Information Flow across the Hospital

1. Information Flow across the Hospital Kenrick Cato

2. How to Ask Questions During the Seminar Submit Questions Here If you experience technical difficulties please call, 1-800-263-6317 Press 1 for GotoWebinar then 2 for TechSupport

3. B.S. in Health Information Management • What will I learn at SPS? • Health Data Management • Health Statistics, Biomedical Research, and Quality Management • Health Services Organization and Delivery • Information Technology and Systems • Organization and Management • What if I have a degree in HIT? See - http://online.sps.cuny.edu Call - 212-652-CUNY (2869)

4. B.S. in Health Information Management • Possible jobs include: • HI Analyst, Information Auditor, Clinical Data Analyst, Privacy Officer, Compliance Specialist, and Quality Assurance … • You can work in Hospitals, Doctor’s Offices, Ambulatory Setting, Insurance Companies, Government (Medicare/Medicaid, NIH), and NonProfit Organizations.

5. B.S. in Health Information Management HOMEWORK ASSIGNMENT Check out Indeed.com. Search for RHIA within 100 miles of your local area. What results did you get? How many jobs and what were the titles?

6. B.S. in Health Information Management

7. Information Flow across the Hospital Kenrick Cato

8. So What! Patient Safety – • Finding - Between 44,000 to 98,000 people die each year as a result of preventablemedical errors Institute of Medicine. To Err is Human: Building a Safer Health System. Washington, DC: National Academies Press; 1999 Quality Health Care- • Recommendation -Knowledge is shared and information flows freely Institute of Medicine. Crossing the Quality Chasm: A New Health System for the 21st Century. Washington, DC: National Academies Press; 2001 Administrative Costs- • Finding - The average U.S. hospital devoted 24.3 percent of spending to administration WoolhandlerS, Campbell T, Himmelstein DU. Costs of health care administration in the United Sates and Canada. N Engl J Med. 2003;349:768–775

9. Topics to be covered • The difference between data and information • Who are the consumers of the information • The Hospital Information System (HIS) • Where does the Information Live • How and where is data stored • How is data transferred • How is the information being used

10. Terminology: • Protocol – The standardized language that one system/machine uses to communicate with another system. • Vendor–is a product made by a company that specializes in those types of products - aka Off the shelf systems. • Homegrown – Developed internally in a hospital, usually by a department and/or IT staff. • Master Patient Index (MPI) is a database that maintains a unique index (or identifier) for every patient registered at a health care organization.

11. Who am I • 14 Years of experience in Managed Care, Healthcare, Health IT, Medical Research • Computer Programmer • Database programmer • Oncology Nurse • Informaticist • Healthcare Quality and Patient Safety • Clinical Decision Support

12. Data vs Information • Data elements originate where activities are recorded. • Vital signs, lab values, clinical examination, radio graphic scans • Information is generated by systems that accumulate and present data in a meaningful way • EHR/EMR, Laboratory information Systems (LIS), Billing systems • INPUT vs OUTPUT

13. Who are the consumers of the information:Output

14. How Does the information Flow:

15. Hospital Information System: Information Repositories

16. Where does the Information Live: Mrs. Sue Zee – An example • Follow the information for a patient (Mrs. Sue Zee) • Mrs Zee is a 65 year old female with a history of Diabetes type 2 • She is being admitted for an elective surgery

17. Where does the Information Live: ADT systems • Admission, Discharge, Transfer ADT systems • Vendors - Eagle, GE(IDX), Epic, McKesson, Cerner, IBM • Function • Patient Master Index (PMI) • Inpatient Management / Bed management • Outpatient Management • Medical records tracking • Medical records coding • Inpatient billing • Reporting

18. Where does the Information Live:Surgery information systems OR Manager • Vendors – Meditech, GE, Siemens • Home grown systems • Functionality • Materials management • Scheduling • Clinical documentation • Complete statistical and reporting capabilities • Billing

19. Where does the Information Live: Post Operation CIS (EMR/EHR) and Computerized Physician Order Entry (CPOE) Vendors - Allscripts, Cerner, Epic, GE, Meditech, Healthland, Mckesson Home grown system – LDS hospital, Partners Health

20. Where does the Information Live: Pharmacy Information System • Functionality • Dispensing of medications to • Replication of data among the pharmacy centers • Generation of transactions as printouts • Integration with the Master Patient Index (MPI) • Integration with the Clinician System Vendors- Pyxis, Seimens, Cerner, GE, Mckesson

21. Where does the Information Live: Radiology Information System • Functionality • Patient Registration and scheduling • Patient List Management • Radiology Department workflow management • Request and document scanning • Result(s) Entry • Reporting and printout • Result(s) Delivery to other systems • Patient Tracking • Decision Support • Vendors - GE, Meditech, Cerner, Seimens, Mckesson

22. Where does the Information Live: Radiology Information System Cont EMR HL7

23. Where does the Information Live: Laboratory Information System (LIS) • Functionality • Lab-pharmacy-clinicals integration • Billing • Scheduling • Vendors - Cerner, Beckman Coulter, Sysmex, Siemens, Ortho, Olympus, Roche, Abbott

24. Hospital Information System: How is the information shared

25. Information Messaging : HL7 • Application – to – application interface • Event driven communication : real world events (e.g. ADT) cause appropriate messages to flow between applications • Abstract messages vs. actual string messages • Definitions of the data to be exchanged, the timing of exchanges, and reporting of application-specific errors between applications

26. How is Information Shared: Interface engine HL7

27. Information Flow Gone Wrong: ADT example

28. Information Flow Gone Wrong: CIS example

29. The Zen of Information Flow: What direction does information flow

30. Questions Thank You