Topic 2: HealthCare Information System

Interoperability

"the ability of two or more systems or components to exchange information and to use the information that has been exchanged."

Healthcare decision support:

A category that encompasses other DSS than mentioned above. For example, a pharmacy order-entry DSS might warn of possible drug interactions or prescribing errors.

Benefits of System Integration

Allows instant access to applications and data Improves data integrity with single entry of data Decreases labor costs with single entry of data Facilitates the creation of a more accurate, complete patient record Facilitates information tracking across the organization

Nursing decision support

Assists nurses in the delivery of care. Some nursing DSS incorporate patient preferences into the nursing care plan. They also include alerts and monitoring.

Executive decision support

Assists the administrative staff in their decision making. Provides access to internal and external data sources that may be used for strategic decisions, budgeting, and monitoring financial and productivity data.

Clinical decision support

Assists the clinician in caring for the patient. A clinical DSS may formulate possible diagnoses given a set of symptoms, or help the clinical person decide on a specific course of care for a patient. A clinical DSS may include alerts and reminders within an overall clinical information system.

Pharmacy information systems

Automated inventory control and ordering, monitoring allergies and drug interactions. Integration with laboratory information systems allows for suggested medication changes based on lab results and potential drug toxicity. Maintains required records for dispensing narcotics. Computerized physician order entry (CPOE) allows providers to order medication online without the use of paper, telephone, or fax machines. E-prescribing allows physicians to enter a prescription into an information system that electronically communicates to the patient's pharmacy.

Materials Management System

Automates inventory control, tracks and charges for supplies, and orders supplies. It may also interface with the accounts payable system to obtain payment discounts.

Human Resource Information System

Automates the functions of tracking employee records. They monitor turnover and absenteeism. A database is maintained on all personnel to track hiring, credentials, performance evaluations, and job transfers. Compensation analysis may also be a function of human resource information systems.

Radiology information systems

Automation of diagnostic and treatment procedures, scheduling of tests, results reporting, instructions to patients, and file room management such as film location. Picture Archiving and Communication System (PACS) uses digital images as a replacement for traditional radiology films. This provides enhanced images that can be electronically sent and viewed.

Certification Commission for Healthcare Information Technology (CCHIT)

CCHIT is a nonprofit organization whose function is to certify electronic health records (EHRs). They have defined which capabilities are needed in EHR systems; they have developed criteria with which to certify the various electronic health record systems.

Financial planning

Decision support systems used to evaluate future financial needs and performance of the organization.

Capital budgeting

Determines long-term expenditures for approval and management. Forecasts expected cash flows and determines risk.

Nursing information systems

Generates a nursing work list, collects and views patient information for automated nursing notes. Provides access to information such as online literature searches, drug information, and hospital policies and procedures. Manages the administrative functions of nursing care such as scheduling, staffing, and performance reporting. Graphic display of vital signs.

Laboratory information systems

Generates specimen labels, results reporting, automated processing of specimens, scheduling specimen collection, quality control and management reporting. Benefits include identification of critical lab values and abnormal values due to age or sex, prevention of duplicate testing, and treatment suggestions for microbiology culture and sensitivity testing.

Management Support Systems

Management support/information systems are part of an organization's internal control system. A management information system monitors the performance of the organization by providing reports on the day-to-day activities for decision making and planning. Performance reports may be run at scheduled times or on demand. Management information systems may be stand-alone systems or integrated into the clinical information systems mentioned previously. Management information systems are intended to be used by administrative and supervisory personnel. The purpose is to automate reporting of management functions such as staffing, organizing, and communicating.

Investment management

Manages (balances) portfolios of short term and high return and risk investments. Analyses investment portfolios.

Contract Management System

Monitors contracts with vendors and suppliers

Risk Management System

Monitors insurance claims, schedules safety inspections, provides OSHA and other regulatory updates, and automates incident reporting.

Facilities Management Information System

Monitors preventive maintenance schedules on facility equipment and monitors energy consumption. It may also be used for the project management of construction projects and the staffing of housekeeping and maintenance personnel.

Operating Systems

Operating systems control the basic functions of the computer, both the hardware and the software. Some of these basic functions are: Serving as the interface between the user and computer Serving as the bridge between business transaction application systems Ensuring that when different programs are running at the same time, they do not interfere with each other Ensuring that unauthorized users do not have access to the systems ​ Note: Operating systems exist for all categories of computers: mainframes, minicomputers, and personal computers. There are several kinds of operating systems, including UNIX, Microsoft Windows, and Mac OS. ​

Accounting

Records and reports how funds flow through the organization. Functions include accounts receivable and payable as well as payroll. General ledger functions combine all processes and produce financial statements.

Cash management

Tracks information with regard to receipts, disbursements, and cash on hand. Forecasts receipts and disbursements using decision support systems.

active decision support system

actually processes data and shows solutions for a problem based upon the data provided. Artificial intelligence is an example of an active decision support system.

multitasking operating system

allows a single user to have more than one software process (task) running at the same time. Most people have this type of operating system on their desktop and laptop computers. An example of multitasking: a user can write a note in a word-processing program while downloading a file from the internet and printing an email message.

Multi-user operating system

allows many people to use a computer's resources simultaneously. An example of this type of operating system would be a client-server network configuration. Each client is able to access the server at the same time.

single-user operating system

allows only one person to access the computer at a time.

graphical user interface (GUI)

allows the individual to use a pointing device such as a mouse to simply click on a particular screen icon that represents a specific command. The user no longer has to enter complicated text commands.

interface

functions as a bridge between systems and translates data format from one system into a data format that another system can understand.

multiprocessing operating system

has more than one central processing unit (CPU) within the computer system. The additional CPUs may be reserved for special processing functions, such as complex imaging in a 3D application.

Unstructured problems

have no routine or structure associated with them at all. ​

DSS (Decision Support Systems)

is an interactive system that helps managers make decisions. A decision support system is not meant to replace the human decision-making process, but, rather, provides information to help (support) the human decision-making process. Decision support systems are used to help solve semi-structured and unstructured problems.

point-to-point interface

is created between only two systems. This type of interface was one of the first types of interfaces to be used in healthcare.

interface engine

is software used to create and manage multiple interfaces among different systems. An interface engine is one component of good user interface design.

System Integration

is the process of connecting disparate systems so that the functionality of each works together with the others.

A bidirectional interface

permits data to flow from one system to another and back again. In the example, the medication error could be corrected within the pharmacy system and then sent back to the clinical information system.

unidirectional interface

permits data to flow from one system to another, but not back again For example, a medication order is entered into a clinical information system (CIS) and is then transmitted (one-way) to the pharmacy information system for completion. Any error noticed by the pharmacist would need to be corrected in the CIS separately and re-sent to the pharmacy system to update

Semi-structured problems

problems in which only some of the decision process phases are structured have well-defined problems, but the inputs and outputs (solutions) are not as structured or defined.

Administrative Systems

refer to the systems that support the daily operations of an organization.

passive decision support system

simply collects and organizes data. It displays the data but does not suggest a specific decision.

Clinical Information Systems

support the delivery of patient care. Clinicians use the systems to plan, implement, and evaluate care. Most of the systems are located within the specific department, but more integration is taking place. Examples of clinical information systems include: Laboratory information systems, Radiology information systems, Pharmacy information systems, Nursing information systems

Financial Systems

support the essential business operations of a healthcare organization. THEY were among the first automated systems implemented in healthcare, dating to the 1960s. The healthcare industry followed the use and functions already in place in other industries.

Elements of decision support system

usually includes: The knowledge base (or database) containing the rules and associations The model (the decision context or user criteria for the problem) The user interface that combines the rules from the knowledge base and the model