Information Management In The Egyptian Hospitals Prof. Nagwa El Hosseiny Quality Consultant MOH April 2009

Management of Communication and Information Providing patient care is a complex process that is highly dependent on the communication of information.

Management of Communication and Information This communication is : To and with the community, To patients and their families, and to other health professionals. Failures in communication are one of the most common root causes of patient safety incidents.

Management of Communication and Information To provide, coordinate, and integrate services, health care organizations rely on Information about : the science of care, individual patients, care provided, results of care, and their own performance. as well as individual and overall organization performance.

Information management The creation, use, sharing, and disposal of data or information across an organization. This practice is critical to the effective and efficient operation of organization activities..

Information management Like human, material, and financial resources, information is a resource that must be managed effectively by the organization’s leaders. Every organization seeks to obtain, manage, and use information to improve patient outcomes

Information management Although computerization and other technologies improve efficiency, the principles of good information management apply to all methods, whether paper based or electronic.

Types of information systems in a health care organization Clinical information systems Administrative information systems Management support systems

Clinical Information Systems 1. Electronic/paper Medical Records It’s a useful source of patient information Important criteria: Storage Data availability Accessibility Security

2. Patient Care and Departmental Clinical Systems: Laboratory Information Systems: document and/or directly capture information from Laboratory machines. Pharmacy Information Systems : a) dispensing of medications, b) control inventory, c)automatically compare drug orders with dosages d) provide information about contraindications, e)online order entry and drug compatibility checks

2. Patient Care and Departmental Clinical Systems: Radiology Information Systems : generate, analyze, and manage images (PACSs) - Filmless Department Nursing Information Systems : features include scheduling for medication distribution and other nursing duties.

3. Clinical Decision Support Systems This systems analyze data from clinical information systems, search for unusual patterns or possible adverse effects, recommend alternative actions to remedy the situation, predict and alert for drug—drug interactions. The system could also provide a complete plan of care based on the patient's health history and clinical assessment. CDS systems can save lives, reduce healthcare costs, improve communication, increase clinician and patient satisfaction, and enhance the overall process of care

B- Administrative Information system 1. Patient Registration Systems cover admission, discharge and transfer systems. Also includes diagnostic and length of stay (LOS) and demographic and insurance information.

B- Administrative Information system 2. Financial Information Systems First computer systems used by healthcare organizations include payroll preparation and accounting, accounts payable, patient accounting including billing and accounts receivable processing, cost accounting, general ledger accounting, budgeting and financial statement preparation.

B- Administrative Information system 3. Human Resource Management Systems Personnel expenses make up 60 to 70 percent of the operating budgets of health- care institutions. These systems report staff productivity, labor expense by cost center, monitor turnover and absenteeism, assess training and continuing education needs, forecast staffing needs and review applicants' qualifications

B- Administrative Information system 4. Materials Management Systems The functions cover electronic purchasing and inventory control, bar coding and wireless devices for tracking supplies and materials. Its benefits include savings, reductions in inventory, greater efficiency, fewer lost charges and lower labor costs.

B- Administrative Information system 5. Facilities Management Systems Well-maintained physical facilities are critical to providing high-quality patient care and a safe comfortable environment for patients and their families. Common functions include preventative maintenance, energy management, and project management and scheduling.

C- Management support systems: 1- Management Information Systems These modules cover day-to-day operations of the organization. Its types include periodic, scheduled reports of the daily hospital census and financial monthly reports of the organization. They also cover exception reports when exceptional or out-of-the-ordinary conditions occur. On-demand reports could also be generated.

C- Management support systems: 2- Strategic Decision Support System It allows managers to manipulate data It also monitors and evaluates key performance indicators and trends, perform simulations of revenue and expense patterns based on various assumptions and estimate potential demand for services within different market areas.

C- Management support systems: C- Management support systems: 3- Executive Information Systems These are decision support system used by high-level managers. It draws data from the organization's other databases. It reorganizes and distills large quantities of data into a form that meets the executive's information needs. It presents information on the summary level, but it also allows a user to "drill down", e.g., :EIS typically provides yearly length-of-stay and average daily census statistics in addition to financial data

Current Situation in Hospitals 1-No unified medical number for every patient 2-Incomplete paper medical records for inpatients 3-No medical number and medical file for outpatients 4-Manual ordering for labs, radiology 5-Manual reports 6-Manual incomplete, inaccurate and illegible drug ordering and dispencing 7-Multiple langauges in the medical file 8-Incomplete manual HR and inventory files 9-No data collection/analysis

Accordingly There is high incidence medical and medication errors Lack of patient safety Lack of performance evaluation system

Egypt Ministry of Health National health information technology coordinator, recently called for expansion of such interoperability to the flow of clinical and other administrative data, citing its importance for encouraging health care IT investment and facilitating health care reform

Egypt Ministry of Health Ministry of health in collaboration with Ministry of Information planned to introduce electronic information system in the governmental hospitals Centrally at MOH, there is a complete renewal of the information system to ensure direct communication with governorates, collect data and improve accordingly National Quality results: Results of PHC accredited units, results of hospital inspection, results of indicators will be available online for patients, in addition to topics for patients awareness and to enhance compitition between health care organizations

New Insurance System A complete Information management system is a cornerstone of the insurance system Communication of patients data between the primary care,investigation sites and the hospital wherever the patient goes.

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