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Paperless Hospital. Presented by: Mary Whipple. Objectives. Describe Paperless Hospital. Describe and evaluate the hardware and software utilized with a paperless hospital. Describe and evaluate the information system used with a paperless hospital.
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Paperless Hospital Presented by: Mary Whipple
Objectives • Describe Paperless Hospital. • Describe and evaluate the hardware and software utilized with a paperless hospital. • Describe and evaluate the information system used with a paperless hospital. • Assess the role and functions of the nurse informaticist when working with a paperless hospital. • Examine related legal/ethical issues. • Discuss Advantages/Disadvantages from a nursing perspective.
Paperless Hospital A paperless hospital functions as a digital hospital to collect, file, store, and retrieve patient data via electronic means. (Versweyveld, 2005)
Paperless Hospital Patient care, charting, dissemination of test results and treatments, and process from admission to discharge and follow-up are facilitated through the use of electronic information systems. (Versweyveld, 2005)
Paperless Hospital Hardware by definition is: • Actual physical parts one can touch • Parts involved in performance or function (McGonigle & Mastrian, 2009)
Paperless Hospital Hardware • Monitor • CPU, casing, fan • Motherboard • Hard disk, drive heads • Memory • Keyboard, mouse, speakers
Paperless Hospital Hardware continued • Printer • Lap-top, Palm Pilot, PDA • Power supply • Modem • Microprocessor • Floppy, flash drive, graphic cards
Paperless Hospital Central Processing Unit (CPU) • The command center or brain • Component that executes, calculates and processes the binary code • Directs the action of all other components • Manages input and output processing across components (McGonigle & Mastrian, 2009)
Paperless Hospital Software by definition is: • Anything that can be stored electronically • Allows users to complete specific tasks • Applications to facilitate specific functions (McGonigle & Mastrian, 2009)
Paperless Hospital Software • FormFast • Horizon Portals • Horizon Expert Orders • Horizon Patient Folder • Image Link Engine • Horizon Health Summary
Paperless Hospital Software continued • McKesson Program Manager • Horizon Clinical Infrastructure • Horizon Care Record, Horizon Care Alerts • Horizon Emergency Care • Horizon Expert Documentation Standard • Horizon AdminRx, Horizon Meds Manager
Paperless Hospital FormFast • Design and store documents, specifically patient identification labels and bar coded arm bands • Create and store clinical documents such as Physician Order and Progress Notes (Kaleta, 2008)
Paperless Hospital Usability Use of this interface supports increased efficiency in output of automatically filled and printed forms. Documents are based on incoming data and are automatically generated to appropriate locations for on-demand print and retrieval. (Oracle, 2008)
Paperless Hospital Horizon Physician Portal • On-line patient medical records • Web based link for access • Available by desktop, PDA, iPhone • Shows deficiencies • Ability to time track for period desired
Paperless Hospital Usability Ease-of-use was tested by internal and external human factors engineers and customers. Content design was reviewed by CNCCE at University of Iowa. Human-centered design specific to nursing work flow was researched by Intel’s Clinical Practice Research division. (McKesson, 2007)
Paperless Hospital Horizon Portals are used by a multi-disciplinary team including, but not limited to, physicians, nurses, radiologists, pharmacists, LCSWs, and laboratory personnel. (McKesson, 2007)
Paperless Hospital Horizon Health Summary • Provides longitudinal clinical information across health care episodes • Supports multiple clinical and financial standards • Provides multi-disciplinary use and relationships between terminologies • Ensures accurate patient history and reporting (McKesson, 2007)
Paperless Hospital The information system utilized in a paperless hospital is a Clinical Information System. With McKesson Horizon IS technology, patient care is enhanced, workflow organization and operating efficiency is streamlined, and record management is improved. (Hickman & Kenyon, 2006)
Paperless Hospital Forty different criteria are used to evaluate performance of clinical information systems, including: • Ease of technology use • Support • Works as promoted • Recommended to peers (KLAS, 2007)
Paperless Hospital Software applications are flexible and offer a wide range of solutions for clinical and departmental settings. High quality data management for every aspect of patient care is provided. (Hickman & Kenyon, 2006)
Paperless Hospital McKesson Horizon Clinical Information Systems are used for: • ordering • documentation • data mining and storage • imaging and diagnosing • coding and billing (McKesson, 2007)
Paperless Hospital • The configuration used for this CIS is a Global Area Network. • American National Standards Institute and Healthlevel 7 standards are used.
Paperless Hospital Disease and Procedure Classification Systems used are: • SNOMED (Systematized Nomenclature of Medicine) • ICD (International and Statistical Classification of Diseases) • HCPCH (HCFA Common Procedure Coding System) • CPT (Current Procedural Terminology) • LOINC (Logical Observations Identifiers Names and Codes) • DSM (Diagnostic and Statistical Manual of Mental Disorders) (McKesson, 2007)
Paperless Hospital Nursing practice classifications schemes used are: • NANDA • NIC • NOC • Omaha (McKesson, 2007)
Paperless Hospital Professional Nurse Competencies • Knowledge of institution-specific nursing software. • Posses computer and informatics skills and knowledge. • Fluency in nursing and informatics terminologies • Advanced analysis and design concept capabilities. • Advanced educational design and research evaluation capabilities. (Staggers, Gassert, & Curran, 2002)
Paperless Hospital Informatics Nurse Functions and Responsibilities • Participates in selection, implementation, and evaluation of systems. • Determine projected impact of application implementation. • Provides troubleshooting for applications and systems. • Develop models for simulation. (Staggers, Gassert, & Curran, 2002)
Paperless Hospital Legal and Ethical Issues • Privacy, confidentiality, accountability, and auditability according to HIPAA standards. • Establish additional & better-refined standards for privacy and information security. • Accurately matching of patient identification and records. • Ownership and continuity of health data. • Federal oversight and regulation, public health, and legal liability. (Gold & Ball, 2007)
Paperless Hospital Advantages • Improved communication • Access to information • Monitoring • Decision support • Prevention of errors • Improved patient care
Paperless Hospital Disadvantages • Different healthcare systems often use varying technologies which can require users to view patient information on unfamiliar screens. (Anter, 2008) • Diversity of software in various departments creates inabilityof different systems to communicate with one another. (May, 2002)
Paperless Hospital This can cause translational challenges to occur that can lead to confusion, delays, and other problems with delivering quality patient care. This is especially important when patients are transferred between hospitals. (Anter, 2008)
Paperless Hospital Summary To achieve a paperless hospital, considerable infrastructure investment is made. Once implemented, a global network of health records provides quick access to the most up to date, complete, and accurate medical record. A paperless future for health care allows for the best possible care delivery to anyone, anytime, anywhere.
References Anter, D. (2008). Compuware Covisint to securely connect, integrate Michigan’s Thumb Health Information System. Retrieved November 4, 2008, from Compuware Pressroom website: http://www.compuware.com/pressroom/news/2007/7223_ENG_HTML.htm Gold, J.D., & Ball, M.J. (2007). The health record banking imperative: a conceptual model. Retrieved December 7, 2008 from HIMSS Transforming healthcare through it website: http://www.himss.org/content/files/Gold-Ball_IBM_SJ_HealthRecordBankingImperative_46-01-2007.pdf Health Level 7, Inc. (2008). What is health level 7? Retrieved November 4, 2008, from Health Level 7website: http://www.hl7.org/
References Hickman, H., & Kenyon, P. (2008). Software solutions. Retrieved November 4, 2008, from HKS Medical Information Systems website: http://www.hksys.com/software/ Kaleta, J. (2008, October 9). Information Technology Update. Take Five, 2. KLAS. (2007). An Independent Report From Healthcare Executives and Professionals. Orem, UT: KLAS Enterprises, LLC.
References May, T. (2002). El Camino wants paperless hospital. Retrieved October 6, 2008, from BusinessJournalwebsite: http://www.bizjournals.com/sanjose/stories/2002/04/08/story7.html McGonigle, D., & Mastrian, K. (2009). Nursing Informatics and the Foundation of Knowledge. Sudbury, MA: Jones and Bartlett Publishers. McKesson Corporation. (2007). Making care planning relevant. Retrieved November 5, 2008, from McKesson Empowering Healthcare website: http://www.mckesson.com/static_files/McKesson.com/MPT/Documents/Making%20Care%20Planning%20Relevant_HorizonExpertPlan_WHT259.pdf
References Oracle. (2008). FormFast, Inc. Retrieved October 12, 2008, from Oracle PartnerNetwork website:http://solutions.oracle.com/partners/formfast Staggers, N., Gassert, C., & Curran, C. (2002). A Delphi study to determine informatics competencies for nurses at four levels of practice. Nursing Research, 51(6), 383-390. Versweyveld, L. (2005). Near-paperless hospital of the future now open in south Florida.Retrieved September 21,2008, from Virtual Medical Worlds Monthly website: http://www.hoise.com/vmw/05/articles/vmw/LV-VM-04-05-11.html