Transcript HLST 2040 – Lec 1

HLST 2040 – Lec 3
Health Informatics 1
Agenda for today
• Finish Last week’s lecture
• Look at Healthcare Information systems
• Define and Classify Information Systems
• Information System Department
– Sections & Responsibilities & Roles
– Technology Infrastructure
– Business Environment
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Example of Information System
Healthcare Information System
–Elements of IS
–Needs of HIS
–Types of HIS
Last Week
• ADSS, CDSS
Quantitative Techniques
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Forecasting
Inventory models
Simulation
Linear Programming
Linear Programming
• Linear programming is generally used to
determine the best consumption of resources
in order to meet some objective.
– In health care, these can be used to: Schedule staff
and use of facilities
– Design the optimal production of medical services
or goods
– Establish the most efficient routes for transporting
patients
– Determine the most efficient use of space
HR-ADSS
– Human resources management software typically
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supports the following functions:
Recruitment and retention
Personnel administration
Management of payroll against budget
Training
Performance evaluation
• Management of compensation and benefits has
become an increasingly complex task facilitated
by decision support
Components of IS
Departments
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Operations
Telecommunications
Clinical applications
Administrative applications
Personal computer and help desk support
Systems administration
Network support
See pg. 133 of the text
Operations Responsibilities
• Operations
– Maintenance of the information systems
hardware
• Activities include production jobs, system
backups
• Machine and printer maintenance
• System backup to include:
–Billing and patient data
Telecommunications
• Provides support for the telephone systems
– Responsibilities include:
• Adds, moves, and changes requested by users
– Managerial functions include:
• Monitoring and verification of billing statements
• Monitoring of switchboard
Systems Development/Project
Management
• Develop small databases
• Internet Web sites
• Project management
Applications Support
• Requires information technology expertise and
application domain expertise
• May be a challenge for the Hospital IS
• Functionality – see top of pg. 134
• Troubleshooting – document the problem and
contact the vendor
• Enhancements- For example, enhance Lotus
Notes
Information Systems Support-pg. 135
• Help desk group
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First response for problem solving
Lost passwords
Network outages
Help desk may use various software packages to enhance
its own efficiency
• PC support section
– Problem solving at the user’s desk, not creating tickets
– Install new PCs
– Reconfigure existing software
Network
• Primarily responsible for wiring that connects
computers
• LAN (local area network)
– Wiring within an organization
• WAN (wide area network)
– Links a number of LANs owned by the organization
Systems Administration – pg. 136
• Responsible for
management of the
operating systems for
all of the health care
organization’s
computers
• Security
• Upgrades of operating
systems
• Resource management
• File management
– Printing
– Network
communication
– Tape management
– Input function
CIO
• CIO Chief Information Officer
• Has primary leadership role of IS department
• Reports to CFO, COO, CEO
• Qualification: master’s in health care
informatics, information sciences, computer
sciences, business and many years experience
Director
• Responsibility for one or more sections
– Responsible for telecommunications, networking,
systems management, operations
• Manager – usually of a department
• Supervisor – hands-on functions with staff
• Operator – job within operations section
Other Information Systems Department
Roles
• Telecom technicians and operators –
support/switchboard management
• Systems analyst – application support/project
management
• Consultant – contract basis
– Selection and installation of applications
– Development of Internet Web site
Technology Infrastructure Components
• Consists of hardware and software that enable all
of the computations performed within an
organization
• Primary components
– Computers
– Data communications network
– Computer peripherals
Computers
• Computers perform the computational tasks
required to process the information required by the
health care organization
• Size, cost, and capacity may vary
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Mainframe computers
Mid-range computers
Servers
Workstations
Portable computers and handheld devices
Mainframe Computers
• Range in cost from $300,000 to several million
dollars
• Trend has been toward less expensive mid-range
and mini-computers
• Sometimes required to run older applications
(sometimes called legacy systems)
Mid-range Computers
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Price range from $50,000 to $300,000
Example of midrange is AS 400
Used to support the lab or radiology systems
Medium and smaller organizations are often able to
run their core software applications on these
systems
Servers
• Low cost server systems range from $10,000 to
$50,000
• More costly cost more
• May be called by the nickname back-end
• Computer networking technology allows such
systems to interact with each other
Workstations – pg. 141
• Supports both local and remote computing
functions
– Local computing
• Word-processing
• Spreadsheet functions
– Remote computing
• Workstation access via the Internet
Portable Computers and
Handheld Devices
• Allow staff to document patient care at point of
care
– Notebook computer on a movable stand
• Handheld computing devices to access health care
information systems is emerging as a preferred
mode of interaction
– Blackberry or PDA at the bedside
Networks
• Information systems have primary responsibility for
design, implementation, and maintenance of
computer networks
• Example of growth is the Internet
• Cloud computing is another big thing today
– Concerns include:
• Security and confidentiality
• Misuse of the Internet
• Provision of adequate bandwidth
Networks
• Hubs: connect devices in LAN
• Routers and switches: link multiple LAN to
WAN and perform filtering of messages going
from LAN to WAN
• Protocol- Language that the computers use to
talk to each other over a network
Peripherals
• Computer peripherals are input and output devices
used by computer systems
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Printers
Magnetic tape devices
Computer terminals
Scanners
Projectors
Business Environment
• IT is always the “Bad Poster Boy” in a healthcare
setting
• Reasons for failure
– Immature technology – too early adopters?
– Lack of alignment of objectives of the information
systems project with the overall organizational strategic
objective
– Inadequate planning and transition management
– Underestimation of resources and overestimation of
the benefits expected from the project
Business Environment
• Key contributors to success
– The relationship the department has with its clients or
primary users (internal staff)
– Leadership abilities to assemble “big picture” strategies
and an ability to keep up with ever-evolving technology
Types of Organization
• Community hospital
– Typically supported using small or mid-range computer
systems
• Small doctor’s office
– Use EMR and cloud computing
Types of Organization
• Teaching hospital
– Many are research oriented and have contributed to
medical information systems advances
• Example: HL7 standard
• Critical care monitoring applications
• Interface engine
Chapter 7
HEALTH CARE INFORMATION
SYSTEMS
Objectives
• Discuss components of a Health care information
system (HIS)
• Recognize six different types of HIS applications
• Identify at least three constraints in the use of HIS
systems
Data ,Information, Knowledge
• Data Input
– User enters data
– Transferred from other systems
– Automatically captured from physiodynamic equipment
• Data Output
– Aggregated data into information
– Reports, Graphs, Screen displays
• Knowledge
– Information combined with medical knowledge
• Various systems are used
– For example, EMR,PACS
Healthcare Information Systems
• Classified in various ways
• Easiest- Clinical or Administrative
• Administartive- Staff scheduling, Finance,
stock and asset management etc.
• All systems use one or more of:
– UI
– Network
– Database
– Output
2nd way of classifying HIS
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Institution-wide Systems
Specialty Support Systems
Documentation Systems
Administrative Systems
Operation Support Systems
Health Care Information System
• Encompasses a wide array of applications( software)
and systems
– Interfaced together
– Supports and communicates required information
• Integration of systems
– Unique to each organization
• Organizational strategic goals drive selection and
prioritization of system selection
• Practice needs shape content and functionality
• Business needs shape scope of information systems
plan
Example of use of IT systems
• See pg. 149
• Typical Ontario hospital has a mix of many large,
small, legacy and new systems
• These can range from 50-200
Types of System Applications
• Institution wide
– Admission, discharge, transfer (ADT)
• Backbone of HIS system
• Patient demographic information
• Bed control
– Financial applications
• Tracks financial interactions
• Provides fiscal reporting
• This kind of software is obviously not clinical
• See pg. 153
Types of System Applications:
• Institution wide (continued)
– Order entry applications
• Regular clinical interaction
• Order communication
• Bill tracking
• For example CPOE
– Results reporting
• Separate from order entry
• Multiple departments
Radiology Information System/ PACS
• Supports the operations of a radiology
department
– File or X-ray tracking
– X-ray scheduling
– Radiology transport and patient tracking
– Supports database of services that are provided by
department and billed against
• PACS
– Filmless Xray
– Fuji, GE , Toshiba
EMR
• eClinical works
• http://www.eclinicalworks.com/Collateral/Flas
h/English-US/indexFLASH_popup.html
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• PS suite EMR
• http://md.cma.ca/ps-suite/emr/
LIS
– Laboratory
• Supports a laboratory department including machinery
that processes the lab specimens
– Tracks and performs quality testing on lab
equipment
– Tracks orders, specimen receipt, reorders,
processing, and results
– Maintains the database to support normal result
ranges, specific test numbers, and suppliers
Pharmacy Systems
• Speciality system for the operations of a pharmacy
department
• Can be evaluated to support either inpatient or
outpatient services
– Quality control for TPN mixtures
– Order communication
– Stock and reorder control
– Narcotic counting and tracking
– Drug reaction recording and tracking
– Kroll is a big vendor of pharmacy systems
Documentation systems
– Available in a variety of formats
• Communication of information real-time
• Needs to support clinical workflow not distract
– Captures physiological data directly
• Vital signs
• Cardiac monitor
• Others
Types of System Applications
• Administrative systems
– Supports collection of data to manage a service line
• Patient care services
• Food services
– Case management systems
– Acuity systems
– Scheduling applications
• Staff
– Patients
Types of System Applications
• Operations support systems
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Addresses the day-to-day operations
Communication or paging systems
Human resource systems
Materials management
System Configurations
• Single vendor for majority of applications
• Core vendor that systems must integrate with
• Multiple systems: Best of breed
Vendors
• EMR - MD Physician Services (MD) owned by
CMA
• GE –PACS
• http://www.gehealthcare.com/euen/iis/produ
cts/radiology/pacs/pacs.html
• Kroll
• http://www.kroll.ca/software.html
Summary
• Look at Healthcare Information systems
• Define and Classify Information Systems
• Information System Department
– Sections & Responsibilities & Roles
– Technology Infrastructure
– Business Environment
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Example of Information System
Healthcare Information System
–Elements of IS
–Needs of HIS
–Types of HIS