Healthcare is an information intensive industry in which quality and timely information is a critical resource. There are a wide range of information systems in health that perform different functions but all are involved in the management of data and information. This chapter provides an overview of Health Information Systems and their use in supporting healthcare

Ayres, Dianne

Conrick, Moya

Soar, Jeffrey

English

University of Southern Queensland ePrints

Health information systems

Conde;:' Helen Cooper, Paul 1e Foster. Isobel Frean. Rod i Except as permrl:ted under the A.:j: (for eXample.a fa,r dealing for th.",I no part olth,s book- maybe reprQdUCed;storcpiJ) :\.,retoeval S)l$tem,I by dny means without pnorWl'ltten p~rmissfOil, All Jnqu'l'lesshou!d h~.m.ri"dh THOMSON ..... "I" SOCIAL SCIENCE PRESS level 7, 80 Dorcas Street South Melbourne. Victoria 3205 Email;highereducation@thomsonlearn.ng.com.au Website; www.thomsonlearnlng.com.au First published ,n 2006 1098765432 1009080706 Marsault, David Mitchell, Ron Peter Scott, jan Stanek . COPYRIGHT , Reproduction and Co.mmunication foreducat!'?l1aJ 'purpose's i The Austrai'an (ojlY'lghl Act '/foB (theAct)lIn<:N''So,a\0'!~m:l.tl)iof611<'j,thapter'br 10% QhQepa~e~pftl1is VIOrl<;. I wh,chever '5 the . be reproduc('\lj ~Qt;l(prtomDnlC~!':dP?a~tlldqcatloQ;U iristituboQ for ft>ecf~catJona! : that thli'.eduCiltlonal.10stlt\itlon·(Qrtniil boar'that admln!stIID.lt).I\~.glvena rern\!.n~lor:uiot'ce ~1il1ited (CAL). (JndertneA(:t, i I For detatls of the CAL licence for eduC(ltionar.tnst~ut\C!ns·,oljtadi; ICop)'l'1ght Agency llmited I Level 19, 1&7L'verpoOI Street NSW.WOO 9)947600 7601 , Reproduction and Communicati'mfor other!liJrposes I Conric;:, Maya. Health informatics: transformin,g healthcare technology. Includes Index. Medical informatics. 2. Information storage and retrieval systems - Medical care. l.Title. 610.285 Editor: Bette Moore Project editor: Chris Wyness Publishing editor; Elizabeth Vella Publishing manager: Michael Tully Indexer: julie King Cover designer: Olga Lavecchia Original cover concept: Patrick Jennings Typeset in New Aster, Gill Sans, Franklin Gothic and Times Ten by Chris Ryan Production controller: jodie Van Teylingcn Printed ,n Australia by Ligare Book Printers This title is published under the imprint ofThomsonlSocial Science Press. Nelson Australia Pty Limited ACN 058 2~9 (him! ~ora"te{fii;~ • trading as Thomson learning Australia. The URLs contained In this publication were checked for currency during the process. Note, however. that the publisher cannot vouch for the ongoing currency contents Preface Acknowledgements Part 1 - The basics of health informatics vi viii Introduction to health informatics Moya Conrick 2 2 IT and infonnation management Moya Con rick 11 Part 2 - The building blo~ks of health informatics 3 Health information interchange Moya Con rick, Sue Walker, Peter Scott and Isobel Frean 20 4 Modelling healthcare information 39 Isobel Frean 5 Introducing databases Stephen Chu 60 6 Knowledge management 85 Moya Conrick Part 3 - Management considerations in health informatics implementations 7 Introduction to the issues in leadership and management Moya Conrick and Catherine Cameron 98 8 Business planning and architectures 1. Richard Dixon-Hughes 110 9 Project management Anyes Marsault 128 10 Risk management Malcolm Pradhan 143 19 , 97 I ~' r iy Contents 11 Change management Rodney Gapp 154 12 Health economics Ian Edwards 169 Part 4 - Health Information Systems 185 13 Systems development Michael Strachan 14 Health information systems Dianne Ayres, Jeffrey Soar and Moya Conrick 15 Software management Jeffrey Soar and Moya Conrick 16 Electronic health records Sam Heard 17 Clinical information systems R. M. Ribbons 18 Decision support systems Jim Warren and Jan Stanek 19 Telehealth and communication -Sisira Edirippulige and Richard Wootton 20 Information across the health system Moya Conrick Part 5 - The human issues in health informatics implementations 21 Informatics professional roles and governance Moya Conrick 22 Workforce capacity bUilding Moya Conrick 23 Human technology interfaces and ergonomics Karen Guest and Moya Conrick 24 Issues of ethics and law Moya Conrick and Christopher Newell 186 197 212 222 236 252 266 279 289 290 300 310 320 '­Contents y 25 Consumer issues in informatics 333 Heather Grain Part 6 - Health informatics supporting practitioners 345 26~ Health education 346 Moya Con rick and Joanne Foster -_ .... _--- ---"" --­27 Researchand evidence-based practice 359 Evelyn Hovenga 28 Case studies from clinical practice 370 David Rhodes Peter Adkins Paul Donaldson Ron Natoli Stella Stevens Bruce Roggiero 29 Management decision-making 378 David Evans 30 Policy decision-making 388 Sheree Lloyd and Helen Cooper Part 7 - Pushing the boundaries 31 Genomics and biotechnology 406 David Mitchell 32 Gazing into the crystal ball 417 Moya Conrick with contributions from Bob Ribbons, Sisira Edirippulige and Richard Wootton Glossary 424 Contributors 434 Index 437 405 ---vii ~ y Preface Technology is one of the most pervasive and ubiquitous tools in healthcare today. It is not only transforming healthcare but also the professions within it. For those of us teaching health informatics over the years, being unable to steer students and other interested people to a comprehensive text on the subject has been trying. The idea for this text was conceived during a meeting with a broad range of stakeholders; it was born from frustration and nurtured by a number of people engaged in health informatics some without even realising they were! book provides information, knowledge and skills necessary to understand collection, storage, retrieval, communication and optimal use of health-related data, information and knowledge. It addresses a wide range of the most essential and current areas of health informatics and is divided into seven sections: Chapter 1 	 introduces the basics of health informatics to the uninitiated. Chapter 2 	 discusses the building blocks of data, information and knowledge and how these are modelled and manipulated for use in health information systems. Chapter 3 considers the issues of leadership, planning, management and economics that are central to successful informatics implementations. '-rLUlfl.EI 4 on the fundamentals to introduce the ins and outs information systems that might be employed in or used across health institutions or practices. Chapter 5 considers the most pressing of the human factors in informatics, including workforce, consumer and philosophical issues. Chapter 6 presents case studies from lived experiences of health informatics. These are wide-ranging and originate from the other side of Katherine (remote Australia) to the corridors of policy-making. Chapter 7 concludes the text with a glimpse at informatics in genomics and a healthcare future increasingly dependent on technology for quality, cost effective outcomes. It also recognises that health informatics is a tool that supports healthcare while demonstrating the interdependent and interconnected technologies that would be falsely isolated from each other. I am still flabbergasted that I took on this task and can only look back on the merriment of the afternoon as the answer. However, the encouragement and help received during this project have made it worthwhile and very satisfying. Finding a name for the text was not difficult in some ways but challenging in another. Information technology is obviously transforming healthcare but the name health /,reb" informatics often produces a 'glazing over' from the uninitiated or enthusiastic noises from the geeks! My hope is that this text will have wide appeal to all healthcare workers as it is written in a reader-friendly style that makes it accessible and a resource that can be used at any time. It also exposes health informatics as the tool of practice that it is and not something [or only the technically savvy. Regards, Moya INFOTRAC!/I COLLEGE EDITION This book also contains Info1rac search terms at the end of each chapter. To access this material please go to: hltp:l/infolrac.lhomsonlearning.com! G. To register: ~ 1. Go to http://infotrac.thomsonlearning.coml 'ilINFOTRAC 2. Click on Register New Accounts 3. 	 Enter your access code found in the InfoTrac card that comes with this text. YOU WILL NEED TO CREATE A USERNAME 4. 	 Fill out the registration form to activate your account. Note: After registration is complete you will only need your lIsemame and password to logon. Acknowledgements A book like this does not just appear. It takes a lot of effort from many dedicated people and I would like to thank them all for their hard work. 1 would particularly like to acknowledge the understanding, help and support of my sons Michael and Gerard because without it this book would still be a thought. I would also like to thank my late night companion, Blu, who kept me awake by grumping at possums. Thanks also to Karen for her great artwork and Cath for being my sounding board and proof reader. However, this book owes its existence to the many authors who have helped me to put it together in the midst of their own busy lives and day jobs. Dedication I would like to dedicate this book to my Dad (who did so much for me), to my Mum for her support and patience and to my sons for being there. if \h) <e [b)<nt.s) acc~ CO>ff heCOl~~[hJ Orruif(Q)rFMCOltOCCS; / .~.ilELJ·';: Patierttlrtstrucflorts.com Don't be afraid load the Internet, search for nat/onalhealth records, click on myhealth record, log In, key In your symptoms. CliCK on self assessment, scan the diagnosis, select the generic brand script, add to yourshopping cart, and submit It to the online pharmacy. ~,s, I C (Q) Ull t [r'~ ro (Ul torrs ..... .... _.­peter Adkil'ls _ _ MBBS. General Practitioner. Birkdale Medical Center. Diane Arres RN RM M.lnfo.Comm.Tech., B.Admin.(Nurs). Manager, Client Partnerships NSW Health. Cath Camerol'l RN RM PhD BN. MN. Grad Cert HE. Lecturer. Griffith University. Stephen. Chiu PhD.FACS. Associate Professor of Health Informatics. University of Auckland. Auckland. New Zealand. Moya Cdnrick RN, RM, PhD. MclED, BN. DipAppSc. Griffith University. Convenor Nursing and Health Informatics. Chair Nursing Informatics Australia. Helen Cooper Assoc Dip MRA (Cumberland College of Health Sciences). B Bus (Marketing) QUT, MTM (Griffith). Paul Donaldson RN PNC BHlthSc{Nurs) MSchMgmt. Manager Clinical Information - Nursing.The Prince Charles Hospital. Richard Dixon-Hughes BSc BE(Hons) MEngSc DipLaw MLS(Hons) FIEAust CPEng FAICD MACS. Managing Director. DH4 Pty Ltd. David Evans MBBS, FRACMA,AFCHSE. CHE. MSIA, BBus Health Admin, Grad Dip IT, Grad Dip OHS. Medical Superintendent. Queen Elizabeth I I Jubilee Hospital. Sisira Edirippulige PhD. MSs. Lecturer Postgraduate Courses. e-Healthcare Center for Online Health. The University of Queensland. Ian Edwards B.Bus (HRM) QUT, MHA UNSW. Queensland Health is Senior Business Analyst. Health Service Executive. Lecturer, Griffith University Joanne Foster RN, Renal Cert, DipAppSc (NsgEdn). BN, GradDipClEdn. Queensland University of Technology. Secretary Nursing Informatics Australia. Isobel Frean RN,MS. Visiting Fellow. Health Informatics Research Centre. University ofWollongong. Contributors 435 Rod Gapp Heather: Gra.in Karen Guest PhD., BSc, BAppSc. Director Masters of Managemen.t (InnoV~tion & Change) & (Research). Department of Management. Griffith University - Gold Coast. AssocDipMRA CaulfieldLincoln, GDipDataProc Caulfield. Coordinator Health informatics. School of Public Health. Consumer Representative. BA CQU. BlnfTech GU. School of Information and Communication Technology. Griffith University, Nathan. Sam Heard MBBS, MRCGP, FRACGP, FACHI. General Practitioner. Adjunct Professor of Health Informatics at Central Queensland University. SeniorVisiting Research Fellow at University College London. Vice-Chairperson of the openEHR Foundation and CEO and Clinical Director of Ocean Informatics. Evelyn Hovenga RN. PhD. FCHSE, FRCNA. FACHI. MACS. Professor, Faculty of Informatics and Communication. Central Queensland University. Rockhampton. Sheree Lloyd B Bus(Computing) QUT,Assoc Dip MRA (Cumberland College of Health Sciences). MTM (Griffith). Honorary fellow QUT. Anyes Manault MMS, GradDipCommM, BBS. Project Manager PMP® ­ EDS Australia. [2005 PMI Project Manager of the Year] David Mitchell PhD,MEI. Research & Business Leader, Biotechnology & Health Informatics CSIRO. Ron Natoli PhC, FPS, FAIPM. Community pharmacist. Fellow/Councillor FPS of the Pharmaceutical Society of Australia NSW Branch. Christopher Newell AM. PhD, BA, BD, MA (Hons). MPET, FACE. Consultant ethicist and Associate Professor of Medical Ethics within the School of Medicine, UniverSity ofTasmania. Malcolm Pradhan MBBS,PhD. Director of Health Informatics, Faculty of Health Sciences, University of Adelaide. David Rhodes L. BSocial Studies, Grad Cert Health Services Management. Director, Allied Health Services. Hunter New England Area Health Service. r , \1 1 ~ 436 Contributors . Bob Ribbons Bruce Roggier6 Peter Scott Jan Stanek Stella Stevens Michael Strachan Jeff Soar Sue Walker Jim Warren Richard Wootton RN, ICCert, BAppSc (Nur), MEd (Computing), FACHI. Manager, Clinical Informatics, Peninsula Health. Frankston. Honorary Senior Lecturer, Faculty of Medicine, Nursing and Health Sciences, Monash University. Aboriginal Community Health. Katherine District Health Services. MBBS,BA. National Centre for Classification in Health (Brisbane). MD (Comenius Univ.), GradDiplT (UniSA). Health Informatics Research Group. Advanced Computing Research Centre, University of South Australia. PhD. Senior Lecturer. Public Health. Griffith University Gold Coast Campus. BBus HIM (QUT)/Grad Cert Health Informatics (Monash). Director. Health Information Services. Mater Health Services, Brisbane. BA (Hons), GDipCommDP, GDipEd, MEd, PhD, MACS. Associate Professor, Information Systems. Director Collaboration for Ageing and Aged Care Informatics Research (CMIR). University of Southern Queensland. MHIthSc, GradDipPH, BAppSc (MRA). Associate Director. National Centre for Classification in Health. PhD, BS. Chair of Health Informatics. University ofAuckland. PhD, DSc. Professor. Director of Research Center for Online Health. 

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Health information systems

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