access to specialized healthcare workers is not always readily available for everyone.

Expert systems have been developed to assist medical and healthcare providers in making decisions about patient care and treatment. These systems are computer programs based on knowledge that aim to improve human abilities in analyzing, problem-solving, treating, diagnosing, and estimating prognosis for health-related conditions (Manageable&).According to Nelson (2002, p.114), nursing expert systems can enhance the overall quality of care when they are tailored to the appropriate end-user group and built upon a knowledge base that reflects nursing expertise. Examples of these systems

include MIMIC, which advises physicians on antimicrobial selection for patients with meningitis or bacteria, and INTERNIST-I, which aids in diagnosing complex problems in general internal medicine (Shortlists, 1986). It is not always feasible for healthcare workers to possess knowledge on every condition or situation they encounter, which is where expert systems come in. These systems bridge the knowledge gap and provide effective, efficient, and accurate care. The goal of expert systems is to improve patient care, reduce costs, and disseminate expert knowledge. Just like x-rays and lab values are utilized to enhance the understanding of a patient's condition, expert systems serve a similar purpose. They serve as an alternative to human memory limitations and preventable medical mistakes. These systems can alert healthcare workers about drug interactions and allergies and recommend the most suitable treatment options. Expert systems also offer diagnostic suggestions, testing prompts, therapeutic protocols, and contribute to the practice's economy as well as the medical education of staff members.Using expert systems effectively can improve patient outcomes and decrease healthcare costs. Fewer mistakes lead to lower financial expenditures and increased profits. Improved quality of care results in improved patient satisfaction, leading to increased reimbursement from Medicare and Medicaid. Expert systems also decrease the variation in medical practice by emphasizing standardized and evidence-based care.

In addition to expert systems, decision aids and decision support systems are utilized to improve patient care. Clinical decision aids help identify solutions to clinical situations and can be in paper or electronic form. The electronic decision aids can be accessed through recorded media or the Internet.

Decision aids are used to facilitate shared decisions between the patient and interdisciplinary team. They help patients

consider the multiple decisions they need to make during their treatment. For example, the Ottawa Patient Decision Aid helps determine whether patients should seek antibiotics for bronchitis. Another example is a decision aid for deciding whether to place a family member with Alzheimer's disease in a long-term care facility (Manageable & Nelson, 2002).

A decision support system (ADDS) is a computer-based information system (CBS) designed to assist decision-making in solving specific problems. According to Manageable and Nelson (2002), a clinical decision support system (CADS) is an automated version of ADDS that mimics human decision-making processes. CADS can aid in clinical diagnostics, promote best practices, facilitate guideline adherence, improve care processes, and prevent errors.

ADDS utilizes data and provides an easy user interface for decision-makers to gain insights. It consists of four components: user interface, model library, model manager, and report writer. The user interface allows communication between the executive and the decision support system. The model library includes statistical, graphical, uncial, and "what if" models. The model manager accesses available models, and the report writer generates written outputs (Manageable ; Nelson, 2002).

There are four types of CADS commonly used in patient care decision-making: systems that use alerts to respond to clinical data, systems that critique decisions to alter care, systems that suggest interventions upon request from care providers, and systems that conduct retrospective quality assurance reviews.

Various nursing-specific decision support systems exist, including nursing diagnosis systems like Computer Aided Nursing Diagnosis and Intervention (CANDID), care planning systems such as the Urological Nursing Information System, symptom management systems like the Cancer Pain Decision Support system, and nursing education systems such as the Creighton Online Multiple Modular

Expert System (Courtney, Alexander, and Demises, 2008). Within healthcare, technology is improving patient and client management by providing on-demand access to information anytime and anywhere it is needed (Become a Meaningful User of Health IT, 2010). Technology can be found in various healthcare settings such as patient homes, clinics, extended care facilities, and hospitals. For patients with chronic conditions, technologies like telekinetic and video-conferencing can enhance their quality of life and reduce associated costs (Finniest ;Friedman, 2000). Improvements in quality, access, and client management are achieved through enhanced information exchange between providers, institutions, and payers, ensuring uninterrupted continuity of care for patients.Technology can improve the restrictions on services and specialists for those living in rural areas (Smith, Bending, Airmailed, Stilling, Chaffer, 2005). In the healthcare field, telecommunications offers the opportunity for patients and providers to meet and exceed expectations (clients and the community) (Smith, Bending, Airmailed, Stilling, Chaffer, 2005). For example, a physician can access a patient's record from home and provide treatment and develop care plans without needing to be in the clinic (Smith, Bending, Airmailed, Stilling, Chaffer, 2005).

Furthermore, caregivers are no longer limited by location or cost for ongoing education (Smith, Bending, Airmailed, Stilling, Chaffer, 2005). Learning management systems available online allow staff to review materials and participate in competency testing (Smith, Bending, Airmailed, Stilling, Chaffer, 2005). Additionally, advancements in technology provide tools for training through simulations of patients in virtual environments and assessing providers' cognitive skills (McGowan, 2008).

Improvements in healthcare technology will continue to impact various aspects of caregiving and patient experiences (Smith, Bending, Airmailed, Stilling, Chaffer, 2005). Communication, teaching methods, and documentation will be affected as clinicians adapt to these changes

(Smith, Bending, Airmailed, Stilling, Chaffer, 2005). Previously, manual methods were predominant in patient care before the introduction of computers and digital equipment seen today in healthcare facilities (Smith et al., 2005).Manual processes can be time-consuming and prone to human error, impacting the quality of patient care (Patton, 2001). According to the Institute of Medical Care, errors are frequent in medical care due to humans being inherently imperfect (Patton, 2001). Technologies that enhance patient care and health status include advancements in imaging systems, documentation solutions, and scheduling systems (Patton, 2001). In modern medicine, various technological systems interconnect, such as the operating room, clinical laboratory, radiology department, and radiation oncology facility (Patton, 2001).

Advancements in technology have allowed for surgeries that previously required large incisions to be performed through microscopic incisions, resulting in shorter hospital stays. Technology has also had a significant impact on early diagnosis and improved treatment plans. However, while technology improves access to patient information that is current and easily accessible, there are potential downsides. Consumers and caregivers have access to vast amounts of information, but not all of it may be understood or accurate.

Society should be aware that not all websites can guarantee credible information monitoring and assurance when accessing information.Despite the inevitability of inaccurate information and the potential for confidential healthcare data, technology can present challenges for physicians' autonomy. The growing complexity of genealogy requires physicians to establish standards for how components relate to each other. This can lead to resistance from some physicians, but the continuous development of user-friendly systems can help overcome this resistance.