Free Hospital Information System Upgrade AND User Training Essay Sample

Type of paper: Essay

Topic: Nursing, System, Medicine, Hospital, Doctor, Patient, Information, Workplace

Pages: 5

Words: 1375

Published: 2023/04/10


Recently, an incident occurred in a hospital where an MRI scan supposedly scheduled for a 55-year-old male patient was mistakenly done to a 25-year-old female patient with a different diagnosis. The error was only recognized when one of the patient’s doctors called the radiology department inquiring on why the scan had taken so long to be done. This was allegedly blamed on the incorrect use of the hospital information system. The case made the hospital’s management question the efficiency of the system because wrong administration of medical procedures could lead to many adverse effects that could include exposure to harmful agents, death, and malpractice law suits. These effects could make the hospital lose money, reputation and sometimes in the most severe cases, their license to practice medicine. To prevent such incidences from happening again, thorough investigation into the case was carried out and a report documenting the findings of the investigation with the recommended solutions produced and submitted to the management of the hospital for implementation.

Investigation and Reporting Process

The IT department staff should be in charge of the investigations since the error is said to have occurred because of misuse of the information system in place. The investigation process should start at the radiology section of the information system and trace back to when the patients’ data were first entered in the system. This will provide sufficient information regarding all of the hospital’s personnel who were in contact with the system when the error occurred. This is possible because the system stores all activities of the hospital in its database from patients’ data, their doctors, recommended treatment and procedures, time and place for procedures to take place and the relevant staff who performed the procedure.
The findings from the investigation should first be reported to the head of the IT department for analysis to see how the system is being misused by the users. The head of the IT department should then come up with clear solutions on ways of making the system more efficient for presentation to the management of the hospital. The management should review the report and see if it is viable to implement it and make the appropriate decision.

Findings of the Investigation

The investigations showed that the radiology department did receive a request on their system to perform an MRI scan on a 25-year-old patient. A look at the records revealed that the doctor who had called regarding lateness of the scan was not the one who placed the order in the system. The doctor had not even logged into the system. Further investigations into the system records showed that the patient was scheduled to have a CT scan, but the request was overwritten by another request for an MRI scan just a few moments later using the same computer and log in details. The doctor who placed the request in the system and the doctor who called regarding the scan were called in for questioning to gain a deeper understanding of exactly what happened. The first doctor did agree to logging into the radiology department request system and placed a scan request for the patient although it was a CT scan. The second doctor also concurred to have placed an MRI scan for a 55-year-old male patient under his care, using the same computer as the first doctor though the second doctor did not seem to remember logging into the system.
These findings showed that the first doctor logged into the system using a certain computer and placed a CT scan request for a 25-year-old female patient but neither logged out of the system nor closed the patient’s file. The second doctor went and used the same computer to place an MRI scan request for a 55-year-old male patient, without logging into the system or logging out the first doctor. The doctor did not even take a look at what file was open at the moment but went ahead and placed the request. This made the second request overwrite the first request placed on the female patient’s file hence leading to the error.

Causes of the Incidence

The primary cause of the incidence was negligence of the two doctors in understanding how the hospital information system operated. Understanding of the system would have lead to the two doctors knowing the harm of not logging out of the system and not logging into the system before placing any requests. Had the two doctors understood how the system operated, the first doctor would have logged out of the system after placing the request and the second doctor would have logged into the system before making any requests. Furthermore, the second doctor would have known that using another doctor’s account to place a request could overwrite any other request placed by the previous doctor in the account if it was in the same department.
Another reason for the occurrence of the error was the fact that the radiology department never checked the patient records to find out if the procedure to be administered adhered to the patient’s diagnosis. Checking the patient’s records would have shown that the procedure being done did not respond to the diagnosis of the patient and the doctor would have been contacted to clarify the reason for the procedure.
The system should have been configured to remind the users to close any files and log out of the system after sending any request. This is necessary for any environment with stress factors such as emergency situations usually observed in hospitals that may lead to users of a system forgetting to log out of a system. Additional features such as automatic logging out of the user after a specified period could also have been implemented in the system to ensure that only authenticated people utilize the system.

Patients, Doctors and Hospital Staff Sensitization

The doctors should be required to tell the patents under their care their names, the disease they are diagnosed with and the treatment recommended. In severe cases where the patients cannot remember or are not in a situation to comprehend what the doctor is saying, it should be complementary that a next of kin or a close relative is contacted by the doctor before any procedures are taken except in emergency situations where the next of kin would be contacted after the necessary life-saving procedures.
The patient, on the other hand, should be notified to ask the doctors or any other relevant hospital staff to read to them or their next of kin their files before the commencement of any treatment or diagnosis procedures. This would make patients alert the staff of any errors relating to their record regarding treatment or procedures.
The hospital staff like nurses should also be asked to read patients data and diagnosis to confirm if the processes or treatment they are administering adhere to the patients’ symptoms and diagnosis.


The first recommendation is that the hospital system in use be upgraded to include features such as automatic logging out of users after a period of idleness in their accounts and also add other important characteristics such as asking questions like “are sure you want to make the following request” before completing any requests from the system users.
The doctors and staff should be trained on the importance of logging in using their user names and passwords before entering any information or requests in the system. They should be sensitized on the incorrect system usage and the dangers associated with it.
Every Hospital staff in constant contact with the system can also be provided with modern IT gadgets such as iPads that they can use to enter data into the system. Nowadays, the items are cheaper and easier to acquire. The staff should be warned about sharing thee gadgets amongst themselves. This will ensure that issues such as one hospital employee using other employees log in details to access the system are minimized.


The use of an information system can be challenging especially in an environment such as a hospital that has could have emergency issues requiring the immediate attention of most of their staff. Also, most of the hospital personnel are not equipped with the knowledge of how to interact with the systems effectively. In this environment, even the smallest of mistakes could lead to the administration of wrong procedures to a patient, and this could various deteriorating effects the hospital that could include suspension of their medical practice license. To prevent this from happening, the system in place should be very effective with all the necessary features necessary for ease of use available. Also, technological resources should be provided to ensure that there is minimal risk of inappropriate use of the system and user training of the system conducted to all its users.


Aggelidis, V. P. & Chatzoglou, P. D., 2008. Methods for evaluating hospital information systems: a literature review. EuroMed Journal of Business, 3(1).
Côrtes, P. L. & Côrtes, E. G. d. P., 2011. Hospital information systems: a study of electronic patient records. Journal of Informal Systems Technology Management, 8(1).

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