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Electronic Health Information System

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Institution

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Electronic Health Information System

The impact of health information technologies on patient care has increased significantly

over the past few years, with growing evidence of their revolutionary effects accelerating their

adoption (Dudhat & Bajaj, 2020). This article describes the types of health information systems

(HIS) required to convert a healthcare organization into an electronic HIS (e-HIS) and their

integrations. Electronic HIS enables healthcare organizations to integrate and exchange patients'

health information quickly and at lower costs (Mäenpää et al., 2009). Converting the healthcare

organization’s data management system into an e-HIS will convey these benefits to the

institution and illuminate existing opportunities availed by the shift to digital technology.

Therefore, careful design and in-depth research were critical in ensuring the implemented

electronic HIS met all the organization’s requirements for optimal patient care.

The e-HIS types required to convert the healthcare organization, in this case, would

consist of an electronic medical record (EMR), a medical practice management system (MPMS),

an e-prescribing software, a laboratory information system (LIS), remote patient monitoring

(RPM), and a patient portal. Each of these HIS types would be essential in providing quality

patient care services in the healthcare organization. The flow diagram for the healthcare

organization equipped with the information systems shown in the appendix (figure 1) indicates

how the operations flow from patient registration to checkout. The initial stages of the process

involve patient registration, requiring an EMR for recording patient information. The EMR also

included information concerning clinical visits, tests, and treatments associated with the patient.

Additional tests sent to the lab enter the LIS that returns the results to the EMR for future

reference. An e-prescribing software generates electronic prescriptions that the EMR logs and

sends to the pharmacy for disbursement, avoiding mix-ups and tedious manual work. The MPMS
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manages administrative work for the healthcare organization, including billing the patients,

scheduling operations, and supporting decision-making with a master patient index. A patient

portal was necessary for enabling patients to track their health information and communicate

with their physicians when necessary.

Clinical Services

This section discusses three clinical services supported by the e-HIS outlined above,

including the data entry points associated with each service, the roles of staff at each data entry

point, and areas that would benefit from improvements in the HIS. The first clinical service

enhanced by the e-HIS in the healthcare organization will be the diagnostic services, which will

be more secure, timely, accurate, and cost-effective, given the EMR’s utility. The EMR contains

the patient’s health history, past test results, allergies, and past and active treatments (Kruse et

al., 2018), making the diagnostic work easier for a physician with access to these records. EMRs

collect data from patients immediately after registering into the healthcare facility and keep track

of the patient's information at each stage of treatment until they check out. Clinical staff and

systems fill relevant patient information into the EMR as their statuses change during their

interactions in the healthcare facility (Kruse et al., 2018). Therefore, subsequent clinical visits

are smoother since the staff can easily access the patient's medical history and other information

for diagnosis.

Medication management was the second clinical service that will benefit from the HIS

described in the previous section. This clinical service involves managing access to, disposing,

and storing medication in the healthcare facility to enhance patient and staff safety. The systems

that handle medication data management include the MPMS and e-prescribing software. Each of

these systems governs various policies concerning medication access and data control
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concerning the storage and disposal of medication in the facility. The MPMS automates most

administrative tasks and requires data input from organizational managers to configure

operations such as medication disposal and storage processes (Brook, 2020). The e-prescribing

system receives data from the physician authorizing patients to receive medication from the

pharmacy. The organization benefits from the controlled procedures for access and disposal with

durable logs tracking any operation concerning medicines for safety and accountability.

The third clinical service that will utilize the e-HIS will be the treatment services (care

plans) afforded to the patients. The LIS and RPM services will enhance the quality of care

services offered to the patients by improving the range of diagnostic services and extending the

communication range between patients and physicians. The LIS receives data from physicians

during the diagnosis process, records lab results in the EMR and returns the outcomes to the

physician for further analysis (Bell, 2018). RPM is becoming more valuable in modern health

organizations since it helps physicians monitor patients outside the facility in real-time by

collecting data automatically and transmitting it to the healthcare professional. The patient portal

coordinates external communications between patients and the healthcare facility by providing

authorized users access to patient data and exchange channels between patients and physicians

(Brook, 2020).

Clinical Information

This article section examines the range of clinical information collected and managed by

the e-HIS discussed above. The clinical information categories in this section include the

patients’ personal information, treatment data, and medical outcomes from various clinical

services offered by the organization. The EMR is responsible for collecting, storing, and

disseminating patient personal information in the healthcare organization. The EMR also feeds
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the patient data into the patient portal system. It is the central repository for the patients' general

information, including medical histories and allergies (Dudhat & Bajaj, 2020). Therefore,

effective utilization of the EMR could significantly improve population health and patient

outcomes, revealing the usefulness of the e-HIS.

Clinical information regarding patient treatments falls into various categories, including

laboratory tests, diagnostics, medication prescriptions, and remote monitoring. The treatment

data in the e-HIS comes from clinical staff and medical professionals involved in treating the

patient. For instance, the data in the LIS comes from the physician requesting the tests and the

lab technicians' reports of the tests conducted. The LIS also shares this treatment data with the

EMR to ensure the patients' records are trustworthy after each test. Prescription information

entered into the e-prescribing system by the medical professional after diagnosing the patient

notifies the pharmacy of the incoming medication request. After dispensing the medication, the

pharmacy notes the action in the EMR, keeping the patient records correctly after each change.

Patients could also access medical outcome information from the patient portal, which

extends the EMR to the external world. Although patient portals expose the e-HIS to external

threats, they limit exposure by providing access to static patient records and secure

communication channels with the healthcare organization’s servers. The MPMS also would

require access to the medical outcome records to support decision-making in the clinic.

Therefore, information flow management will be crucial in selecting the best approach to

implement the e-HIS, as shown by their relationships in the discussion above.

Data Entry Role

As discussed in previous sections, the data entry roles for the e-HIS proposed above vary

with the system components. However, the overall importance of dividing the data entry roles
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was maintaining data integrity in the information systems and promoting accountability in the

healthcare facility. An unstructured e-HIS approach results in messy databases that introduce

challenges when troubleshooting operations or data entry errors. Roles explicitly determine the

users authorized to perform data entry and access procedures in the e-HIS, reducing security

threats and medication errors. Therefore, a careful user roles scheme, such as the one applied in

this case, was essential for an integrated electronic HIS.

PDSA

The Plan-Do-Study-Act (PDSA) process improvement approach has shown significant

potential in enhancing healthcare procedures and systems over the past few years (Coury et al.,

2017). This article section outlines the benefits of applying the PDSA approach to the e-HIS

discussed in the previous sections. A critical area that requires significant improvement is the

patient portal, which requires substantial security enhancements to increase its utility to the

users. The PDSA approach would help introduce the new programs associated with the new e-

HIS to the clinical environment by identifying the areas that will benefit most from various

implementation processes and planning how best to incorporate them (Coury et al., 2017). This

approach works best when the system required to intervene in the process is readily available and

well-known to the researcher. The other significant benefit associated with the PDSA approach is

its ubiquity in clinical research, making it easily adaptable in most healthcare organizations

(Coury et al., 2017). Therefore, adapting the e-HIS to the PDSA quality-improvement approach

will be easier in the clinical environment discussed above, given the prevalence of clinical

researchers in the organization.

Conclusion

In conclusion, this article explored various health information systems that will form the

core e-HIS for a healthcare organization and the flow of information between them. The e-HIS

includes several components, such as the EMR, LIS, MPMS, e-prescribing software, and RMS.

It also incorporates a patient portal to give customers access to medical information outside the

healthcare facility. This article also discussed the clinical services and information associated

with the e-HIS and the roles at each data entry point in the system. The article's final section

explored the benefits of using the PDSA quality improvement approach for this information

system.
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References

Bell, A. (2018). Types of Health Information Systems. Scott-Clark Medical. Retrieved 25 August

2022, from https://www.scott-clark.com/blog/types-of-information-systems-used-in-

healthcare-facilities.

Brook, C. (2020). What is a Health Information System? Digital Guardian. Retrieved 25 August

2022, from https://digitalguardian.com/blog/what-health-information-system.

Coury, J., Schneider, J. L., Rivelli, J. S., Petrik, A. F., Seibel, E., D’Agostini, B., ... & Coronado,

G. D. (2017). Applying the Plan-Do-Study-Act (PDSA) approach to a large pragmatic

study involving safety net clinics. BMC health services research, 17(1), 1-10.

Dudhat, N., & Bajaj, S. (2020). 8 Types of Health Information Technology and Healthcare

Software System. SoftwareSuggest Blog. Retrieved 25 August 2022, from

https://www.softwaresuggest.com/blog/types-of-health-information-technology-and-

healthcare-software.

Kruse, C. S., Stein, A., Thomas, H., & Kaur, H. (2018). The use of electronic health records to

support population health: a systematic review of the literature. Journal of medical

systems, 42(11), 1-16.

Mäenpää, T., Suominen, T., Asikainen, P., Maass, M., & Rostila, I. (2009). The outcomes of

regional healthcare information systems in health care: a review of the research

literature. International journal of medical informatics, 78(11), 757-771.

Appendix

Figure 1: The flowchart above represents the electronic health information system from customer

registration to checkout (stop), as discussed in the first section of this article. The chart also

shows how data flows in the system (as indicated by the arrows).