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Information ManagementFel Rose Singgo

Lloyd Singgo


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Objectives

1. Define information management, itsbackground and importance especially inhealthcare setting.

2. Enumerate and explain the concepts ofinformation management.

3. Differentiate information management from

records management.


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Introduction

Information is vital for nurses, managers,scientists, and for practitioners, in any

organization to take decisions, to prepare plans,to control activities, to pursue research atadvanced level for the betterment of care, toprovide services, etc. Information plays an

important role both in public and private sectorsas well. Information, formal or informal, ishowever to be managed. Information is nowseen as a valuable resource within many

organizations.


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Information management (IM)-is the collection and

management of informationfrom one or more sources and

the distribution of thatinformation to one or moreaudiences. This sometimesinvolves those who have a stake

in, or a right to thatinformation. Managementmeans the organization of andcontrol over the structure,processing and delivery of

information.


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1970s

Throughout the 1970s this was largelylimited to files, file maintenance, and the life

cycle management of paper-based files, othermedia and records. With the proliferation ofinformation technology starting in the 1970s, thejob of information management took on a new

light, and also began to include the field of datamaintenance. No longer was informationmanagement a simple job that could beperformed by almost anyone.


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1990sAs information storage shifted to electronic

means, this became more and more difficult. By the

late 1990s when information was regularlydisseminated across computer networks and byother electronic means, network managers, in asense, became information managers. Thoseindividuals found themselves tasked withincreasingly complex tasks, hardware and software.With the latest tools available, informationmanagement has become a powerful resource and alarge expense for many organizations.


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Information Management Concepts

Following the behavioral science theory ofmanagement, mainly developed at Carnegie

Mellon University and prominently representedby Barnard, Richard M. Cyert, March andSimon, most of what goes on in serviceorganizations is actually decision making and

information processes. The crucial factor in theinformation and decision process analysis isthus individuals limited ability to processinformation and to make decisions under these

limitations.


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According to March and Simon,

organizations have to be considered ascooperative systems with a high level of

information processing and a vast need

for decision making at various levels.They also claimed that there are factors

that would prevent individuals from

acting strictly rationally, in opposite to

what has been proposed and advocated

by classic theorists.


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According to the Carnegie Mellon School and

its followers, information management, i.e., theorganization's ability to process information, isat the core of organizational and managerialcompetencies. Consequently, strategies fororganization design must be aiming at improvedinformation processing capability. Jay Galbraithhas identified five main organization design

strategies within two categories increasedinformation processing capacity and reducedneed for information processing.


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Five main organization design strategies within

two categories increased information processing

capacity and reduced need for informationprocessing.1. Reduction of information processing needs

Environmental management

Creation of slack resources

Creation of self-contained tasks

2. Increasing the organizational information

processing capacity Creation of lateral relations

Vertical information systems


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Environmental Management.Instead of adapting to

changing environmentalcircumstances, the

organatizion can seek tomodify its environment.Vertical and horizontalcollaboration, i.e.

cooperation or integrationwith other organizations inthe industry value systemare typical means of

reducing uncertainty.


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Creation of Slack Resources

In order to reduce exceptions, performancelevels can be reduced, thus decreasing theinformation load on the hierarchy. Theseadditional slack resources, required to reduceinformation processing in the hierarchy,

represent an additional cost to the organization.The choice of this method clearly depends on thealternative costs of other strategies.


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Creation of Self-Contained Tasks

Achieving a conceptual closure of tasks isanother way of reducing information processing.

In this case, the task-performing unit has all theresources required to perform the task. Thisapproach is concerned with task (de-

)composition and interaction between differentorganizational units, i.e. organizational andinformation interfaces.


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Creation of LateralRelations

In this case, lateral decision processes areestablished that cut across functionalorganizational units. The aim is to apply asystem of decision subsidiarity, i.e. to movedecision power to the process, instead of movinginformation from the process into the hierarchyfor decision-making.


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Investment in Vertical InformationSystemsInstead of processing information through

the existing hierarchical channels, the

organization can establish vertical informationsystems. In this case, the information flow for aspecific task (or set of tasks) is routed in

accordance to the applied business logic, ratherthan the hierarchical organization.


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Information systems

-are complex automated systems that areintegrated through networked computers toprocess data in order to answer questions, solve

problems, or make decisions. Informationtechnology can link separate entities into aseamless, system of information available to allusers, obviating the need for multiple record

keeping.


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These are several purposes for such asystem: To make relevant patient data available in a usual

form so patient care problems can be solved.

To process information to support managementfunctions such as receiving data from thedepartments and supplying data to departments tomake policy decisions, operating decisions, as well

as patient care decisions. To provide a comprehensive automated information

processing system for all phases of nursing process.

To develop a care plan for families and patient.


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Forecasting Information Needs

Management Information Systems have beenfound to rapidly and accurately manipulate largequantities of data, thereby saving time for the

nurse, who can be deployed to provide directcare services. In multiple studies nurses havebeen shown to spend 40% of their time in someform of indirect care including communication

and information processing.


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In a nursing organization a computerized

system would be helpful in a number of arenas:to collect, transmit, analyze and report patientrelated, employee related, and process relatedinformation among the managers, nurses, and

families. Such a system could also be used forprojecting workload needs, summarizing patientclassification data, projecting personnelrecruitment, hiring and scheduling, evaluating

nursing resource used by patients, monitoringsupplies, budgeting, recording payroll, andanalyzing quality of care data.


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To forecast information needs for an

organization, representatives from all departments

or units of an organization should be represented on

the planning committee, including material and

staff level personnel. To prepare for a MIS the

committee should review the agencys current

system for types of information and methods for

recording and transmitting data to determine what

is available and what is lacking in the current

system.


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Few nurses have had experience with

management information systems. The followingtips are offered in the development of a newsystem:

Choose software first

Request software information from severalvendors

Provide vendor with pertinent information

about size of agency, number of departments,type of departments, number of patients.

Provide information about other computerizedsystems within the organization


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Provide information about the capabilities of the

system users.Have the Planning committee make a site visit of

an organization where the selected software hasbeen used.

Observe use of software in a similarorganization.

Have vendor install, maintain, and duplicatesystem information and train personnel.

Have the vendor phase out former system.


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Obstacles to Using Information Systems

Although information systems offer manybenefits to nursing, there are also a number ofobstacles. One is user resistance, including concernabout loss of control over practice,

depersonalization of care, previous negativeexperiences, and resistance to change. Time to learn,problems with faulty systems, and cost are alsoobstacles. As a hardware and software continue toimprove and become more user friendly, user

resistance diminishes somewhat. Also wide spreadconsumer use of computers and the internetimproves user ability and comfort in using thetechnology.


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Information Management vs.

Records Management Senior line managers and information technology

managers often suffer from misconceptions aboutthe relationship between information management

and records management which are normallyregarded as very different activities. This is due, inlarge part, to historical accident, because of the factthat usually hard organizational lines have beendrawn that should not exist between the computer-

based operations and the paper recordsmanagement operations of most organizations.Information management and technology (IM&T)professionals traditionally have been more

interested in the medium than the message.


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Future Trends in Information Management

Management Information System aregrowing and developing rapidly, as organization

move o n to the information highway. Trends forfuture automation include automated medicalrecords, artificial intelligence, use of optical disk,and robotics.


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Use of artificial intelligence would assist inenhancing the process of clinical decisionmaking. Such a system creates a model of realitybased problem-solving, analyzing all the factorsthat are input about the patient; describes the

risk are uncertainties related to alternativeinterventions; select a course of action to meet aspecific objective; and suggest implementationof selected actions and evaluates the effect of the

action.


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Robotics is already being used in surgery forpositioning surgical instruments, in laboratoriesfor transporting and placing samples, and innursing for delivery of supplies and medications.User friendly is another trend that is making

information technology more accessible andmore efficient to use. Problems are usuallysolvable with the menu-driven software and helpmenu. It has become much easier to design self-

made programs within hours or days rather thanmonths. These are but a few of the trends thatnurses will want to be aware of in preparationfor system changes within health care delivery.


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Human Technology Interface: Issuesin Adjustment to InformationIntensive Systems

Information management system is afuturistic concept in nursing and health care

delivery and although we can use such systemsfor a number of work-related activities, systemscannot provide everything. The computer hasbecome a necessary tool within nursing andhealth care delivery.


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Being computer literate is no longer an

option but a must for nurses, nursing

educational curricula, and in nursingpractice. One major concern to all in this

age of computers is the accidental or

intentional access by persons without rightto specific information. Restrictions and

security precautions especially related to

patient information are essential.


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Essential information can be inadvertentlycommunicated to health care workers, toinsurance companies, and to others and used tothe detriment of the patient. Likewise,employees vitas, health information, academic

information, performance evaluations, ordisciplinary procedures could be communicatedto peers, other managers, and external agencyresources that have no right to or responsibility

of the information. In making decisions about amanagement information system, one shouldthink carefully about access to information.


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