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Current and Emerging Use of Clinical Information Systems

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39 views28 pages

Current and Emerging Use of Clinical Information Systems

Uploaded by

Subha
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
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Current and Emerging

Use of Clinical
Information Systems

Chapter 5
Learning Objectives
Describe the purpose, use, key
attributes, and functions of major types
of clinical information systems used in
health care.
Define the key components of an EHR
system and the current status of these
systems.
Discuss the major barriers to EMR and
EHR adoption and strategies being
employed to overcome them.
Learning Objectives
Give examples of how clinical information
systems might affect patient safety,
quality, efficiency, and outcomes.
Define HIE, RHIO, NHIN and identify
challenges associated with sharing
information across organizational
settings.
Outline
•Clinical
Information Systems—
adoption, use, value
– Electronic Medical Record/Electronic
Health Record
– Computerized Provider Order Entry (CPOE)
– Medication Administration
– Telemedicine
– Telehealth
– Personal Health Record
•Fitting Applications Together
•Information Exchange Across
Boundaries
•Overcoming Barriers to Adoption
Electronic Medical
Record
An electronic record of health-
related information on an
individual that can be created,
gathered, managed, and
consulted by authorized
clinicians and staff in one health
care organization.
(Source: National Alliance for Health Information Technology,
2008)
Electronic Health
Record
An electronic record of health-related
information on an individual that
conforms to nationally recognized
interoperability standards and that can be
created, managed, and consulted by
authorized clinicians and staff across
more than one health care organization.
Core Functions
Where are we today?

Broad Spectrum
EMR Adoption in
Hospitals
EMR Use in Physician
Practices
Value of EMR
Improved quality, outcomes and safety
 Computerized reminders and alerts
 Improved compliance with practice guidelines
 Reduction in medical errors
Improved efficiency, productivity, and
cost reduction
Improved service and satisfaction
Health Care Information Systems: A Practical Approach for Health Care Management 2nd Edition W
ager ~ Lee ~ Glaser
Other major types of
CIS
Computerized provider order entry
(CPOE)
Medication administration using
barcoding
Telemedicine
Telehealth—for our purposes, we will
focus on online communication (e.g.
email) between patients and providers
Personal health record
CPOE
• Driven by need
to improve
patient safety
• Automates the
ordering
process
• Accepts orders
electronically,
provides
decision
support, may
aid in diagnosis
and treatment
Use and Status of
CPOE
Estimates vary from 5-15%; higher
estimates usually indicate that
physicians are not direct ordering
Teaching hospitals more likely to use
Many organizations are in planning or
early implementation stages
Barriers to CPOE use
• Complexity of ordering process
• Physician entry an issue
• Takes longer to place order; many
systems are ‘cumbersome’, take too
many steps
• Incentives may not be aligned with
use
• Lack of confidence in system reliability
• Insufficient training
• Mandating use – should you?
Medication
administration
• Use of barcoding • More widely
becoming more accepted
widespread • Has been used
• Aids in correctly successfully by
identifying many health care
patient, drug, organizations
dose, etc.
• Again, has
potential to aid in
• HIMSS making sure the
implementation right meds, get to
guide—good the right patient,
resource at the right dose…
Telemedicine
• Use of
telecommunciations
for the direct
provision of care to
patients at a
distance
– Over 200 telemedicine
programs in nation
– Store and forward
– Two-way interactive TV
• Funding an issue
• Cost effectiveness
not fully known
Telehealth
Using telecommunications to
communicate with patients and
deliver services
 Email communication
 Refilling prescriptions
 Registering patient
 Scheduling appointments
Telehealth
Current use of email communication
between patients and physicians
Value to patients and providers
Issues
 Complexity of infrastructure
 Degree of integration
 Message structure
 Cost
 Security
 Reimbursement
Personal Health
Record
An electronic record of health-related
information on an individual that
conforms to nationally recognized
interoperability standards that can
be drawn from multiple sources while
being managed, shared, and
controlled by the individual.
(Source: National Alliance for Health Information
Technology, 2008)
PHR
Consumer-
empowerment
Comprehensive
Longitudinal
Individual
controls
Companies
offering
 Insurers
 Microsoft
 Google, others
Personal Health Record
Ad

http://www.aetna.com/showcase/phr/demo2.htm
l

Health Care Information Systems: A Practical Approach for Health Care Management 2nd Edition W
ager ~ Lee ~ Glaser
Information Exchange
Health Information Exchange
Regional Health Information
Organization
National Health Information Network
Fitting Pieces Together
Barriers to Adoption &
Strategies for Overcoming Them
Financial
Organizational or Behavioral
Technical
Strategies for Overcoming
Barriers
What strategies are being employed
to help overcome—
 Financial barriers?
 Behavioral barriers?
 Technical barriers?
Summary
• Examined five clinical information
systems—their current use, status,
and value & their relationship to each
other
• Discussed the value of sharing health
information across organizations
• Discussed the three major barriers to
adoption of these systems—financial,
behavioral and technical and
strategies to overcome them

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