HASTANELERDEKİ BİLİŞİM SİSTEMLERİNDEN KLİNİK BİLGİ SİSTEMLERİNİN KULLANIMINA YÖNELİK BİR ARAŞTIRMA: DENİZLİ VE ISPARTA ÖRNEĞİ

Gelişen dünyada bilgi kavramının öneminin giderek artması ve yaşanan teknolojik gelişmelerle birlikte sağlık sektöründe bilgi teknolojilerinin kullanımı giderek artmaktadır. Dünyamızda bilgi teknolojileri alanında yaşanan hızlı gelişmeler dolayısıyla sağlık bakanlığı sağlık alanında çeşitli sistemleri uygulamaya koymaya çalışmaktadır. Bu alanda yapılan çalışmalardan biri klinik bilgi sistemleri adı altında oluşturulan bazı bilgi sistemleridir. Bu sistemler hastanelerde doktorların ve diğer çalışanların işlerini kolaylaştırmak ve hastalara daha iyi ve hızlı bir şekilde hizmet sunulmasını sağlamaktadır. Bu çalışmada Isparta ve Denizli illerinde araştırmaya katılan hastaneler hakkında genel bilgilerin yanında sağlık sektöründe kullanılan klinik bilgi sistemlerinin son üç yılda kullanım düzeyinde meydana gelen değişiklikler, klinik bilgi sistemlerini kullanma amaçları ve bu amaçlara ulaşma düzeyleri, hastanelerin klinik bilgi sistemlerini kullanmada karşılaştıkları sorunların tespitine yönelik bir saha araştırması yapılmıştır.

A STUDY ON THE USE OF CLINICAL INFORMATION SYSTEMS: THE CASE OF DENIZLI AND ISPARTA

Nowadays, technology has been widely used thanks to ever-increasing innovations. Healthcare is one of the industries using the new technologies. In recent years, healthcare industry has faced a significant transformation process. The use of new technologies in healthcare, increasing population and lifespan, and increasing awareness of consumers also increase the quality and the quantity of the demand for healthcare services. Healthcare services aim to protect individuals’ and societies’ health, treat patients, rehabilitate them and improve quality of the healthy life of the society as a result. Although the functions of hospitals vary depending on their objectives and mission, there are four major functions: treatment services, protection and healing services, training and research activities. Information is the base of technology and for the use of technology. Information systems are defined as “the structure that consists of humans, computers and information tools to collect, form and save the data, and to use them for decision making and transferring.” As a result of recent technological developments in information systems and communication technologies, healthcare data can be saved and accessed digitally. Medical information systems (MIS) are important data resources, so it is the most popular research area. MIS deal with the information, data of which was collected and formed by the healthcare organizations. Developments in medical information systems provide fast pace of innovations in information modeling and diagnostic tools. MIS provides diagnostics, treatment, training, communication, data collection and preparation, database management, and medical decision-making services. MIS consist of necessary hardware, software, approach and procedures that is effectively used for producing, distributing and using the necessary data of protective and treating medical services. MIS can be collected under two broad groups, which are Clinical Information Systems (CIS), and Diagnostic-Treatment Systems (DTS). CIS collect private information of the patients to provide necessary useful information about them. DTS, which are web-based systems, however, provide interfaces for pharmacy, laboratory and radiology systems. Those systems are designed to obtain necessary data on time to increase the quality and the productivity of clinical services. CIS also help MDs to investigate the standards of medical services while helping hospital management to control the employees’ works and behaviors. CIS consist of several components such as electronic medical records, clinical decision support systems, nurse information systems, medical monitoring and storage systems, clinical communication systems, case informatics, virtual reality, telemedicine, smartcard applications, hospital information systems, standards, and clinical manuals and maintenance maps. DTS, however, consist of necessary information and hardware infrastructure for diagnosing and treating the illness. DTS utilizes recent medical technologies and systems to treat all kinds of medical problems. DTS consist of laboratory systems and other necessary applications. In recent years, developments in healthcare industry significantly increased the use of information technologies. As a result, cost, quality and productivity have become key issues in the industry. Such issues lead wide use of CIS in hospitals. This study aims to investigate the level of medical information system use in Isparta and Denizli cities. It also aims to examine the aim of MIS usage and its problems in the regions. While Denizli is a well-known industrial city, Isparta is famous with a variety of hospitals. Another difference between Denizli and Isparta is the level of development. While Denizli is a developed city, Isparta is a developing city. The number of hospitals is increasing in both cities. The number of hospitals is approcimately the same in both cities. In this context, this study examines the usage level of CIS in both cities. The sample of the research is the hospitals in Isparta and Denizli cities. Ten of Isparta hospitals and 15 of Denizli hospitals have been included in the research. A questionnaire has been manually distributed to the participants. As some of the participants have not returned the questionnaires, the response rate 72 per cent is. Average use of information technologies is eight years in participant hospitals. Ten of the participants (55.5%) are private hospitals. The number of private and public hospitals is almost the same in Isparta. Nevertheless, there are more private hospitals in Denizli. Possible reason of this difference can be started as the preference of the patients. The patients in Denizli, more industrialized then Isparta, profer more expensive private hospitals. Majority of he participants prefer purchasing third-party information technologies. The participants are also satisfied with the Return-on-Investment of the MIS that they use. Although most of the participants use online reservation systems, approximately 45.5% of the hospitals are satisfied with the system. Two major reasons of this dissatisfaction are absence of the patients who prefer online reservations and unethically abuse of the system by competitors to fill all available reservations using fake patient names to mislead possible customers. The participants in both Isparta and Denizli state that they use electronic patience record system, nurse information system, electronic medical records, clinical information systems, and hospital information systems. Participants in both cities, however, do not widely use telemedicine, case informatics, virtual reality, and smartcard applications. Medical monitoring and storage systems are widely used in the hospitals of Denizli but not in in Isparta. Smartcard applications also only used in some of the hospitals of Denizli. In general, although both cities are now using more CIS, the findings suggest that Denizli use such technologies more effectively. It is important to support CIS usage for the productivity of healthcare industry. Wider usage of CIS will not only help providing better patient services, it will also help doctors and other medical personnel. For that reason, it is important for hospitals to learn and adopt such systems. However, the findings of this study highlight that there is a lack of personnel, who can use such systems professionally. Some participants assert that they need technical personnel, who can deploy and effectively use those systems. The main reason of this key issue is the misbelief that the higher initial investment cost can be paid by the systems itself in short term and higher revenues can be obtained in near future. Participants believe that technology can always return the investment cost in short term. Hospitals need to have more resources to deploy such systems. In order to diagnose and treat the patients’ illnesses, it is necessary to make investment on those systems.