Enhancing Health Information Management and Exchange for Children with Tracheotomy - Essay Sample

Introduction

The research seeks to extract some of the problems relating to health information management and information exchange. After an analysis of the problem, the paper then suggests some of the solutions which may be helpful in the situation.

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Situation

Recently, tracheotomy is increasingly being performed on children who suffer from complex chronic conditions such as chronic lung disease. The medical complexity of children is tied to many medications, reliance on home-based caregivers with the expertise to maintain health, and dependence on equipment (respiratory) requiring constant adjusting. However, the services offered by these individuals are spread in multiple locations (Berry et al., 2011).

Some of the challenges that caregivers, parents, and patients experience include unavailability, exchanging health information, accessibility, and uncoordinated care. This may affect the ability of the provider to fully meet a child's needs, mostly in cases of acute sickness. These challenges place the children at risk leading to poor treatment outcomes.

Young children that undergo tracheotomy often get healthcare from different health providers within different hospitals and health systems. In previous studies, substandard health information exchange systems between parties of these sectors and families have been highlighted. Records have also put across the fact that the poor systems have a hand in the care for these children (Shapiro et al., 2011).

Thus, the study critically investigates the experiences and perceptions of care providers and parents regarding care plan development, health information management, and coordination of services for the children with tracheotomy and strategies that may be used to improve the health information management in the sectors (Shapiro et al., 2011).

The study was done with participants from Franciscan Hospital for children and also the Children's Hospital in Boston (CHB). Group and individual interviews were done with fifteen healthcare providers (specialty and primary care, nursing, therapist) and eight parents of children with tracheotomy (Berry et al., 2011). The primary diagnoses for the children were airway anomaly, neuromuscular impairment, and chronic lung disease. Coding and in-depth reading of all interviews were conducted by two independent reviewers to uncover themes related to the objectives.

From the study, it was discovered that the health information of the children was scattered across many providers with no apparent central place for aggregating the health information (Shapiro et al., 2011). There was an absence of a clear documentation plan indicating the active medications, equipment adjustments, and medical history. The parents and health caregivers also affirmed that in most cases, no specific provider was in charge of the child's records and information. Most of the primary care providers reported they were nervous about maintaining a comprehensive record since the diet plans and equipment setting was updated continuously. It was also clear that even the parents found it hard to be responsible, while not forthcoming information. Some parents created their organized notebooks to help in maintaining a proper record, while others made one-paged computer-based records derived from copies of previous procedures of treatment. The preparation of personal summaries and sharing it with different caregivers was expressed as an unfair task.

Solution

One solution to the challenges would be the application of a medical home-based concept. This system would offer an accessible and central medical record containing all the required medical information relating to care. There have been efforts to use some components of the model, but the full model is not readily available for the majority of families. Medical needs of most children with tracheotomy require a single pediatric practice that can sustain a centralized health record.

Another strategy to facilitate health information exchange between the parents and caregivers is embracing a system that uses electronic health records (HER's). The families, out-patient caregivers, and the patients may access a selected section of the patient's electronic health records from the hospital through a simple internet-based portal.

The use of relationship registries may also be useful in ensuring well-structured information access. The sophisticated mapping of the relationship between a health provider, care teams, can improve the care across settings and transitions. A relationship between a caregiver and a patient registry can show which provider is engaged in the care provisioning. Hence, the providers can notify each other about the child's diagnoses and health care schedules without or beyond a health information exchange infrastructure.

The results of the study laid out crucial situations relating to poor tracheotomy care that may help in guiding future research on the impact of growing health information management systems for children with a tracheotomy and, by extension, to all other health information systems. There is also an urgent need to apply the strategies and test whether they help improve the quality of health care and that of the Health Information Exchange.

References

Berry, J. G., Goldmann, D. A., Mandl, K. D., Putney, H., Helm, D., O'Brien, J., ... & Weinick, R. M. (2011). Health information management and perceptions of the quality of care for children with tracheotomy: A qualitative study. BMC health services research, 11(1), 117. Retrieved from: https://bmchealthservres.biomedcentral.com/articles/10.1186/1472-6963-11-117

Shapiro, J. S., Mostashari, F., Hripcsak, G., Soulakis, N., & Kuperman, G. (2011). Using health information exchange to improve public health. American journal of public health, 101(4), 616-623. Retrieved from: https://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2008.158980?casa_token=iusmLKOXUn0AAAAA:H-xnBKajwdSrMpEX1yPKNy-x8MdrLA3QpMsBZUWWrLDf90tOY2SdhS7zDCNuNHJ2G4fOAlfyylnC