Contributors Slides 25-29: Arnold, Lori Slides 6-10: Estes, Rachel Slides 1-2, 5,13-24, 30-39: McHugh, Robyn Slides 3-...
Technology-based systems applied at the point      of care, designed to support the acquisition      and processing of inf...
   Advantages         Easy access to patient data, increase the          amount of data available for clinical          ...
Staff                nurses &                 Nurse                managers           Who should be involved in           ...
Education    “The most important participants in the health care      delivery system are the patients and their families ...
Education        Problems       Volume of information           Can make it difficult to implement certain education    ...
Education       Educators, and users, should be well trained in        order to provide the best care for the patient and...
Education        Goals       Should not take RN away from bedside to        classroom       Needs to be convenient – com...
Education                                                        Example of interactive                                   ...
   Initial costs         License fees for databases and interfaces         External services: process consulting, user ...
   Operating costs         Personnel costs: for system          administration, workstation maintenance, user          h...
Electronic Health Record                 A compiled electronic record of patient              health information generated...
Electronic Health Record                                      Longitudinal                                      collection...
Promotes greater                                quality/                             efficiency in                        ...
1. Health Information & Data     • All patient data included       • Benefits:           • Immediate access to key informa...
2. Results Management     • Manages all results, from all departments       • Benefits:           • Integrates all patient...
3. Order Management     • Enters and stores orders for       tests, prescriptions, and other services.       • Benefits:  ...
4. Decision Support     • Uses two or more items of patient data to       generate case specific advice       • Benefits: ...
5. Communications & Connectivity     • Networking between other care providers       and patients through Web. 2.0 applica...
6. Patient Support     • Tools provided to patient including access to       health records, patient       education, moni...
7. Administrative Processes     • Computerized administration in such areas as       scheduling, billing, and out-patient ...
8. Reporting     • Provides data collection capabilities, specific       to institution, to support reporting       requir...
   Legal requirements restrict access to the patient        and those providing patient care only.       HIPPA defines w...
HIPAA    It is a way to protect and maintain patient’s health information    It is the health care professional’s respon...
Access and Authentication   Who has access?      Access can be gained by policies and job titles      Policies help with...
Access and Authentication   How do users gain access?      Access through passwords, identification cards, and       biom...
Security Threats  “The most common threats a corporate network faces               are hackers, malicious code     (spywar...
Security Tools      Firewalls:         Examine all incoming and outgoing network information      Proxy servers:       ...
   Access should be based on role-based        definitions.       Tasks associated with care provision roles:        Sh...
   Evaluate each employee to ensure appropriate        level of access       System administrator should be identified i...
Active knowledge systems                      Use two or more items of patient data                      Generate case spe...
   Administrative             (Clinical coding)         Clinical Detail Management             (Referrals, follow-up)   ...
   Automatic prompts rather than user activation       Integrated decisional support into clinical work        flow    ...
   Should provide periodic performance        feedback       Request documentation for reasons when        system recomm...
   Continuous maintenance and updating of        system necessary       Maintenance alarms should be in place       Not...
Companies that design clinical decisionmaking systems for the CISAnvita Health       www.anvitahealth.comCapterra         ...
AHIMA, (2011.). Retrieved Oct 25, 2011, from AHIMA:   http://campus.ahima.org/audio/2007/RB112007Kawamoto, K ., Houlihan, ...
Open Clinical (2006). Decision support systems. Retrieved Oct. 25, 2011, from     OpenClinical: http://www.openclinical.or...
CIS Innovations in Healthcare
Upcoming SlideShare
Loading in …5
×

CIS Innovations in Healthcare

661 views

Published on

Our Southwest Baptist BSN nursing course assigned this project. This project covers modern Computer Information Systems that are specially designed for healthcare. The purpose of the project is to promote a knowledgable selection

0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total views
661
On SlideShare
0
From Embeds
0
Number of Embeds
1
Actions
Shares
0
Downloads
18
Comments
0
Likes
0
Embeds 0
No embeds

No notes for slide

CIS Innovations in Healthcare

  1. 1. Contributors Slides 25-29: Arnold, Lori Slides 6-10: Estes, Rachel Slides 1-2, 5,13-24, 30-39: McHugh, Robyn Slides 3-4, 11-12: Pellegren, Leigha
  2. 2. Technology-based systems applied at the point of care, designed to support the acquisition and processing of information as well as providing storage and processing capabilities  Goal  To become a comprehensive system that provides clinical decision support, an electronic patient record, and professional development training tools(McGonigle & Mastrian, 2009)
  3. 3.  Advantages  Easy access to patient data, increase the amount of data available for clinical use, reduce medical errors, and patient safety  Disadvantages  Computer literacy is required and there could be a breach in confidentiality, privacy and security if a computer screen is left open or unattended.(McGonigle & Mastrian, 2009)
  4. 4. Staff nurses & Nurse managers Who should be involved in choosing, implementing, and revising the CIS? . Performance improvement analysts Support staff End users(McGonigle & Mastrian, 2009)
  5. 5. Education “The most important participants in the health care delivery system are the patients and their families who receive the care and the clinicians who provide the care.”(Sittig et al., 2002)
  6. 6. Education Problems  Volume of information  Can make it difficult to implement certain education pieces  Ever changing and dynamic  Just like technology!  Maintenance is difficult – re-education is key(McGonigle & Mastrian, 2009)
  7. 7. Education  Educators, and users, should be well trained in order to provide the best care for the patient and patient’s family!  Educators should be specifically qualified and knowledgeable in the healthcare field in order to instruct more effectively.  Information continually provided establishes compliance.(Sittig et al., 2002; McGonigle & Mastrian, 2009)
  8. 8. Education Goals  Should not take RN away from bedside to classroom  Needs to be convenient – computerized  Needs to be interactive  Repetition and frequent re-education(McGonigle & Mastrian, 2009)
  9. 9. Education Example of interactive education Joy Hilty, RN Those documenting If answeredDeveloped a “prompt” on the computer see They can answer them correctly, they receive system on pop-up boxes with a with an e-mail a vacation from thecomputerized charting question pop-up boxes Encourages Pop-ups are colorful interaction, especially and eye catching! between peers(McGonigle & Mastrian, 2009)
  10. 10.  Initial costs  License fees for databases and interfaces  External services: process consulting, user training, customizing, etc.  Internal implementation expenditure: for initial user training and intensive support activities during implementation phase(Cost benefit study of ORBIS)
  11. 11.  Operating costs  Personnel costs: for system administration, workstation maintenance, user helpdesk, etc.  Depreciations on workstation and server hardware and infrastructure  Costs for maintenance and care of hardware and software(Cost benefit study of ORBIS)
  12. 12. Electronic Health Record A compiled electronic record of patient health information generated via one or more encounters of care provision including: Patient demographics Problems Medical history Medications Laboratory data Vital signs Immunization Radiology Patient drug history reports allergies(mitre.org)
  13. 13. Electronic Health Record Longitudinal collection of health information Immediate Provides access to patient knowledge and info. by decisional authorized user support Supports efficient processes for health care delivery(http://www.openclinical.org/emr.html#benefits)
  14. 14. Promotes greater quality/ efficiency in healthcare Promotes greater US IOM report safety in is key! healthcare Eight core care delivery functions(openclinical.org)
  15. 15. 1. Health Information & Data • All patient data included • Benefits: • Immediate access to key information • Provides ability to make timely, sound clinical decisions(McGonigle & Mastrian, 2009; mitre.org)
  16. 16. 2. Results Management • Manages all results, from all departments • Benefits: • Integrates all patient results between departments • Enables providers to participate in patient care in multiple settings(McGonigle & Mastrian, 2009; mitre.org)
  17. 17. 3. Order Management • Enters and stores orders for tests, prescriptions, and other services. • Benefits: • Enhances legibility • Reduces duplication and speeds execution(McGonigle & Mastrian, 2009; mitre.org)
  18. 18. 4. Decision Support • Uses two or more items of patient data to generate case specific advice • Benefits: • Improves compliance with evidence based practice • Ensures regular screenings and preventative services • Facilitates diagnoses and treatments(McGonigle & Mastrian, 2009; mitre.org)
  19. 19. 5. Communications & Connectivity • Networking between other care providers and patients through Web. 2.0 applications • Benefits: • Improves continuity of care • Increases timeliness of diagnoses and treatments • Reduces frequency of adverse events(McGonigle & Mastrian, 2009; mitre.org)
  20. 20. 6. Patient Support • Tools provided to patient including access to health records, patient education, monitoring, and tele-health • Benefits: • Improves control of chronic conditions • Allows provision of patient care in patient’s own home(McGonigle & Mastrian, 2009; mitre.org)
  21. 21. 7. Administrative Processes • Computerized administration in such areas as scheduling, billing, and out-patient services • Benefits: • Improves hospital/clinic efficiency • Provides more timely service to patients • Reduces lost charges(McGonigle & Mastrian, 2009; mitre.org)
  22. 22. 8. Reporting • Provides data collection capabilities, specific to institution, to support reporting requirements to federal, state, & private entities • Benefits: • Allows healthcare agencies to respond more quickly to required reporting mandates(McGonigle & Mastrian, 2009; mitre.org)
  23. 23.  Legal requirements restrict access to the patient and those providing patient care only.  HIPPA defines who should have access:  Joint commission IM 2.10.7 provides protection from unauthorized access, corruption or damage.(Walsh, T. & Miaoulis, W., 2011)
  24. 24. HIPAA It is a way to protect and maintain patient’s health information It is the health care professional’s responsibility Data should be backed up daily Missouri’s Medical Retention Laws on storage of data Missouri 5 years Skilled nursing, intermediate care, and RS Mo. Section residential care facilities must maintain medical records for five years after the 198.052.7 resident leaves the facility, or until the resident (1983) reaches the age of 26, whichever is longer.(LTC Consortium, 2004)
  25. 25. Access and Authentication Who has access?  Access can be gained by policies and job titles  Policies help with who can access and what type of activities are permitted(McGonigle & Mastrian, 2009)
  26. 26. Access and Authentication How do users gain access?  Access through passwords, identification cards, and biometrics  Biometrics are  Devices that recognize thumb prints, retina patterns, or facial patterns.(McGonigle & Mastrian, 2009)
  27. 27. Security Threats “The most common threats a corporate network faces are hackers, malicious code (spyware, viruses, worms, Trojan horses) and the malicious insider.”(McGonigle & Mastrian, 2009)
  28. 28. Security Tools  Firewalls:  Examine all incoming and outgoing network information  Proxy servers:  Acts as a filter to block users from the Internet  Intrusion detection systems:  Monitors who is using network and what is being accessed(McGonigle & Mastrian, 2009)
  29. 29.  Access should be based on role-based definitions.  Tasks associated with care provision roles: Should be tied to corresponding access necessary to perform care provision role(Walsh, T. & Miaoulis, W., 2011)
  30. 30.  Evaluate each employee to ensure appropriate level of access  System administrator should be identified in order to  Authorize new roles and staff  Verify employee status  Terminate access when employee leaves  Monitor access  Develop policy & exceptions to policy(Walsh, T. & Miaoulis, W., 2011)
  31. 31. Active knowledge systems Use two or more items of patient data Generate case specific advice Designed to integrate medical knowledge with patient data(http://www.openclinical.org/dss.html#definition)
  32. 32.  Administrative (Clinical coding)  Clinical Detail Management (Referrals, follow-up)  Cost control (Monitor medication orders)  Decision Support (Best treatment options)(http://www.openclinical.org/dss)
  33. 33.  Automatic prompts rather than user activation  Integrated decisional support into clinical work flow  Decisional support provided at time/location of care provision  Provides active voice recommendations for care provision  Uses a computer to generate this support  These support structures improve clinical practice based on Evidence-based practice  These structures all make it easier for care providers to use decisional support systems(Kawamoto, K., Houlihan, C. A. , Balas,E. A., & Lobach, D. F. 2005)
  34. 34.  Should provide periodic performance feedback  Request documentation for reasons when system recommendations are not followed  Share decision support results with patients(Kawamoto, K., et al., 2005)
  35. 35.  Continuous maintenance and updating of system necessary  Maintenance alarms should be in place  Notification of current system performance should be in place  Provision for support & maintenance of systems should be in place(http://www.openclinical.org/dss)
  36. 36. Companies that design clinical decisionmaking systems for the CISAnvita Health www.anvitahealth.comCapterra www.capterra.comPlante-moran www.plantemoran.comActive Health www.activehealth.comMed Assets www.medassets.com
  37. 37. AHIMA, (2011.). Retrieved Oct 25, 2011, from AHIMA: http://campus.ahima.org/audio/2007/RB112007Kawamoto, K ., Houlihan, C. A. , Balas,E. A., & Lobach, D. F. (2005). Improving clinical practice using clinical decision support systems: a systematic review of trials to identify features critical to success. BMJ, 1-8. Retrieved Oct. 25, 2011, from BMJ Online First: http://www.bmj.com/content/330/7494/765.full.pdf doi:10.1136/bmj.38398.500764.8FLTC Consortium. (2004). State by State Medical Record Retention Laws: Nursing Facilities. Retrieved October 25, 2011, from http://www.ahcancal.org/facility_operations/hipaa/Documents/State%20by%20State%20M edical%20Record%20Retention%20Laws-Nursing%20Facilities%202004.pdfMITRE, (2011). Retrieved Oct. 25, 2011, from MITRE: http://www.mitre.org/Electronic medical records. (2011, Sept. 14). Retrieved Oct. 25, 2011, from Open Clinical: http://www.openclinical.org/emr.html#benefitsMcGonigle, D. & Mastrian, K. (2009). Nursing informatics and the foundation of knowledge. Sudbury, MA: Jones and Bartlett.
  38. 38. Open Clinical (2006). Decision support systems. Retrieved Oct. 25, 2011, from OpenClinical: http://www.openclinical.org/dssOpen Clinical (2006). Decision support systems. Retrieved Oct. 25, 2011, from Open Clinical: http://www.openclinical.org/dss.html#definitionMcGonigle, D. & Mastrian, K. (2009). Nursing informatics and the foundation of knowledge. Sudbury, MA: Jones and Bartlett.Sittig, D. F., Hazlehurst, B. L., Palen, T., Hsu, J., Jimison, H., & Hornbrook, M. C. (2002). A clinical information system research landscape. The Permanente Journal, 6(2). Retrieved from http://xnet.kp.org/permanentejournal/spring02/landscape.html#

×