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IS531_Lecture-1.ppt

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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

Healthcare settings

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Information

Data (facts, numbers, characters)

Information (what)

Knowledge (concept / idea)

Wisdom (why, when, how, what-next…)

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From Facts to Knowledge

Data – raw facts about people, places, events, and things that are of importance in an organization.
Information – data that has been processed or reorganized into a more meaningful form for someone.
Knowledge – data and information that is further refined based on the facts, truths, beliefs, judgments, experiences, and expertise of the recipient.
Wisdom – when to apply a certain knowledge

Information Technologies /Information Systems needed for each type of knowledge !

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Roles of Healthcare Professionals in HIS

Data gatherer

Information user

Knowledge user

Knowledge builder

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“Good” Information

Right user

Right format

Right information

Right time

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Information Quality

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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?

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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

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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Information Technology

Computer equipment

Hardware

Software

Telecommunication network

to collect / store, process, and display data

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Information Systems

Use of computer hardware and software to process data into information

for operation management and decision making

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Combinations of hardware, software, and telecom networks use to process data

Combinations of hardware, software, and telecom networks that people build and use to collect, create, and distribute useful data in organizations (for decision making)

Information Technology vs. Information System

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Information Systems

Combination of :

Hardware
Software
Telecommunications networks
Data
People
Procedures (business rules /practices)

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Decision-Making Levels
of an Organization

Organizational Levels

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Decision-Making Levels
of an Organization

Executive Level
Long-term decisions (Strategies)
Unstructured decisions (Competitions)
Managerial Level
Decisions covering weeks and months (Tactics)
Semi-structured decisions (Effectiveness)
Operational Level
Day-to-day decisions (Operations)
Structured decisions (Efficiency)

Information Technologies /Information Systems needed for each level of decision making !

Information Systems across Organizational Boundaries

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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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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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Types of Healthcare Information Systems

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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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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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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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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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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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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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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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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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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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Pharmacy

May include:

In pharmacy dispensing systems (robots)

Unit-based dispensing cabinets in care areas

Barcode and RFID Medication Administration

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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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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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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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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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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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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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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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2.2. Financial Systems

Charge for service and receive reimbursement

Access patient demographic data and insurance information from registration system

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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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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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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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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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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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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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Mobile Devices in HIS

Mobile devices to improve the functionality of HIS

personal digital assistants (PDA),

tablet computers,

iPhones / iPads

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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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Healthcare Settings

Categories of Hospitals & Facilities

Types of Patients

Types of Services

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Categories of Hospitals & Facilities

Acute Care Facilities
Full rage of healthcare services
Ancillary services
Single vs multi-hospitals
Bed count / bed size
Length of stay : long/short term(acute)

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Categories of Hospitals & Facilities …

Categories
Critical access hospitals (emergency)
General hospitals
Specialty hospitals
Rehabilitation hospitals
Behavioral health care hospitals

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Types of Hospital Patients

Ambulatory and outpatients
Ambulatory surgery patients
Emergency care patients
Inpatients General hospitals
Observation patients
Sub-acute care

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Ambulatory & Outpatient Care

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Behavioral Health Care Facilities

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Home Care and Hospice

Skill Care
Durable medical equipment
Personal care and support services / home infusion care
Hospice

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Long-term Care

Adult day care
Assisted-living facilities
Continuing Care Retirement Communities
Intermediate care facilities
Long-term care hospitals
Residential care facilities
Nursing facilities
Rehabilitation facilites

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Managed Care

Exclusive Provider Organization (EPO)
Integrated Delivery Systems (IDS)
Health Maintenance Organization (HMO)
Point-of Service Plan (POS)
Preferred Provider Organization (PPO)
Flexible Benefit Plan

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Federal, State, and
Local Health Care

Veterans Health Administration (VHA)
Medicare
Medical
Public Health Service
etc…

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