Health Informatics Challenges and Care Delivery, Explained

UPI Study › Courses › Healthcare Organization and Management › Free lessons › Lesson 10.2 Free with a free account

Health Informatics Challenges and Care Delivery

Healthcare Organization and Management · Chapter 10: Health Informatics and Technology ManagementSection 10.2 · lesson 60 of 10510 min · free with a free account

← Hospital Information Systems: Implementation and DataNext lesson: Electronic Health Records: Adoption and Patient Safety →

Earn 3 college credits for Healthcare Organization and ManagementRecommended for credit by NCCRS · Health 302 · self-paced · one payment, lifetime access
Enroll in Healthcare Organization and Management · $250 →Download the syllabus (PDF)

In this lesson

Managing usability, alert fatigue, and other problems of working health IT.

  • Distinguish usability from functionality in clinical information systems
  • Explain alert fatigue and how override rates guide alert design
  • Prepare for duplicate records, information gaps at transitions, and system downtime
  • Turn staff complaints into actionable change requests for informatics governance

Free study notes

Get this lesson's notes by email

The key points and 4 practice questions with answers, in your inbox. One email, free.

One email. Unsubscribe in one click.

Transcript

Everything said in the video, section by section (1,365 words). Read along, or search it.

Opening Case

Printed Lists Beside Every Workstation

Six weeks after Larkfield's new record went live, Wes Adler, the imaging manager, notices printed lists taped beside every workstation, marked up in pen through each shift. Samuel Ndiaye, the compliance officer, sees them too, and asks Wes to stop it. The lists hold patient information, sit in an open area, and duplicate the official record. Wes agrees with both points. But he doesn't start there. Should he ban the lists, or learn from them first?

Usability

Working Systems Still Create Problems

Kenji Watanabe has seen this before. The new system works. It passed testing, meets its specification, and is used every day. Yet it creates problems a manager must recognize, name, and act on. Treat them as a broken product, and you get nowhere. Treat them as design and governance problems, and you can act. The first is usability. Usability is whether users can finish their tasks accurately, efficiently, without undue effort. Functionality is only whether the system can do something at all. Requirements list capabilities; work happens in sequence. A requirement asks: can it record an allergy? The work asks: can a nurse do that mid-admission, while the patient talks, without losing a half-finished screen?

Workarounds

A Workaround as Free Diagnostic Data

Back in imaging, Wes asks his two senior technologists what the list gives them. The answer takes ninety seconds. The new screen sorts pending work by when it arrived. Their work runs by urgency, and by whether a prerequisite step is done. The old system had that view. The new one has a filter that can do something similar, but it resets at every login, and resetting takes too long. So they print once a shift, and mark it by hand. A workaround is an unofficial practice that gets work done when the official process makes it hard. Restating the rules removes the workaround, not the difficulty. It's free diagnostic data.

Documentation Burden

Subtracting Fields Nobody Uses

A second problem is documentation burden: time and effort spent recording care rather than giving it. Each part was added for a good reason: safety, billing, quality reporting, compliance, legal risk. Each came from a different department. None removed anything, and nobody sees the total. It hurts staff, adding work that runs past the shift. And it hurts care, eating consultation minutes and thinning the record. A template full of defaults passes every audit, and tells nobody anything. The move available is subtraction. For each mandatory field, ask who uses it, for what decision, and what would happen if it were optional.

Alert Fatigue

Override Rates and Alert Thresholds

Third, alert fatigue: responding less to warnings after many turn out to be unimportant, so real ones get dismissed too. It's a design problem, not a discipline problem. A system that interrupts twenty times a shift, when nineteen don't matter for this patient, trains people to dismiss interruptions. Behind it is a real trade-off. Fire on every case, and you catch nearly all, buried in noise. Fire narrowly, and you're heeded, but miss some. Clinical governance picks the setting. The measure to watch is the override rate: the share of firings dismissed without action. A very high rate says the alert isn't doing its job.

Quick Check

A Sepsis Alert Nurses Dismiss

Quick check. Larkfield's sepsis alert fires on about one in four emergency patients, and nurses dismiss nearly all of them. Leaders want to act. Which response fits? Pause, and decide. A governance review of the alert's trigger. The dismissals are a rational response to a weak signal, so clinical governance should reset the threshold, using the override data. Making it impossible to dismiss is tempting, because it forces attention. But it spends more attention on the same noise. Training treats design as a discipline problem.

Transitions of Care

Designing for Missing Information

Some problems cross the hospital's walls. Inside one organization, integration is solvable engineering. Across organizations, there are different systems, identifiers, and definitions, and no shared authority. The damage shows at transitions of care, like discharge to a nursing home or a clinic. Those are already the riskiest moments, and exactly where information arrives late, partial, or needing retyping. A manager can't fix that. But a manager can design the receiving process for missing information: will the gap be noticed, who chases it, and does care proceed meanwhile?

Duplicate Records

Fragmentation Starts at Registration

Data fragmentation spreads one patient's information across systems that don't show it together, so someone must know where to look. Its dangerous relative is the duplicate record. That's one patient registered twice under slightly different details, giving two partial records where clinicians believe there's one complete one. Duplicates start almost entirely at registration, when a rushed search misses an existing record. So manage them at the source: search practice, identity checks, and registration staffing, plus merges for the rest.

Downtime Procedures

Running Care Without the System

Systems go down, planned or not, and care can't pause. Downtime procedures cover running without the system, and restoring the record afterward. Departments often get three parts wrong. Information during downtime: if every reference is inside the system, staff have nothing to work from, which is why printed or separately stored summaries exist. Capture during downtime, on forms designed in advance, not improvised. And catch-up entry afterward, which takes staff hours nobody budgeted. Skip it, and the record has a permanent hole. Downtime plans are tested by rehearsal, not by reading. A department that's never rehearsed one doesn't really have one.

Change Governance

Rationing Limited Build Capacity

Every change request, a new field, an order set, a report, competes for limited build capacity. Requests are unlimited, so governance rations them: what gets built, in what order, on whose authority. A working structure has three properties. It includes people with clinical and operational authority, because these are priority decisions, not technical ones. It applies published criteria: safety, regulatory need, users affected, and effort. Not whoever shouts loudest. And it reports back: declined, deferred, or scheduled. Without that, managers quietly stop asking, the queue looks healthy, and the organization loses its best signal about where systems fail.

Actionable Requests

Turning a Complaint Into a Request

So the skill this asks of a manager is turning a complaint into an actionable request. "The system is slow" can't be acted on. An actionable request names the task being attempted, the point where it fails, how often and for how many, and the consequence when it happens. Add the workaround in use, because it shows the problem is real enough that staff paid to avoid it, and what a solution must achieve. Governance criteria are stated in exactly these terms.

Quick Check

Which Request Governance Can Act On

Quick check. Three requests reach Larkfield's informatics governance group. Which one can it act on? Pause, and decide. The discharge request. It names the task, where it fails, the frequency, and the consequence, so the group can rank it against its criteria. The order-entry request is tempting, because it names a task. But it gives no failure point, no frequency, and no consequence, and redesigning every screen is a wish, not a request.

Unintended Effects

Fixes That Create Side Effects

Even good fixes have side effects, because a system change alters a process connected to other processes. A mandatory field added for completeness creates pressure to enter something, not the right thing. A structured template reduces the free text where nuance lived. A notification that closes a gap in one department fills another's task list. And a tightened permission blocks someone whose need nobody considered. Two habits help. Before a change, ask who else touches this process. After it, look for the effect in a measure other than the one you meant to improve.

Case Resolved

A Controlled, Temporary Exposure

Back to Wes. The lists told him something precise: the upgrade lost a saved, role-specific view of pending work. He submits that as a configuration request, with a printed list as evidence. Then the exposure. He doesn't simply ban the lists, because a ban without a fix pushes the information onto phone photos or memory. With Samuel, he agrees an interim rule: the list stays, cut to the minimum identifiers, kept out of public view, and shredded at shift end. It's a controlled, temporary exposure, accepted openly to keep the practice visible while the real fix is built. And he sets a review date, so temporary doesn't become permanent.

Key Takeaways

Read Workarounds, Make Requests Actionable

To recap. Working systems still create problems of usability, burden, and attention. Subtract fields nobody uses, and let clinical governance tune alerts. Read workarounds as diagnostic data, not defiance. Design for information gaps, duplicate records, and downtime. And make every request actionable: task, failure point, frequency, and consequence.

About Healthcare Organization and Management at UPI Study

Healthcare Organization and Management (Health 302) is a self-paced online course of 105 video lessons in 18 chapters, from health systems and the law to ethics, leadership, teams, strategy, informatics, finance, quality, human resources, marketing and evidence-based practice. It carries a NCCRS credit recommendation for 3 semester credits.

Every lesson transcript is free on pages like this one, and the videos are free with a free UPI Study account. Enrolling adds a practice quiz after each lesson, the graded work and final exam that earn the credit, lifetime access, and an official transcript on completion. UPI Study has helped over 130,000 students with college credits. ACE and NCCRS have over 2,100 cooperating colleges that will consider accepting credits; the final decision is with the universities.

Enroll now → Course details Download the syllabus All Health courses Every course with PRO →

Why take it here

Why students take Healthcare Organization and Management with UPI Study

How hospitals and clinics are runHealthcare Organization and Management covers how care organizations are led and run: health law and ethics, leadership and teams, strategic planning, health informatics, budgets, quality improvement, staffing and marketing. It is a core course in healthcare administration and health management degrees.
Credit at a fraction of the priceThe same 3 credits can cost $750 or more at a US college. Here it is one payment, self-paced, with lifetime access.
Finish your degree soonerTransfer credits reduce the courses you still owe, so you can graduate earlier or lighten a heavy semester.
Strengthen an applicationA completed college-level course on an official transcript shows admissions and scholarship committees you can do the work.
Study on your own scheduleNo start dates, no deadlines. Watch the lessons, practice, and take the final when you are ready.
130,000+students helped with college creditsACE and NCCRS have over 2,100 cooperating colleges that will consider accepting credits; the final decision is with the universities.

Where the credit goes

Universities that work with NCCRS

Healthcare Organization and Management carries a NCCRS credit recommendation. These universities work with NCCRS; some are UPI Study's signed partners. ACE and NCCRS have over 2,100 cooperating colleges that will consider accepting credits; the final decision is with the universities.

Thomas Edison State UniversityThomas Edison State UniversitySigned partnerUniversity of the PeopleUniversity of the PeopleSigned partnerCharter Oak State CollegeCharter Oak State CollegeSigned partnerStrayer UniversityStrayer UniversitySigned partnerColumbia Southern UniversityColumbia Southern UniversitySigned partnerIndiana TechIndiana TechSigned partnerPenn StatePenn StateWorks with NCCRSSouthern New Hampshire UniversitySouthern New Hampshire UniversityWorks with NCCRSSUNYSUNYWorks with NCCRS +many more cooperating universitiesFind my college →

Find my college → Not listed? Ask Athena in the corner of this page, or book a 15-minute call.

FAQ

Questions students ask us

About Health Informatics Challenges and Care Delivery

What is alert fatigue in electronic health records?
Alert fatigue is a declining response to warnings after many turn out to be unimportant, so important alerts get dismissed too. It is a design problem rather than a discipline problem. A key measure is the override rate, the share of firings dismissed without action. A very high rate suggests clinical governance should review the alert's trigger rather than force clinicians to acknowledge it.
Why do clinicians create workarounds to health IT systems?
A workaround is an unofficial practice that gets work done when the official process makes it hard. Staff create them when a system's design does not match how work is sequenced, such as a work list sorted by arrival when the work runs by urgency. Banning a workaround removes the practice but not the difficulty, so it is better read as diagnostic data.
How do duplicate patient records happen?
A duplicate record occurs when one patient is registered twice under slightly different details, creating two partial records that clinicians may believe are one complete record. Duplicates start mostly at registration, when a rushed search misses an existing record. Managing them at the source means good search practice, identity checks, and adequate registration staffing, with merges handling the remainder.
What makes a health IT change request actionable?
An actionable request names the task being attempted, the point where it fails, how often and for how many users, and the consequence when it happens. It also notes any workaround in use, which shows the problem is real, and what a solution must achieve. A complaint such as the system is slow gives a governance group nothing to rank against its criteria.

About the Healthcare Organization and Management course

How many college credits is Healthcare Organization and Management?
Healthcare Organization and Management (Health 302) carries a NCCRS credit recommendation for 3 semester credits. ACE and NCCRS have over 2,100 cooperating colleges that will consider accepting credits; the final decision is with the universities.
How much does Healthcare Organization and Management cost and what is included?
$250, paid once, with lifetime access: all 105 video lessons, a practice quiz after each, the graded work and final exam, and an official transcript when you finish. Students who want several courses choose UPI Study PRO instead.
Which universities accept UPI Study credits?
UPI Study has signed partner agreements with universities such as Thomas Edison State University, University of the People and Charter Oak State College, and works with universities such as Penn State, SNHU and SUNY. ACE and NCCRS have over 2,100 cooperating colleges that will consider accepting credits; the final decision is with the universities. Use "Find my college" on this page to check yours.
How long does Healthcare Organization and Management take?
It is self-paced with no deadlines. The 105 lessons total about 17 hours of video; most students add reading and practice time and finish in a few weeks to a few months, on their own schedule.
How are the exams done?
Quizzes and assignments are online in the course. The final exam is taken online with proctoring; a person on the UPI Study team checks assignments, usually within two days.
How do my credits reach my college?
When the course shows 100% complete, request the official transcript from your dashboard. It is sent to the college you name, and you can send it to more than one. Check your college first with "Find my college" on this page, or ask Athena.

Ready for the full course? Earn 3 credits in Healthcare Organization and Management.

105 video lessons, a quiz after each one, and the graded work that earns the credit. Recommended for credit by NCCRS.

Enroll in Healthcare Organization and Management →Download the syllabusEvery course with PRO →
Healthcare Organization and Management
3 credits · NCCRSEnroll →