Clinical Information System Informatics

UHN in Toronto is a major community care network that reaches out to and provides care to the masses. However in order to provide this kind of care they must have a very powerful decision support system. UHN utilizes an advanced CPR to support computerized physician order entry (CPOE). (Wu, Perters, & Morgan, 2002) A CPR system is a computer-based patient record system. A CPR system must provide a comprehensive clinical decision support it must include both a patient focus and a population focus. The physical computer system that is installed on the computers at UHN is called Patient 1® which is a clinical information system developed by Atlanta Based Per-Se

In response to the “Patient Protection and Affordable Care Act (ACA) amended by the Health Care and Education Reconciliation Act (Reconciliation Act), collectively referred to as healthcare reform” (); Wishard-Eskenazi Health of Indianapolis, Indiana has begun to make milestone changes to meet the requirements of the healthcare reform. Being a leader in today’s technology which began thirty years ago with development of one of the nation’s first electronic medical record and continues to excel in the healthcare informatics technology today continues to use this technology in quality improvement initiatives, support for future technology research and improving the quality care of the patient.

Healthcare systems are highly complex, fragmented, and use multiple information technology systems and vendors who incorporate different standards resulting in inefficiency, waste, and medical errors (Healthinformatics, 2016). A patient 's medical information often gets trapped in silos, which prevents information from being shared with members of the healthcare community (Healthinformatics, 2016). With increasing healthcare costs, a system needed to be created that would lead to the development and nationwide implementation of an interoperable health information technology system to improve the quality and efficiency of healthcare. Introducing the National Health Information Network (NHIN), this organization can be defined as a set of

Background: The Federal Agency for Healthcare Research and Quality (AHRQ) identified five goals for adopting health information technology (HIT) into the current health care systems that would significantly improve healthcare in America. (Abdelhak, Grostick, & Hanken, 2012, p. 82) These goals will help improve the quality of care within the federal health system by reducing medical errors, cost, and duplication of workload.

The principal utilization of health informatics began in the 1950s with dental information gathered by the National Institute of Standards and Technology (NIST). Utilization accelerated in subsequent decades which gave a standard programming language to clinical applications. Today, the International Medical Informatics Association (IMIA) oversees member organizations involved in health informatics worldwide. (Rouse, 2010). The potential for health IT to enhance the safety of health care delivery has been regarded for quite a long time. The Health Information Technology for Economic and Clinical Health (HITECH) Act,

Information Technology can be use to address escalating health care costs, reform payment systems, reducing health care disparities, and can be effective in comparative research (). In this next section will discuss how these recommendations fit or not fit with the initiatives of the ACA.

A significant, impactful trend on healthcare organizations (HCOs) is the implementation of technology-based information systems (IS). The systems consist of hardware and software used in gathering and processing data that supports the provision of patient care. There are administrative systems, which have been in place for decades and their usefulness are highly recognized. They track services rendered, billing processes used for third party payers and patients, as well as payroll for employees. Administrative systems are essential for the financial component of a business. More recently, the importance of clinical information systems has moved into the spotlight. They are intended to

Wager, K. A., Lee, F. W., & Glaser, J. P. (2009). Health care information systems, a practical approach for health care management. (2nd ed.). Jossey-Bass Inc Pub.

The current and consistent incompatibility of systems and the ability to share information must be resolved through modifying the system so that it works to share information. The goal of the UMR system was to have shared access while assuring privacy, quality and security to patient. To date that goal has not been achieved. The key to facilitating access is providing effective and efficient treatment to patients and secondary is cos effectiveness. Discontinuing use of the current UMR is no longer an option. Considerations should be given to outsourcing the task to a vendor in which we have outlined our needs. This information will be internet based for more flexibility in which data can be managed and consulted by authorized physicians, specialists, and staff across more than one healthcare organization. This will allow for the information to move with the patient to the physician, specialist, nursing home, laboratory, state and/or across the country. Ultimately resulting in improved quality of care for the

Recent reforms in health care, such as the passage of measures mandating electronic health care records, make unified public health information systems an increasingly viable option for providers, insurance companies, and care facilities. An examination of the experience of the Missouri Department of Health indicates that the construction of such a system based on information engineering has a number of benefits but only if properly implemented with prudent foresight. Some of the most valuable lessons learned that can assist other health care providers with the implementation of a similar system include protecting client confidentiality, procuring funding, sharing information with other agencies, gaining executive sponsorship, and allocating a sufficient amount of time and resources to such an undertaking.

Currently, the healthcare industry only spends 2% of gross revenues on health information technology, while the banking industry spends upwards of 10%. However, the Veterans Healthcare System is one of the largest integrated systems in the world. One hundred fifty-five hospitals and eight hundred clinics rely on one electronic health system (Gupta & Murtaza, 2009). Implementing information systems in hospitals is more challenging than elsewhere because of the complexity of medical data, data entry problems, security and confidentiality concerns and a general lack of awareness of the benefits of Information Technology (Boonstra et al., 2014). The newly implemented system must be reliable from the onset as patient care does not cease in the meantime. Technology has the potential to streamline current practices and reduce costs, however, hospitals must consider the potential risks and consequences of a poorly implemented project and agree that failure is not an option. Good project planning and management can assure success of Electronic Health Record

Health care information systems cover a wide range of issues dealing with the supervision and use of biomedical information. Health information systems are central support tools in the administration of health care services. An acceptable health information system is important not only for evaluating the health needs of populations but also for preparation and for application of health interventions. It is equally imperative in the assessment of programs. The goal of information systems is to create an appropriate working environment. This is done by providing initial and going training, allocating resources, and by managing unintended consequences (Wager, Lee & Glaser, 2009).

HIS, also known as healthcare information system is a broad system used in healthcare settings. Depending on the needs of the facility, determines the complexity of the system. This can range from basic needs such as billing to the more complex which encompasses several systems that help manage every service available to the patient. Learning to use and integrate this into the nursing field is crucial to effectively care for and manage patients. In 2004, the Office of the National Coordinator (ONC) was established. This merged healthcare and IT programing in the United States. In 2008, ONC decided on terms used to identify patient’s records. Within the clinical information system, there are three different types of patient records being

It is true that "information and information exchange are crucial to the delivery of care on all levels of the health care delivery system the patient, the care team, the health care organization, and the encompassing political-economic environment" (Reid et al., 2013, p 63). Information systems play a huge role in health care in the contemporary context, although they had a much more limited role in the past, and even twenty years ago HCIS systems were nowhere near as complicated or as multi-faceted as they are today. As the need for dynamic and holistic care has increased in recent years, so has the adaptation of HCIS systems which streamline both administrative and clinical processes, making health care more efficient on a much larger scale.

The trend called healthcare reform is not something that is new to the healthcare industry. Healthcare has been progressing in this direction since 1932, when the Committee on the Costs of Medical Care reported a proposal to “integrate practice of medicine rather than autonomous individual set of practices” (Kirschner, p. 3). By definition, an Accountable Care Organization (ACO) is “a legal entity composed of a group of providers that assumes responsibility (are accountable) to manage and coordinate care for a defined group of patients in an effective (high quality) and efficient (low cost) manner” (Kirschner, p. 2). Therefore, as health information management (HIM) professionals, we must focus on whether or not ACO’s can truly provide this