Healthcare Information and Management Systems Society (HIMSS)

is a nonprofit organization that works to optimize the use of

technologies in a healthcare setting. Its stated goals are related to
improving both safety and quality of healthcare delivery, as well as
access and cost management.

Information systems (IS) is the study of complementary networks of hardware and software that
people and organizations use to collect, filter, process, create, and distribute data.

“Information systems are combinations of hardware, software, and telecommunications

networks that people build and use to collect, create, and distribute useful data, typically in
organizational settings.

“Information systems are interrelated components working together to collect, process, store,
and disseminate information to support decision making, coordination, control, analysis, and
viualization in an organization.”

As you can see, these definitions focus on two different ways of describing information systems:
the components that make up an information system and the role that those components play in
an organization. Let’s take a look at each of these.

The Components of Information Systems.

The first way I describe information systems to students is to tell them that they are made up of five
components: hardware, software, data, people, and process. The first three, fitting under the
technology category, are generally what most students think of when asked to define information
systems. But the last two, people and process, are really what separate the idea of information
systems from more technical fields, such as computer science. In order to fully understand
information systems, students must understand how all of these components work together to bring
value to an organization.

Different types of Information system in medical:

1. Clinical Information System (CIS) is a computer based system that is designed for collecting,

storing, manipulating and making available clinical information important to the healthcare
delivery process
Clinical Information Systems provide a clinical data repository that stores clinical data such as the
patient’s history of illness and the interactions with care providers. The repository encodes
information capable of helping physicians decide about the patient’s condition, treatment options,
and wellness activities as well as the status of decisions, actions undertaken and other relevant
information that could help in performing those actions.

2. Pharmacy Information System

is a system that has many different functions in order to maintain the supply and
organization of drugs. It can be a separate system for pharmacy usage only, or it can be
coordinated with an inpatient hospital computer physician order entry (CPOE) system. A PIS
paired with a CPOE allows for an easier transfer of information.

 A PIS is used to reduce medication errors, increase patient safety, report drug
usage, and track costs. Inpatient pharmacy information systems are used in
the hospital setting while outpatient pharmacy information systems are used
 in home settings for discharged patients, clinics, long-term care facilities, and
home health care. Most of the uses and capabilities of the PIS are similar for
inpatient and outpatient settings. However, the outpatient PIS has a stronger
emphasis on medication labeling, drug warnings, and instructions for
administration.

3. health information system (HIS) is a system designed to manage the

data collected and stored in any healthcare facility. This includes
doctors’ offices, private and public clinics as well as hospitals. These
facilities collect, store, manage and send patients’ electronic medical
records.

Applications for prescribing:

1. Electronic medical record (EMR) systems, defined as "an electronic record of

health-related information on an individual that can be created, gathered, managed,
and consulted by authorized clinicians and staff within one health care organization,"

which are the digital equivalent of paper records, or charts at a clinician’s

office. EMRs typically contain general information such as treatment and
medical history about a patient as it is collected by the individual medical
practice.
By implementing EMR, patient data can be tracked over an extended
period of time by multiple healthcare providers. It can help identify those
who are due for preventive checkups and screenings and monitor how
each patient measures up to certain requirements like vaccinations and
blood pressure readings. EMRs are designed to help organizations
provide efficient and precise care.

Perhaps the most significant difference is that EMR records are universal,
meaning that instead of having different charts at different healthcare
facilities, a patient will have one electronic chart that can be accessed
from any healthcare facility using EMR software.

An electronic (digital) collection of medical information about a person that is stored

on a computer. An electronic medical record includes information about a patient’s
health history, such as diagnoses, medicines, tests, allergies, immunizations, and
treatment plans. Electronic medical records can be seen by all healthcare providers
who are taking care of a patient and can be used by them to help make
recommendations about the patient’s care. Also called EHR and electronic health
record.

is a digital version of the traditional paper-based medical record for an individual. The
EMR represents a medical record within a single facility, such as a doctor's office or
a clinic. 

 Electronic Health Record (EHR) - This term refers to computer software that
physicians use to track all aspects of patient care. Typically this broader term also
encompasses the practice management functions of billing, scheduling, etc.
 do all those things—and more. EHRs focus on the total health of the patient—going
beyond standard clinical data collected in the provider’s office and inclusive of a
broader view on a patient’s care. 

 Electronic Medical Record (EMR) - This is an older term that is still widely
used. It has typically come to mean the actual clinical functions of the software
such as drug interaction checking, allergy checking, encounter documentation, and
more.

are a digital version of the paper charts in the clinician’s office. An EMR contains the
medical and treatment history of the patients in one practice. EMRs have advantages
over paper records.

 different types of digitized health records that contain most of the same types of
information.
A. Personal health record (PHR), is health-related documentation maintained by the
individual to which it pertains.
-ontain the same types of information as EHRs—diagnoses, medications,
immunizations, family medical histories, and provider contact information—but are
designed to be set up, accessed, and managed by patients. Patients can use PHRs
to maintain and manage their health information in a private, secure, and confidential
environment. PHRs can include information from a variety of sources including
clinicians, home monitoring devices, and patients themselves.
B. Electronic health record (EHR) is an official health record for an individual that is
shared among multiple facilities and agencies. There are government incentives in
many countries to standardize EHRs and ensure that every citizen has one.

 -are built to go beyond standard clinical data collected in a provider’s office

and are inclusive of a broader view of a patient’s care. EHRs contain information
from all the clinicians involved in a patient’s care and all authorized clinicians
involved in a patient’s care can access the information to provide care to that
patient. EHRs also share information with other health care providers, such as
laboratories and specialists. EHRs follow patients – to the specialist, the hospital,
the nursing home, or even across the country.

Advantages of EMR
  
 More convenient and efficient: When any medical or administrative team
deals in physical papers and records, it can mean that a lot of sorting through those
papers becomes a natural part of working life. Not only is this slow and cumbersome,
but it is also time-wasting, taking away from the productivity and your team would be
able to use elsewhere. Finding the information that you need on digital systems is
much easier, often taking only a few clicks or presses of the keyboard, saving time
and effort.
 Easier to read and organize than physical notes: Physician’s notes may
be a comfortable and familiar way of taking down records, but they can prove
unreliable over time. For one, digital records are much easier to read and more
legible. What’s more, because the electronic health record stores them all in a
standardized format, it is much easier to skim through directly for the information
more relevant to your queries at the time.
 Easier access for patients: Whether they want to check a prescription that
they are on, or they want to provide their medical history to a specialist, patients have
both a right and a need to access their records. As such, they will often request them
from their physician, but finding, copying, and providing them can take time. An
 electronic health record system often provides an online patients’ portal that they can
use to access their medical history and information wherever and whenever they
wish.
 Safer storage for your medical records: Paper records are easy to lose,
easy to accidentally destroy, and potentially easy to steal if they are left unattended
or your physical storage space isn’t secured as effectively as it should be. Online
EHR systems can be much safer, since they are stored on a database that you
require the right login details to access.

1. Reduced labor

 Faster review of patient data

 Less time spent calling or emailing appointment reminders
 Easier documentation using templates

2. Minimized resource consumption

 Fewer paper forms, reduced need to print physical copies

 Fewer duplicate or unnecessary lab orders
 Easier medication management

3. Improved care delivery

 Faster time to treatment

 Better medication management
 Earlier and better diagnosis

4. Easier data collection and analysis

 Faster report creation

 More thorough view of data trends
 Inventory control

5. More organizational efficiency

 Improved collaboration between partners and other providers

 Easier billing through coding applications
 Reduced risk of malpractice claims through better documentation

Advantages of EMR for the Patient
 Improved diagnosis and treatment
 Significantly fewer errors found within personal health records
 Faster care and decision making responses from assigned medical professionals

Disadvantages of EMR
 .
 
 Cybersecurity issues: While digital storage can be safer than carrying
physical papers around, data breaches are becoming much more widespread. Most
certified EHR systems have security measures in place, but the staff of a physician’s
business must be trained in basic digital security to ensure they do not leave their
 stations vulnerable to unauthorized access. Having your patient’s data fall into the
wrong hands is not acceptable.
Opening a patient portal also increases the risk of data breeches. Administrators can
mitigate this risk by installing secure firewalls and other IT security measures to keep
patient portals from becoming entryways into the electronic health records system for
all patients.
The patient portal must require strong passwords and have robust encryption.

 Require frequent updates: Since other healthcare professionals partnered

with you, such as personal trainers and pharmacists, may be using the same
electronic health record system as you, it is essential that you keep patient records
updated after every appointment or consultation. Otherwise, they may check the
system later to find inaccurate data without your knowledge, leading to inappropriate
approaches to treatment.
 Restricted to computer access alone: There is far from a shortage of digital
devices, and most doctors are growing more comfortable with working digitally.
However, losing access to those devices, whether due to location or other issues
such as power cut or loss of internet access, could mean that records aren’t updated
or are inaccessible for some time. Even forgetting your device on a consultation can
create a small gap in the records that shouldn’t be there.
 Doctor Comments and Medical Jargon
With patient access to medical records, all comments are visible, including negative
ones.
Patients may misconstrue comments that only appear negative but, in reality, are not.
Most patients too will not know the various terminologies and shorthand used by
medical professionals. The patient may get confused and this can lead to
misunderstandings.

 Computer Luddites

Older patients may not know how to operate computers and electronic software as
well as younger patients. This unfamiliarity may confuse them.
Administrators can overcome this disadvantage easily by education and patience,
ensuring that simplified training brochures and videos are available, with designated
ways for the patient to get personalized help if needed.

2. Computerized provider order entry (CPOE) refers to the process of

providers entering and sending treatment instructions – including medication,
laboratory, and radiology orders – via a computer application rather than
paper, fax, or telephone.

CPOE has several benefits. :

o Reduce errors and improve patient safety: At a minimum, CPOE

can help your organization reduce errors by ensuring providers produce
standardized, legible, and complete orders. In addition, CPOE technology
often includes built-in clinical decision support tools that can automatically
check for drug interactions, medication allergies, and other potential
problems.
o Improve efficiency: By enabling providers to submit orders
electronically, CPOE can help your organization get medication, laboratory,
and radiology orders to pharmacies, laboratories, and radiology facilities
faster, saving time and improving efficiency.
o Improve reimbursements: Some orders require pre-approvals from
insurance plans. CPOE, when integrated with an electronic practice
management system, can flag orders that require pre-approval, helping you
reduce denied insurance claims.

In short, CPOE is safer and more efficient for providers and patients.

CPOE systems mimic the paper chart workflow making

the documentation intuitive and easy to use.
CPOE is the use of the computer to enable a physician or other provider to enter orders (for
medications, procedures, or other actions), thus ensuring that they are legible, so they can be
unambiguously stored in the EHR, communicated to pharmacies or other entities responsible for
carrying them out, monitored for completion, and billed.

The advantages of Computerized Provider Order Entry are primarily

related to improved patient safety by avoiding transcription errors,
illegible orders, and unsafe abbreviations, as well as reducing
inappropriate dosages, harmful drug interactions, and therapeutic
duplications.

Function
The most important function of CPOE is to make it easy for the provider to do the
correct thing for the patient and difficult to do the wrong thing for the patient. Many
safeguards are available in most CPOE systems. These include checks on: 

Drug-Drug interaction
Drug-Disease interactions (for example, alerts when ordering a blood thinner
in a patient with an active diagnosis of upper gastrointestinal (GI) bleed for
instance)
Drug age (Beers list is included to assist providers when ordering medications
for the geriatric population or with Pediatric patients many dosages are
different).

WHAT IS CPOE? CPOE is a computer application that accepts physician orders such as:
• Medication
• Laboratory Tests
• Diagnostic Studies
• Ancillary Support
• Nursing Orders
• Involves electronic communication of orders
• Consultation

FEATURES OF CPOE
• Ordering .  Orders are communicated to all departments, improving response time and avoiding
scheduling problems and conflict with existing orders.
• Patient-centered decision support. The ordering process includes a display of the patient's medical
history and current results and evidence-based clinical guidelines to support treatment decisions.
• Patients safety features. Allows real-time patient identification, drug dose recommendations,
adverse drug reaction, also reviews and checks on allergies and test or treatment conflicts. Physicians
and nurses can review orders immediately for confirmation.
• Intuitive human interface. The order entry workflow corresponds to familiar "paper-based" ordering
to allow efficient use by new or infrequent users.
• Security. Access is secure, health profession can entering and reviewing the data with there ID.

CPOE HAS MANY BENEFITS FOR BOTH PRACTICES AND PATIENTS:

1. Patient charts are not misplaced or misfiled
2. Comprehensive case documentation and medical history of patient
3. Improve patient care with clinical decision support systems
4. access to Drug specific information that eliminates confusion
5. Reduced healthcare costs due to improved efficiencies
6. Improve communication between various departments such as lab assistants, doctors, nurses,
specialists, pharmacist etc
7. reduce errors related to poor handwriting or transcription of medication orders.
8. Patient Safety