Despite the new capabilities provided by the HIS, after 2 months of use, the system received mixed reviews about its effectiveness. Most of the people who raised concerns were involved in patient care. A consulting expert was called in to assess the computer systems strengths and weaknesses. He interviewed members of the hospital staff and noted their responses.

A nurse said, I like the system a lot. I found it hard to get used to at first (I never have been a very good typist), but once I got the hang of it, I found that it simplified much of my work. The worst problem has turned out to be dealing with doctors who dont like the system; When they get annoyed, they tend to take it out on us, even though were using the system exactly as weve been trained to do. For instance, I cant log onto the computer as a physician to log verbal orders in someone elses name, and that makes some of the doctors furious. The only time I personally get annoyed with the computer is when I need to get some work done and the other nurses are using all the ward terminals. They ought to have a few more terminals available.

One medical resident was less than enthusiastic about the new HIS, it is totally unrealistic in terms of the kinds of things it asks us to do or wont allow us to do. Did the guys who built it have any idea what it is like to practice medicine in a hospital like this? For example, the only way we used to be able to keep our morning ward rounds efficient was to bring the chart rack with us and to write orders at the bedside. With the new system, we have to keep sending someone back to the ward terminal to log orders for a patient. Whats worse, they wont let the medical student order drugs, so we have to send an intern. Even the nurses arent allowed to log orders in our name something to do with the legality of having all orders entered by a licensed physician but that was never a problem with paper order sheets as long as we eventually countersigned the orders.

Some of the nursing staff are doing everything by the book now, and sometimes they seem to be obstructing efficiency rather than aiding it. And the designers were so hung up on patient confidentiality that we have a heck of a time cross-covering patients on other services at night. The computer wont let me write orders on any patient who isnt known to be mine, so I have to get the other physicians passwords from them when they sign out to me at night. And things really fall apart when the machine goes down unexpectedly. Everything grinds to a halt, and we have to save our management plans on paper and transcribe them into the system when it finally comes up.

I should add that the system always seems to be about three hours late in figuring out about patient transfers. Im forever finding that the computer still thinks a patient is on the first floor when I know hes been transferred to the intensive-care unit. In addition, the diagnosis system is a joke. Sure, it can generate lists of diseases, but it doesnt really understand what the disease processes are, cant explain why it thinks one disease is more likely than another, and is totally unable to handle patients who have more than one simultaneous disease. I suppose the lists are useful as memory joggers, but I no longer even bother to use that part of the system.

And by the way, I still dont really know what all those buttons on the terminal keyboard mean. We had a brief training session when they first installed the system, but now were left to fend for ourselves. Only a couple of the house staff seem to know how to make the system do what they want reliably. Whats the best part of the system? I guess it is the decrease in errors in orders for drugs and lab tests, and the improved turnaround time on those orders but Im not sure the improvement is worth the hassle. How often do I use the system? As rarely as possible!

A hospital pharmacist said, the HIS has been a real boon to our pharmacy operation. Not only can we fill new orders promptly because of the improved communication, but also the system prints labels for the bottles and has saved us the step of typing them ourselves. Our inventory control also is much improved; The system produces several useful reports that help us to anticipate shortages and to keep track of drugs that are about to expire. The worst thing about the system, from my point of view, is the effect it has had on our interaction with the medical staff. We used to spend some of our time consulting with the ward teams about drug interactions, for example. You know, wed look up the relevant articles and report back at ward rounds the next day. Now our role as members of the ward teams has been reduced by the systems knowledge about drugs. Currently, a house officer finds out about a potential drug interaction at the moment she is ordering a treatment, and the machine even gives references to support the reported incompatibility.

this is study case give me at least 6 problems and how to solve it