Health (hospital) Information Systems. The Healthcare and the Information System. The functions of the hospital. I/O, query, report

Transcription

1 Health (hospital) Information Systems The Healthcare and the Information System Dr. László Daragó PhD Associate professor Semmelweis University Health Informatics Institute The functions of the hospital Medical Care Diagnostics Therapy Nursing Hotel services The function of the HIS (Hospital Information System) It supports Daily routine (input, output (work lists)) Managing (queries) Decision making (reports) 3 4 input I/O, query, report output The structure of Hungarian Healthcare Healthcare Primary care Care Outparient s care In s care parameter query output Basic level Active care report output High-level Chronic care 5 6 1

2 Finance Structure of HIS Healthcare Return Case Primary care Capitation Care Performance based Hospital case Hospital (indirect) costs Out s care In s care Departmental case Event Resource (Direct-) Costs Basic level Itemised (German score) Active care Normative (DRG s) High-level Itemised vs. normative Chronic care Itemised (Daily fee) 7 8 Functional architecture of HIS Admission/discharge/transfer (ADT) subsystem/module Clinical subsystem/module Out s care In s care Order communication Pharmacy Catering Lab Imaging Economical subsystem/module General ledger Personnel Waging Logistics Hotel services Technical supports Security Module vs. subsystem Information system (Top-Down) Database (well defined: MBDS based) User surfaces (by several type of users) Communication system (Bottom-Up) User tailored systems (subsystems) Communication interfaces Distributed/integrated database 9 10 MIS Management information system Integrated or interfaced "user-machine" system for servicing information to support the operation, managing and decision support in a given organisation. That is: Connected to an organisation End-user system included Services information It supports Operation (daily routine) Managing Controlling Decision support 12 2

3 IS, MIS, MISS, HIS, EIS, DSS MIS DSS SP/EIS TP OP & C MISS MIS/IS HIS Strategic planning: Goals, policy and general procedures at a given life cycle of the organisation. Management control and tactical planning: Source, input and output tactics, developments, budget planning and monitoring. Operational planning and controlling: Accessing the optimal efficacy, efficiency and economical way in the given circumstances. Transactional system: I/O, Query, Report MIS HW, SW component (EDP: electric data processing) Human procedures, automations Models for analysis, planning, controlling and decision support Well defined database System definition: the requirement s document 15 The requirement s document contains Functional The user s expectations on the services, should be performed. Non functional Restrictions and constraints of the performing -product restrictions -organisational restrictions -external (third party) restrictions Domain Professional, what must be performed independently of the aim of the provider or customer. 17 The types of the requirement s documentation User demands User s vision on the system: Incomplete, full of contradictions User s Free of contradictions, complete User correspondence contract System Free of contradictions, complete Provider Software requirement specifications Determines only external behaviour Specifies any restrictions that can prevent a succesfull implementation Must be easily updated It can be used as reference for IS maintenance It should contain forecast for the lifecycles of the IS Whenever possible predicts and offers solutions for unwanted events System producer (IT) 18 3

4 Goals of data handling Data handling - To support the health protection, conserve the health status. - To help the medical activity of the health service provider. - Tracking the health status of the. - In interest of arrangements in public health or epidemic affairs. - Data processing for statistical goals (depersonalisation) - Scientific research (Personal data must not be referred) - Data handling of Social Security. - Data handling for criminal, judicial, national security reasons. 20 Entities External External-external external-internal outgoing report (work list) archives incoming dictation (sheets) Output: Form (screen), report (paper/screen), file, sound, multimedia, , etc. Input: Form (sheet with formatted/unformatted text), file, image, sound, video, etc. Internal Stored: file External-external output Patient: closing report, medical report, prescription, assigning, letter of advice Health insurance: performance based financing out- in- GP: closing report, medical report Medical college: defined by the professions Health government: epidemic reports Office of Statistics: statistical report Office of Tax: tax reports (VAT: Value Added Tax, PIT: Personal Income Tax) Ministry of Labour: reports on employment, report on employ State Treasury: waging Medical Technical Institute: state of instrumentality, probate Owner/supporter: property, performance, trusted tools Other hospital: data related on a transfered (see data security) External data transfer (simplified scheme) Health insurance Health gov. Tax office Patent Treasury Med. tech. office Min. of Labour hospital Owner/supporter Stat. office Medical college GP Other hospital External-internal output Administrative admission (personal, social, insurance data) (ADT: Admission, Discharge, Transfer) Medical admission (anamnesis, status, suspected diagnose, plan of diagnostics) Nursing diary (nursing status, plan for nursing, nursing decursus) Temperature chart (medical status, plan for diagnostics and therapy, decursus, consultation) Medical history Order communication diet medicine examination procedure transfer

5 Structure of hospital database General (basic) data of case Personal data Insurance data ADT basic data In/out financing data Clinical data of case Medical data Nursing data Social data Views of the HIS 25 HIS User MD (memory support (, guideline), make to document the case easy ) Patient (inform, decision support) Organizer/Informatician (conformance, userfriend solution, compliance with law and professional guidelines) Technician/Information Technology (robustness, reliability, maintenance, data security and safety) HIS user External data supply Minimum Basic Data Set (DRG s) Obligatory reports Scientific research Worklists Medical report Prescription Assigning (hospitalization) Requirements Solution Application Training Hot line Help desk HIS organizer HIS IT Hardware Intelligent/dumb terminal Network Printing Software Operating system Applications, frame system Internet

6 HIStory General ledger Accounting, inventory (materials, technical support, catering) Controlling Patient-statistics Perfomance financing reporting Flowchart of the real-time hospital management diagnose Administrative admission Hospital case Clinical admission examining Making therapy Hospital case decursus nursing closing evaluation Dataflow diagram Scheduling Basic entity of the cure, Minimum Basic Data Set (MBDS) Patient scheduled Input personal data anamnesis Open case status Make diagnostic plan status Nursing decursus decursus status closing report Evaluate therapy Execute therapy plan Financial case Medical case In/out event ADT: Admission, Discharge, Transfer Examination Procedure Therapy Diet Transportation Consultation diagnostic procedure order diagnose therapy order Execute diagnostic plan Make therapy plan That s All Folks!