Addressing Challenges with Interoperability

Addressing Challenges with Interoperability

The usage of technology has become ubiquitous in all health care spheres since the turn of the present decade. Health care facilities have embraced the usage of this phenomenon to ensure that patient data is shared seamlessly across difference geographical locations, systems and departments within a hospital. At the core of the implementation of health care interoperability is the electronic health record system. The interconnectedness of this system makes it easier for various stakeholders within the health care sphere to access and share pertinent patient data during assessment and treatment processes. However, even with the adoption of this interconnected network to enhance sharing of patient information and generally improve the quality of care, challenges still abound in the usage of such systems. Appreciating these challenges thus becomes an important aspect of seeking solutions in order to make interoperability a reality in health care. To this end, the present paper will identify an interoperability challenge, identify the root cause of the same using workflow structure, and then offer a workable solution to it using evidence-based literature.

Identification of the Problem

            The issue of patient billing has experienced some avoidable technicalities as regards health care interoperability within hospital settings. One of the most affected aspects of the entire process involves health care billing. During one of my nursing care shifts at the intensive care ward, I wanted to bill a patient using the hospital’s EHR database system. As with all other hospitals, the final billing of critical care cases entail recording the entire supplies utilized during the treatment process, which may involve surgical supplies (Kohler, 2015). The availability of such information helps in summing up the bill accrued by a patient upon their discharge or, in unfortunate cases, death. However, when pulling out the information on the list of surgical supplies used by the patient, I experienced a delay that lasted forever without resolving. When the IT technician was summoned, she could not resolve the issue only to later identify that a security breach of the system had occurred.

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A further analysis of the issue revealed that the entire database hosting patient information had been compromised. As a consequence, over one hundred and fifty patient files had gone missing from the database. This had impacted several health care personnel, from nurses, to physicians to pharmacists, who could not prescribe drugs while the former personnel could not perform their duties on these patients as pertinent information regarding their conditions was missing. Thus, essentially, the workforce at the facility could not treat or care for the patients at various levels due to missing data concerning their medication dosages, the evaluation of progress, and even prescription of new drug regimen at the facility due to the system breach.

Analysis of Workflow and Structure Associated with the Security Breach

The diagnosis of the issue revealed the existence of a malware at the hospital’s EHR system’s central server unit. Apparently, a hacker had compromised the multi-patient monitors for the entire patient registry and deleted certain files belonging to the 150 patients that were affected. The anonymous hacker achieved this through the introduction of a malware into the system (Rezaeibagha, Khin & Susilo, 2015). However, the normally active events-drive alerts did not work as the hacker had disabled it prior to accessing the system. The coding of the malware had been done such that it was instructed to coordinate the execution of workflow commands from the intensive care wards to the principal server at the facility’s records unit minus compromising data from other wards. As a consequence of this omission in the attack, it was not easy to detect that the files from the intensive care wards had been compromised since the hacker deployed the virus into the hospital’s EHR workflow management system.

Moreover, the notification alerts did not occur as the hacker had disabled it enabling the malware to become integrated into the HER management system related to the intensive care ward patients as initially stated. Whereas the possibility of a human handler integrating the malware into the system was high, the system was already vulnerable to attacks since it was operating on a public network (Frie