1-4 an introduction to clinical informatics: clinical information systems
TRANSCRIPT
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Section One: An Introduction to Clinical Informatics
Module 1-4 Clinical Information Systems
What They Are Types of Each
EHR Integration
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What is a Clinical Information System?
Clinical Information Systems (or Healthcare Information Systems) are systems that
capture, store, manage, transmit, and/or recall organizational or personal health
information
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Uses of Clinical Information Systems
• Clinical Functions • Patient Management • Practice Management • Health System Management • Public Health Management • Research Management • Payer Management
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Where Clinical Information Systems are Used
Inpatient Outpatient
Medical Specialties Research Trials
Laboratory Pharmacy
Non-Clinical Settings
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Electronic Health Record (EHR)
• A systematic collection of electronic health information about an individual patient or population of patients – Allows practitioners to record and share data
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EHRs
• Benefits: Eliminates paper records, decrease handwriting errors, allows for implementation of error-reducing technology, lays foundation for a longitudinal health record, allows those eligible to receive meaningful use incentives
• Drawbacks: Additional privacy, security, cost, software,
and quality of care concerns. Possibility for unintended consequences and changes to workflows, communication, and data entry demands.
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Clinical Decision Support & Clinical Decision Support Systems
(CDS/CDSS) • Clinical Decision Support [Systems] provide
clinicians, staff, patients, and other individual with knowledge and person-specific information, intelligently filtered or presented at appropriate times to enhance health and health care – Provides alerts, pop-ups, reminders, condition-
specific order sets, diagnostics, patient reports and summaries, and other relevant information
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CDS/CDSS
• Benefits: Reduced clinical errors, increased quality of care, improved efficiency, increased patient and provider satisfaction
• Drawbacks: Alert Fatigue, Ethics and Malpractice
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Computerized Patient Order Entry (CPOE)
• A system that allows physicians and medical practitioners to electronically enter patient treatment instructions – Information may be sent directly to the
pharmacy, lab, or radiology departments. CPOE can incorporate patient decision support, patient safety features, billing codes, and more
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CPOE
• Benefits: Decreases time to order completion, reduces prescription errors, improves dosage timing for patients, reduces transcription errors
• Drawbacks: Time-consuming and problematic usability, enforcement of predefined relationships between clinical tasks and between providers
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Imaging / Picture Archiving and Communication System (PACS)
• A system that provides add to and storage of medical image documents in electronic form – Allows X-rays, CT, MRIs, and other images to be
reviewed and interpreted by physicians in a timely matter
– Uses Digital Imaging and Communications in Medicine (DICOM) standard
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PACS
• Benefits: Replaces traditional film retrieval/ distribution/display, allows for remote access, improves image workflow, integrates with EHRs and other CIS
• Drawbacks: Once “filmless”, difficult to revert to a film environment, utilizes large amounts of bandwidth, requires high-resolution monitors for reading “films”, expensive
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Laboratory Information System (LIS)
• Provides workflow management, data tracking, data exchange, and other features to support laboratory operations – Varying levels of LIS complexity can do
everything from simply track samples to provide lab analytics, audit trails, compliance, calibration, maintenance, QA, and reporting
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LIS
• Benefits: Sample management, quality control, sample data storage, instrumentation and application integration, limit checking
• Drawbacks: May need custom workflow interfaces, must use adequate validation
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Inventory Management System
• Manages supply levels and usage throughout a health care system
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LIS
• Benefits: Real-time inventory levels, increase charge capture for supplies, allows for lower inventory levels
• Drawbacks: Must be fully integrated into providers workflow to be useful – un-captured usage of inventory results in inaccurate results
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Personal Health Record
• A health record where the data is managed by the patient, not the healthcare provider – Allows patients to share their information with
providers
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Personal Health Record
• Benefits: Improves communication between provider and patient, covers medical history that may otherwise be spread out between EHRs
• Drawbacks: Privacy concerns, patient failure to disclose some health activities/events/histories, not clinically detailed
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EHR as the Foundation
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Review Questions
1. The CIS which helps pharmacies electronically receive prescriptions from physicians is a:
1. LIS 2. EHR 3. CPOE 4. PHR
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Review Questions
1. The CIS which helps pharmacies electronically receive prescriptions from physicians is a:
1. LIS 2. EHR 3. CPOE 4. PHR
Computerized patient order entry lets physicians send their orders electronically to the pharmacy. CPOE combined with CDSS & EHR can check for drug-allergy and drug-drug reactions and alert users to possible errors.
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Review Questions
1. A system that provides alert, pop-ups, and reminders based on clinical guidelines and rules is known as a(n):
1. EHR 2. CDSS 3. CPOE 4. PACS
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Review Questions 1. A system that provides alert, pop-ups, and
reminders based on clinical guidelines and rules is known as a(n):
1. EHR 2. CDSS 3. CPOE 4. PACS
CDSS provide alerts, pop-ups, and reminders, as well as guidelines, order sets, diagnostics, reports, summaries, and other relevant information for physicians to make informed decisions regarding their patient’s health.