Healthcare Information Systems Quiz

Learning Objectives

• Distinguish between information systems common to all industries and those unique to health care.
• Assess key systems used by health care managers.
• Differentiate between the electronic medical record (EMR) and the electronic health record (EHR).
• Analyze the challenges to clinical system adoption.
• Examine the concept of meaningful use and its implications for health care providers.
• Assess the future of health-care information technology (HIT) and the vision of an integrated U.S. health care system.
• Critique the impact of HIT on the health care manager.
• Examine the impacts of HIPAA and other regulations, laws, and policies regarding confidentiality of patient information.
• Investigate sources of data for assessing the impact of electronic health record implementation.

Introduction

• Information Technology is shifting from supporting back office functions to clinical areas.
• This is due to increasing pressure to reduce healthcare costs and improve safety.
• Electronic health records (EHRs) are expected to become standard for all U.S. citizens.
• Technological advancements will significantly impact healthcare managers' roles.

Health Information System (HIS)

• HIS encompasses all computer systems (hardware, software, operating systems, end user devices, networks, and data capture/creation).
• These components form the foundational blocks for all healthcare functions and applications.
• Balgrosky (2015) developed the HIS Scope Model based on these building blocks.

Networks

• Networks are categorized as Intranets (internal) or Extranets (external) allowing information sharing.
• Local Area Networks (LANs) include wireless LANs (WLANs), wide area networks (WANs), wireless WANs (WWANs), and storage area networks (SANs).
• The internet is a well-known WAN.

Information Systems Used by Managers

• Traditional management systems focus on managing organizational expenses and revenues.
• Healthcare organizations primarily invest in staff and equipment management.
• Examples of widely used systems include standard office applications, Enterprise Resource Planning (ERP), budget systems, fundraising, cost accounting, billing, and accounts receivable.

Systems Applications in Health Care

• Standard office applications (word processing, spreadsheets, email, etc.) are used for administrative tasks and collaboration.
• Budget systems manage expenses and income.
• Cost accounting models profits/losses of services/products.

Systems in Health Care (Cont'd)

• Enterprise resource planning (ERP) systems manage HR, payroll, accounts payable, materials mgt and general ledger functions.
• Time and attendance, staffing, and scheduling systems support the diverse workforce in healthcare organizations.
• Marketing systems, including CRM and social media (Facebook, website), are used for customer relationship management.
• Non-profit organizations utilize fundraising systems to manage donor contributions.
• Billing and accounts receivable systems manage payments from customers (patients and insurance companies) for services provided.

Historical Uses of Information Technology

• Information technology is used in hospitals, physician practices, nursing homes, home health care and insurance companies.
• Historical use was primarily for administrative support and regulatory requirements (e.g., MOH, CBAHI).
• Use in clinical settings is increasing to reduce costs and improve patient safety/treatment effectiveness.

Evolution of the Automation of Health Care

• Repetitive tasks (filling prescriptions, lab tests, radiology images) are suitable for automation.
• Initial automation was focused on individual clinical areas and not integrated across the entire process.
• Caregivers did not widely adopt computers as daily tools; systems were cumbersome and time-consuming.
• Medical devices and robotic applications (like pharmacy robots) have become more sophisticated.
• Integration of medical devices and information systems is becoming more prevalent in clinical settings.
• Healthcare managers are increasingly reliant on these technological applications.

The Electronic Medical Record (EMR)

• In 1991, the Institute of Medicine (IOM) identified computer-based patient records as essential.
• The 2000 IOM report "To Err Is Human" highlighted the need for automating patient care to improve safety.
• Initial focus was on improving patient safety through technology, such as automated drug order entry and reminders for treatments.
• The adoption of EMRs has accelerated as clinicians focus on safer care practices.

What is EMR?

• An EMR is a computer application that includes: clinical data repository, clinical decision support, controlled medical vocabulary, physician order entry, pharmacy and clinical documentation.
• Used in both inpatient and outpatient areas to support patient records.
• EMRs are crucial for documenting, monitoring, and managing care delivery by healthcare professionals within an organization.

What is EMR (Cont'd)

• EMRs provide a complete legal record of patient care through their medical encounter with a care delivery organization.

EMR or EHR?

• EHR is a broader term than EMR.
• EHR captures the complete health history of a patient, including immunizations, allergies, medications, etc.
• EHR data is accessible to multiple providers (patient and other healthcare personnel).

Barriers to Adoption

• Cost of purchasing and maintaining the system.
• Loss of productivity during the transition period.
• Inadequate training programs.
• Finding systems to fit particular practice needs.

Challenges to Adoption

• Patient privacy concerns.
• Lack of standardized medical terms.
• Cost.
• Lack of user-friendliness and intuitive design.
• Industry focus on service completion impeding initial system capabilities

Meaningful Use

• "Meaningful use" criteria for EHRs focus on five health policy priorities:
  • Improving quality, safety, efficiency, and reducing health disparities.
  • Engaging patients and families in their health.
  • Improving care coordination.
  • Improving population and public health.
  • Ensuring adequate privacy and security of patient health information.

Problems with EHRs

• Poor usability.
• Time-consuming data entry.
• Interference with face-to-face patient care.
• Inefficient and less fulfilling work content.
• Inability to exchange health information and degradation of clinical documentation.

Solutions?

• Scribes: trained individuals who record patient information while the physician interacts with the patient.
• Better training and more intuitive systems.

HIPAA

• The Health Insurance Portability and Accountability Act (HIPAA) was established in 1996.
• HIPAA focused on standardizing data and regulating patient privacy.
• Increased focus on safeguarding personally identifiable health information (PHI).

PHI

• "Individually identifiable health information" relates to:
  • Past, present, or future physical/mental health conditions.
  • Provision of health care.
  • Past, present, or future payments for health care.
  • Information that can reasonably identify an individual.

Future of Health Information Technology (HIT)

• Portability: EMRs accessed from personal devices.
• Virtual health care: remote patient interaction without physical examination.
• Future uses: patients wearing monitoring devices (smart vests), embedded microchips, and improved systems for handling complex information.

Potential Confounders

• Optimizing existing vs. replacing EHRS.
• Data integrity.
• Promoting patient safety.
• Interoperability.
• Cybersecurity.
• BYOD.
• Capturing socioeconomic data in EHRs.
• ICD-10 adoption.

Additional Areas

• E-health: electronic data transfer.
• mHealth: mobile technologies for health-related activities.
• Telemedicine & Telehealth: remote health care delivery.
• Health informatics, analytics and big data: aggregating and sharing health data.

HIT Impact on the Manager

• Complex and rapidly evolving work environment.
• Effective managers need technology proficiency to manage employees.
• Dependencies necessitate new processes during system downtimes.

Conclusion

• The impact of HIT on healthcare managers is increasing.
• Costs have risen, but quality hasn't improved to the same extent.
• Clinical system adoption is increasing despite existing barriers.
• The EMRAM model assists in evaluating EHR adoption.
• Healthcare managers' competencies must include comfort with complex information systems.

Test your knowledge on healthcare information systems, including Health Information Systems (HIS), Electronic Health Records (EHR), and Enterprise Resource Planning (ERP) systems. This quiz covers their roles, functions, and impacts in healthcare management. Determine your understanding of key concepts and systems used in modern healthcare.