A Clinical Information System (CIS) is a computer based system that is designed for collecting, storing, manipulating and making available clinical information important to the healthcare delivery process. (biohealthmatics.com)
Clinical Information Systems may be limited in extent to a single area (e.g. laboratory systems, ECG management systems) or they may be more widespread and include virtually all aspects of clinical information (e.g. electronic medical records ). (biohealthmatics.com)
Clinical Information Systems provide a clinical data repository that stores clinical data such as the patient’s history of illness and the interactions with care providers. The repository encodes information capable of helping physicians decide about the patient’s condition, treatment options, and wellness activities as well as the status of decisions, actions undertaken and other relevant information that could help in performing those actions. (biohealthmatics.com)
Who Should be involved? Key leaders in the choosing, implementing, and revising the CIS should be …… Clinical Staff Administration Staff Information technology staff
A 2003 and 2006 study were carried out at a teaching hospital to obtain an average figure.
On average, implementation costs for the health IT system amounted to about $14,500 per bed, and annual operating costs were about 19 percent of those one-time costs, or $2,700 per bed.
Hoffmann and Podgurski's scholarly study estimate the cost of purchasing is $33,000 per physician.
RAND Corporation researchers estimated for a larger grouping of teaching hospitals for costs considerably higher
nearly $63,000 per bed. The RAND researchers estimated that annual costs for maintaining and updating the system would equal 30 percent of acquisition costs—a figure that is higher than the corresponding proportion in other estimates and that adds $18,900 per bed per year.
Additional hardware and devices including networking devices, scanners, printers or kiosk devices
Consultants or project manager to facilitate the implementation (large practices in particular should strongly consider using a consultant to help manage the EMR selection, implementation and post-implementation phases
A basic statement would be that everyone who needs access to the EHR needs to have it available.
This means that they must have a Windows computer available wherever and whenever they need to see the record. For the most part this will mean computer access in every examination room, at every provider's desk, at all nursing work areas, and at all other points of patient care or consultation. This might be accomplished by fixed desktop computers or by mobile workstations.
Computers will have to retrieve RPMS patient data, the facility needs to have a reliable network connecting all of the above locations. This network should also have a high-speed Internet connection, to facilitate the clinical decision support functions of EHR
Information Technology is a huge part of the healthcare practice. It includes hardware, software, networks, internet, and problem solving. These all need to be integrated to work effectively and efficiently.
New positions are recommended by the EHR program since the point of a clinical system is to work during all hours of patient care, there also needs to be someone there to perform clinical support duties at all hours of patient care.
Projections for jobs available to IT technical support/health information support shows employment in 2008 as 172, 500 and projected employment for 2018 to be 207, 600.
Earnings to these employers and costs to our healthcare systems
Just like any profession or network there is a learning curve that is constantly changing. This ranges from social networks and email to the EMR system and medical advances in technology.
The training to implement a EHR system is costly:
Training costs such as computer-based tutorials and hired trainers
Office staff back fill costs for while staff are in training to cover there originally positions
So when the basic training is done, the technology is still evolving and will need someone to continue to implement and teach the changes as they come. The costs will be less then the implementation but there will still be a cost if your system is to be successful.
Education for the CIS HOW ? Hands on for first time users Verbal instruction during live computer lab sessions Updates-interactive computer tutorials with quick reference guide handouts. A.Martin- AAMrtin-11
Education for CIS Formats of Learning: Amartin-2 http://www.arrowhead.lib.mn.us/renewal/formats.htm Touch -classroom based activities and practice skills See - demonstration & observation, handouts and resource guides Hear - verbal instruction provides increased comprehension
Education for CIS TIME Periodic updates should be given every few months as people become more familiar with the initial training. (ex: show one way to perform a task at the initial education then a month later show another way or a short cut method to help with user speed) Annual re-education- cover any upgrades to the software that users may not be familiar with. Amartin-3
Education for CIS Who Education should be done by nurses that are currently practicing and have an extensive computer background. A clinical informatics specialist team would be the most desirable educators. Amartin-4 http://my.clevelandclinic.org/nursing/informatics. aspx
The EHR is a computer-based data warehouse or repository of information regarding the health status of a client, replacing the former paper-based medical record; it is the systematic documentation of a client's health status and health care 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 health care across the client's healthcare continuum. (Mastrian & McGonigle, 2009)
Access: Patient may view their orders. Physicians and proper licensed personal may enter orders.
Importance: Permits proper clinical providers to electronically enter orders. This system offers a range of functionality, from pharmacy ordering to more sophisticated systems such as complete ancillary service ordering, alerting, customized order sets, and result reporting.
Hoffmann, S, & Podgurski, A. (2008, October 30). Case western reserve university professors call for regulation of electronic health records . Retrieved from http://blog.case.edu/case-news/2008/10/30/ehrregulation
Mastrian, K., & McGonigle, D. (2009). Nursing informatics and the foundation of knowledge . Sudbury, MA: Jones and Bartlett Publishers, LLC.
Occupational outlook handbook , 2010-11 edition . (2009, Dec 17). Retrieved from http://www.stats.bls.gov/oco/ocos103.htm
Zytkowski, M, & Oblack, M. (n.d.). Nursing informatics . Retrieved from http://my.clevelandclinic.org/nursing/informatic s.aspxhttp://www.arrowhead.lib.mn.us/renewal/formats.htm