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Determining a Need for a Systems Change

This was a discussion topic from one of my health informatics classes:

How would you determine the need for a systems change at your workplace?

I’ve been trying for a year, but I don’t have a workplace yet.  However, I went with my significant other to an appointment with his new general practitioner and I was able to see the computer screen and to read the notes he was writing on the chart.  The doctor was kind enough to answer a few questions for me about the process of capturing patient medical information from his end and I am basing my answer to this question on that. 

As Wager et al. (2009) suggests, a good place to start determining the need for a systems change in an organization is to understand what the organization’s goal is.  The health center I visited strives to provide quality patient care while complying with all state and federal mandates in an efficient, cost-effective manner.  I witnessed one process that could potentially undermine several of the health center’s goals. 

The doctor’s process for information gathering and capture was slow and tedious.  The doctor entered part of the information on the computer and scribbled the rest on a “chronological record” in the margins.  He informed me he used the Dragon system and I asked if he was going to dictate the rest of the information or if another staff member was going to complete the record, and he said he would be entering this information into the computer later. 

The doctor’s time-consuming process inevitably decreases waiting room throughput, negatively impacting patients who are waiting too long.  Some patients may be disgruntled enough to spend their medical dollars elsewhere.  The doctor indicated he was less than thrilled with the system as he must duplicate efforts to get patient information into the system.  There is a chance he is under-utilizing the existing system and if that’s the case, then he needs training.  If not, then there is opportunity for improvement in accessing and entering data. 

An IT solution that would allow the doctor to complete the patient record real-time and have access to the patient’s in-network records would shorten the length of an office visit, produce accurate information for better decision-making, and increase waiting room throughput.  The IT-enabled values would include increased patient satisfaction, patient retention, improved efficiency and cost reduction based on efficiencies and greater patient throughput (Wager et al., 2009). 


Wager, K. A., Wickham Lee, F., Glaser, J. P, & Burns, L.B. (2009). Health care information systems: a practical approach for health care management (2nd ed.). Hoboken, NJ: John Wiley & Sons, Inc.