Health Information Systems Fundamentals

Health Information Systems Fundamentals

Introduction

  • Course Title: HIM72060: Health Information Systems

  • Instructor: Laurie Lafleur

  • Session Date: July 9

Evolution of Healthcare

  • Key Themes:

    • Individualized care

    • Evolution of sophisticated medical devices

    • Centralization of healthcare services

    • Development of connected consumer devices

Identifying Health Information Systems (HIS)

  • Prompt Question: How many HIS can you name?

Healthcare Information Systems Overview

  • List of HIS Examples:

    • Electronic Medical Records (EMRs)

    • Clinical Decision Support Systems (CDSS)

    • Picture Archiving and Communication Systems (PACS)

    • Computerized Provider Ordering System (CPOE)

    • Telemedicine/Telehealth

    • Virtual Reality/Augmented Reality

    • Connected health and IoT/wearables

    • Public Health Informatics

    • Additional systems exist beyond this list.

Complexity of Health Information Systems

  • Health Information Systems are characterized as complex entities.

Learning Objectives

  • Scope and Complexity: Discuss the scope and complexity of health information systems.

  • System Fundamentals: Explore fundamental principles of health information systems.

  • HIS Model Introduction: Introduce the Health Information Systems model.

Informatics Domains

  • Major Domains of Informatics:

    • Clinical Informatics: Intersection of clinical workflows and information technologies that support healthcare delivery.

    • Bioinformatics: Focused on analysis and interpretation of biological data encompassing microbiology, biochemistry, physiology, and genetics.

    • Imaging Informatics: A subspecialty of biomedical informatics particular to medical images and tissues/organs data.

    • Public Health Informatics: Applying information in public health practice, research, and learning.

    • Additional areas may be discussed under informatics.

Scope of Health Information Systems

Multiple Contexts:

  • Enterprise Level:

    • Examples: Hospital System, OLIS, HDIRS.

  • Facility Level:

    • Examples: Hospital, Physician practice, Outpatient imaging center.

  • Individual Level:

    • Examples: Patient portals, Apps (e.g., PocketHealth), Healthcare devices (e.g., ButterflyIQ).

  • Department Level:

    • Examples: Emergency, Radiology, Surgery, Pharmacy.

Multi-disciplinary Perspective

  • Key Concept: Different stakeholders contribute to systems, workflows, and data from a singular patient perspective.

Discussion Question on HIS Importance

  • Core Question: Why is understanding HIS critical for healthcare providers, support staff, or leaders?

HIS Fundamentals

  • Key Components:

    • Governance

    • Strategy and Planning

    • Management of HIS

    • Value Extraction from HIS

    • Regulatory, Security & Standards

Governance in HIS

  • Definition: Governance is foundational to health information strategy. It establishes direction, influences change, mitigates risk, and enhances accountability.

Governance Roles & Responsibilities

  • Strategic objectives include:

    • Aligning HIS initiatives with strategic planning.

    • Maintaining multi-disciplinary collaboration.

    • Defining and enforcing policies and processes.

    • Allocating resources effectively (people, technology, budget).

    • Oversight and auditing for quality and regulations.

COVID Response Plan Example

  • Governance Levels in Pandemic Response:

    • Layers include Federal, Provincial, Regional, and Organizational governance.

    • Illustrations of governance: Public Health Ontario, WRDSB, Communitech, YMCA, etc.

Governance Components for HIS

  • Key Elements:

    • People: Roles, organization structure, cultural aspects.

    • Processes: Governance workflows, enabling processes, data management.

    • Technology: Tools and technology that support governance efforts, data quality management, and metrics monitoring.

Higher-Order Governance Structure

  • Multi-Layered Governance Framework:

    • Involves Federal and Provincial layers, including:

    • Canadian Constitution

    • Various health ministries and agencies (e.g., Health Canada, Public Health Agency of Canada).

    • Health care coverage and delivery strategies discussed.

Governance in Healthcare Organizations

  • Stakeholders Include: Radiology departments (organizational, departmental, individual roles) including assignments for roles such as CMO and CIO.

HIS Strategic Planning

  • Objective: Align HIS and technologies with organizational goals, producing a balanced portfolio of systems.

  • Long-term Vision: Define aspiration for future states across extensive timelines (5, 10, 15, 20 years).

Managing HIS

  • Core Functions of HIS Management:

    • Tactical planning for IT, infrastructure, software, and data.

    • Workflow design, configuration, training, support, and maintenance.

Value Opportunities of HIS

  • Enhance accessibility, increase capacity within health systems, reduce care costs, and deliver better individual care, thus fostering healthier populations.

Effective Data Management

  • Focus Areas:

    • Efficient collection, organization, and storage of data.

    • Implementing AI tools to extract relevant data insights.

    • Real-time learning capabilities for HIS design revision.

Creating New Knowledge

  • HIS Contributions:

    • Cultivating a Learning Health System that integrates personal health records, health information exchanges, national health analytics, and public health policy.

Importance of Standards in HIS

  • Key Questions:

    • Why are standards critical in health information systems?

    • What are the common standards?

    • Who defines these standards?

Common Fundamental Failures Activity

  • Objectives for Group Discussion:

    • Analyze impacts of specific failures on stakeholders.

    • Identify contributing factors for failures.

    • Discuss HIS fundamentals to prevent setbacks.

Compliance and Risk Management

  • Comparison of Legislation:

    • United States vs Canada in terms of privacy legislation (HIPAA vs PIPEDA).

    • Medicare and Medicaid discussions highlighting differences between U.S. and Canadian health systems.

Healthcare Information System Model Overview

  • Model Components:

    • Infrastructure, Hardware, Middleware, Software, User Roles.

    • Emphasis on governance policies and operational performance implications.

Key Takeaways and Homework

  • Summary Points:

    • Purpose of HIS model and definitions of HIS fundamentals.

    • New knowledge creation and value opportunities inherent in HIS transitions.

  • Homework Assignment: Read Chapter 2, pages 21-32 focusing on the introduction, system management, HIS uses in various settings with discussion questions 1-4.

Next Steps

  • Explore layers of the HIS model further.

  • Discuss management and deployment of HIS across diverse care settings.