Informations system and healthcare benefit in informatics

Information health care and it's benefit

1. Handbook of Informatics for Nurses
and Healthcare Professionals
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition
Toni Lee Hebda and Patricia Czar
Chapter 5
Health Care Information Systems

2. Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition
Toni Lee Hebda and Patricia Czar
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
health care

3. Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition
Toni Lee Hebda and Patricia Czar
Types of Information Systems
•Clinical information
systems (CISs)
–Directly support
care
–Individual systems
may be stand alone
–Goal: data
exchange among
systems
•Administrative
systems
–Indirectly support
patient care
–Individual systems
may stand alone
–Goal: data
exchange among
systems

4. Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition
Toni Lee Hebda and Patricia Czar
Clinical Information Systems (CISs)
•Nursing
•Multidisciplinary
•Monitoring
•Laboratory
•Pharmacy
•Radiology
•Emergency
department
•Physician practice
management
systems
•Longterm
•Homecare

5. Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition
Toni Lee Hebda and Patricia Czar
Administrative Systems
•Client management (registration)
•Financial
•Payroll
•Human resources
•Quality assurance
•Contract management
•Risk management systems
•Materials management

6. Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition
Toni Lee Hebda and Patricia Czar
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

7. Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition
Toni Lee Hebda and Patricia Czar
Nursing Information System
Advantages
•Improved access to information
•Better documentation
•Improved quality of care
•Improved productivity and communications
•Tracking capability
•Enhanced regulatory compliance

8. Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition
Toni Lee Hebda and Patricia Czar
Despite advantages information systems
that are used by all clinicians are seen
more commonly
NIS Status

9. Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition
Toni Lee Hebda and Patricia Czar
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

10. Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition
Toni Lee Hebda and Patricia Czar
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

11. Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition
Toni Lee Hebda and Patricia Czar
Clinical Information Systems
Support provider order entry, results
retrieval, documentation, evidence-based
practice, and decision support across
distributed locations and by different
disciplines

12. Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition
Toni Lee Hebda and Patricia Czar
Monitoring
•Comprised of devices that 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”

13. Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition
Toni Lee Hebda and Patricia Czar
Order Entry Systems
•Orders entered into the computer are
transmitted to the appropriate areas such
as the pharmacy, laboratory, radiology,
social service
•Direct entry of orders by the physician,
nurse practitioner, physical therapist, or
other provider is preferred (CPOE)

14. Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition
Toni Lee Hebda and Patricia Czar
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

15. Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition
Toni Lee Hebda and Patricia Czar
Laboratory Information Systems
•↓Turnaround time, duplicate testing, errors
•Can
–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

16. Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition
Toni Lee Hebda and Patricia Czar
Radiology
•Allows direct order entry or accepts orders
from other systems
•Provides scheduling of diagnostic tests
•Generates client instructions
•Permits transcription of results
•Provides picture archiving and
transmission of images and tracking of film
•Generates charges once procedures done

17. Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition
Toni Lee Hebda and Patricia Czar
Pharmacy Information Systems
•Provide checks in order and administration
process using evidence-based guidelines
•↓ Errors when used with bar code
technology
•Use lab results, allergy, and interaction
information from clinical systems
•Track medication use, costs, billing
information

18. Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition
Toni Lee Hebda and Patricia Czar
Pharmacy
•May include more than one system
–In pharmacy dispensing systems(robots)
–Unit-based dispensing cabinets in care areas
–Barcode and RFID Medication Administration
•E-prescribing
–Process that allows the physician to enter a
prescription which is then electronically sent
to the pharmacy from computers, PDAs

19. Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition
Toni Lee Hebda and Patricia Czar
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

20. Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition
Toni Lee Hebda and Patricia Czar
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

21. Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition
Toni Lee Hebda and Patricia Czar
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

22. Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition
Toni Lee Hebda and Patricia Czar
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 fin information
needed for billing

23. Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition
Toni Lee Hebda and Patricia Czar
Longterm 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

24. Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition
Toni Lee Hebda and Patricia Czar
Decision Support and
Expert Systems
…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

25. Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition
Toni Lee Hebda and Patricia Czar
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

26. Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition
Toni Lee Hebda and Patricia Czar
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

27. Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Handbook of Informatics for Nurses and Healthcare Professionals, Fourth Edition
Toni Lee Hebda and Patricia Czar
Future Directions
The adoption and refine of healthcare
information systems will continue driven by
demands for safety, quality, efficiency, and
retention of the workforce