This document provides an overview of the evolution and development of electronic health information systems. It discusses how clinical information systems began in hospitals in the 1980s as standalone systems, and later developed into integrated electronic health record systems. The document also outlines the various types of clinical information systems, as well as administrative, research and analytics systems used in healthcare. It describes the roles of health information management professionals in developing and managing electronic health information systems.

1. © 2011
Chapter 15: Introduction to Electronic Health
Information Systems
Health Information Management
Technology: An Applied Approach
Fourth Edition

2. © 2011
Evolution of Information Systems in
Healthcare
• Information systems began in healthcare in
1960s.
o Developed in-house
o Administrative and financial systems
o Mainframe computers

3. © 2011
Development of Clinical Systems
• Clinical systems began being used in the 1980s
• Standalone systems

4. © 2011
Electronic Health Record Systems
• Institute of Medicine report on the computer-
based patient record
o Addressed problems with paper records
• 1990s: Internet and home computers

5. © 2011
Electronic Healthcare Information
Applications
• Clinical information systems
• Administrative information systems
• Management support systems

6. © 2011
Clinical Information Systems
• Patient registration
o Admission-discharge-transfer (ADT)
o Link to ancillary departments
• Laboratory information systems
• Pharmacy information systems
• Radiology information systems
o Picture archiving and communications systems

7. © 2011
Clinical Information Systems
• Nursing information systems
• Emergency medical systems
• Patient monitoring system
o Fetal monitoring
o Vital signs
o Oxygen saturation

8. © 2011
Clinical Information Systems
• Clinical provider order entry
o Alerts
o Reminders
• Electronic documentation
o Structured documentation
o Unstructured documentation
o Templates

9. © 2011
Clinical Information Systems
• Medication administration systems
• Multidisciplinary care pathways
• Point-of-care charting
o Computers on wheels (COW)
o Data entry models
• Structured data entry
• Unstructured data entry
• Template-based data entry

10. © 2011
Clinical Information Systems
• Clinical practice guidelines
• Clinical decision support systems
• Document imaging
o Scanning
o Advantages
• Immediate access to information
• Multiple users can access same information

11. © 2011
Clinical Information System
• Digital dictation
o Operative report
o History and physical
o Discharge summary
o Voice recognition

12. © 2011
Clinical Information Systems
• Multimedia and Telematics Systems
o Telehealth
o Telesurgery

13. © 2011
Toward an Electronic Health Record
System
• Transition to EHR takes years.
• Many facilities have hybrid systems.
• Interoperability

14. © 2011
Administrative Information Systems
• Information systems that assist in managing the
organization

15. © 2011
Administrative Information Systems
• Financial information systems
• Human resource management systems
• Materials management systems
• Facilities management systems
• Management information systems
o Periodic scheduled reports
o Exception reports
o Demand reports

16. © 2011
Administrative Information Systems
• Strategic decision support system
• Executive information systems

17. © 2011
Research and Data Analytics Systems
• Manages data for use in decisions
• Includes public health systems

18. © 2011
Research and Data Analytics Systems
• Data warehouse
o Consolidated database
o Updated periodically
o Uses financial and clinical data
• Data mart
o Subset of data warehouse

19. © 2011
Research and Data Analytics Systems
• Data mining
o Analyzes data
o Looks for trends
o Techniques
• Decision tree
• Genetic algorithms
• Neural networks
• Predictive models
• Rule inductions
• Fuzzy logic

20. © 2011
Research and Data Analytics Systems
• Online analytical processing

21. © 2011
Healthcare Information Resource
Management
• Coordinates systems to ensure they operate
efficiently and effectively
• Information resource management
o Information is valuable resource
o IRM includes:
• Creation
• Use
• Storage
• Disposal

22. © 2011
Healthcare Information Resource
Management
• IRM based on strategic plan
• IRM addresses
o System infrastructure
o Data structures
o Policies and procedures
o Fostering technological ideas and solutions

23. © 2011
Overview of Electronic Clinical
Information Applications in Non-Acute
Care Settings
• Ambulatory care information system
• Long-term care
• Home health

24. © 2011
Healthcare Information Resource
Management
• Data quality is important
• Categories of information
o Patient-specific information
o Aggregate information
o Expert knowledge-based information
o Comparative information

25. © 2011
Organizational structures
• Chief information officer
• Information systems steering committee
• Chief privacy officer
• Chief information privacy officer
• Chief medical informatics officer
• Information services department
• Health information management department
• Enterprise content and records management department

26. © 2011
Roles of HIM Professionals in Electronic
Health Information System
• New roles are being created
• Sample roles
o Data management
o Data quality
o Data collection and analysis
o Data privacy
o Data security
o Electronic system design and development

27. © 2011
Roles of HIM Professionals in
Electronic Health Information System
• Other
o Consumer health informatics
o Data integrity
o Data mining