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Issues and Trends in HBI Ch06 pp

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  • 1. Handbook of Informatics for Nurses & Healthcare Professionals Fifth Edition CHAPTER 6 Healthcare Information Systems Handbook of Informatics for Nurses & Healthcare Professionals, Fifth Edition Toni Hebda • Patricia Czar
  • 2. Learning Outcomes1. Identify the various types of information systems used within healthcare institutions. Handbook of Informatics for Nurses & Healthcare Professionals, Fifth Edition Toni Hebda • Patricia Czar
  • 3. Learning Outcomes2. Define the terms healthcare information system, hospital information system, clinical information system, nursing information system, physician practice management system, long-term care information system, home care information system, and administrative information system. Handbook of Informatics for Nurses & Healthcare Professionals, Fifth Edition Toni Hebda • Patricia Czar
  • 4. Learning Outcomes3. Explain the functions of a nursing information system.4. Differentiate between the nursing process and critical pathways/protocol approaches to the design of a nursing system. Handbook of Informatics for Nurses & Healthcare Professionals, Fifth Edition Toni Hebda • Patricia Czar
  • 5. Learning Outcomes5. Review the key features and impacts on nursing and other healthcare professionals associated with order entry, laboratory, radiology, and pharmacy information systems.6. Describe the functions of client registration and scheduling, and coding systems. Handbook of Informatics for Nurses & Healthcare Professionals, Fifth Edition Toni Hebda • Patricia Czar
  • 6. Learning Outcomes7. Explain the purpose of decision support and expert systems.8. Identify ways that mobile devices such as personal digital assistants, tablet computers, and iPods can improve the utility of healthcare information systems. Handbook of Informatics for Nurses & Healthcare Professionals, Fifth Edition Toni Hebda • Patricia Czar
  • 7. Information System• Use of computer hardware and software to process data into information• Healthcare information system (and hospital information system)—a group of systems used to support and enhance healthcare Handbook of Informatics for Nurses & Healthcare Professionals, Fifth Edition Toni Hebda • Patricia Czar
  • 8. Types of Information Systems• Clinical information • Administrative systems (CISs) systems – Directly support – Indirectly support care patient care – Individual systems – Individual systems may be standalone may stand alone – Goal: data – Goal: data exchange among exchange among systems systems Handbook of Informatics for Nurses & Healthcare Professionals, Fifth Edition Toni Hebda • Patricia Czar
  • 9. Clinical Information Systems (CISs)• Nursing • Emergency• Multidisciplinary department• Monitoring • Physician practice• Laboratory management systems• Pharmacy • Long term• Radiology • Home care Handbook of Informatics for Nurses & Healthcare Professionals, Fifth Edition Toni Hebda • Patricia Czar
  • 10. Administrative Systems• Client management (registration)• Financial• Payroll• Human resources• Quality assurance• Contract management• Risk management systems• Materials management Handbook of Informatics for Nurses & Healthcare Professionals, Fifth Edition Toni Hebda • Patricia Czar
  • 11. Nursing Information System (NIS) • Supports the use and documentation of nursing activities and provides tools for managing the delivery of nursing care – Access to online databases Handbook of Informatics for Nurses & Healthcare Professionals, Fifth Edition Toni Hebda • Patricia Czar
  • 12. Nursing Information System Advantages• Improved access to information• Better documentation• Improved quality of care• Improved productivity and communications• Tracking capability• Enhanced regulatory compliance Handbook of Informatics for Nurses & Healthcare Professionals, Fifth Edition Toni Hebda • Patricia Czar
  • 13. NIS Status• Despite advantages, information systems that are used by all clinicians are seen more commonly. Handbook of Informatics for Nurses & Healthcare Professionals, Fifth Edition Toni Hebda • Patricia Czar
  • 14. Documentation• Nursing process—based on traditional documents with nursing diagnosis as organizing framework, may use standardized nursing languages• Critical pathway—often used for multidisciplinary documentation, may incorporate physician orders• Flowsheets, charting by exception Handbook of Informatics for Nurses & Healthcare Professionals, Fifth Edition Toni Hebda • Patricia Czar
  • 15. Standardized Nursing Languages• Provide a common language for all nurses in all locations• Important to the development of the electronic health record• Measure nursing’s contributions• Contribute to the body of nursing knowledge Handbook of Informatics for Nurses & Healthcare Professionals, Fifth Edition Toni Hebda • Patricia Czar
  • 16. Clinical Information Systems• Support provider order entry, results retrieval, documentation, evidence- based practice, and decision support across distributed locations and by different disciplines Handbook of Informatics for Nurses & Healthcare Professionals, Fifth Edition Toni Hebda • Patricia Czar
  • 17. Monitoring• These devices monitor temperature, pulse, respirations, blood pressures, oxygen saturation, or other measures automatically feeding the input into a clinical information system.• Alarms notify caregivers of readings that are outside the range of “normal.” Handbook of Informatics for Nurses & Healthcare Professionals, Fifth Edition Toni Hebda • Patricia Czar
  • 18. Order Entry Systems• Orders entered into the computer are transmitted to the appropriate areas such as the pharmacy, laboratory, radiology, and social services.• Direct entry of orders by the physician, nurse practitioner, physical therapist, or other provider is preferred (CPOE). Handbook of Informatics for Nurses & Healthcare Professionals, Fifth Edition Toni Hebda • Patricia Czar
  • 19. CPOE• Computerized provider order entry• Initiative by the Institute of Medicine and Leapfrog Group to improve the quality of care and reduce medication errors – Eliminates transcription error – Expedites treatment – Encourages more accurate, complete orders Handbook of Informatics for Nurses & Healthcare Professionals, Fifth Edition Toni Hebda • Patricia Czar
  • 20. Laboratory Information Systems• Issues that LIS address – Turnaround time – Duplicate testing – Errors Handbook of Informatics for Nurses & Healthcare Professionals, Fifth Edition Toni Hebda • Patricia Czar
  • 21. Laboratory Information Systems• Can do the following: – Alert providers when new or stat tests results are back or values are critical – Send results to clinical system for view – Accept input from bedside devices – Generate labels for specimen collection – Use rules to order additional tests when indicated Handbook of Informatics for Nurses & Healthcare Professionals, Fifth Edition Toni Hebda • Patricia Czar
  • 22. Radiology• Allows direct order entry or accepts orders from other systems• Provides scheduling of diagnostic tests• Generates client instructions• Permits transcription of results Handbook of Informatics for Nurses & Healthcare Professionals, Fifth Edition Toni Hebda • Patricia Czar
  • 23. Radiology• Provides picture archiving and transmission of images and tracking of film• Generates charges once procedures are done Handbook of Informatics for Nurses & Healthcare Professionals, Fifth Edition Toni Hebda • Patricia Czar
  • 24. Impact of Mobile Computing• Allows access to data at the point of care to facilitate treatment decisions – Test results – Evidence-based practice guidelines• Facilitates documentation at the point of care for improved accuracy Handbook of Informatics for Nurses & Healthcare Professionals, Fifth Edition Toni Hebda • Patricia Czar
  • 25. Pharmacy Information Systems• Provide checks in order and administration process using evidence- based guidelines• Reduces errors when used with bar code technology• Use lab results, allergy, and interaction information from clinical systems• Track medication use, costs, and billing information Handbook of Informatics for Nurses & Healthcare Professionals, Fifth Edition Toni Hebda • Patricia Czar
  • 26. Pharmacy• May include more than one system – In pharmacy dispensing systems (robots) – Unit-based dispensing cabinets in care areas – Barcode and RFID Medication Administration Handbook of Informatics for Nurses & Healthcare Professionals, Fifth Edition Toni Hebda • Patricia Czar
  • 27. Pharmacy• E-prescribing – Process that allows the physician to enter a prescription which is then electronically sent to the pharmacy from computers, PDAs Handbook of Informatics for Nurses & Healthcare Professionals, Fifth Edition Toni Hebda • Patricia Czar
  • 28. Barcode and RFID Medication Administration• Quality initiative identified by the Leapfrog Group and the Veterans Administration’s National Center for Patient Safety• Uses barcode on the unit-dose medication package and patient bracelet to ensure right patient, right drug, right dose, right time, right route Handbook of Informatics for Nurses & Healthcare Professionals, Fifth Edition Toni Hebda • Patricia Czar
  • 29. E-prescribing Benefits• Provides a longitudinal prescription record• Checks formulary compliance and reimbursement• Provides alerts about drug interactions• Generates reminders to order home meds for the discharged client• Eliminates phone authorization for refills Handbook of Informatics for Nurses & Healthcare Professionals, Fifth Edition Toni Hebda • Patricia Czar
  • 30. Physician Practice Management Systems• Features include capture of demographic and insurance data, scheduling, billing, outcome tracking, and report capability• May, or may not, connect to hospital electronic patient records or maintain separate patient records Handbook of Informatics for Nurses & Healthcare Professionals, Fifth Edition Toni Hebda • Patricia Czar
  • 31. Long-Term Healthcare Systems• Slow to come to this area• Needed for the improved quality of care and efficiency• Critical to business survival• Integration with other systems needed to best serve patients• Can include all features seen in other clinical information systems Handbook of Informatics for Nurses & Healthcare Professionals, Fifth Edition Toni Hebda • Patricia Czar
  • 32. Home Healthcare• May communicate with hospital systems to exchange data• Support demands for excessive documentation• Improve payment for services because it is easier and quicker to find information needed for billing Handbook of Informatics for Nurses & Healthcare Professionals, Fifth Edition Toni Hebda • Patricia Czar
  • 33. Other Healthcare Systems• Administrative systems• Registration systems• Scheduling systems• Contract management systems• Financial systems• Risk management systems Handbook of Informatics for Nurses & Healthcare Professionals, Fifth Edition Toni Hebda • Patricia Czar
  • 34. Registration Systems• Admission/discharge/transfer (ADT) systems• Collect and store demographic and insurance data that are verified and updated at the time of each visit• Critical to operations to ensure correct patient identification and reimbursement for charges Handbook of Informatics for Nurses & Healthcare Professionals, Fifth Edition Toni Hebda • Patricia Czar
  • 35. Decision Support and Expert Systems• These aid in and strengthen the selection of viable options using the information of an organization to facilitate decision making and overall efficiency.• Decision support software organizes information to fit new environments. Handbook of Informatics for Nurses & Healthcare Professionals, Fifth Edition Toni Hebda • Patricia Czar
  • 36. Smart Technology• Improves quality, safety, and efficiency in patient care• Optimization of workflow by slowing problems to create better workflow for clinicians• Benefits clinicians and patients• Adoption can be slow and expensive Handbook of Informatics for Nurses & Healthcare Professionals, Fifth Edition Toni Hebda • Patricia Czar
  • 37. Future Directions• The adoption and refinement of healthcare information systems will continue to be driven by demands for safety, quality, efficiency, and retention of the workforce. Handbook of Informatics for Nurses & Healthcare Professionals, Fifth Edition Toni Hebda • Patricia Czar

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