Austin and Boxermans chapter 1

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Austin and Boxermans chapter 1

• HSPM J713

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Learning objectives

• Health care in the US has issues about
• Cost
• Quality
• Access

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Learning objectives

• Health care in the US has issues about
• Cost
• Quality
• Access
• These have implications for health services
  information systems

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Learning objectives

• History and current state of health services
  information systems

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Learning objectives

• Be able to Assess how well healthcare system
  challenges and their implications align with
  healthcare information system priorities.
• Huh?

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The Future is Now

• Restructuring
• Reengineering
• Existing organizations to
• Meet challenges
• Take advantage of technology
• Teamwork

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Technology ? Organization
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Health services environment

• Spending is growing
• (not as fast as projected on page 7)

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Health services environment

• Evidence-based medicine
• 1990s (1890s?)
• Evidence-based management
• Seems to set up false dichotomy
• experience, judgment, intuition, political sense
• vs. information-based decision-making?

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Health services environment

• Organizational change
• Changes in how your organization gets paid
• Managed care in health care payment
• Performance-based budgeting schemes
• are driving changes in information technology
• Much more to document

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Future Healthcare Systems
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Future Healthcare SystemsTrendy concerns that
IT is expected to address

• Medical errors and quality

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Trendy concerns that IT is expected to address

• Cost control

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Trendy concerns that IT is expected to address

• Consumer empowerment
• Through the provision of information

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Trendy concerns that IT is expected to address

• Evidence-based medicine
• a systematic approach to diagnosis and
  treatment that encourages the physician to
  formulate questions and seek answers from the
  best available published evidence.
• Havent doctors been doing this for a century or
  more?
• Yes, but now its being enforced centrally

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Evidence-based medicine

• Whats new IT can facilitate this with
  information systems
• Integrate the diagnostic and treatment processes
  with directed access to library information
• Other sources of information the
  pharmaceutical and equipment industries
• The elephant hiding in the room?

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Trendy concerns that IT is expected to address

• Privacy and information control
• Health Insurance Portability and Accountability
  Act of 1996 HIPAA
• Legal standards for privacy and control

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History of IT in health services

• Accounting
• Payroll, for example
• Clinical support
• Developing
• Outside communication and coordination
• Cutting edge networking
• Tele-medicine
• Electronic medical records

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Priorities for IT

• An apples-and-oranges list

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Priorities for IT

• Jobs to do
• Make information secure
• Support medical team decisions
• Interoperability
• Communication among disparate systems through
  standard protocols
• http//www.ors.state.sc.us/
• Your data system only has to be able to
  communicate with us

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Priorities for IT

• Technologies
• Internet
• Wireless
• Customer Relationship Management
• Customized personal web page
• Access for health services professionals

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Categories of information systems

• Clinical
• Support individual patient care

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Categories of information systems

• Operational
• Payroll, purchasing, inventory,

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Categories of information systems

• External interchange
• Insurance claims and billing
• Accessing outside clinical and public health
  databases
• Communication with independent providers
  (especially hospital staff physicians)
• Communicating with patients before and after
  services
• Public communication

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Categories of information systems

• Strategic
• Draw on clinical, operational, and external
  systems
• Information for executive decisions