1. Lecture 1 Healthcare Information Systems (Ch. 6)

2. 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
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3. Information Data (facts, numbers, characters) Information (what)
Knowledge (concept / idea)
Wisdom (why, when, how, what-next…)
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4. Roles of Healthcare Professionals in HIS
Data gatherer
Information user
Knowledge user
Knowledge builder
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5. “Good” Information Right content Right format Right time Right user
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6. 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
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7. 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
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8. Information Technology
Computer equipment
Hardware
Software
Telecommunication network
to collect / store, process, and display data
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9. Information Systems
Use of computer hardware and software to process data into information
for operation management and decision making
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10. Information Systems Combination of : Hardware Software
Telecommunications networks
Data
People
Procedures (business rules /practices)
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11. Organizational Levels
Decision-Making Levels of an Organization
Organizational Levels
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12. Information Systems across Organizational Boundaries
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13. Healthcare Information System
Healthcare Information System (Hospital Information System HIS)—a group of systems used to support and enhance healthcare business functions
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14. 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
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15. Types of Healthcare Information Systems
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16. 1. Clinical Information Systems
Nursing
Monitoring
Order entry
Laboratory
Radiology
Pharmacy
Other Ancillary Systems ( Physician Practice, Ambulatory, Long-term, Home-care …)
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17. 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 …
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18. Nursing Information System Advantages
Improve access to information
Better documentation
Improve quality of care
Improve productivity and communications
Tracking capability
Enhanced regulatory compliance
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19. 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
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20. 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 …)
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21. Computerized Provider Order Entry - CPOE
Improve the quality of care and reduce medication errors
Eliminates transcription error
Expedites treatment
Encourages more accurate, complete orders
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22. 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
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23. 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
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24. 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
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25. Pharmacy May include: In pharmacy dispensing systems (robots)
Unit-based dispensing cabinets in care areas
Barcode and RFID Medication Administration
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26. 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
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27. 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
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28. 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
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29. 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
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30. 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
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31. 2. Administrative Systems
Client Registration
Financial
Payroll and Human Resource
Risk management
Quality assurance
Contract management
Materials management
Scheduling
Other Administrative Systems …
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32. 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
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33. 2.2. Financial Systems Charge for service and receive reimbursement
Access patient demographic data and insurance information from registration system
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34. 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
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35. 2.4. Contract Management
Provide visibility and control to negotiate better contracts with the third parties (vendors, suppliers …)
Ensure contractual obligations, compliances, deliveries
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36. 2.5. Scheduling Systems
Schedule client appointments and facilities/resources
Dates and times, Department, Room, Staff, Equipment, Insurance approval and charging information
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37. 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
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38. 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
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39. 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)
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40. Mobile Devices in HIS
Mobile devices to improve the functionality of HIS
personal digital assistants (PDA),
tablet computers,
iPhones / iPads
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41. 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
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