Lecture 1 Healthcare Information Systems (Ch. 6)

Learning Objectives Information Technology vs. Information Systems Information Systems in Organization Various types of information systems used within healthcare institutions. Functions/features of some Clinical Information Systems Functions/features of some Administrative Information Systems New IT in HIS IS 531 : Lecture 1

Information Data (facts, numbers, characters) Information (what) Knowledge (concept / idea) Wisdom (why, when, how, what-next…) IS 531 : Lecture 1

Roles of Healthcare Professionals in HIS Data gatherer Information user Knowledge user Knowledge builder IS 531 : Lecture 1

“Good” Information Right content Right format Right time Right user IS 531 : Lecture 1

Information Quality Is there any incorrect value in the information? Is there any value missing from the information? Is aggregate or summary information in agreement with detailed information? Is the information current with respect to the needs? Is each transaction and event represented only once in the information? Do you have any examples of a time when you encountered a problem due to low quality information? For example, you did not receive a package because the address was incorrect or missing List the business ramifications that can occur for an organization that maintains low quality information What is the expense to a business that provides its employees with hourly updates, when the employees only require weekly updates? Updating information costs money Updated information must be stored; the more frequently an organization updates its information, the more information they will have in their data warehouse and databases Updating information changes information Review the scenario in the text that discusses three managers who make different business decisions based on the same report The reason for the different business decisions is because the managers pulled the report at three different times during the day Since the information was continually being updated, they came to different conclusions IS 531 : Lecture 1

Difficulties in Managing Data Amount of data increases exponentially. Data are scattered and collected by many individuals using various methods and devices. Data come from many sources. Data security, quality and integrity are critical. An ever-increasing amount of data needs to be considered in making organizational decisions. Solution: network database IS 531 : Lecture 1 7

Information Technology Computer equipment Hardware Software Telecommunication network to collect / store, process, and display data IS 531 : Lecture 1

Information Systems Use of computer hardware and software to process data into information for operation management and decision making IS 531 : Lecture 1

Information Systems Combination of : Hardware Software Telecommunications networks Data People Procedures (business rules /practices) IS 531 : Lecture 1

Organizational Levels Decision-Making Levels of an Organization Organizational Levels IS 531 : Lecture 1

Information Systems across Organizational Boundaries IS 531 : Lecture 1

Healthcare Information System Healthcare Information System (Hospital Information System HIS)—a group of systems used to support and enhance healthcare business functions IS 531 : Lecture 1

Types of Healthcare Information Systems Clinical information systems Directly support care Individual systems may be standalone Goal: data exchange among systems Administrative systems Indirectly support patient care Individual systems may stand alone Goal: data exchange among systems IS 531 : Lecture 1

Types of Healthcare Information Systems IS 531 : Lecture 1

1. Clinical Information Systems Nursing Monitoring Order entry Laboratory Radiology Pharmacy Other Ancillary Systems ( Physician Practice, Ambulatory, Long-term, Home-care …) IS 531 : Lecture 1

1.1. Nursing Information Systems Supports the use and documentation of nursing activities and provides tools for managing the delivery of nursing care: view/ update vital data /patient condition access to online drug info, procedure guidelines databases provide quality patient care … IS 531 : Lecture 1

Nursing Information System Advantages Improve access to information Better documentation Improve quality of care Improve productivity and communications Tracking capability Enhanced regulatory compliance IS 531 : Lecture 1

1.2 Monitoring Systems Monitor patient vitals and other findings, or automatically feeding the input into a clinical information system. Immediately alert the caregivers “abnormal” findings, real-time patient conditions IS 531 : Lecture 1

1.3. Order Entry Systems Direct entry of orders for medications and treatments by the physician, nurse practitioner, physical therapist, or other providers (CPOE) Transmitted online orders to the appropriate areas (pharmacy, laboratory, radiology, social services and others …) IS 531 : Lecture 1

Computerized Provider Order Entry - CPOE Improve the quality of care and reduce medication errors Eliminates transcription error Expedites treatment Encourages more accurate, complete orders IS 531 : Lecture 1

1.4. Laboratory Systems Alert providers when new or stat tests results are back or values are critical Send results to clinical system for view Accept input from bedside devices Generate labels for specimen collection Use rules to order additional tests when indicated Address issues such as turnaround time, duplicate testing, errors IS 531 : Lecture 1

1.5. Radiology Systems Allows direct order entry or accepts orders from other systems Provide scheduling of diagnostic tests Generate client instructions Permit transcription of results Provide picture archiving and transmission of images and tracking of film Generate charges once procedures are done IS 531 : Lecture 1

1.6. Pharmacy Systems Provide checks in order and administration process using evidence-based guidelines Reduce errors when used with bar code technology Use lab results, allergy, and interaction information from clinical systems Track medication use, costs, and billing information IS 531 : Lecture 1

Pharmacy May include: In pharmacy dispensing systems (robots) Unit-based dispensing cabinets in care areas Barcode and RFID Medication Administration IS 531 : Lecture 1

Barcode and RFID Medication Administration Use barcode on the unit-dose medication package and patient bracelet to ensure right patient, right drug, right dose, right time, right route Use radio frequency identification (RFID) tags on medication package IS 531 : Lecture 1

E-prescribing Provide a longitudinal prescription record Check formulary compliance and reimbursement Provide alerts about drug interactions Generate reminders to order home meds for the discharged client Eliminate phone authorization for refills IS 531 : Lecture 1

1.5. Physician Practice Management Systems Capture of demographic and insurance data, scheduling, billing, outcome tracking, and report capability May connect to hospital electronic patient records or maintain separate patient records IS 531 : Lecture 1

Long-Term Healthcare Systems For the improved quality of care and efficiency Integration with other systems needed to best serve patients Can include all features seen in other clinical information systems IS 531 : Lecture 1

Home Healthcare May communicate with hospital systems to exchange data Support demands for excessive documentation Improve payment for services because it is easier and quicker to find information needed for billing IS 531 : Lecture 1

2. Administrative Systems Client Registration Financial Payroll and Human Resource Risk management Quality assurance Contract management Materials management Scheduling Other Administrative Systems … IS 531 : Lecture 1

2.1 Registration Systems Admission/discharge/transfer (ADT) systems Collect and store demographic and insurance data that are verified and updated at the time of each visit Critical to operations to ensure correct patient identification and reimbursement for charges IS 531 : Lecture 1

2.2. Financial Systems Charge for service and receive reimbursement Access patient demographic data and insurance information from registration system IS 531 : Lecture 1

2.3. Risk Management Enhance ability to identify potential risks and develop appropriate strategies Track back to the point of origin to address specific liabilities IS 531 : Lecture 1

2.4. Contract Management Provide visibility and control to negotiate better contracts with the third parties (vendors, suppliers …) Ensure contractual obligations, compliances, deliveries IS 531 : Lecture 1

2.5. Scheduling Systems Schedule client appointments and facilities/resources Dates and times, Department, Room, Staff, Equipment, Insurance approval and charging information IS 531 : Lecture 1

2.6. Decision Support and Expert Systems Use organization’s historical data of to facilitate decision making and overall efficiency. What-if analysis, scenario analysis, case-based analysis to select of viable options IS 531 : Lecture 1

Large-scale Database in HIS Able the location, abstraction, comparison of patient information in many format came from many sources, stored in many places Real-time information Network database IS 531 : Lecture 1

Knowledge Representation (Dashboard Display) Display all real-time data/ indicators/ trends from many sources on one screen for overview Allow to go to details of each area (drill-down) IS 531 : Lecture 1

Mobile Devices in HIS Mobile devices to improve the functionality of HIS personal digital assistants (PDA), tablet computers, iPhones / iPads IS 531 : Lecture 1

Impact of Mobile Computing Allow access to data at the point of care to facilitate treatment decisions Test results Evidence-based practice guidelines Facilitate documentation at the point of care for improved accuracy IS 531 : Lecture 1