clinical applications of health informatics

1
NURSING INFORMATICSChapter 6

• clinical applications of health informatics

2
Introduction

• Healthcare organizations integrate a variety of
  clinical and administrative types of information
  systems.
• These systems collect, process and distribute
  patient-centered data to aid in managing and
  providing care.
• An understanding of how each of these types of
  systems works within healthcare organizations is
  fundamental in the study of Nursing Informatics.

3
CLINICAL INFORMATION SYSTEMS

• Electronic Health Records (her) system
• Electronic Health Record (EHR) is data storehouse
  of information regarding the health status of
  patients, replacing the former paper-based
  medical record.

4

• It is the systematic documentation of a clients
  health status and healthcare in a secured digital
  format, meaning that it can be processed, stored,
  transmitted and accessed by authorized
  interdisciplinary professionals for the purpose
  of supporting efficient, high quality healthcare
  across the clients healthcare continuum

5

• Also known as an Electronic Medical Record  An
  electronic health or medical record is a
  computer-based patient medical record that can be
  used to collect and look up patient data by
  physicians or health professionals at various
  locations such as doctors offices or hospitals.
• The record includes information such as patient
  problems, medications, allergies, laboratory
  results, etc.

6

• Advantages of the EHR
• No more long interpretation of poor penmanship
  and handwritten orders
• Reduced turn-around-time for lab results in an
  emergency department
• Long wait for the administration of the first
  dose of antibiotics in an inpatient nursing unit.
• In the ambulatory care setting evidence of
  improved management of cardiac related risk
  factors in patients with diabetes
• Effective patient notification of medication
  recalls have been demonstrated

7

• Acuity System
• Calculates the nursing care requirements for
  individual patients based on
  severity of illness, specialized equipment and
  technology needed, and intensity of nursing
  interventions determines the amount of daily
  nursing care needed for each patient in a nursing
  unit.

8

• Admission, Discharge and Transfer (ADT) System
• Provides the backbone structure for the other
  types of clinical and business systems.
• It contains the groundwork for the other types of
  healthcare information systems since it includes

9

• The patients name, medical record number, visit
  or account number and demographic information
  such as age, sex, home address and contact
  information they are the central source for
  collecting this type of patient information and
  communicating it to the other types of healthcare
  information systems including clinical and
  business.

10

• Case Management Information System (CMIS)
• An information system, or group of components
  that interact to produce information, "designed
  to facilitate the practice of case management by
  supporting the information needs of case
  managers"

11

• Clinical Documentation System
• Array or collection of applications and
  functionality amalgamation of systems, medical
  equipment, and technologies working together that
  are committed or dedicated to collecting, storing
  and manipulating healthcare data and information
  and providing secure access to inter-disciplinary
  clinicians navigating the continuum of client
  care designed to collect patient data in real
  time to enhance care by providing data at the
  clinician's fingertips and enabling decision
  making where it needs to occur, at the bedside
  also known as clinical information systems (CIS).

12

• Communication System
• Collection of individual communications networks
  and transmission systems in healthcare, it
  includes call light systems, wireless phones,
  pagers, email, instant messaging and any other
  devices or networks that clinicians use to
  communicate with patients, families, other
  professionals, internal and external resources.

13

• Computerized Physician Order Entry System (CPOE)
• A system that automates the way that orders have
  traditionally been initiated for patients. 
• Clinicians place orders within these systems
  instead of traditional handwritten transcription
  onto paper provide major safeguards by ensuring
  that physician orders are legible and complete
  thereby providing a level of patient safety that
  was historically missing with paper-based
  orders. 

14

• These systems provide decision support and
  automated alert functionality that was previously
  unavailable with paper-based orders.

15

• Core Business Systems
• Enhance administrative tasks within healthcare
  organizations.
• Unlike clinical information systems whose aim is
  to provide direct patient care, these systems
  support the management of healthcare within an
  organization.
• Core business systems provide the framework for
  reimbursement, support of best practices, quality
  control, and resource allocation.

16

• There are four common core business systems 1)
  admission, discharge and transfer (ADT), 2)
  financial, 3) acuity, and 4) scheduling systems.

17

• Laboratory Information System
• Report on blood, body fluid and tissue samples
  along with biological specimens that are
  collected at the bedside and received in a
  central laboratory.
• These systems provide clinicians with reference
  ranges for tests indicating high, low or normal
  values in order to make care decisions.
• Often the laboratory system provides result
  information directing clinicians towards the next
  course of action within a treatment regime.

18

• Order Entry System
• A system that automates the way that orders have
  traditionally been initiated for patients. 
• Clinicians place orders within these systems
  instead of traditional handwritten transcription
  onto paper provide major safeguards by ensuring
  that physician orders are legible and complete
  thereby providing a level of patient safety that
  was historically missing with paper-based
  orders. 

19

• These systems provide decision support and
  automated alert functionality that was previously
  unavailable with paper-based orders.

20

• Patient Care Information System (PCIS)
• Patient-centered information systems focused on
  collecting data and disseminating information
  related to direct care. 
• System of components that make up each of the
  specialty disciplines within healthcare and their
  associated patient care information systems.
• Several of these systems have become mainstream
  types of systems used in healthcare. 
• The four systems most commonly found include

21

• Clinical documentation systems.
• Pharmacy information systems.
• Laboratory information systems.
• Radiology information systems.

22

• Pharmacy Information System
• Information systems that facilitate the ordering,
  managing and dispensing of medications for a
  facility.
• They also commonly incorporate allergies and 
  height and weight information for effective
  medication management streamline the order
  entry, dispensing, verification and authorization
  process for medication administration while they
  often interface with clinical documentation and
  order entry systems so that clinicians can order

23

• and document the administration of medications
  and prescriptions to patients while having the
  benefits of decision support alerting and
  interaction checking.

24

• Picture and Archiving Communication System (PACS)
• Systems that are designed to collect, store and
  distribute medical images such as computed
  tomography (CT) scans, magnetic resonance imaging
  (MRI) and X-rays replace traditional hard copy
  films with digital media that is easy to store,
  retrieve and present to clinicians.

25

• These systems may also be stand-alone systems,
  separate from the main radiology system, or they
  can be integrated with radiology information
  systems (RIS) and computer information systems
  (CIS).
• The benefit of RIS and PACS systems is their
  ability to assist in diagnosing and storing vital
  patient care support data.

26

• Radiology Information System (RIS)
• Information systems designed to schedule, result,
  and store information as it relates to diagnostic
  radiology procedures. 
• One common feature found in most radiology
  systems is a Picture Archiving and Communication
  System (PACS). 
• These systems may also be stand-alone systems,
  separate from the main radiology system, or they
  can be integrated with RIS and computer
  information systems (CIS).

27

• These systems collect, store and distribute
  medical images such as computed tomography (CT)
  scans, magnetic resonance imaging (MRI) and
  X-rays. 
• PACS replace traditional hard copy films with
  digital media that is easy to store, retrieve and
  present to clinicians.
• The benefit of RIS and PACS systems is their
  ability to assist in diagnosing and storing vital
  patient care support data.

28

• Scheduling System
• Designed to coordinate staff, services,
  equipment, and allocation of patient beds.
• These systems frequently integrate with the other
  types of core business systems. 
• By closely monitoring staff and physical
  resources, these systems provide data to the
  financial systems. 

29

• For example, resource-scheduling systems provide
  information about operating room utilization, and
  distribution of those resources or availability
  of intensive care unit beds and regular nursing
  unit beds.
• These systems also serve as a great asset to the
  financial systems when they are used to track
  medical equipment within a facility. 
• Procedures and care are planned when the tools
  and resources are available help to track
  resources within a facility while managing the
  frequency and distribution of those resources.
•  

30

• Case Management Information Systems (CMIS)
• Case management information systems (CMIS)
  identify resources, patterns and variances in
  care to prevent costly complications related to
  chronic conditions and enhance the overall
  outcomes for patients.
• Once a trend is identified case management
  systems provide decision support promoting
  preventative care.

31

• A care plan is a set of care guidelines that
  outline the course of treatment and the
  recommended interventions that should be
  implemented to achieve optimal results.
• CMIS are especially beneficial for patient
  populations with a high cost of care and complex
  health needs such as the elderly or patients with
  chronic disease conditions.

32

• Case management systems assimilate massive
  amounts of information obtained over a patients
  lifetime by reaching far beyond the walls of the
  hospital and track care from one medical visit to
  the next.
• Information collected by case management systems
  is processed in a way that helps to reduce risks,
  ensures quality, and decrease costs.

33

• Communication Systems
• Communication systems promote the interaction
  between healthcare providers and patients.
• Communication systems have historically been
  separate from other types of health information
  systems and from one another.
• Examples of communication systems include call
  light systems, wireless phones, pagers, email,
  and instant messaging, which have traditionally
  been forms of communication targeted at the
  clinicians.

34

• Integrating communication systems with clinical
  applications provides a real-time approach that
  will facilitate care among the entire healthcare
  team, patients and their families.

35

• Core Business Systems
• Core Business Systems enhance administrative
  tasks within healthcare organizations.
• Core business systems provide the framework for
  reimbursement, support of best practices, quality
  control, and resource allocation.
• There are four common core business systems
• Admission, discharge and transfer (ADT),
  Financial, Acuity, Scheduling systems.

36

• ADT systems provide the backbone structure for
  the other types of clinical and business systems.
• Financial systems manage the expenses and revenue
  for providing healthcare.
• Acuity systems monitor the range of patient types
  within a healthcare organization using specific
  indicators.
• Scheduling systems coordinate staff, services,
  equipment, and allocation of patient beds.

37

• Scheduling systems help to track resources within
  a facility while managing the frequency and
  distribution of those resources.

38

• Order Entry Systems
• Order entry systems are one of the most important
  systems in use today.
• These systems automate the way that orders have
  traditionally been initiated for patients.
• Order entry systems provide major safeguards by
  ensuring that physician orders are legible and
  complete thereby providing a level of patient
  safety that was historically missing with
  paper-based orders.

39

• Patient Care Support Systems
• Most specialty disciplines within healthcare have
  an associated patient care information system.
• These patient-centered systems focus on
  collecting data and disseminating information
  related to direct care.
• Clinical Documentation Systems also known as
  Clinical Information Systems (CIS) are the most
  commonly used type of patient care support system
  within healthcare organizations.

40

• Clinical information systems are designed to
  collect patient data in real time.
• Pharmacy information systems have also become a
  mainstream patient care support system.
• These systems typically allow pharmacists to
  order, manage and dispense medications for a
  facility.
• Laboratory Information Systems were perhaps some
  of the first systems ever used in healthcare.

41

• Laboratory information systems report on blood,
  body fluid and tissue samples along with
  biological specimens that are collected at the
  bedside and received in a central laboratory.
• Radiology Information System (RIS) are systems
  schedule, result, and store information as it
  relates to diagnostic radiology procedures.
• The benefit of RIS and PACS systems is their
  ability to assist in diagnosing and storing vital
  patient care support data.

42

• Departmental Collaboration and Knowledge/Informati
  on Exchange
• The implementation of systems within healthcare
  is the responsibility of many people and
  departments.
• Knowledge exchange is the product of
  collaboration when sharing an understanding of
  information promotes learning from past
  experiences to make better decisions in the
  future.

43

• At an administrative level, collaboration among
  key stakeholders is critical to the success of
  any project.
• Collaboration also occurs among the various
  departments impacted by the system.
• From collaboration comes the exchange of
  information and ideas through knowledge sharing.
• A multidisciplinary approach assures that systems
  will work in the complex environment of
  healthcare organizations with diverse and complex
  patient populations.

44
(No Transcript)