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Health Information Systems: Architectures and Strategies
Health Information Systems: Architectures and Strategies
August 2010
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We will discuss the interrelation between health information systems on one side and health care on
the other side:
– Information processing should offer a holistic view of the patient and of the
hospital.
Decisions of health care professionals are based on vast amounts of information about the patient's health state
It is essential for the quality of patient care and for the quality of hospital management to fulfill these
information needs
For example: when a patient is admitted to a hospital, a physician or nurse first needs information about the reason for patient
admission and about the patient history. Later, she or he needs results from services such as laboratory and radiology which
are some of the most frequent diagnostic procedures
– Incorrect reports, e.g. lab report, may lead to erroneous and even harmful treatment decisions
– Repeated examinations or lost findings have to be searched for, the costs of health care may increase
– Information should be documented adequately, enabling health care professionals to access the
information needed and to make sound decisions
In general clinical patient-related information should be available on time, and it should be up-to-date
and valid
In 2007, states of the OECD1 spent between 6% and 15 % of their total gross
domestic product (GDP) for health care
Already in the 1960s, studies observed that 25% of a hospital's costs are due to
(computer-based and non-computer-based) information processing
the annual budget that health care institutions spend on information and
communication technology (including computer systems, computer networks, and
computer-based application components) was in 2006 between 2.5% and 3.3% of
the total hospital operating expense, depending on the number of beds
In many hospitals, the annual budget is even lower. Most hospital CIOs expect an
increasing budget
It is clear that, on the one hand, efficient information processing offers vast
potential for cost reductions
Holistic in this context means to have a complete picture of the care of a patient
available, independent of the health care institutions and hospital departments in which
the patient has been or will be treated
This holistic view on the patient can reduce undesired consequences of highly specialized
medicine with various departments and health care professionals involved in patient care
However, it must be clearly ensured that only authorized personnel can access
patient data and data about the hospital as an enterprise
A hospital information system might be regarded as the memory and the nervous
system of a hospital
The hospital information system also receives, transmits, processes, stores, and
presents information
ICT has become a major factor for quality and efficiency of health care
worldwide. ICT in health care also emerged to a leading industry branch
Computer-based training systems strongly support efficient learning for health care
professionals
Decision support tools, for example in the context of drug prescription, support
high-quality care
– All groups of people and all areas of a hospital depend on its quality,
– The amount of information processing in hospitals is considerable, and
– Health care professionals frequently work with the same data
Nearly all people and all areas of a hospital are affected by the quality of the
information system, as most of them need various types of information in their
daily work
The patient certainly profit most from high-quality information processing since it
contributes to the quality of patient care and to reducing costs
There are different reasons for pursuing holistic and integrated information
processing
The most important reason is that various groups of health care professionals
within and outside health care institutions need the same data
The degree of highly specialized and distributed patient care creates a great
demand for integrated information processing among health care professionals and
among health care institutions
Systematic information processing is the key factor for raising quality and
reducing costs
Systematic in this context means purposeful and effective, and with great benefit
regarding the costs
These investments concern both staff and tools for information processing. They
aim at increasing quality of patient care and at reducing costs
This has severe consequences: decreased data quality, and higher costs, especially
for tools and information processing staff, not to mention aspects such as data
protection and data security violation