The Use of Management Information Systems within the NHS in the UK - Coursework Example

Investigate The Use Of Management Information Systems Within The NHS In The United Kingdom And Discuss The Impact On Managers And Clinicians NHS (National Health Service) modernization process by the UK (United Kingdom) government is driven by the evident promises to enhance the equity and standards of health care in UK. The government expects that the healthcare systemization will bring out cost effective and revolutionary changes in the way care is delivered (Booth 2003, p114). NHS has introduced a number of management information systems that set to improve the delivery of health and sharing of information. Among the notable information systems introduced by NHS include R&D Information Management System (RDMIS), NHS Scotland Patient Management System, NHS Wales Radiology Management System (RMS), and other management information systems. Each of the management information system serves various functions in NHS and their effect on the managers and clinicians is diverse, as it will be explained in the essay. The NHS’s National Institute for Health Research (NHIR) uses the R&D Information Management System (RDMIS). RDMIS serves various functions within the research institute. RDMIS offers the following: The provision of information concerning NIHR research or studies so that the patients are informed about research relevant to them. It enables research managers and researchers to access and control the information and guidance needed to operates successfully and take part in high quality people- and -patient based R&D under proper governance. It offers standard underpinning services and systems to support operation of all the main components of NHIR including funding, research management, approvals, research outputs, and commissioning. To be national foundation of information related to the NHIR studies. Offer and enhance the secure integration of the existing systems. To enable the facility to conduct a once only data-entry research study, therefore, eliminating multiple entry of data in different systems. In the process, the system would have addressed associated data integrity problems or issues. Minimize the administrative burden of applications and reporting, and proposals. Thus, releasing the effort to control outcomes and facilitate review that is more effective, and monitoring (National Institute for Health Research [NHIR] 2011, p2). The NHS Scotland Patient Management System program for the hospitals offers authorized users direct access to better administration and clinical information from a single standard healthcare information system. The program intends to modernize clinical processes, promote more cost-effective means of working, and enhance patient care. The program is a strategic aim of the Scottish Government in e-health transformation. Thus, the program will empower a 21st century Scottish NHS in offering fair, affordable, and effective care (InterSystems Corporation 2011, p1). The program is set to facilitate sharing of information, workflow, and processes for the interoperability between the other systems. Patient information is entered once and all permitted or authorized users share it. Thus, evading expensive storage and transport, and tracking of paper records between care facilities and departments. Effective and immediate recording of patient discharges, transfers, and admissions at all the points-of-care to make sure there is continuity of care and to maintain comprehensive audits for the service level reporting and management. The program has an easy to use Web-based access (InterSystems Corporation 2011, p2). The Web-based access has visual alerts that draw attention to the patient waiting times, and important care information like allergies and reports and dashboards for management insights. It offers easier access to results and test ordering; this includes PACS and radiology images and this reduces lost and unnecessary repetition of tests. It facilitates efficient use of resources, for instance, it offers real-time bed management within the coordinated care processes. Summing up, NHS Scotland utilizes TrakCare to enhance patient care and safety, diagnosis, and create improved reporting at the same minimizing the amount of paper work used. Care providers and patients benefit from enhanced outcomes from the hospital to home, and better patient experience (InterSystems Corporation 2011, p2). The Wales Radiology Management System (RMS) permits the sharing of information to support flawless patient care in all the NHS Wales organizations. The present or current radiology information system is the All Wales RMS-Radis2. Radis2 offers a firm foundation for the integration of radiology systems in Wales. The programs allow secure shared access to results, management information, diagnostic imaging services, and images across organizations. Radis2 has other functions like the management of waiting times and management of clinics. The benefits of Radis2 include: improved structure and data; a complicated front end enabling easy use of it; the staff’s ability to multi-task; enhanced management of statistics; the capability to effectively manage radiology waiting lists; desktop integration with the digital dictation and PACS system; the integration of the systems (thus, fewer systems are used by the staff to log on); better management of the codes and easier user management; a devoted obstetric ultrasound reporting module that permits the development of structured reports and the collection of vital clinical data; and the ability to offer an automated email report to the other departments and external companies or organizations such as CARIS (Congenital Abnormality Register Information Service) in Swansea (NHS Wales Informatics Service [NWIS] 2011, p1). PACS (Picture Archiving and Communications Systems) is also used by NWIS. It manages the retrieval, presentation, storage, and distribution of images. These images include ultrasound, MRI and CT scans, and X-rays. PACS enables the sharing of information and it benefits both the doctors, medical experts and the patients. The patient can benefit from medical experts and a team of doctors when they analyse the PACS images together, and agreeing on the best form of care for the patient. For instance, the multi-disciplinary teams can meet and discuss diagnosis for cancer. In other cases, a health professional at a different location may want to access the PACS information, for instance, when the patient is being transferred to a different hospital (such as a specialist hospital), and the doctors may want to previous images and reports (NHS Wales Informatics Service [NWIS] 2011, p1). The Impact on Managers and Clinicians Recently, NHS had implemented a number of management information systems and their impact on managers, clinicians, and other staffs was both positive and negative. In 1986, the NHS Resource Management (RM) initiative was launched and it was aimed at persuading the nurses to make use of the ward nursing information management systems (WNIMS). The systems provided the possibility of evaluating or calculating workload. A survey conducted in 1990 revealed significant problems of implementing the system. The implementation of the new systems was putting more demand on the nurses’ time. Non-nursing managers were beginning to be more aware of the difficulty of the area facing the nursing staffs who were attempting the implementation of the Resource Management initiative (Scott 2003, p12). The decline in popularity of the computerized WNIM systems was because of the increase in complication of the systems. The systems was added other functions such as rostering and care planning. Majority of these systems required the nurses to spend most of their time at the computer entering data, a task that was not required of them during their nursing training. As a result, majority of the trusts favoured the installation of a more flexible workload-measurement system that could be incorporated into the existing hospital information management systems. These systems unlike the previous ones had fewer demands on the nurses’ time (Scott 2003, p12). Majority of the legacy problems stemming from local organizational history intrude the day-to-day NHS Managers’ convenient organization of work. Three hospital sites are not connected or networked and there are many problems facing the present Management Information Systems. The information section, which is charged with the input of all the MIS data, can directly access data from the departments. However, when they need information from other hospitals, they are required to use the telephone and that has made it impossible to obtain accurate and up-to-date information of a situation, for instance, the waiting lists. For instance, the impact of this form of organizational issue stems from the Directorate Manager of Orthopaedics (DMO) (Clarke et al. 2001, p3). In the following case, time delay and inaccurate information from the MIS can lead to the delay of delivery of care and a care, which is not of quality. Thus, MIS (Management Information Systems) poses a great challenge to the manager. The DMO has created process maps for each likely type of patient seen by the directorate, for example, referrals from Accident & Emergency Department and referrals through GP. One role of the directorate is to monitor how effectively the patient has been treated. The focus is on the number of activities taking place in the directorate, that is, the number of patients being treated. The main idea behind the process maps is to determine bottlenecks or challenges in the medical process. For instance, a field on the process map such as new fracture clinic patients may indicate that there is an issue with the patient’s “case notes not being collected prior to their appointment” (Clarke et al. 2001, p3). This frequently causes a delay because the process does not occur in the process map; this is because there are no records for the patient. The direct impact of such a situation is that the appointment of the patient is cancelled if the relevant records are not found immediately. Thus, the patient is left on the waiting list longer than it is required (Clarke et al. 2001, p3). On the other hand, the DMO cannot access current or up to date information from the MIS concerning the patients on the waiting lists. In addition, the available information does not reflect the challenges – that is, the MIS information displays the number of patients on the waiting lists but does not give other information required by the DMO. The target maximum waiting list time can be thirteen weeks and the MIS data indicates the percentage of patients for every consultant who have been on waiting lists in excess of the indicated time. Such information may be misleading, for instance, there is a “case of spinal patients where the MIS information showed that an apparently alarming 100% were waiting over thirteen weeks for one particular consultant” (Clarke et al. 2001, p3). However, there was only one patient on the waiting list, the concerned consultant had left, and the person replacing him or her had not yet taken the post. In such a situation, the DMO must find other forms of recall and record. Thus, the DMO makes use of the MIS information but does fully trust it to give all the information required (Clarke et al. 2001, p4). The challenges in the implementation of management information systems in NHS are many and significant. For instance, there are numerous configuration issues or problems concerning the comprehensive design of system interaction. Other issues include the level to which record-keeping practices can be standardized. Integration can transform the existing or develop new work dependencies between administrative and clinical departments in ways not expected. Important data can be lost when the staff violates the procedures, short-cuts or ignores the system. This posse a great risk to the kind of service being delivered; it can degrade the level of service when the staff avoids using the system and consequent failure in achieving strategic and operational goals (Clarke et al. 2001, p6). In summary, the management information systems have significant impact on the managers and clinicians. As stated earlier, the MIS systems at times can give misleading information and thus force the manager or the clinician to find other means when delivering care to the patient; a major risk is that patient can fail to get the required care. However, management information systems have made easy for the clinicians and managers to share information and deliver the required care to the patient. The care delivered is of quality and cost effective, and the patient can be treated in a different hospital or facility because the information is available and can be shared. Bibliography Armoni, A. (2002) Effective healthcare information systems, London, UK: Idea Group Inc (IGI). Booth, N. (2003) Sharing patient information electronically throughout the NHS: Time for all clinicians to get involved. BMJ, 327, pp114-115. Clarke, K., Hartswood, M., Procter, R. & Rouncefield, M. (2001) NHS managers closely observed: Some features of new technology and everyday managerial work [online]. Available from: [accessed 4 Nov. 2011]. Deloitte. (2010) NHS Scotland’s patient management system: A healthy procurement [online]. Available from: [accessed 5 Nov. 2011]. Edgar, D., Grant, K., Hackney, R. (2010) Strategic information systems management, Mason, OH: Cengage Learning EMEA. InterSystems Corporation. (2011) Unifying healthcare in Scotland [online]. Available from: [accessed 5 Nov. 2011]. InterSystems. (2011) Scotland National Health Service, Scotland [online], InterSystems. Available from: [accessed 5 Nov. 2011]. Knight, S. (1995) The NHS information management and technology strategy from a mental health perspective. Journal of Continuing Professional Development, 1, pp223-229. Mumford, E. (1991) Need for relevance in management information systems: What the NHS can learn from industry. BMJ, 302, pp1587-1590. National Institute for Health Research. (2011) Information systems function [online], NHS. Available from: [accessed 4 Nov. 2011]. National Institute for Health Research. (2011) Unified research information management systems [online]. Available from: [accessed 5 Nov. 2011]. NHS Scotland. (2007) Managing clinical effectiveness [online], NHS Scotland. Available from: [accessed 5 Nov. 2011]. NHS Wales Informatics Service. (2011) Picture archiving and communications [online], NWIS. Available from: [accessed 5 Nov. 2011]. NHS Wales Informatics Service. (2011) Radiology management system [online], NWIS. Available from: [accessed 5 Nov. 2011]. Scott, C. (2003) Setting safe nurse staffing levels, London: Royal College of Nursing. Read More