Introduction to Health Information Systems (HIS)

1. Introduction to Health Information Systems (HIS)

2. What is an Information System? • An information system (IS) is an arrangement of information (data), processes, people, and information technology that interact to collect, process, store, and pro- vide as output the information needed to support the organization (Whitten & Bentley, 2005).

3. What is a Health Information System? Ahealth care information system (HCIS) is an arrangement of information (data), processes, people, and information technology that interact to collect, process, store, and provide as output the information needed to support the health care organization. The discipline of health information systems (HIS) involves a synergy of three other disciplines (Tan, 2005): • Health is the end-purpose of HIS applications. The ultimate goal in applying HIS solutions is to improve the health status of people. • Organization management provides the managerial perspective on developing and using HIS applications for health service organizations. • Information management is how the information is used. To achieve their goals, health managers must rely on health information.

4. Difference between MIS and HIS

5. MIS HIS

6. IT • The health care sector has been slow to adopt health care information systems, m • Health care information is complex, unlike simple bank transactions, for example, and it can be difficult to structure. Health care information may include text, images, pictures, and other graphics. • There is no simple standard operating procedure the provider can turn to for diagnosing, treating, and managing an individual patient’s care. The provider relies on prior knowledge and experience. • Terminologies used to describe health information are also complex and are not used consistently among clinicians. • Health information is highly sensitive and personal. Every patient must feel comfortable sharing such sensitive information with health care providers and confident that the information will be kept confidential and secure.

7. IT 5. Health care IT is expensive, and currently it is the health care provider or provider organization that bears the brunt of the cost for acquiring, maintaining, and supporting these systems. 6. In the U.S. health care system is not a single system of care but rather a conglomeration of systems, including organizations in both the public and private sectors. So the major challenge facing health care is the integration of heterogeneous systems.

8. IT • Integration issues may be less of an issue when a health care organization acquires an enterprise-wide system from a single vendor or when the organization itself is a self-contained system. • However, rarely does a single vendor offer all the applications and functionality needed by a health care organization. Significant progress has been made in terms of interoperability standards, yet much work remains.

9. Challenges Facing HIS • Rising Costs • Medical Errors • Coordination

10. Rising Costs • New diagnostic technologies, such as magnetic resonance imaging devices, lead to increased costs of healthcare. • The rapid rise in healthcare costs sets off a series of events. Briefly stated, the rise in costs forces the insurance programs and employers to contain costs. These efforts of the payers to contain healthcare expenditures have an impact on the hospitals and physicians.

11. Medical Errors • Some estimates show that about 100,000 people die each year in the United States from medical errors that occur in hospitals. • Existing information systems, designed primarily for billing purposes, often fail to record important information about a patient’s condition. • A comparison of claims and patient records reveals that claims do not accurately reflect over half of the clinically important patient conditions. • Even when information system software allows for the entry of additional information, that information often is incorrectly entered.

12. Medical Errors • Important to patient safety is the ordering, transcribing, and administering of medications. • The most common error is in dosing, which occurs three times more frequently than the next type. The top causes of failure include: • Prescribing errors due to deficiency in drug knowledge related to incorrect dose, form, frequency, and route. • Order transcription errors due to manual processes. • Allergy errors due to the systems poor notification to healthcare providers. • Poor medication order tracking due to a cumbersome, inefficient system, that is, dose administration is recorded in more than one location. • Poor interpersonal communication, that is, illegible orders.

13. Coordination • Because of its decentralized nature, the healthcare industry has a very complex business model consisting of a fragmented community of trading partners. • Improvements in information systems are also needed to support the coordination of care. • To provide effective care, health professionals and providers need access to a patient’s treatment history, test results, and related information. • Paper records are difficult to transfer between organizations. Where computer records are kept, the use of incompatible hardware and software configurations makes file sharing difficult.

14. A Failure to Share. My grandmother died because there was no medical history available so that the physician could be aware of her condition and provide appropriate treatment to save her life. She always went to Adventist Hospital for surgery and other procedures. All of her medical histories were at this hospital, and this is where her primary care physician was affiliated. One tragic weekend my grandmother went to see my mom in Adamsville. That morning my grandmother told my mom that she was having stomach pain, and about noon the pain was still there and my grandmother felt tired and short of breath. My mom called the ambulance to take my grandmother to the emergency room. When the ambulance personnel arrived, they took her to St. Mary s Hospital. My mom said no, we want you to take us to Adventist Hospital . The ambulance personnel replied we must take her to the nearest hospital . When my grandmother got to St. Mary s Hospital, the medical staff didn’t know what to do. They asked us to give them my grandmother s medical history. Our family gave all the information that we knew to the nurse. After a few hours, my grandmother cried and asked for medication. The nurse responded that the ER physician was trying to contact her primary care provider for further information so that the ER physician could determine the best treatment. Another hour passed, and nothing was done to stop the pain. The ER physician decided to admit my grandmother to the hospital for further evaluation. After they took my grandmother to her room, still nothing had been done for the pain. My grandmother lay in bed and cried. Two hours later my grandmother went into cardiac arrest. Nurses gave her CPR and were able to bring her back, but she was in a coma and connected to numerous machines. For 10 days my grandmother never awoke or responded to the family. Finally, our family had to make the painful decision to remove the machine that was keeping her alive. The problem was that St. Mary s Hospital did not have any medical records of my grandmother so the ER physician was not able to determine a treatment for her. Her primary care physician wasn’t affiliated with the hospital; he didn’t have privileges to access the facility. Think of the senseless deaths that are the result of an ER physician being unable to make an accurate decision on which care to give a patient.

15. References • “Health Care Information Systems: A Practical Approach for Health Care Management”By Karen A. Wager, Frances W. Lee, John P. Glaser • “Information Systems and Healthcare Enterprises”By Roy Rada