Transforming Healthcare Quality through Information Tehnology

Information and information exchange are crucial to the delivery of care on all levels of the health care delivery system—the patient, the care team, the health care organization, and the encompassing political-economic environment. To diagnose and treat individual patients effectively, individual care providers and care teams must have access to at least three major types of clinical information—the patient’s health record, the rapidly changing medical-evidence base, and provider orders guiding the process of patient care. In this frame, Information Technology can help healthcare organizations improve the quality of care that they provide, improve patient safety, improve cost-effectiveness, accelerate the translation of research findings into practice, improve care for the medically underserved, increase consumer involvement, improve accuracy and privacy, and increase their ability to monitor health nationally. Consequently, in the present article are presented some implementations of Information and Communication Technologies in the Health Care field.Healthcare; Quality; Information and Communication Technologies

Clinical Information System (CIS) teaching is ESSENTIAL for Primary Care

Supported by the local SHA and PCTs and with live access to a clinical information system (CIS), Leeds University Academic Unit of Primary Care and the Yorkshire Centre for Health Informatics together developed teaching tools to meet this outcome and prepare undergraduate medical students for clinical placements and future practice. Tomorrow’s Doctors Outcome 19 (TD 19) states that doctors should make effective use of computers and information systems, understand confidentiality and data protection and apply the principle of health informatics to medical practice. The aim of the project is to ensure health care professionals are better able to use clinical information system (CIS) for patient care (4PC), and that CIS use is maximised in supporting teaching of undergraduates, postgraduates and in continuing professional development. The main objectives of CIS4PC include enabling students’ to explore the CIS and understanding how CISs support clinical care (e.g.: decision aids, prompts,); quality monitoring and patient safety (e.g.: read coding, audit, e-Prescribing); and communication (e.g.: Choose and Book, GP2GP record transfer). The live system (TPPs SystmOne) is used to deliver ‘hands on’ interactive teaching sessions covering topics on information governance, patient record keeping, the consultation, chronic disease management and soon prescribing and public health. The poster provided an overview of the project, what has been developed, delivered and student feedback on the benefits of received the teaching

Giving context to health informatics

The Department of Health and the General Medical Council agree that information systems and the application of health informatics are crucial to improving quality of patient care. Clinical Information Systems (CIS) are now firmly embedded in clinical practice: essential for facilitating communication between multidisciplinary teams and enabling coherent long term care for patients. In order to ensure medical students’ skills were fit for purpose when qualifying, changes needed to be reflected in the curriculum. The ‘Clinical Information Systems for Patient Care’ (CIS4PC) project was developed at Leeds using TPP SystmOne (used widely in West Yorkshire GP practices). Leeds was the first University to incorporate a ‘live’ CIS into the classroom as part of the students’ preparation for clinical placements. Teaching is delivered through a combined clinical and informatics approach, using experiential learning for students to explore and understand how CISs support clinical care, quality monitoring, patient safety and communication within the safety of a classroom environment. Through interactive role-play using the CIS, students cover topics including information governance, record keeping, consultations, decision support and disease management. Key learning outcomes are augmented with opportunities for students to experience how technology can benefit them as future practitioners and their patients. The session will include how we worked together to integrate health informatics and the technology into clinical teaching. Delegates will also be able to experience some of the hands-on session content for themselves

Development of a Computerized Infectious Disease Monitor (CIDM)

journal articleBiomedical Informatic

Implementation Success of Clinician Information Systems in Healthcare Contexts

The success of information systems in healthcare contexts is becoming increasingly important as the healthcare profession continues to adopt information systems for its internal operations. Using the DeLone and McLean model of information systems success that has found traction in a variety of research contexts, we develop a model for examining the success of clinician information systems. Our research model, while grounded in prior literature on information systems success, also benefits from insights gained from preliminary interviews and surveys of healthcare professionals and clinicians. The pilot round of data collection is planned for next month and actual data collection for summer; we will present preliminary findings at the conference

Issues and Structures for Sharing Medical Knowledge among Decision-Making Systems: The 1989 Arden Homsetead Retreat

Conference PaperBiomedical Informatic

The Arden Syntax for Medical Logic Modules

journal articleBiomedical Informatic

The HELP System Development Tools

book chapterBiomedical Informatic

MS

thesisHealth information systems are networks of computers employed by health care enterprises to facilitate the delivery of their health care product. Computers originally entered the medical domain solely as tools aimed at the business functions of the hospital. Having demonstrated their utility in this area, computers were perceived by certain innovators to have usefulness in the clinical domain. As clinical computer applications were successfully developed and implemented, they have over time been merged together into systems offering multiple areas of functionality directly impacting the clinical aspects of health care delivery. Such health information systems have now assumed major importance in the provision of health care in a complex medical environment. Although the focus of substantial investment for development and implementation, relatively little work has been done to assess the value of such health information systems. The business information technology literature and the medical informatics literature each include only a small number of published reports examining the value question in an incomplete manner. No generally accepted valuation strategy has been developed for information systems in either the business or health care domains. Several valuation methods with potential applicability to health information systems have evolved: cost-effectiveness / cost- benefit analysis, return on investment, information economics, measurement systems, the Strassmann approach, the Japanese approach, and the strategic value approach. None of these valuation strategies is clearly superior; each has different strengths and weaknesses. A matrix comparing these strategies on the bases of explicitness and ease of implementation is proposed. Intermountain Health Care (IHC) has been instrumental in the development of health information systems and a leader in the application of such technology in clinical health care delivery. IHC's HELP system has played a seminal role as a catalyst to the development of the health information system industry. Although both historically and functionally important, detailed financial information regarding HELP'S origins and implementation no longer exists. Current IHC budget information demonstrates the major financial commitment underway within this health care enterprise totaling approximately $157 million over the last decade and with additional expenditures of$47 to $61 million projected annually through fiscal year 2004. The complex budgetary relationships between HELP and the other health information systems at LDS Hospital further obscure the magnitude of the information technology investment within this institution. Benefits of health information systems are potentially most substantial within the domain of clinical integration. IHC has not implemented any formal valuation strategy for its health information systems, but the ad hoc measurement systems valuation approach applied to date is practical, flexible, and the most appropriate of the available systems. Adequate valuation of health information systems cannot readily be achieved given the existing traditional hierarchical accounting structure; an alternative accounting framework patterned after a relational database is proposed

Enabling health care students to lead patient care

In 2008 the DoH stated that sophisticated information management and technology were crucial to improving the quality of patient care and increasing patient safety. In 2009 the GMC followed by specifying that doctors should make effective use of computers and information systems and apply the principles, method and knowledge of health informatics to medical practice. These principles were acknowledged and addressed by Leeds University medical school as they recognised that the use of technology in general was changing the medical undergraduate’s (students) learning journey. Plus in general practice the use of technology was rapidly evolving with the increasing use of Clinical Information Systems (CIS) and electronic medical records. In order to ensure the students of the day were fit for purpose when qualifying, this needed to be reflected in the curriculum. The ‘Clinical Information Systems for Patient Care’ (CIS4PC) project was developed at Leeds University with TPP SystmOne. Leeds was the first University in the United Kingdom to incorporate the use of a ‘live’ CIS into the classroom as part of the student’s preparation for clinical placements in general practice. CIS4PC teaching has been delivered through a combined clinical and informatics approach, within the ‘safe’ university environment. Students receive ‘hands on’ interactive teaching (covering various topics including information governance, patient record keeping, the consultation, and chronic disease management). CIS4PC is now fully integrated and spiralled throughout the medical curriculum and is used to expose medical undergraduates to the technology they will experience in practice, thereby developing their practical skills which will enhance the interactive patient experiences. A key objective has been enabling students to explore the CIS and understand how CISs support clinical care (e.g.: decision aids); quality monitoring and patient safety (e.g.: read coding); and communication (e.g.: Choose and Book). Key learning outcomes are specified with built in opportunities for students to experience how technology can benefit them as future practitioners and their patients. Student feedback (2013) has shown clear benefits but also identified they want even more integrated use of digital technology within their education. The session is a standard 20 minute presentation on the project work, brief examples of CIS4PC session content and how we worked together to integrate health informatics and the technology into clinical teaching. CISs are an essential tool for all health care providers/practitioners and yet there is still limited access for health students in a safe learning environment; the students of today are the practitioners of tomorrow and they need to experience the digital technology as students in order to be better practitioners when qualified. Department of Health (2008) High Quality Care for All: NHS Next Stage Review Final Report. London http://www.gmc-uk.org/education/undergraduate/tomorrows_doctors_2009.asp Outcome 2: 19 Accessed 8/4/1