HEALTHCARE INFORMATION SYSTEMS

•ORIGINALLY DEVELOPED FOR HOSPITALS.
•FOUR PRIMARY FUNCTIONS
1. THE BACKBONE OR PRIMARY SYSTEM USED TO INTEGRATE WITH THE VARIOUS
APPLICATIONS THROUGHOUT THE ORGANIZATION.
2. MANAGE THE ADT (ADMISSION, DISCHARGE AND TRANSFER) PROCESS
3. COMMUNICATE INFORMATION BETWEEN THE CLINICAL UNITS AND THE
VARIOUS HOSPITAL DEPARTMENTS.
4. USED TO PRODUCE A NUMBER OF REPORTS THAT SUPPORT THE DAILY
OPERATIONS OF THE INSTITUTION.


CLINICAL INFORMATION SYSTEM

• CONSISTS OF A LARGE GROUP OF AUTOMATED SYSTEMS THAT PROCESS PATIENT DATA TO SUPPORT
PATIENT CARE
•FUNCTIONS:
• COLLECTING PATIENT ASSESSMENT AND HEALTH STATUS DATA
• DEVELOPING HEALTH CARE PLANS
• MANAGING THE ORDER ENTRY PROCESS
• KEEPING MEDICATION ADMINISTRATION RECORDS,
• DEVELOPING WORK LISTS, AND PRODUCING REPORTS SUCH AS PATIENT PROBLEM
LISTS.

TYPES OF CLINICAL INFORMATION SYSTEM :

•DOCUMENTATION SYSTEMS
•DEPARTMENTAL SYSTEMS

TYPES OF CLINICAL INFORMATION SYSTEM :

•DOCUMENTATION SYSTEMS
•USED FOR THE DEVELOPMENT OF PLANS OF CARE,
DOCUMENTATION OF PATIENT DATA AND ACCESS TO
CLINICAL INFORMATION
•DECREASING THE TIME USED TO DOCUMENT CARE WHILE
INCREASING THE QUALITY OF THE DOCUMENTATION AND
INCREASING DATA ACCESS TO CLIENT DATA

TYPES OF CLINICAL INFORMATION SYSTEM :

•DEPARTMENTAL SYSTEMS
•SUPPORT THE DAILY WORK OR OPERATIONS OF A CLINICAL
DEPARTMENT
•ACCEPT PATIENT ORDERS, SCHEDULE PATIENTS, EQUIPMENT
AND ROOMS, PRINT LABELS AND WORK LISTS AND MAINTAIN
INVENTORIES
•IMPROVED EFFICIENCY OF THE DEPARTMENT

FOUR DOMAINS:

•CLINICAL PRACTICE
•ADMINISTRATION
•EDUCATION
•RESEARCH
CLINICAL PRACTICE


•PROVIDE AUTOMATED SUPPORT TO THE NURSING PROCESS.
•USED TO COLLECT AND RECORD PATIENT DATA FOR ASSESSMENT
OR MONITORING PURPOSES, TO DEVELOP PLANS OF CARE, TO
PRINT REMINDERS AND WORK LISTS, TO DOCUMENT CARE, AND
TO IDENTIFY GOAL ACHIEVEMENT.
ADMINISTRATION
•SUPPORT THE ADMINISTRATIVE ROLE AND USUALLY DEAL WITH
THE DAY-TO-DAY OPERATION OF THE CLINICAL OR NURSING
SERVICE DEPARTMENT


EDUCATION

•SUPPORT NURSING EDUCATION AND ARE USED IN TEACHING AS
WELL AS IN MANAGING THE EDUCATIONAL PROCESS
RESEARCH
•CONSISTS OF A VARIETY OF DIFFERENT GENERIC COMPUTING PROGRAMS.
•IT IS NOW POSSIBLE TO COLLECT DATA FROM AN AUTOMATED DATABASE
IN SECONDS, WHEREAS IT WOULD HAVE REQUIRED MONTHS OF
SEARCHING IF THE SAME DATA WERE STORED IN PAPER RECORDS.
Standard Areas of NURSING:
Nursing P ractice
Nursing E ducation
Nursing R esearch
Nursing Administration


COMPUTERS IN NURSING
EDUCATIONS
 COMPUTER Assisted Education
 PDA (Personal Digital Assistants)
 LCD Projectors
 Wireless Routers
 Desktops
 Laptops
 Smartphone
 VIDEOS/ANIMATIONS
 Distance learning
 Testing (NCLEX)
 Student and course record
management
COMPUTERS IN NURSING
PRACTICE
Functions
Records client information
Provides access to other
departments
Used to manage client
scheduling
DOCUMENTAION OF CLIENT STATUS
AND MEDICAL RECORDS KEEPING
 Provides access to
standardized forms, policies
and procedures
 Access data about client that
may be somewhere in the
medical record or elsewhere
in health care agency.


BEDSIDE DATA ENTRY
 records clients assessments, medication administration, progress notes,
care plan updating, client acuity and accrued charges

COMPUTER BASED CLIENT RECORD
 EMRs/CPRs
 Provides easy retrieval of specific data such as trends in vital signs,
immunization records, current problems
 It can be designed to work providers about conflicting medications
or client parameters that indicate dangerous conditions


ELECTRONIC ACCESS TO CLIENTS
 Used extensively in health care to assess and monitor clients
conditions
 Data accumulated from various electronic devices are stored for
research purposes
 Can monitor client
 Computerized diagnosis
 Telemedicine

PRACTICE MANAGEMENT
 Used to order supplies, tests, meals, and services, from other
departments
 Allows nursing service to determine the most costly items used by a
particular nursing unit.
 May provide information or decisions to modify budget, provide different
staffing, move supplies to different locations, or make other changes for
more efficient and higher quality care





COMPUTERS IN NURSING
PRACTICE
A. Human resources
 All employers must maintain a data a database on each
employee
 Administrators can use this database to communicate with
employees, examine staffing patterns, and create budget
programs
 B. Medical records management
 Allow client records to be searched for trends, number of
cases, most expensive cases, and client outcomes.
 Nurse informaticist can assist administrators with the design and
implementation of systems that allow such searches to be
generated, analyzed, printed, and distributed.

COMPUTERS IN NURSING
PRACTICE
C. Facilities management
 heating, air conditioning, ventilation, alarm systems are
computer controlled.

D. Budget and finance
 claims are transmitted much more quickly
 Can also effect cost-savings by reducing the desired services
time needed for accounts payable and receivables.

COMPUTERS IN RESEARCH

1.
 Useful in locating current
literature about the problem
and related concepts
 Helps in searching for existing
documents, and e-mail to
colleagues.
2.
 Software facilitate searches,
contains thesauruses so that
the most appropriate terms
can be selected.

COMPUTERS IN RESEARCH
3.
 Search literature for instruments that have
already been established or to design and
test instruments that need to be
developed for past study.
4.
 Helps create form for the collection of
data such as informed consent,
demographic data, and recording forms.
 Commonly used software for quantitative
data analysis: SPSS ( statistical package for
social sciences), SAS ( statistical analysis
system), Sys STAT, MYSTAT

5.
 computer word processing programs are
used to author the final reports of research
and send research to various readerships.
 Help speeds completion or research
projects


ELECTRONIC HEALTH RECORD
ELECTRONIC HEALTH RECORD
 …any information related to the past,
present, or future physical/mental health,
or condition of an individual. The
information resides in electronic system(s)
used to capture, transmit, receive, store,
retrieve, link, and manipulate multimedia
data for the primary purpose of providing
healthcare and health related services..
ELECTRONIC HEALTH RECORD
 Increased patient safety:
All information about the patients existing
conditions, allergies and drug intolerances is
available when Physicians need it, where they
need it so that they can make the best decisions
for their patients.
 Increased efficiency:
A single source of accurate patient data means
Physicians don't need to spend time logging in to
different specialist clinical systems or contacting
other healthcare institutions for information.
ELECTRONIC HEALTH RECORD
 Trend and data analysis:
A central clinical repository of clinical information
means that information can be mined and
analyzed to contribute to more effective
healthcare delivery in the future, and can give a
better understanding of trends, patterns and
epidemiology in public health.

What is an Electronic Record (EHR)?
• Other common names –
computerized patient record
(CPR), electronic medical
record (EMR) and the
electronic patient record
(EPR)
• Part of CIS
• Resides in a software
program providing the health
provider an instrument to
obtain clinical information
and transcribe data into the
computer
• Classified in three groups: (1)
Office Based (2) Web-based
(3) Handheld or Wireless
System


ADVANTAGES
- Instant Access
- Legibility
- Safer data (protects from
loss)
- Confidentiality
- Flexible Layout
- Integration with other info
resources
- Electronic data
- Continuous data
processing
- Assisted Search
- Tailored Paper Output
- Always Current!


Clinical DSS focus in EHR for Nurses
CPOE – Computerized Prescriber Order Entry



BCMA – Bar Code Medication Administration
Integrated EHR Features
 Digital Imaging (Laboratory Informatics)
Integrated EHR Features
Integrated EHR Features
Integrated EHR Features
 Nursing Documentation
Integrated EHR Features
 Nursing Documentation
AUTOMATED
INFORMATION
SYSTEMS IN
HEALTH CARE
By: Aquia C. Evangelista
Subtopics:
 Administrative System
 Classification systems
 Quality Assurance systems
 Material Management systems
 Decision Support and Expert System

Administrative System

automate the management of data
used in the daily operations of the
institution as well a data used for
strategic and long range planning.
Classification Systems
Quality Assurance Systems
Material Management Systems


Classification Systems

 utilize data to classify patient by the amount and
type of care required. Data from classification
system can be used to decide the amount of staff
to a clinical unit. When classification data are
used to make this determination, the classification
system is also a staffing system.
 e.g. second and third degree burns over 605 of
the body may require 6 hours of professional
nursing time every 8-hour shift. A fifth-day
postoperative from open heart surgery may
require 2 hours of professional nursing time.
Quality Assurance Systems

attempt to measure and report on cost-
effective quality care resulting in a high
level of patient satisfaction.
e.g. patient outcomes or variance reports,
performance indicators for providers,
infection reports, incident reports, patient
satisfaction results, and costing data.
These data can be reported for individuals
or in aggregate format.

Material Management Systems

for managing supplies and other inventory
of an institution.
e.g. online catalogue that can be
searched, an automatic interface to
budget systems, automatic re-ordering of
supplies, and alerts that can be issued
when there is a significant increase or
increase in inventory reports.

Decision Support and Expert System

Decision Support (Automated Decision Support Systems)
 identify information gaps and taps external knowledge bases.
 are systems that process information, identifying and
demonstrating pertinent relationships.
 helps in decision-making, but they do not make decisions.
 e.g. automated scheduling system contains extensive online
knowledge base. The system will “know” several facts about
the staff and the institution’s staffing rules. The scheduling
system will not decide who will work when.
 aid to a decision maker
 provides a more complete picture of the interrelations
between the information being considered.
 it is the decision maker who interprets the information and
decides what action to take.

Expert Systems

 are knowledge-based systems with built-in
procedures for determining when and how to
use that knowledge.

 Wisdom
 makes it possible for the caregiver to use
theories related to death and dying to help a
terminal patient express anger and frustration.


Disadvantages of Computer
Application in Health Care

high upfront acquisition costs,
ongoing maintenance costs, and
 disruptions to workflows that contribute to
temporary losses in productivity that are
the result of learning a new system.
potential perceived privacy concerns
among patients, which are further
addressed legislatively in the HITECH Act.
Brendon C. Borja R.N.

The Advantages of
Computer application in
Health Care.


Better staff management

 provides an efficient way to handle administrative
like workload management, maintaining staff
records, scheduling shifts, etc.
 task accomplished by each nurse can be recorded,
and such shift reports can be viewed in a patient-
specific manner.
 aides nurse administrators in assessing staffing
requirements, as well as financial management
through budgeting and monitoring of expenses.

Improved documentation

 Proper clinical documentation is the pillar of every
heath care system, and it provides an easy way to
record all the necessary data
 system reduces the need for redundant paperwork
and also enables maintaining patient history that can
be easily accesses when required.

Efficient decision making

In addition to storing data, certain features of NIS
enable information management and decision-making
through active and passive systems.
Passive systems can organize and formulate the data
according to the present parameters, as well as provide
parameter specific information, as and when required.
Active systems are a step advanced and suggest
diagnoses on the basis of predefined criteria applied to
the patient information.


Enhance Synchronization

Patient data generated in all the units is always
essential for the decision-making in any unit of a
medical facility.
can be achieved through the integration of NIS with
other clinical systems, which enables fast and easy
access of the documented information to all the
appropriate units.

The Disadvantages of
Computer Application in
Health Care System

Need for training

nurses need to be trained for the use of various
features provided by the system
Certain studies have reported that sometimes the
nursing personnel find it difficult to understand the
design of the system
it increases their workload rather than helping them.
medical practitioners need to alter some of their
practices in order to accommodate the new system.

Long Charting time

The initial time required for creating the record
for a new patient may require more than the regular
paper-based charts, due to variety of fields that need
to be filled.

Difficulty in Customization
Clinical systems require a higher degree of
customization, not just with respect to the particular
health care facility, but also at the level of the patient.
Each patient may have a different set of parameters to
be considered as vital.
Lack of Standardized Vocabulary

Nursing Information System lacks a standardized
language for the same time.
there is always scope for ambiguity.
the terminology available in the system may not match
of every user, which causes confusion, making it
difficult to use.
Disclosure confidentiality
The medical records of a patient may become
vulnerable to hacking. Patient’s information is at risk
especially if the personnel are sharing passwords and
hospital computer codes.

Conclusion

Information systems have greatly influenced
management of information in several disciplines of
health care, including diagnostics, treatments, nursing
as well as palliative care. With their speed and
accuracy, Nursing Information System confers several
advantages as far as Nursing is concerned. But, there
still remain certain drawbacks that need to be tackled
in order to improve their efficiency and usability.


*END*
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