Study for 1 covering chapters 1 - 3 will post on Monday.
montezmack601
HISChapter2.pptxChapter 2: The Scope, Definition, and Conceptual Model of HIS
Introduction
Scope of HIS: all computer systems, networks, and data created and captured by software
The conceptual model: systems and management; health informatics; data and analytics; research, policy and public health
Progression and maturation of HIS
Foundation, use, learning/knowledge, and change
HIS uses in organization and community settings
Systems and Their Management
Scope of HIS Model for the Health Professions
Systems and Their Management
Meaningful health information and data are only as good as the HIS platform and technical foundation that serves as the data source
Data are created and captured in HIS that provide features and functions to support
Workflows (sequences of common tasks) and
Processes (end-to-end methods) of healthcare providers and organizations, patients, and public health professionals
Systems and Their Management
HIS that create and capture data serve as the foundation upon which all other information- and data-related capabilities depend
Essential building blocks of all other advanced uses of data and information
Clinical decision support (CDS)
Artificial intelligence (AI)
Data must emanate from real healthcare processes
Systems and Their Management
Health informatics
The use of information systems and technology to redesign, improve, and recreate the way work is done in medicine, nursing, medical imaging, and public health
Focus on certain quality- or process-improvement objectives, which vary based on the setting
Comprise the “use” of the computer capabilities HIS provide to end users
Systems and Their Management
Data
Primary uses involve transactions that support day-to-day activities of professionals and organizations
Must be aggregated and compiled to create meaningful information
Creating of information and ability to conduct analysis and gain knowledge are dependent upon the creation and capture of individual data elements
Systems and Their Management
Data
”Business intelligence” (BI): Value realized by flexibly analyzing comprehensive stores of data representing the totality of an organization’s/provider’s scope of activity
In health care, the BI concept leads to the notion of “clinical intelligence” (CI)
Systems and Their Management
Research, policy, and public health
Data created and captured in HIS become available for research
Fuel the work of university researchers and enable analysts to measure health and provide evidence for improving efficiency and effectiveness of healthcare processes and outcomes
Policy makers rely on researchers’ findings
Data captures in electronic health record (EHR) systems are aggregated into databases
Systems and Their Management
Data creation/data aggregation
Systems and Their Management
Research, policy, and public health
Public health officials harvest HIS data
Work expands from a individual to national to international in scope
Data are analyzed according to dimensions
Demographic, pathogen, disease, provider, payment mechanism, etc.
Options/variations available for a particular scope are determined by the available data
Progression and Maturation of HIS Through the HIS Conceptual Model
HIS progression and maturation
Progression and Maturation of HIS Through the HIS Conceptual Model
Foundation
Progression begins with a strong foundation of technology and infrastructure and core HIS and their effective and proper management
Subsequent layers cannot exist without this
Progression and Maturation of HIS Through the HIS Conceptual Model
Use (people, process, data, and informatics)
Health informatics
Support of healthcare activities and use of HIS to develop more effective workflows in the care of patients
Success is an outcome of the balanced involvement of people-process-technology
“Informaticist”: intersection of computers; the work of professionals using those systems; and the work of IT professionals designing, building, and implementing
Progression and Maturation of HIS Through the HIS Conceptual Model
Learning/knowledge (Analytics: BI, CI, AI)
Use of data for gaining new knowledge begins when transactional data are created and captured in HIS through use of HIS software and then coalesced into databased and analytics platforms
These data are used for analysis and creation of CDS, BI, CI
AI employs newer technological capabilities
Machine learning, natural language processing
Progression and Maturation of HIS Through the HIS Conceptual Model
Change (global HIS, policy, and research)
Eventually the progression and maturation of use of HIS and data they produce will improve our ability to conduct research, create effective policy, and improve public health through change
Path to change for the better is illuminated by evidence
HIS Uses in Organizational and Community Settings
Mission, vision, and goals of each organization will drive types of systems “core” to its purpose
“What is the fundamental reason for using HIS?”
Requires thinking through types of systems and access to data different kinds of providers will need to deliver care and measure outcomes
Also need to determine types of HIS needed by different types of payers, patients/consumers, public health agencies, or research organizations
HIS Uses in Organizational and Community Settings
Inpatient, outpatient, and ambulatory healthcare provider organizations
Anywhere care is delivered, HIS and data they house play an essential role
Internet was a game-changer in spread of HIS across all settings
Kaiser Permanente, Intermountain Health System, Veterans’ Administration were pioneering organizations
Current norm in U.S. health care is automation
Has created a multibillion-dollar HIS industry
HIS now connect to external partners
HIS Uses in Organizational and Community Settings
Patients’/consumers’ homes
Mobile computing and use of Internet allow patients to access their records and providers, monitor personalize health data
Health-related information is accessible
Best outcomes in organizational performance and clinical care involve patient engagement
People expect to be part of their own healthcare process
Innovators are embracing means of personal connectivity and engagement using IT tools widely applied in other industries
HIS Uses in Organizational and Community Settings
Payers, insurance companies, and government programs and agencies
Private insurance companies, government programs, self-pay
Public health organizations
Exist to monitor, protect, and improve public health
Serve as “safety net” by providing health care for uninsured/underinsured patients
Typically funded by government programs
Some exist to measure, monitor, and report statistics (CDC, Public Health Institute)
Case Example: Vista’s Future: Exchanging Innovation for Commercialization?
Background
The challenges needing a solution
The solution
Anticipated outcomes of the new approaches
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HIS Uses in Organizational and Community Settings
Health information exchanges and regional health information organizations
Health information exchange (HIE): collaborative arrangements with goal of sharing patient-related health information
Aim is to improve timeliness of data availability, support clinicians in emergency situations, make existing data available in an emergency, reduce need to repeat tests
Interoperability: Health Information Technology for Economic and Clinical Health (HITECH) Act and Meaningful Use (MU)
HIS Uses in Organizational and Community Settings
Health information exchanges and regional health information organizations
Regional health information organizations (RHIOs) Organizations designed to accomplish HIE have gained momentum as result of HITECH Act
Work in MU initiated through HITECH Act is being built upon by Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), which combines quality and process improvement activities into one program
HIS Uses in Organizational and Community Settings
External regulatory, reporting, research, and public health organizations
Some third-party organizations set standards (metrics) for healthcare providers to use when measuring quality and cost of services
They then create benchmarks from aggregated data and issue report cards
Some external organizations are state or federal regulatory agencies
Some monitor key metrics regarding quality of care for a particular state or the country as a whole
HIS Uses in Organizational and Community Settings
External regulatory, reporting, research, and public health organizations
The Joint Commission: quasi-regulatory organization that inspects and accredits hospitals based on ability to meet a rigorous set of scored criteria
The Cardiac Reporting Organization: established to monitor cardiac mortality rates nationally
Some third-party reporting relationships are voluntary to enable comparison to similar organizations in an effort to improve cost performance, quality of care, and transparency to communities
HIS Uses in Organizational and Community Settings
External regulatory, reporting, research, and public health organizations
Secondary uses of data: data originally created and captured in the clinical and administrative transactions systems of health provider organizations
Primary uses of data: data created and housed in these providers’ HIS
HIS Uses in Organizational and Community Settings
Summary of Meaningful Use Criteria Stages 1, 2, and 3
HIS Uses in Organizational and Community Settings
Primary and secondary uses of HIS data
Data from the Institute of Medicine Report “Key Capabilities of an Electronic Health Record System: Letter Report.” Washington, DC: The National Academies Press, 2003.
Summary
The layers of the HIS conceptual model provide a comprehensive view of the total scope of HIS activity
HIS and management
Health information
Business intelligence/clinical intelligence
Research, policy, and public health
HIS are used extensively in a wide variety of organizational and community settings
