Transcript Information Technology and Systems

Information
Technology
and Systems
©2010 Jones and Bartlett Publishers
Information System
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A collection of related components that interact to
perform a task in order to accomplish a goal.
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The integration of several elements of a business
process to effect a specific outcome
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A process that refines raw facts into meaningful
information
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Provides opportunities to improve internal operations,
create competitive advantage in the marketplace,
improve patient care delivery, enhance research, and
provide better service
©2010 Jones and Bartlett Publishers
Evolution of IS in Health Care
1960s – 1970s
1980s
1990s
2000s
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Financial focus
Few Clinical
Systems
In-house
development
Shared
systems
Turnkey
systems
Transaction
processing
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Continuing
financial focus
More clinical
development
Stand-alone
systems
Distributed
systems
Management
Information
Systems (MIS)
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Focus on
Clinical
Systems
Integration of
systems
Executive
Information
Systems
Decision
Support
Systems
Enterprisewide Systems
Office
Automation
Virtual
Systems
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Standards
E-health
Internet
Intranets
Extranets
Clinical
Repositories
Data
Warehouses
Data Mining
©2010 Jones and Bartlett Publishers
Categories of Computer Systems
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Supercomputers
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Fastest and highest capacity machines built today
Can cost millions of dollars and are used in large
scale activities such as weather forecasting and
mathematical research
Mainframe Systems
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Only computers available until 1960s
Can perform millions of instructions per second and
hundreds of users can be connected at the same
time
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Categories of Computer Systems (cont.)
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Midrange Systems
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Minicomputers
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Introduced in 1960s and can support up to 4,000
connected users at the same time via terminals consisting
of a keyboard and a video screen
Cheaper than mainframes
Workstation
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Introduced in 1980s
Very powerful desktop computer
Comparable to midsize mainframes but sit on a desktop
Used as severs to microcomputers connected through a
network
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Categories of Computer Systems (cont.)
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Microcomputers
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Also called personal computers (PCs)
Introduced in 1970s
Variety of sizes including desktop, laptop, palmtop, personal
digital assistant and pen based
Web Appliances
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Used in conjunction with Internet to navigate the Web
One device sits on top of a television and allows user to surf
the Internet using a remote control device
Do not have processing units or storage devices
©2010 Jones and Bartlett Publishers
5 Programming Languages
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Machine language
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Binary representation of
0,1
Assembly language
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High level languages
Replaced 0,1
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Very high level languages
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BASIC
COBOL
FORTRAN
PASCAL
MUMPS
JAVA
HTML
XML
Structured Query Language
(SQL)
Natural languages
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Artificial Intelligence
©2010 Jones and Bartlett Publishers
System versus Application Software
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System software
– Set of instructions
that direct actual
computer operation
functions
– Acts as a conductor
for all the hardware
components and
application software
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Operation system
Utility programs
Language Translator
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Application software
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Set of instructions
used to accomplish
various types of
business process
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Productivity
Specialty software
Education and
Reference
Entertainment
©2010 Jones and Bartlett Publishers
Quantities of Bytes
Name
Value in bytes
Kilobyte (kb)
10241 or 1.024 x 103
Megabyte (mb)
10242 or 1.049 x 106
Gigabyte (gb)
10243 or 1.074 x 109
Terabyte (tb)
10244 or 1.100 x 1012
©2010 Jones and Bartlett Publishers
5 Types of Information Systems
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Transaction processing system (TPS)
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Collects and stores data about transactions
Manages the different kinds of transactions that
occur in a healthcare facility
Example:
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Patient
Management information system (MIS)
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Supported by transaction processing systems
Provides routine information to managers for
decision making
©2010 Jones and Bartlett Publishers
5 Types of Information Systems (cont.)
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Executive information system (EIS)
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Interactive system that allow top managers to answer “what if”
queries and project trends
Several databases are attached to type of system including
external and internal operations and special management
Expert system (ES)
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Generates advice or suggest a decision
A knowledge system built from a set of rules applied to specific
problems
Decision support system (DSS)
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An interactive system that helps managers solve problems and
make decisions
Example:
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Clinical DSS that alerts physician when lab results are outside
normal range
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6 Components of an HIS
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Patient Scheduling, Admission, Discharge, Transfer
system
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Business and financial systems
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Communication and networking applications
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Departmental systems such as radiology and
pharmacy
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Documentation systems used to collect, store and
retrieve patient data
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Reminder and advice functions
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Strategic Information System Planning
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Process of identifying and
assigning priorities to the
various upgrades and
changes that might be
made in an organization’s
information system
Ensures all changes
contribute to the
achievement of the
organization’s strategic
goals and objectives
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Establishes enterprise wide
priorities for information
systems
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Serves as a guide to make
decisions of resource
allocations
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Sets stage for system
development life cycle
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Lead by the Chief Information
Officer
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System Development Life Cycle
(SDLC)
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System analysis
– Identify business issue or problem that
needs to be solved
– Feasibility of the system is assessed and the
scope of project defined
– Assess information needs of users and
define the functional requirements of system
– Provides a system that meets user and or
department needs and that also supports
the strategic objectives of the organization
©2010 Jones and Bartlett Publishers
SDLC (cont.)
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System design
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Specify details of new system (logical and
physical design)
Decide how system will be designed or
selected
Built in-house
Turnkey
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SDLC (cont.)
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System Implementation
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Select project manager
Make system operational
Test system
Train users
Prepare site
Install hardware and software
Manage organization change and system impact
System evaluation
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Evaluate system against pre-developed criteria
©2010 Jones and Bartlett Publishers
Nolan’s 6 Stage Theory
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Initiation - initiates automation
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Expansion - growth of automation
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Control - manage information technology growth
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Integration - integrates systems through policies and
procedures
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Data Administration - databases developed and
information is critical
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Maturity - growth of application is the focus on
strategic importance of organization
©2010 Jones and Bartlett Publishers
Classification of Information Systems
Administrative
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Admission,
Discharge,
Transfers (ADT)
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Human
Resources
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Materials
management
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Facilities
management
Financial
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Budgeting
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Billing
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Payments
Clinical
• CPR
• Results Reporting
• Patient care
management
• Order Entry
• Point of care
documentation
• Nursing Services
• Laboratory
• Pharmacy
• Clinical decision
support
• Research, QI,
Peer Review
Outpatient
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Appointment
Scheduling
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Patient billing
Electronic insurance
payment
Automatic payment
posting
Patient collection and
mail-merge
Medical record data
capture and retrieval
Prescription writing
Report generation
Research, QI, Peer
Review
Research
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Data mart
Data mining
©2010 Jones and Bartlett Publishers
5 Major Database Models
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Relational
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Data stored in predefined
tables that contain rows
and columns similar to a
spreadsheet
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Hierarchical
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Supports treelike
structure that consist of
parent (root) and child
segments; many-tomay relationships difficult
to represent
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Each parent has a child
or more; each child has
only one parent
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User queries database;
search seeks answer
from parent to child
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Network
– Similar to hierarchical except that
a child can have more than one
parent
– Parent referred to as owner; child
as member
– Supports many-to-many
relationship
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Object-oriented
– Stores objects of data
– Can model relational data or data
types such as graphics, movies
and audio
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Object-relational
– Combines best of relational and
object-oriented
– Uses both traditional data types
(currency, integers and strings)
and advanced data types
(graphics, movies and audio)
©2010 Jones and Bartlett Publishers
Data Warehouses
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Provide organizations the ability
to access data from multiple
databases and to combine the
results into a single question and
reporting interface
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Integrate organization wide data
into a single repository from which
managers can pose ad hoc
queries, run reports and perform a
variety of analyses
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Sets up large stores of data for
strategic decision support
analysis
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Analytical databases designed to
support strategic and tactical
decision making
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Selected data are extracted from
multiple sources in the
organization’s information system
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Organization uses historical data
and integrate them with a variety
of analytical techniques to help
solve problems
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Subject oriented, integrated, time
variant and nonvolatile collection
of data in support of
management’s decision making
process
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In order for the value of the data
warehouse to be realized,
techniques such as data mining
must be applied
©2010 Jones and Bartlett Publishers
Data Marts
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Subset of a data warehouse that supports the
requirements of a particular department or business
function
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Focuses on the data needs for a specific department
or business function as opposed to warehouse that
stores data for the entire organization
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Tailored to meet needs of department
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Amount of historical data and level or granularity
(detail) can be specific to needs of department
©2010 Jones and Bartlett Publishers
Data Mining
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Encourages a broad view of all data for a set of patients to
explore relationships among the data that might not be
readily apparent during the initial hypothesis
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The extraction of data from large databases to uncover
previously unknown information to help managers make
decisions
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Helps to uncover previously unknown and hidden
information trends
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Identifies patterns and relationships among variables that
were previously unrecognized using predictive modeling,
database segmentation, link analysis and deviation
detection
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In order to perform data mining, a data warehouse is
needed
©2010 Jones and Bartlett Publishers
HIM Security and Protection
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Employ a security program
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Employees should only have access to information on
a need to know basis
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Equipment and information should be secure from
threats and unauthorized access
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Hardware should be secured from extreme
temperatures, power outages, and other environmental
threats and installed according to manufacturer
instructions
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Software system should be in place for SDLC
©2010 Jones and Bartlett Publishers
HIM Security and Protection (cont.)
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Access to specific applications should be limited
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System should automatically log all transactions
through audit trails
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Firewalls system to prevent access to a private
network from the outside or limit access to the outside
from within
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Encrypt data
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Ensure Internet security
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Authenticate communication (aging passwords)
©2010 Jones and Bartlett Publishers
Intranets versus Extranets
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Intranet
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Special form of a LAN
Networking capability
within one organization
that uses Internet
technologies, software
which uses HTML and
web browser software to
accomplish computer
communications within
the organization
Servers are located inside
a firewall or security
barrier and can be
accessible only to
authenticated users on a
specific network
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Extranets
– Similar to intranet
– Provides network
connectivity between
suppliers to allow direct
connection to each other’s
network
©2010 Jones and Bartlett Publishers
Internet Network Protocols
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Secure Socket Layer (SSL) protocol
– Web servers that support an SSL session
have an address that begins with “https”
instead of “http”
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IP (internet protocol) Telephony
– Allows real time calls to be initiated through
the Internet instead of public telephone
system
©2010 Jones and Bartlett Publishers
Electronic Health Record (EHR)
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Any information relating to the past, present or
future physical, mental health or condition of
an individual. Resides in electronic systems
used to capture, transmit, receive, store,
retrieve, link and manipulate multimedia data
for the primary purpose of providing health
care and health related services
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Form of computer based health record in
which information is stored by whole files
instead of by an individual data elements
©2010 Jones and Bartlett Publishers
Capabilities of EHR
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Positively impact workflow operations
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Improve administrative process
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Include uniform core data elements and standardized
coding
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Use common data dictionary
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Perform searches
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24 hour access with rapid retrieval
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Links to other information systems
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Real time alerts and possible remedies
©2010 Jones and Bartlett Publishers
Role of HIM Professional
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Information broker
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Intermediary between a client and an information
product or group of services
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Advocate for effective system development or
selection by assuming prominent role in the
system development life cycle
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Custodian of patient health information
regardless of media on which it is maintained
©2010 Jones and Bartlett Publishers
Role of HIM Professional (cont.)
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Establish policies, procedures, systems and
safeguards to ensure patient health information is
documented, maintained and disclosed in accordance
with all health information laws, regulations and
standards
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Ensure the functionality of Electronic Health Record
systems with respect to the practice of Health
Information Management and its support of other
business functions of the organization
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Information retrieval, analysis and policy development
©2010 Jones and Bartlett Publishers
Role of HIM Professional (cont.)
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Under the information engineering domain
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Strategic planning
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Data modeling
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Analyzing the processes of an organization usually on a
departmental basis
Data administration
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Development of a detailed logical database design
Process modeling
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Identification of goals and the critical success factors of the
enterprise
Administrative rather than technical functions associated with
data and database management
Interface design
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Content or layout of screens and reports
May use CASE tools such as screen painters, report generators
or prototyping software
©2010 Jones and Bartlett Publishers
Chief Information Officer (CIO)
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Senior level executive manager of IRM
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Responsibilities
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Lead strategic information system planning process
Help leadership team use information systems in
support of strategic planning and management
Oversee the organizations Information Resources
Management (IRM) functions
©2010 Jones and Bartlett Publishers
E-commerce
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Allows consumers to learn • Provides
– Physician referral services
about medicines they are
– Listing of health care
taking, buy medicines, learn
classes and seminars
about diseases, disease
– Information on clinical trials
prevention and other
– Uses Internet to create
activities
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The marketing, buying,
selling and support of
products and services over
the Internet, intranets, and
extranets
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Involves electronic data
interchange (EDI) and
electronic funds transfer
(EFT) payment systems
bulletin boards, electronic
surveys, newsletters, and email information on
diagnoses and treatment of
diseases
– External links to federal
agencies and other
organizations that provide
health care
– Builds strategic alliance with
customers, suppliers,
consultants and competitors
©2010 Jones and Bartlett Publishers
E-Health
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Companies provide a range of services
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Storing personal health data
Reference information on a variety of health
issues
Manage health care superstores
©2010 Jones and Bartlett Publishers