Healthcare Information and Management Systems Society (HIMSS)

- is a nonprofit organization that works to optimize the use of technologies in a healthcare setting.
 Information systems are interrelated components working together to collect, process, store, and disseminate
information to support decision making, coordination, control, analysis, and viualization in an organization
 Five components:
Hardware
Software
Data
People
Process

Different types of Information system in medical:

1. Clinical Information System (CIS)
- is a computer based system that is designed for collecting, storing, manipulating and making
available clinical information important to the healthcare delivery process.
2. Pharmacy Information System
- is a system that has many different functions in order to maintain the supply and organization of drugs. It
can be a separate system for pharmacy usage only, or it can be coordinated with an inpatient hospital computer
physician order entry (CPOE) system. A PIS paired with a CPOE allows for an easier transfer of information.
3. Health Information System (HIS)
- is a system designed to manage the data collected and stored in any healthcare facility. This includes
doctors’ offices, private and public clinics as well as hospitals. These facilities collect, store, manage and send
patients’ electronic medical records.

Applications for prescribing:

1. Electronic medical record (EMR) systems

- an electronic record of health-related information on an individual that can be created, gathered, managed,
and consulted by authorized clinicians and staff within one health care organization.

Different types of digitized health records that contain most of the same types of information.

A. Personal health record (PHR)

- is health-related documentation maintained by the individual to which it pertains.
- contain the same types of information as EHRs—diagnoses, medications, immunizations, family medical
histories, and provider contact information—but are designed to be set up, accessed, and managed by patients.

B. Electronic health record (EHR)

- is an official health record for an individual that is shared among multiple facilities and agencies. There are
government incentives in many countries to standardize EHRs and ensure that every citizen has one.
- contain information from all the clinicians involved in a patient’s care and all authorized clinicians involved
in a patient’s care can access the information to provide care to that patient.

Advantage of Electronic Medical Records

a. Reduced labor

 Faster review of patient data

 Less time spent calling or emailing appointment reminders
 Easier documentation using templates

b. Minimized resource consumption

 Fewer paper forms, reduced need to print physical copies

 Fewer duplicate or unnecessary lab orders
 Easier medication management

c. Improved care delivery

 Faster time to treatment

 Better medication management
 Earlier and better diagnosis
d. Easier data collection and analysis
 Faster report creation
 More thorough view of data trends
 Inventory control

e. More organizational efficiency

  Improved collaboration between partners and other providers
 Easier billing through coding applications
 Reduced risk of malpractice claims through better documentation

Disadvantages of Electronic Medical Records

a. Cybersecurity issues: While digital storage can be safer than carrying physical papers around, data
breaches are becoming much more widespread.
b. Require frequent updates: Since other healthcare professionals partnered with you, such as personal
trainers and pharmacists, may be using the same electronic health record system as you, it is essential that you
keep patient records updated after every appointment or consultation.
c. Restricted to computer access alone: There is far from a shortage of digital devices, and most doctors
are growing more comfortable with working digitally.
d. Doctor Comments and Medical Jargon
With patient access to medical records, all comments are visible, including negative ones.
Patients may misconstrue comments that only appear negative but, in reality, are not.
e. Computer Luddites
Older patients may not know how to operate computers and electronic software as well as younger patients.
This unfamiliarity may confuse them.

2. Computerized provider order entry (CPOE)

- refers to the process of providers entering and sending treatment instructions – including medication,
laboratory, and radiology orders – via a computer application rather than paper, fax, or telephone.

CPOE is a computer application that accepts physician orders such as:

• Medication
• Laboratory Tests
• Diagnostic Studies
• Ancillary Support
• Nursing Orders
• Involves electronic communication of orders
• Consultation

CPOE has several benefits. :

Reduce errors and improve patient safety: At a minimum, CPOE can help your organization reduce errors by
ensuring providers produce standardized, legible, and complete orders.

Improve efficiency: By enabling providers to submit orders electronically, CPOE can help your organization get
medication, laboratory, and radiology orders to pharmacies, laboratories, and radiology facilities faster, saving time
and improving efficiency.

In short, CPOE is safer and more efficient for providers and patients.

FEATURES OF CPOE
a. Ordering .  Orders are communicated to all departments, improving response time and avoiding scheduling
problems and conflict with existing orders.
b. Patient-centered decision support. The ordering process includes a display of the patient's medical history
and current results and evidence-based clinical guidelines to support treatment decisions.
c. Patients safety features. Allows real-time patient identification, drug dose recommendations, adverse drug
reaction, also reviews and checks on allergies and test or treatment conflicts. Physicians and nurses can review
orders immediately for confirmation.

CPOE HAS MANY BENEFITS FOR BOTH PRACTICES AND PATIENTS:

1. Patient charts are not misplaced or misfiled
2. Comprehensive case documentation and medical history of patient
3. Improve patient care with clinical decision support systems
4. Access to Drug specific information that eliminates confusion
5. Reduced healthcare costs due to improved efficiencies
6. Improve communication between various departments such as lab assistants, doctors, nurses, specialists,
pharmacist etc
7. Reduce errors related to poor handwriting or transcription of medication orders.
8. Patient Safety

Applications for Dispensing and Administration:

1. Bar code medication administration (BCMA) systems
- are electronic scanning systems that intercept medication errors at the point of administration.
- is an inventory control system that uses barcodes to prevent human errors in the distribution of prescription
medications at hospitals.
 BCMA systems also can be used for pharmacy stocking and retrieval processes to help avoid medication
dispensing errors
The Basic:
a. Bar code
- is a graphic representation of data (alpha, numeric, or both) that is machine-readable. -are a way of
encoding numbers and letters by using a combination of bars and spaces of varying widths. Both the lines and
spaces are read, are often used to help organize and index information or prices about an object.

b. Symbology is considered a language in bar code technology.

c. BCMA system consists of a barcode printer, a barcode reader, a mobile computer (with Wi-Fi), a computer server
and software.
* BCR (barcode reader)or scanner, also known as a POS (point of sale) scanner is a hardware input device
capable of reading a barcode using a laser. 
* Barcode printer is a hardware device capable of printing adhesive barcodes that can be attached to a product to
identify it and help keep inventory.

Two types of barcodes:

1. Linear barcodes - "one dimensional" barcode that is made up of lines and spaces of various widths that create
specific patterns
2. 2D barcodes-  incorporate rectangles, dots, hexagons, and other geometric patterns to form scannable squares
and rectangles. 
Types of 2D Barcodes: Data Matrix Codes, QR Codes 

Advantages of BCMA system:

I. REPRESENT UNIQUE IDENTITY OF A PRODUCT 
II. ACCURACY OF DATA INPUT (ERROR FREE)
III. COST EFFICIENT 
IV. REAL TIME DATA COLLECTION
V. MEASUREMENT OF WORK IN PROGRESS THROUGHOUT THE FACTORY 
VI. RAPID ACCESS TO TOTAL PRODUCTION COSTS

Disadvantages of BCMA system::

I. System Failure may cost more delays
II. Scratched or crumpled barcodes may cause problems
III. Data must be coded in the barcode
IV. In laser scanning, durability and cost are the two disadvantages

Types of errors reduced include:

 Administering medication to the wrong patient. It’s crucial to follow hospital protocol when using a BCMA
system. Oftentimes nurses find workarounds to make their shifts a little easier.
 Mistaking one medication for another. Anyone who works in the medical field knows that there are
thousands of drugs on the market. They also know that a lot of them look and sound the same, but treat completely
different symptoms.
 Administering the medication incorrectly. It’s not always clear how a drug should be administered.

Variety of ways to use barcodes.

a. Document Routing
You can batch scan documents with barcodes and save the documents into different groups based on the
barcode value.

b. Inventory
For inventory, barcodes are useful for tracking medical devices or implantable devices. Medical devices are
costly and represent significant investments that a healthcare facility makes. Using barcodes to track their
location, such as when one device is checked out or in and by whom, can help prevent their theft or
misplacement.

c. Asset Tracking
Barcodes can then be used to track devices given to a patient. This can work both ways. You can track a device
to each patient it was given to and you can track who administered it. For the administrator, this can include a
doctor, nurse or other staff. For tracking where the device came from, this can include suppliers or
manufacturers. These trails in an EHR are all helpful in administering patient care or for managing device
vendors and their transactions with you.

3. Robot for medication dispensing (ROBOT)

Robotic dispensing can fill 30-60% of your daily prescription volume. It does this work with extreme accuracy and
safety. The robot actually drives the workflow and eliminates chaos in both high and low volume practice settings.
From the largest hospitals in the world to the smallest retail pharmacies,
 ScriptPro is freeing up pharmacists' time to provide additional patient care and create new revenue services.

When you partner with ScriptPro, you can:

 Manage employment costs and cover peak times without extra staff
 Track will call, partial fill, and out of stock prescriptions
 Dispense prescriptions safely and quietly-no air pressurized dispensing 
 Ensure no cross-contamination-dispenses directly into vial 
 Easily calibrate cells on-site when drugs change

ROBOT-Rx is a centralized drug distribution system that automates the storage, dispensing, return, restocking and
crediting of unit-dose, bar-coded inpatient medications.

4. Automated Dispensing Machines (ADM)

- are a computerized drug storage device.

ADCs allow drugs to be stored and dispensed near the point of care while the control and track the drug
distribution. Hospital pharmacies have traditionally provided drugs to the wards through the ward-stock system. The
ADCs are designed to replace non-automated ward stock storage and have facilitated the transition to alternative
delivery models and more decentralized medication distribution systems. ADCs can improve patient safety and the
accountability of the inventory, reduce costs and lead to increased nursing and patient satisfaction. Because
automated dispensing cabinets track user access and dispensed medications, their use can improve control over
medication inventory. The real-time inventory reports generated by many cabinets can simplify the filling process
and help pharmacy track expired drugs.

Automated Dispensing Cabinets Manufacturers

When looking at this market, we should consider that there are several product lines, including:

 Medication dispensing, administration, and management

 Supply distribution and management
 Cath Lab supplies
 Anesthesia carts
 Health Data Analytics

Company
AcuDose- is the third largest pharmacy
automation product line. Their dispensing
Pyxis- This technology was initially built as units have been recently redesigned, and
an extension of their medication products, offer a feature that allows nurses to hold
their place in the workflow if they get
interrupted and have to come back later.
Omnicell- had clear Plexiglass-like panels on
most sides, making it easier to see supplies.
They also made it faster to get in, get
CAPSA
supplies, and log out, and used a patented
“guiding lights” technology to help users
locate supplies in the cabinets.

5. electronic Medication Administration Record (eMAR)

- Technology that automatically documents the administration of medication into certified EHR technology
using electronic tracking sensors (for example, radio frequency identification (RFID)) or electronically readable
tagging such as bar coding)
Using HCS eMAR, clinicians can document medication administrations, vital signs, and other observations. Alerts
are displayed immediately if clinical actions need to be taken.

benefits of eMAR include the following: 

 Less emphasis on paperwork and more time spent with the patient, which increases efficiency;
 Less administrative errors, with changes being recorded instantly;
 More accurate documentation of a patient’s vital signs, problem lists, pain scales and other information;
 More accurate medication records and other patient history, using medication and other barcodes for quick
scanning and reporting options;
 Reminders to pass along to the patients, including overdue medications, reports needed and more;
 A friendly interface that multiple users can feel comfortable using;
 Modifications and settings that each user can change to accommodate their own industries and preferences;
 Availability on wired and wireless networks and in several hardware options, such as desktop computers,
laptops and handheld devices with touch screens;
 Easier reporting to superiors and patients.