1. Lab 2: SOLUTIONS

2. Goals  “CENTRICITY” = Centralized records  Many kinds of records = integration  Faster access to records  Support diagnoses  Reduce errors, save lives  Control information explosion, save $$$

3. Trends  Aging population and poor diet  Need for skilled nurses/doctors  Improved IT / Information explosion  Centralization  Security and privacy  Insurance/Legal/Gov’t regulations  Budgets becoming thin

4. I/P/O/F/S analysis: INPUTS  Prescriptions, allergies  x-ray and EKG results  Patient data: family history, tests, visits, insurance, billing  IV pump data, temperature  Heart rate, etc.

5. PROCESSING  System sign-in, analyze patient history  Find test results (searching, organizing)  Integrated system (workflow) admit to treat to discharge.  Monitor patient  Check for prescription side effects  Insurance benefit and Cost analysis

6. OUTPUT  Patient info screens  Treatment DECISIONS  Screens for each function, reports  Bills  Print or display test results  Transmit data/tests to other organizations?

7. FEEDBACK  Beat national standards: time to perform angioplasty Average length of stay Number of errors  Performance Less staff Less legal and insurance costs Since nurses closer to patient: less falls Survey patients and system users Error and exception reports generated by system Monitor costs for ROI

8. STAKEHOLDERS  Government (Medicare, Medicaid)  Insurance co’s  Legal system  Staff, patients  GE and other software providers  HMOs

9. Attribute Analysis:Accurate  No errors, recorded correctly Scanners track medications Doctor enters prescription, sent to pharmacy  Required for correct diagnoses  Should data check on input – ranges  Better than handwriting  No duplication of information

10. Complete  No omissions  Every item required for some function/goal Support diagnoses Insurance and billing Patient and family history Medications and tests

11. Economical  Save Doctor/Nurse/Staff time – fast search  Easy to enter or merge data into system  Remove paper records, file clerks  Quicker diagnoses  Reduce errors – less legal liability

12. Flexible  Support many users/functions Registration desk Billing Insurance Easy to change/add new data types: tests Adapt easy to new regulations, enhancements Many kinds of devices: PDA s, terminals, etc.

13. Reliable  System available 24X7  Can be depended on  No glitches  Correct data displayed every time  Updated by trusted users

14. Relevant  Just data to support task at hand Billing, insurance, diagnosis Display in correct format or detail Don’t display other data Clean out/archive old data

15. Simple  Easy to interpret by staff for given task Standard code system  Easy to use / find info

16. Timely  New data entered quickly into system Tests, medications, procedures New data available to use immediately  System runs quickly, even with many users  Find patient info quickly  Recognize adverse reactions quicker

17. Verifiable  Can check with other sources Login Audit trail (track who made changes) Maybe sign-off by two staff members Connect to other databases (ins. Co.) Compute other values (e.g., medication doses) Nurse checks vital signs

18. Accessible  Convenient for staff member needing access Terminal stations Pocket PC/ PDA – wireless Access to outside organizations/specialists No rummaging through paper files

19. Secure  Access to data only as needed by function Registration/doctors/nurses/accounting Secure Logon/Passwords Wireless : need encryption Data physically protected (backed up)