Transcript gartee_ch08_lecture

Health Information
Technology and Management
CHAPTER
8
Additional Health
Information
Systems
Health Information Technology and Management
Richard Gartee
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Pretest (True/False)
• During clinical drug trials, phase II testing
is performed on patients for whom the
treatment is intended.
• A transplant is a device intentionally put
into the body to serve a particular purpose.
Health Information Technology and Management
Richard Gartee
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Pretest (True/False) (continued)
• The ER typically has ready access to a
patient’s records in the HIM department.
• Speech recognition software can be taught
to avoid past mistakes.
• A glucose monitor is an example of an
instrument that facilitates point-of-care
testing.
Health Information Technology and Management
Richard Gartee
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Departmental Information
Systems
• HIS is core system for hospital:
– Includes both clinical and administrative
systems
– Consists of complex arrangement of multiple
individual systems
• Practice management system is principal
system for medical office
Health Information Technology and Management
Richard Gartee
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
EHR Interface
• Health records originate from many
separate systems:
– Records imported into EHR
– Records imported into central CDR
– Records only retrieved and displayed from
EHR; stored on own respective systems
Health Information Technology and Management
Richard Gartee
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Why Multiple Information
Systems?
• IT department may follow two different
approaches to information systems:
– Integrated systems approach uses systems
from one vendor
– Best-of-breed approach chooses software
based on departmental needs
Health Information Technology and Management
Richard Gartee
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Why Multiple Information
Systems? (continued)
• Certain hospital departments may have
more influence and select their own
software
• Some equipment may come with own
software required for operation
– CAT scan, MRIs, PET, biomedical devices
Health Information Technology and Management
Richard Gartee
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Patient Registration System
• Demographic information about patient
• Guarantor and insurance information used
for billing
• Some clinical data (admitting and
discharge diagnosis, LOS, and organ
donor, DNR, consent, other forms)
• Patient’s medical record number
Health Information Technology and Management
Richard Gartee
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Figure 8-1 Patient registration screen. (Courtesy of McKesson Corporation.)
Health Information Technology and Management
Richard Gartee
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Master Patient Index (MPI)
• Includes all previously registered patients
– Contained in special database (large
healthcare organization) or patient registration
database (smaller facility)
• Prevents duplicate entry of same patient
• Provides quick universal lookup of patients
for all systems interfaced to the HIS
Health Information Technology and Management
Richard Gartee
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Master Patient Index (MPI)
(continued)
• Helps locate patient chart (paper-based
system)
• Often includes Soundex field to facilitate
finding surnames when name’s spelling
unclear
Health Information Technology and Management
Richard Gartee
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Figure 8-2 Master patient index. (Courtesy of McKesson Corporation.)
Health Information Technology and Management
Richard Gartee
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Laboratory Information System
(LIS)
• Receives orders and sends results of
medical tests performed by lab
• Receives information directly from
automated lab instruments via electronic
interface
• Sends information about equipment to LIS
Health Information Technology and Management
Richard Gartee
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Laboratory Information System
(LIS) (continued)
• Uses HL7 interface standard to connect
with HIS, CPOE, EHR, other healthcare
systems
Health Information Technology and Management
Richard Gartee
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Workflow of Electronic
Lab Orders
• Some clinical pathology tests performed
with automated instruments receive orders
from LIS; send results back to LIS
• Anatomic pathology findings and
nonautomated clinical pathology tests
entered manually
• LIS generates printed or faxed lab report;
also sends to EHR if interfaced
Health Information Technology and Management
Richard Gartee
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Workflow of Electronic
Lab Orders (continued)
• Digital pathology captures specimen
images digitally, displays on computer
monitor; images stored on PAC system
Health Information Technology and Management
Richard Gartee
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Figure 8-5 Workflow of electronic lab orders and results.
Health Information Technology and Management
Richard Gartee
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Radiology Information System
(RIS)
• Manages workflow in radiology
departments
• Communicates with PAC systems
• Schedules and tracks radiologic studies
• Posts charges
• Communicates with other systems such as
HIS, EHR, billing
Health Information Technology and Management
Richard Gartee
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Examples of Images
• Digital x-ray images
– Computed radiography (CR)
– Digital radiography (DR)
• Computerized axial tomography (CAT)
• Magnetic resonance imaging (MRI)
• Positron emission tomography (PET)
Health Information Technology and Management
Richard Gartee
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Dictation/Transcription Systems
• Based on provider’s dictation, which may
be recorded on microcassette tapes,
digital voice files, or via telephone
• Typed by transcriptionists using special
equipment and word processor
• Reviewed by provider for accuracy, then
corrected as needed by transcriptionist
Health Information Technology and Management
Richard Gartee
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
How Speech Recognition
Software Works
• Noise-canceling microphone sends
speaker’s word sounds to computer, which
converts into digital data
• Software uses mathematical calculations
to identify phonemes in digital data and
compare to “language model”
• Software then groups phonemes correctly
into words displayed on screen as if keyed
Health Information Technology and Management
Richard Gartee
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
How Speech Recognition
Software Works (continued)
• Errors may be corrected by user; software
stores for future reference
Health Information Technology and Management
Richard Gartee
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Pharmacy Systems
• Comprised of one or more computer
systems for tracking, ordering, dispensing
medications
• Interfaced with registration, billing, CPOE,
EHR systems
Health Information Technology and Management
Richard Gartee
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Pharmacy Systems (continued)
• Include decision support, patient
medication administration reports,
controlled substance tracking, intervention
documentation, inventory control, pricing,
purchasing, repackaging, distribution
Health Information Technology and Management
Richard Gartee
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Emergency Department
System Considerations
• ER may use different software system
than rest of hospital
• ER may not have access to patient’s
records (HIM or physician office)
• ER patients may be unconscious and
unidentified
– Allergies or medical history information may
be unknown
Health Information Technology and Management
Richard Gartee
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Emergency Department System
Considerations (continued)
• Some patients without primary care
physician may treat ER as walk-in clinic
Health Information Technology and Management
Richard Gartee
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Perioperative Software
• Records all aspects of presurgery,
surgery, postsurgical recovery
• Includes nonpatient functions such as
management and scheduling of operating
rooms, surgical supplies, equipment,
personnel
• May include software for anesthesiologist
Health Information Technology and Management
Richard Gartee
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Implants and Transplants
• Implants: device or substance intentionally
put into the body to serve particular
purpose
– Examples: heart valves, pacemakers, breast
implants, artificial joints
• Transplants: organ or tissue from human
donor
– Examples: kidney, heart, liver, bone marrow
Health Information Technology and Management
Richard Gartee
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Implant Registry Data
• Facilitates study of performance and
longevity of implants
• Includes adverse events resulting from
implant
• Includes patient demographic data, facility,
implant manufacturer, implant
identification information
Health Information Technology and Management
Richard Gartee
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Transplant Registry Data
• Tracks potential recipients and includes
clinical data about patient status and
condition
• Includes information on donors, such as
cause of death, medical history,
medications, procurement process,
consent forms
Health Information Technology and Management
Richard Gartee
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Transplant Registry Data
(continued)
• Communicates with international registries
like UNOS and NMDP
• Includes post-transplant records on
recipient and on living donors
Health Information Technology and Management
Richard Gartee
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Clinical Trial Phases
• Phase I: Small groups of subjects tested in
controlled setting to see if drug is safe,
tolerated by healthy person
• Phase II: Testing performed on patients for
whom treatment intended; focuses on
finding right dosage levels and proving
drug works
Health Information Technology and Management
Richard Gartee
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Clinical Trial Phases (continued)
• Phase III: Large patient groups undergo
controlled studies; some patients receive
drug, others receive placebo
• Phase IV: Survey drug once approved and
on market
Health Information Technology and Management
Richard Gartee
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.