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Management of Information in Healthcare Organizations

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Chapter 13 Management of Information in Healthcare Organizations Intranet vs Internet Intranet is a private corporate network that uses the same structures as the ... – PowerPoint PPT presentation

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Title: Management of Information in Healthcare Organizations


1
Chapter 13
  • Management of Information in Healthcare
    Organizations

2
Healthcare organizations (HCOs)
  • Any business organization, such as a physicians
    practice, hospital, or health maintenance
    organizations, that provides care to patients.

3
Healthcare information system (HCIS)
  • An information system used within a healthcare
    organization to facilitate communication, to
    integrate information, to document health care
    interventions, to perform record keeping, or
    otherwise to support the functions of the
    organization

4
Challenges of Sharing data
  • components purchased from different vendors
  • No national standards among products
  • Systems created for specific users only
  • Different programming languages

5
Development to improve sharing data
  • Development of the Interface Engine, a computer
    system that translates and formats data for
    exchange between independent (sending and
    receiving) computer systems.
  • Creation of the HL7, healthcare-based initiative,
    to develop standards for the sharing of data
    among individual systems.

6
President Obamas Summary of American Recovery
and Reinvestment Plan
  • Scientific Research
  • 2 billion in biomedical research, 1.5 million
    for expanding good jobs involving biomedical
    research to study Alzheimers, Parkinsons, cancer,
    and heart disease.
  • 900 million to prepare for pandemic influenza,
    support advanced development of medical
    countermeasures for chemical, biological,
    radiological and nuclear threats and for cyber
    security protection at HHS.

7
President Obamas Summary of American Recovery
and Reinvestment Plan Lower Healthcare costs
To save not only jobs, but money and lives, we
will update and computerize our healthcare system
to cut red tape, prevent medical mistakes, and
help reduce healthcare costs by billions of
dollars each year
  • Health Information Technology 20 billion to
    jumpstart efforts to computerize health records
    to cut costs and reduce medical errors.

8
Regional Health Information Network (RHIN)
  • Also referred to sometimes as organization rather
    than network (RHIN)
  • RHIN-A public-private alliance among health care
    providers, pharmacies, public health departments,
    and payers, designed to share health information
    among all health participants thereby improving
    communication health and health care.

9
National Health Information Infrastructure
  • NHII- A comprehensive knowledge based network of
    interoperable systems (RHIN) of clinical, public
    health, and personal health information that is
    intended to improve decision making by making
    health information available when and where it is
    needed.

10
Utahs RHIO UHIN
  • In operation since 1993
  • Governor Leavitts Health Print
  • Statewide value added network
  • Community-based inclusive
  • Community standards
  • Not-for-profit
  • Self-sustaining
  • Began with what members thought would bring the
    most value Claims

11
UHIN today
Clearinghouse
UHIN Gateway
12
UHINs RHIO Vision
  • Goal Create a sustainable business
  • Begin with direct messages where the receiver is
    known
  • Easier to bring value to end user
  • ADOPTION!

13
(UHINet)
14
Challenges with moving to EMR within a facility
  • Paper environment
  • Cost
  • Change/training requirement
  • HIPAA

15
Davis Hospital IASIS Challenge
  • 1. ILE Component of the EMR
  • low-volume scanning application
  • Condition of admission
  • HIPAA Privacy
  • Insurance card
  • Drivers license

16
Davis Hospital IASIS Challenge
  • 2. HED, component of the EMR
  • Nursing documentation
  • Patient history
  • Flowsheets
  • Vitals
  • Medication record
  • assessments

17
Davis Hospital IASIS Challenge
  • 3. DCS/QCI, component of the EMR
  • High-volume scanning application
  • All records that are not electronically entered
    (records from other facility,physician office)

18
Davis Hospital IASIS Challenge
  • 4. Dictaphone, component of the EMR
  • Transcription
  • Dictated reports

19
Davis Hospital IASIS Challenge
  • 5. STAR, component of EMR
  • Contains MPI
  • Ordering systems for labs/radiology
  • Result systems for labs/radiology

20
Davis Hospital IASIS Challenge
  • 6. MD Portal, component of the EMR
  • Record viewing application
  • Web-based
  • Clinical use
  • Current status of patient
  • Trending
  • Completion of Charts (Physician use)

21
Davis Hospital HIM function
  • How will components interface with the HPF,
    Component of the EMR
  • Record viewing application
  • Queues
  • Deficiencies (HIM)
  • Adjust images

22
Davis Hospital Challenge
23
Mountainside Medical Center
  • See text on pg 493

24
HCOs Operational Information needs
  • Operational requirements
  • Planning requirements
  • Communication requirements
  • Documentation and reporting requirements

25
Operational requirements
  • Required detail and up-to-date factual
    information. (bread butter of the institution)

26
Planning Requirements
  • Short and long term decisions about patient care.
    Clinical decision making. High-quality care.

27
Communication requirements
  • Communication among caregivers, multiple
    personnel, business units.

28
Documentation and reporting requirements
  • Need/requirement to maintain records for future
    reference or analysis and reporting. Legal health
    record

29
HIPAA Acronyms
  • HIPAA Health Insurance Portability and
    Accountability Act
  • TPO Treatment, payment, and operations
  • PHI Protected health information

30
Security Confidentiality Requirements
  • Designated Security officer
  • Train employees so they understand the
    appropriate uses of patient-identifiable
    information and the consequences of violations
  • Use electronic tools such as access controls and
    information audit trails not only to discourage
    misuse of information, but to teach employees and
    patients that people who access confidential
    information can and will be tracked and held
    accountable.

31
HIPAA Security standards Implementation
Specifications
  • Pg 488 of text
  • Administrative safeguards
  • -security management process (risk analysis)
  • -Assigned security responsibility
  • -workforce security (authorization)
  • -security awareness and training

32
Administrative safeguards cont.
  • -Security Incident Procedures
  • -Contingency plan
  • -Evaluation
  • Business Associate Contracts Arrangements

33
2. Physical Safeguards
  • -Facility Access Controls (Access controls
    validation procedures)
  • -Workstation use
  • -workstation security
  • -Device and media controls

34
Intranet vs Internet
  • Intranet is a private corporate network that uses
    the same structures as the Internet.
  • Internet a global network of networks, connecting
    innumerable smaller networks, computers, and
    users.
  • How do we protect our intranet?

35
Ways of Protecting Information
  • A firewall is either the program or the computer
    it runs on, usually an Internet gateway server,
    that protects the resources of one network from
    users from other networks. Typically, an
    enterprise with an intranet that allows its
    workers access to the Internet will want a
    firewall to prevent outsiders from accessing its
    own private data resources.

36
Firewall example
Home network
firewall
internet
blocker
37
Encryption
  • Encryption is the process of encoding information
    in such a way that only the person (or computer)
    with the key can decode it.
  • What would you want encrypted?
  • Name
  • Address
  • Credit card number
  • Social security number
  • Bank account information
  • Health information
  • Computer encryption is based on the science of
    cryptography, which has been used throughout
    history. Before the digital age, the biggest
    users of cryptography were governments,
    particularly for military purposes. The existence
    of coded messages has been verified as far back
    as the Roman Empire. But most forms of
    cryptography in use these days rely on computers,
    simply because a human-based code is too easy for
    a computer to crack. Most computer encryption
    systems belong in one of two categories
  • Symmetric-key encryption
  • Public-key encryption

38
Understand your Threat Risk Assessment at your
facility
39
3. Technical Safeguards
  • -Access controls (audit trails)
  • -Integrity
  • -Personal authentication
  • -Transmission Security (integrity controls,
    encryption)

40
Functions Components of the Healthcare
Information System (HCIS)
  • Patient Management Billing
  • -Master patient index (MPI)-the module of a
    health care information system used to identify a
    patient uniquely within a system. The MPI stores
    patient identification information, basic
    demographic data, and basic encounter-level data
    such as dates and locations of service.

41
Functions Components of the Healthcare
Information System
  • Admission-discharge-transfer One component of a
    hospital information system that maintains and
    updates the hospital census, including bed
    assignments of patients.

42
Functions Components of the Healthcare
Information SystemCare Delivery
  • Order Entry online entry of orders for drugs,
    laboratory tests, and procedures, usually by
    nurse or physician.
  • Results reporting online access to results of
    laboratory tests and other procedures.
  • Clinical Pathways Disease-specific plan that
    identifies clinical goals, interventions, and
    expected outcomes by time period.

43
Functions Components of the Healthcare
Information SystemCare Delivery
  • Clinical decision-support system a
    computer-based system that assists physicians in
    making decision about patient care.
  • Computer based physician order entry A clinical
    information system that allows physicians and
    other clinicians to record patient-specific
    orders for communication to other patient care
    team members and to other information systems
    (such as test orders to lab systems or medication
    orders to pharmacy systems).

44
Functions Components of the Healthcare
Information System Financial Resource
Management
  • Electronic data interchange (EDI) Electronic
    exchange of standard data transactions, such as
    claims submissions and electronic funds transfer.
  • Contract-management system A computer system
    used to support managed care contracting by
    estimating the costs and payments associated with
    potential contract terms and by comparing actual
    with expected payments based on contract terms.

45
Functions Components of the Healthcare
Information System Financial Resource
Management
  • Provider-profiling systems computer system used
    to manage utilization of health resources by
    tracking and comparing physicians resource
    utilization (e.g. cost of drugs prescribed, lab
    tests ordered) compared to severity-adjusted
    outcomes
  • Patient triage A computer system that helps
    health professionals to classify new patients and
    direct them to appropriate health resources
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