NS

Health Information Systems Fundamentals chapter 1

Introduction

  • Fundamentals are important for Health Information Systems (HIS): key skills, training, methods, standards, and principles guide the planning, design, testing, implementation, maintenance, and enhancement of HIS.

  • Emphasis on regulatory compliance and risk management, HIS standards, governance, and policy.

HIS Fundamentals

  • Health Information Systems (HIS) and HIS Strategic Planning

    • HIS Strategic Plan aligns HIS and technologies to strategic business directions and initiatives.

    • Supports and enables the strategies to be accomplished.

  • Governance

    • Use of consistent management methods, policies, decision rights, and processes across all units and departments.

    • Structural methods: steering committees, standards, auditability, and consistent policies and processes.

    • Culture of ethics, integrity, and personal accountability.

  • Managing HIS

    • Key activities: Planning, Budgeting, System Selection, System Implementation, Managing Changes, Managing Vendors.

  • HIS Planning and Budgeting

    • Uses the organization’s strategic business plan as a guide.

    • Reflects forward movement toward business and clinical strategies.

    • Annual or near-term plans/budgets are established based on a $5$-$10$-$15$-year view of the HIS Strategies Plans.

    • Annual plans drive the annual HIS capital and operating budgets.

  • HIS Selection

    • Process for decisions about which new software systems to bring into the organization.

    • Must justify why a new system is best rather than using something already in the HIS portfolio.

    • HIS Steering Committee oversees the process.

  • Implementing HIS

    • Activities to move from a business plan to a fully utilized HIS.

    • Implementation includes activating new software that runs on new hardware, operating systems, programming languages, storage, and other infrastructure.

    • Also includes a carefully designed and timed training program for end users.

  • Managing Change

    • Reality of what happens with a new HIS.

    • Work with interdisciplinary teams on design, requirements, training, testing, activation, and use.

    • Closely collaborate with end users, management, and clinical staff.

  • Managing Vendors

    • Organizations rely on external companies that produce, deliver, and support HIS software, hardware, and services.

    • For-profit corporations exist to create value for shareholders or investors.

  • Harvesting the Yield from HIS

    • The magnitude of the work can prevent organizations from fully leveraging data resources.

    • HIS produces and captures data to create new knowledge through analytics, business intelligence (BI), and/or clinical intelligence (CI).

    • Increases value and ROI in the core HIS.

    • Value garnered is widely underachieved.

  • Data Management and Stewardship

    • Definition of each data element must be accurate and used consistently.

    • Data must be managed according to organizational goals.

    • Consistency, accuracy, accessibility, and safety must be checked regularly.

Data, Information, Knowledge (D-I-K)

  • Data: Elementary description of things, events, activities, and transactions.

  • Information: Data organized so that they have meaning.

  • Knowledge: Accumulated learning and expertise as it applies to a current problem.

Information Overload

  • In 2023, the average internet user created about $1.7$ MB of data per second, or $147$ GB per day.

  • World data creation in 2023 was around $120$ zettabytes (ZB), or $337{,}080$ petabytes (PB) per day.

Business, Clinical, and Artificial Intelligence

  • Business intelligence, clinical intelligence, and artificial intelligence (AI) provide analytical systems, resources, data management, and personnel capabilities.

  • Health Informatics: uses biomedical data, information, and knowledge for scientific inquiry, problem-solving, decision making, motivated by efforts to improve human health; enables organizations to gain insights and knowledge.

HIS Regulatory Compliance and Risk Management

  • Key regulations: Health Insurance Portability and Accountability Act (HIPAA), Medicare Access and CHIP Reauthorization Act (MACRA), Department of Health Services (DHS) regulations.

  • Healthcare is highly regulated because it is paid for by government/third-party insurance; fraud constitutes roughly $10\%$ of healthcare costs; patient safety, data, and privacy must be protected.

HIS Security

  • Security of HIS, data, and Protected Health Information (PHI) is a primary goal.

  • Threats include hackers, black market activity, and ransomware.

  • Prevention is among the highest priorities for any HIS agenda.

HIS Model for the Health Professions (Overview)

  • A holistic model that includes: Global HIS, policy, and research; Analytics, BI/CI, and AI; Data and informatics; People and processes; Systems and management; Technology and infrastructure; Central HIS.

  • Visualized as an integrated framework showing how each domain supports the HIS function in health professions.

HIS Terminology

  • Health Information Systems (HIS)

    • An organized combination of system components, including infrastructure, hardware, middleware, application software, devices, intended to support an organization or key processes in health care.

  • Technology Infrastructure

    • Elements include fiber optics, routers, switches; bandwidth connectivity; middleware; intranet; Internet; extranet capabilities.

  • Hardware

    • The backbone of computing environments, whether in a data center or cloud-based; provides the technology upon which software operates; accessed by end users.

  • Software

    • Applications can be clinical, administrative, analytic, or business-oriented.

    • Core clinical programs include EHR systems, etc.

  • Middleware

    • Software that connects software applications to the data and technology supporting the application.

    • As a transaction layer, enables communication and data management for multiple or distributed applications.

  • Networks

    • Computers linked to exchange data using technical and data connections; linkages enabled through fiber optics, cables, wires, routers, switches, Wi-Fi, etc.

  • End-users

    • Include clinical professionals, business people, and analysts using systems and information to meet professional goals.

    • Knowledge workers and professionals in clinical, business, informatics/analytics, and patient care.

  • User Interface (UI)

    • UI is activated through typing on a keypad, speaking into a device, or other means of connecting the user to the HIS or computer.

Review Questions (from the transcript)

  • Q1: M_ is software that connects software applications to the data and technology supporting the application.

    • Answer: Middleware

  • Q2: H_ I S___ comprise an organized combination of system components, including infrastructure, hardware, middleware, application software, intended to support an organization or key processes in health care.

    • Answer: Health Information Systems

  • Q3: How many bytes in 1 TB? billion bytes

    • Answer: 1000

Notes on specific figures and conventions used in the content

  • Planning horizons mentioned for HIS planning: $5$-$10$-$15$ year view.

  • Regulatory emphasis includes HIPAA, MACRA, and DHS regulations, with an estimated fraud burden around $10\%$ of healthcare costs.

  • Data scale figures cited: $1.7$ MB/s, $147$ GB/day, $120$ ZB/year (2023 context), $337{,}080$ PB/day.

  • Use of LaTeX formatting for clarity in study materials: e.g., $5$-$10$-$15$ year view, $1.7$ MB/s, $147$ GB/day, $120$ zettabytes, $337{,}080$ PB/day, $10\%$.