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Chapter 2
Medical Informatics: The Health
Information Technology Decade
Information Technology for the Health Professions, Third Edition
Lillian Burke and Barbara Weill
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Medical Informatics

Medical informatics has many
definitions. The common emphasis in all
definitions is on the use of technology to
organize information in health care.
Information Technology for the Health Professions, Third Edition
Lillian Burke and Barbara Weill
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Medical Informatics (cont)

Medical Informatics focuses on using
computers to organize information to:







Improve diagnostic images and image-guided
and minimally invasive surgery
Develop simulations; develop low-cost
diagnostic tests
Treat physical handicaps
Provide consumers with information
Coordinate international medical reporting
Develop and improve information systems
Develop decision-support systems
Information Technology for the Health Professions, Third Edition
Lillian Burke and Barbara Weill
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Medical Informatics (cont)
 Subspecialties
include:
 Bioinformatics
 Dental
informatics
 Nursing informatics
 Public health informatics
Information Technology for the Health Professions, Third Edition
Lillian Burke and Barbara Weill
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
The Health Information
Technology Decade
 The
U.S. government is attempting
to make the EHR and e-prescribing
universal by 2014
 It is calling 2004–2014 the Health
Information Technology (HIT)
decade
Information Technology for the Health Professions, Third Edition
Lillian Burke and Barbara Weill
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
HIPAA: A Brief Introduction

HIPAA was passed by the U.S.
Congress and signed into law in 1996

Its goals are:
 To
make health insurance portable from one
job to another
 To secure the privacy of medical records
Information Technology for the Health Professions, Third Edition
Lillian Burke and Barbara Weill
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
The Patient Information Form

Includes:
Personal
 Medical
 Insurance information

Information Technology for the Health Professions, Third Edition
Lillian Burke and Barbara Weill
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
The Paper Medical Record

The traditional patient record was on
paper stored in one doctor’s office

Problems
 Paper
medical records may be illegible,
which can lead to serious errors in
diagnosis, treatment, and billing
 There is only one copy of a paper medical
record, leading to difficulty in sharing patient
information
Information Technology for the Health Professions, Third Edition
Lillian Burke and Barbara Weill
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
The Electronic Medical
Record (EMR)
Encouraged by HIPAA and the
federal government, the electronic
medical record (EMR) is very slowly
replacing the paper record
 The EMR is a record of a patient at
one healthcare facility; it belongs to
the facility

Information Technology for the Health Professions, Third Edition
Lillian Burke and Barbara Weill
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
The Electronic Health
Record (EHR)
 The
information on a patient’s EMR will
form the basis of the electronic health
record (EHR)
 The EHR is an electronic record of patient
health information
Generated by one or more encounters in any
care delivery setting
 Includes information from all the health care
providers and institutions that give care to
the patient

Information Technology for the Health Professions, Third Edition
Lillian Burke and Barbara Weill
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Electronic Health Record (cont)
 Ideally
the EHR is not the property
of any one institution or practitioner
 Eventually, it must be interoperable
nationally and internationally
Information Technology for the Health Professions, Third Edition
Lillian Burke and Barbara Weill
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Regional Health Information
Organizations (RHIOs)
Regional cooperation is being
fostered through the establishment of
Regional health information
organizations (RHIOs) in which data
could be shared within a region
 It is a first step toward national
interoperability

Information Technology for the Health Professions, Third Edition
Lillian Burke and Barbara Weill
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
The Indian Health Service
Electronic Health Record
 The
Indian Health Service of the
Department of Health and Human
Services of the federal government
 Developed
an electronic health record
with a graphical user interface
 Interacts with the Resource and Patient
Management System (RPMS) database
of health care applications
Information Technology for the Health Professions, Third Edition
Lillian Burke and Barbara Weill
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Indian Health Service Electronic
Health Record Patient Chart
Information Technology for the Health Professions, Third Edition
Lillian Burke and Barbara Weill
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Indian Health Service Electronic
Patient Chart (cont)
 Problem
List
Information Technology for the Health Professions, Third Edition
Lillian Burke and Barbara Weill
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
The Indian Health Service
Patient Chart (cont)
 Medications
Information Technology for the Health Professions, Third Edition
Lillian Burke and Barbara Weill
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
The Indian Health Service
Patient Chart (cont)
 Review
labs
Information Technology for the Health Professions, Third Edition
Lillian Burke and Barbara Weill
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
The Indian Health Service
Patient Chart (cont)
 Order
entry
Information Technology for the Health Professions, Third Edition
Lillian Burke and Barbara Weill
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
The Indian Health Service
Patient Chart (cont)
 Superbill
Information Technology for the Health Professions, Third Edition
Lillian Burke and Barbara Weill
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Computer Information
Systems in Health Care

Computerized information systems
are used in some hospitals and other
health-care facilities
Help manage information
 Organize relevant information

Information Technology for the Health Professions, Third Edition
Lillian Burke and Barbara Weill
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Computer Information Systems
in Health Care (cont)

To receive the full benefits of
computer technology:

Each of these separate information
systems needs to be linked under the
hospital information system
Information Technology for the Health Professions, Third Edition
Lillian Burke and Barbara Weill
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
EMR Adoption 2006

According to HIMSS Analytics, in
2006:
No hospital in the U.S. had fully
computerized hospital information
systems
 Only 2.5 percent had computerized
physician order entry and computerized
decision support systems installed

Information Technology for the Health Professions, Third Edition
Lillian Burke and Barbara Weill
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Source: HIMSS AnalyticsTM Database (derived from the Dorenfest IHDS+ DatabaseTM)
Information Technology for the Health Professions, Third Edition
Lillian Burke and Barbara Weill
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Hospital Information Systems

Hospital information systems (HIS)
should include:
Clinical information systems
 Financial information systems
 Laboratory information systems
 Nursing information systems
 Pharmacy information systems
 Picture archiving communication systems
 Radiology information systems

Information Technology for the Health Professions, Third Edition
Lillian Burke and Barbara Weill
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Does Computerization
Improve Patient Outcomes?
 Not
enough providers are using the
EHR to see the full benefit of
computerization
 An editorial in Health Affairs
asserted that more testing is
needed
Information Technology for the Health Professions, Third Edition
Lillian Burke and Barbara Weill
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
The Introduction of
Computer Systems
Studies that do exist suggest that the
most successful systems are created
with the participation of those who
will use them
 Systems imposed from above are not
as readily accepted

Information Technology for the Health Professions, Third Edition
Lillian Burke and Barbara Weill
Copyright ©2009 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.