Lecture 1

Healthcare Information Systems

http://www.csun.edu/~dn58412/IS531
 Learning Objectives
1. Information Technology vs. Information
Systems
2. Information Systems in Organization
3. Various types of information systems
used within healthcare institutions.
4. Functions/features of some Clinical
Information Systems
5. Functions/features of some
Administrative Information Systems
6. New IT in HIS
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 Information

• Data (facts, numbers, characters)

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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
• 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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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

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 Information Systems
• Use of computer hardware and
software to process data into
information

• for operation management and

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

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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
Organizational Levels
of an Organization

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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 • Administrative
systems systems
– Directly support – Indirectly support
care patient care
– Individual systems – Individual systems
may be standalone may stand alone
– Goal: data – Goal: data
exchange among exchange among
systems 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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