Information Management

Fel Rose Singgo Lloyd Singgo

Objectives
1. Define information management, its background and importance especially in healthcare setting. 2. Enumerate and explain the concepts of information management. 3. Differentiate information management from records management.

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 at advanced level for the betterment of care, to provide services, etc. Information plays an important role both in public and private sectors as well. Information, formal or informal, is however to be managed. Information is now seen as a valuable resource within many organizations.

Information management (IM)

-is the collection and management of information from one or more sources and the distribution of that information to one or more audiences. This sometimes involves those who have a stake in, or a right to that information. Management means the organization of and control over the structure, processing and delivery of information.

1970s
Throughout the 1970s this was largely limited to files, file maintenance, and the life cycle management of paper-based files, other media and records. With the proliferation of information technology starting in the 1970s, the job of information management took on a new light, and also began to include the field of data maintenance. No longer was information management a simple job that could be performed by almost anyone.

1990s
As information storage shifted to electronic means, this became more and more difficult. By the late 1990s when information was regularly disseminated across computer networks and by other electronic means, network managers, in a sense, became information managers. Those individuals found themselves tasked with increasingly complex tasks, hardware and software. With the latest tools available, information management has become a powerful resource and a large expense for many organizations.

Information Management Concepts

Following the behavioral science theory of management, mainly developed at Carnegie Mellon University and prominently represented by Barnard, Richard M. Cyert, March and Simon, most of what goes on in service organizations is actually decision making and information processes. The crucial factor in the information and decision process analysis is thus individuals limited ability to process information and to make decisions under these limitations.

According to March and Simon,

organizations have to be considered as cooperative 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.

According to the Carnegie Mellon School and its followers, information management, i.e., the organization's ability to process information, is at the core of organizational and managerial competencies. Consequently, strategies for organization design must be aiming at improved information processing capability. Jay Galbraith has identified five main organization design strategies within two categories increased information processing capacity and reduced need for information processing.

Five main organization design strategies within two categories increased information processing capacity and reduced need for information processing. 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

Environmental Management.
Instead of adapting to changing environmental circumstances, the organatizion can seek to modify its environment. Vertical and horizontal collaboration, i.e. cooperation or integration with other organizations in the industry value system are typical means of reducing uncertainty.

Creation of Slack Resources

In order to reduce exceptions, performance levels can be reduced, thus decreasing the information load on the hierarchy. These additional slack resources, required to reduce information processing in the hierarchy, represent an additional cost to the organization. The choice of this method clearly depends on the alternative costs of other strategies.

Creation of Self-Contained Tasks

Achieving a conceptual closure of tasks is another way of reducing information processing. In this case, the task-performing unit has all the resources required to perform the task. This approach is concerned with task (de)composition and interaction between different organizational units, i.e. organizational and information interfaces.

Creation of Lateral Relations

In this case, lateral decision processes are established that cut across functional organizational units. The aim is to apply a system of decision subsidiarity, i.e. to move decision power to the process, instead of moving information from the process into the hierarchy for decision-making.

Investment in Vertical Information Systems

Instead of processing information through the existing hierarchical channels, the organization can establish vertical information systems. In this case, the information flow for a specific task (or set of tasks) is routed in accordance to the applied business logic, rather than the hierarchical organization.

Information systems
-are complex automated systems that are integrated through networked computers to process data in order to answer questions, solve problems, or make decisions. Information technology can link separate entities into a seamless, system of information available to all users, obviating the need for multiple record keeping.

These are several purposes for such a system:

To make relevant patient data available in a usual form so patient care problems can be solved. To process information to support management functions such as receiving data from the departments and supplying data to departments to make 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.

Forecasting Information Needs

Management Information Systems have been found to rapidly and accurately manipulate large quantities of data, thereby saving time for the nurse, who can be deployed to provide direct care services. In multiple studies nurses have been shown to spend 40% of their time in some form of indirect care including communication and information processing.

In a nursing organization a computerized system would be helpful in a number of arenas: to collect, transmit, analyze and report patient related, employee related, and process related information among the managers, nurses, and families. Such a system could also be used for projecting workload needs, summarizing patient classification data, projecting personnel recruitment, hiring and scheduling, evaluating nursing resource used by patients, monitoring supplies, budgeting, recording payroll, and analyzing quality of care data.

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.

Few nurses have had experience with management information systems. The following tips are offered in the development of a new system: Choose software first Request software information from several vendors Provide vendor with pertinent information about size of agency, number of departments, type of departments, number of patients. Provide information about other computerized systems within the organization

Provide information about the capabilities of the system users. Have the Planning committee make a site visit of an organization where the selected software has been used. Observe use of software in a similar organization. Have vendor install, maintain, and duplicate system information and train personnel. Have the vendor phase out former system.

Obstacles to Using Information Systems

Although information systems offer many benefits to nursing, there are also a number of obstacles. One is user resistance, including concern about loss of control over practice, depersonalization of care, previous negative experiences, and resistance to change. Time to learn, problems with faulty systems, and cost are also obstacles. As a hardware and software continue to improve and become more user friendly, user resistance diminishes somewhat. Also wide spread consumer use of computers and the internet improves user ability and comfort in using the technology.

Information Management vs. Records Management

Senior line managers and information technology managers often suffer from misconceptions about the relationship between information management and records management which are normally regarded as very different activities. This is due, in large part, to historical accident, because of the fact that usually hard organizational lines have been drawn that should not exist between the computerbased operations and the paper records management operations of most organizations. Information management and technology (IM&T) professionals traditionally have been more interested in the medium than the message.

Future Trends in Information Management

Management Information System are growing and developing rapidly, as organization move o n to the information highway. Trends for future automation include automated medical records, artificial intelligence, use of optical disk, and robotics.

Use of artificial intelligence would assist in enhancing the process of clinical decision making. Such a system creates a model of reality based problem-solving, analyzing all the factors that are input about the patient; describes the risk are uncertainties related to alternative interventions; select a course of action to meet a specific objective; and suggest implementation of selected actions and evaluates the effect of the action.

Robotics is already being used in surgery for positioning surgical instruments, in laboratories for transporting and placing samples, and in nursing for delivery of supplies and medications. User friendly is another trend that is making information technology more accessible and more efficient to use. Problems are usually solvable with the menu-driven software and help menu. It has become much easier to design selfmade programs within hours or days rather than months. These are but a few of the trends that nurses will want to be aware of in preparation for system changes within health care delivery.

Human Technology Interface: Issues in Adjustment to Information Intensive Systems

Information management system is a futuristic concept in nursing and health care delivery and although we can use such systems for a number of work-related activities, systems cannot provide everything. The computer has become a necessary tool within nursing and health care delivery.

Being computer literate is no longer an option but a must for nurses, nursing educational curricula, and in nursing

practice. One major concern to all in this

age of computers is the accidental or intentional access by persons without right

to specific information. Restrictions and

security precautions especially related to patient information are essential.

Essential information can be inadvertently communicated to health care workers, to insurance companies, and to others and used to the detriment of the patient. Likewise, employees vitas, health information, academic information, performance evaluations, or disciplinary procedures could be communicated to peers, other managers, and external agency resources that have no right to or responsibility of the information. In making decisions about a management information system, one should think carefully about access to information.