John Wieler

Management Information Systems

In a Healthcare Setting

John Wieler

Objectives

• Understand Management Information Systems in a Healthcare context

• Develop a base understanding of data flow

• Identify key systems common to most healthcare providers

John Wieler

Clinical Data Concepts

• The Patient is the center of attention in a hospital (at least for Clinical Systems)

• What data is unique to the patient and the care process?

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The Patient:NameAddressNext of Kin Other DemographicsUnique Identifiers

- Hospital Numbers- PHIN- Etc.

Data Flow I: The Patient

AKA: Master Patient Index

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The Visit:- Visit Dates and Times- Bed and Room Occupancy- Bed and Room Availability- Visit #/Encounter #/Case#

Data Flow II : The VisitThe Patient

AKA: ATD, Hotel Functions

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The Treatment:- Clinical Information - Patient Treatment- Patient Diagnosis- Any other clinical interaction with the Patient

Data Flow III: The Treatment

The Visit

AKA: The Chart (Electronic or Not),

The Medical RecordMedical Acts

The Patient

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The Treatment

Order

Schedule

Order Fulfillment

Diagnostic Review

Result

Data Flow III: The Treatment, cont.

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The Outcome:- Case Costing- Patient Accounting- Physician Accounting- Coding and Abstracting- Links to External Systems

Data Flow IV : The Outcome

The Treatmen

t AKA: Management Reporting

Decision Support

The Visit

The Patient

John Wieler

General Concepts

• In a most general sense there are a number of interdependent “types” of systems in a healthcare environment

• The base model of Information Systems in Healthcare is what I call the “Greek Temple” diagram.

John Wieler

INFRASTRUCTURE

Start with Infrastructure

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Key Infrastructure

• Infrastructure == People, Policy, Stuff

• Essentially, how to keep things running

• Examples include– Networking– Helpdesk/PC support– Server administration– Security Policy and Administration

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INFRASTRUCTURE

CLIN

ICA

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SAdd Clinical Systems

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Key Clinical Systems

• Defined as “Having to do with Patients”• Master Patient Index• Admission Transfer Discharge (ATD)• Order Entry & Result Reporting• Diagnostic Imaging and PACS• Lab Systems• Pharmacy Systems

John Wieler

INFRASTRUCTURE

CLIN

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…then add Administrative Systems

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Key Administrative Systems

• Running the Hospital as an Organization• Systems common to most other Organizations• Financial Systems i.e. AP/GL• Materials Management• Payroll• Human Resources (HR)• Staff Scheduling

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Admin Systems (II)

• Departmental Systems – Equipment Tracking – O.R. Scheduling– Information Services Help Desk– And many, many others

John Wieler

INFRASTRUCTURE

CLIN

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DECISION SUPPORT

Top off with Decision Support

John Wieler

Key Decision Support Systems

• Measuring delivery of service

• Using Data to plan future delivery of service

• Health Care Specific – Coding and Abstracting– ICD 9/10– CIHI

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Decision Support (II)

• Data Mart/Warehouse Applications

• Smaller Departmental Systems– Workload Measurement– Information Services Help Desk

John Wieler

INFRASTRUCTURE

CLIN

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DECISION SUPPORT

Support Necessary

Data Flow

Systems

John Wieler

Challenges in Healthcare

• Integration Between Clinical Systems can be very complex

• Want to make things seamless from a patients point of view

• Want to make things easy for a Hospital Employees point of view

• Want to give Clinicians what they want

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Challenges in Healthcare (II)

• Example, Ordering an CAT Scan

• Systems involved = Paper, ATD, Scheduling, Radiology, PACS, Order Entry, Result Reporting

• Need data to be consistent and correct

• Need systems to be fast, easy to use

John Wieler

Challenges in Healthcare (III)

• Integration of Data to systems outside of Facilities– Physicians Offices/Clinics (Primary Care)– Integration into Community Services

• Immunization Records• Home Care

• Need identity management, security to be in place across multiple jurisdictions

John Wieler

Why Should I Care?

• Business Processes Issues map into Healthcare space, many career opportunities

• There is a lot of money spent in Healthcare, a good understanding as a vendor can make you successful

John Wieler

Questions or Comments?