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CLINICAL
INFORMATION SYSTEM
BY:
Shannon Simpson
Healthcare Informatics
NUR 3563
CIS Definition/overview
   Clinical Information System—is a
    technology based system that is applied
    at the point of care and is designed to
    support the acquisition and process of
    information as well as providing storage
    and processing capabilities. It is a
    collection of various information
    technology applications that provides a
    centralized repository of information
    related to patient care across distributed
    locations.(McGonigle, D & Mastrain, K).
The 8 components needed in
the CIS system
                       Schedule designe
                                           Number of system
Type of application       and budge
                                               users
                          constraints




Department using      Where software and   How & where data
  the systems          data will reside    will be backed up



                       Requiements for
                      system redundancy
                          (Thede, L &
                           Sewell, J).
Technological Competencies
   All users of computerized clinical
    information system need to have
    technological competencies. These
    competencies, computer literacy and
    keyboarding skill, should be
    addressed long before a system is
    implemented (Thede, L & Sewell, J).
Who are the key players?
Implementation should involve those who work w/ patients to

           improve the interface, accuracy and security             .
 IT Department
                                                                Physicians, P
    & Project                      Support Staff
                                                                CA’s & Nurses
  Management
                                                                Essential in entering patient
                                                                information and HIPPA laws
                                                                to ensure privacy, reducing
                                                                errors in distribution of meds
                                                                      to patient (book)
                                    Ensures proper screening
                                   and preventative measures


  Essential skill of the nursing                                Provides timely response to
     informatics specialist.                                           patient needs
  Refers to the management
   of the project from start to
          finish. (book)

                                                                    Ensures accuracy and
                                   Timely manner in which any    eliminates the need for lost
                                     problems are addressed      charts (Thede, L & Sewell,
                                                                              J).
Costs involved with
implementing a CIS system
Tier 1: (less than 100 bed facility) $1-$2
million spent on hardware, software and
implementation. $100,000 spent each year
on maintenance fees



     Tier 2: (100-300 bed facility) $3-$10 million
     spent on hardware, software and
     implementation. $200,000-$300,000 spent
     per year on maintenance.



          Tier 3: (more than a 300 bed facility) $10m-
          $1b spent on hardware, software, and
          implementation. $1m spent each year on
          maintenance. (Cotti & Swab)
SAFETY
Safety Con’t
   Storage of Data
    ◦ Should provide retrieval of data used in
      long-range planning and research
      (Thede, L & Sewell, J).

   Protection of the files
    ◦ Major software upgrades include new
      virus protectors.
    ◦ Equipment and software upgrades to
      ensure up-to-date software (Thede, L &
      Sewell, J).
Safety Con’t
   Ways to protect your passwords
    ◦ Change your password often
    ◦ Use letters and numbers
    ◦ Never give your password out to anyone

   Ways to back up data
    ◦   DVD
    ◦   To a main Hub off site
    ◦   A zip drive
    ◦   Any other device that can be stored off
        location site (Thede, L & Sewell, J).
HIS project requirements
refer to certain needs that
include:
  Schedule, design, and budget
          constraints

    The number                    The departments that will
     of system                        use the system
       users
                                                                   The type and
                                   Requirements for system      availability of system
                  Where the       redundancy (if one system        support that is
The type of   software and data   fails, another system takes   available. (Thede, L
application       will reside                                       & Sewell, J).
                                              over)
Electronic MEDICAL Record
   Electronic medical records are records about
    patient care that are kept on a computer rather
    than on paper, the traditional medium for patient
    histories. These records can include extensive
    information about a patient's general
    health, current and past illnesses and medical
    conditions, diagnostic test results and treatments
    and medications prescribed. Often, electronic
    medical records also include an application for
    prescribing and ordering medication (Heflin, C).
    They are owned and managed by the institution
    or provider that creates them, and are often
    combined so that information from all member
    agencies and providers is accessible by those
    with the required authorization (Thede, L &
    Sewell, J).
How often should it be
updated to meet EBP guidelines?
 EBP guidelines should be updated
 frequently, as little as every 3 months
 but no longer than 1 year, to ensure the
 best standard of care is being delivered
 to the patients.
Advantages of EMR
Advantages
Computerized records have several advantages over traditional
  paper records:
  1. The data tends to be more accurate. Electronic records
  eliminate the possibility of mistakes as a result of misreading
  a doctor's handwriting.
  2. They're easily accessible to all care providers and to more
  than one care provider at a time.
  3. They're easy to store and take up less space than paper
  records.
  4. They're easily portable from one doctor's office to another.
  5. Their use can lead to cost savings, since keeping
  electronic records is more efficient than retaining paper
  records (Heflin, C).
Disadvantages of EMR
Disadvantages of computerized records include the
  following:
  1. The possible incompatibility of computer
  systems among various health care providers
  can lead to difficulty in sharing the data.
  2. Privacy and security can be an issue. If
  someone hacks into a computer
  system, thousands of patients' records can be
  compromised. Also, some critics say the federal
  government wants to use electronic records
  systems to ration health care services.
  3. Computer crashes make records inaccessible.
  4. The cost of implementing an electronic records
  system can be expensive (Heflin, C).
References
Ciotti, V. & Swab, J (2010). What to consider when
  purchasing an EHR system. Healthcare financial
  management, 64(5):38-41 Cinhal plus with Full
  Text.
Heflin, C Definition of electronic medical record.
  (n.d) retrieved 04/10/2012, from eHow Web Site:
  http://www.ehow.com/about_5059193_definition-
  electronic-medical-records.html
McGonigle, D & Mastrain, K (2009). Nursing
  Informatics and the Foundation of Knowledge.
  Jones and Bartlett Publishers. Pg 193.
Thede, L & Sewell, J (2010). Informatics and
  Nursing. Philadelphia, PA 19106: Lippincott
  Williams & Wilkins. Pg. 233-234, 329-340, 350,

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Clinical information system presentation

  • 2. CIS Definition/overview  Clinical Information System—is a technology based system that is applied at the point of care and is designed to support the acquisition and process of information as well as providing storage and processing capabilities. It is a collection of various information technology applications that provides a centralized repository of information related to patient care across distributed locations.(McGonigle, D & Mastrain, K).
  • 3. The 8 components needed in the CIS system Schedule designe Number of system Type of application and budge users constraints Department using Where software and How & where data the systems data will reside will be backed up Requiements for system redundancy (Thede, L & Sewell, J).
  • 4. Technological Competencies  All users of computerized clinical information system need to have technological competencies. These competencies, computer literacy and keyboarding skill, should be addressed long before a system is implemented (Thede, L & Sewell, J).
  • 5. Who are the key players? Implementation should involve those who work w/ patients to improve the interface, accuracy and security . IT Department Physicians, P & Project Support Staff CA’s & Nurses Management Essential in entering patient information and HIPPA laws to ensure privacy, reducing errors in distribution of meds to patient (book) Ensures proper screening and preventative measures Essential skill of the nursing Provides timely response to informatics specialist. patient needs Refers to the management of the project from start to finish. (book) Ensures accuracy and Timely manner in which any eliminates the need for lost problems are addressed charts (Thede, L & Sewell, J).
  • 6. Costs involved with implementing a CIS system Tier 1: (less than 100 bed facility) $1-$2 million spent on hardware, software and implementation. $100,000 spent each year on maintenance fees Tier 2: (100-300 bed facility) $3-$10 million spent on hardware, software and implementation. $200,000-$300,000 spent per year on maintenance. Tier 3: (more than a 300 bed facility) $10m- $1b spent on hardware, software, and implementation. $1m spent each year on maintenance. (Cotti & Swab)
  • 8. Safety Con’t  Storage of Data ◦ Should provide retrieval of data used in long-range planning and research (Thede, L & Sewell, J).  Protection of the files ◦ Major software upgrades include new virus protectors. ◦ Equipment and software upgrades to ensure up-to-date software (Thede, L & Sewell, J).
  • 9. Safety Con’t  Ways to protect your passwords ◦ Change your password often ◦ Use letters and numbers ◦ Never give your password out to anyone  Ways to back up data ◦ DVD ◦ To a main Hub off site ◦ A zip drive ◦ Any other device that can be stored off location site (Thede, L & Sewell, J).
  • 10. HIS project requirements refer to certain needs that include: Schedule, design, and budget constraints The number The departments that will of system use the system users The type and Requirements for system availability of system Where the redundancy (if one system support that is The type of software and data fails, another system takes available. (Thede, L application will reside & Sewell, J). over)
  • 11. Electronic MEDICAL Record  Electronic medical records are records about patient care that are kept on a computer rather than on paper, the traditional medium for patient histories. These records can include extensive information about a patient's general health, current and past illnesses and medical conditions, diagnostic test results and treatments and medications prescribed. Often, electronic medical records also include an application for prescribing and ordering medication (Heflin, C). They are owned and managed by the institution or provider that creates them, and are often combined so that information from all member agencies and providers is accessible by those with the required authorization (Thede, L & Sewell, J).
  • 12. How often should it be updated to meet EBP guidelines?  EBP guidelines should be updated frequently, as little as every 3 months but no longer than 1 year, to ensure the best standard of care is being delivered to the patients.
  • 13. Advantages of EMR Advantages Computerized records have several advantages over traditional paper records: 1. The data tends to be more accurate. Electronic records eliminate the possibility of mistakes as a result of misreading a doctor's handwriting. 2. They're easily accessible to all care providers and to more than one care provider at a time. 3. They're easy to store and take up less space than paper records. 4. They're easily portable from one doctor's office to another. 5. Their use can lead to cost savings, since keeping electronic records is more efficient than retaining paper records (Heflin, C).
  • 14. Disadvantages of EMR Disadvantages of computerized records include the following: 1. The possible incompatibility of computer systems among various health care providers can lead to difficulty in sharing the data. 2. Privacy and security can be an issue. If someone hacks into a computer system, thousands of patients' records can be compromised. Also, some critics say the federal government wants to use electronic records systems to ration health care services. 3. Computer crashes make records inaccessible. 4. The cost of implementing an electronic records system can be expensive (Heflin, C).
  • 15. References Ciotti, V. & Swab, J (2010). What to consider when purchasing an EHR system. Healthcare financial management, 64(5):38-41 Cinhal plus with Full Text. Heflin, C Definition of electronic medical record. (n.d) retrieved 04/10/2012, from eHow Web Site: http://www.ehow.com/about_5059193_definition- electronic-medical-records.html McGonigle, D & Mastrain, K (2009). Nursing Informatics and the Foundation of Knowledge. Jones and Bartlett Publishers. Pg 193. Thede, L & Sewell, J (2010). Informatics and Nursing. Philadelphia, PA 19106: Lippincott Williams & Wilkins. Pg. 233-234, 329-340, 350,