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Architectures of Health �Information Systems

Unit 3 Lecture 2

ALLPPT.com _ Free PowerPoint Templates, Diagrams and Charts

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HIS Architectures

Definition:

How MIS components can be synthesized and assembled in order to achieve that what users nowadays experience as the hospital information system

Architecture: structure of the central processing unit and its interrelated elements within an information system.

From a functional viewpoint, an MIS supports three main levels of a health care system:

    • Central government at national and regional level
    • Primary Care Health Services
    • Secondary Care Health Services

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Laboratory

Management

Pharmacy

Management

Billing

Patient�Admission

Patient

Trajectory

Management

Radiology

Management

HIS

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Architectures of Hospital Information Systems

Main functions to be supported by a HIS:

    • Patient care
    • Supply and disposal management, scheduling and resource allocation
    • Hospital administration
    • Hospital management
    • Research and education

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Architectures of Hospital Information Systems

Patient care includes:

    • Patient admission
    • Decision making, planning and organization of patient treatment
    • Order entry
    • Execution of diacnostic, therapeutic and nursing procedures
    • Coding of diagnoses and procedures
    • Patient discharge

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Patient care

1. Patient admission

* This hospital function can be decomposed as follows:

    • Appointment scheduling
    • Patient identification and checking for recurrent
    • Administrative admission
    • Medical admission
    • Nursing admission
    • Visitor and information service

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Patient care

Extract of the domain layer of the 3LGM² based reference model describing the enterprise function patient admission, its subfunctions and interpreted and updated entity types.

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Patient care

2. Decision making, planning and organization of patient treatment

All clinical procedures of health care professionals must be discussed, agreed upon, efficiently planned, and initiated. This process is repeated each time new information is available

This hospital function can be decomposed as follows:

    • Decision making and patient information
    • Medical and nursing care planning

Decision making is a permanent enterprise function which is triggered by new information about the patient

Decisions about clinical procedures must be documented

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Patient care

Extract of the domain layer of the 3LGM² based reference model describing the enterprise function patient admission, its subfunctions and interpreted and updated entity types.

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Patient care

3. Order entry

Diagnostic and therapeutic procedures must often be ordered at specialized service units (e.g., laboratory, radiology, or pathology).

These units execute the ordered procedures and communicate the findings or results back to the ordering department

This hospital function can be decomposed as follows:

    • Preparation of an order
    • Appointment scheduling

An order should be initiated only by authorized persons.

If necessary, modification to already transferred orders by the ordering health care professional should be possible

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Patient care

Extract of the domain layer of the 3LGM² based reference model describing the enterprise function patient admission, its subfunctions and interpreted and updated entity types.

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Patient care

4. Execution of diacnostic, therapeutic and nursing procedures

The planned diagnostic, therapeutic, or nursing procedures (such as operations, radiotherapy, radiological examinations, medication) must be

The hospital must offer adequate tools and resources (e.g., staff, room, equipment) for the execution of the necessary procedures

It is important that changes in care planning that may be due to new findings are promptly communicated to all involved units and persons, enabling them to adapt to the new situation

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Patient care

Extract of the domain layer of the 3LGM² based reference model describing the enterprise function patient admission, its subfunctions and interpreted and updated entity types.

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Patient care

5. Coding of diagnoses and procedures

The hospital must be able to document and code all diagnoses stated and all medical procedures carried out in a correct, complete, quick, and patient-oriented way.

These data are the basis for the hospital's billing. Diagnoses and medical procedures are also used for controlling. In addition, some of the data must be documented and communicated due to legal requirements

Diagnoses and medical procedures are recorded and coded in a standardized way (e.g., using the International Classification of Diseases, ICD-1030 for diagnoses codes), and then processed.

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Patient care

Extract of the domain layer of the 3LGM² based reference model describing the enterprise function patient admission, its subfunctions and interpreted and updated entity types.

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Patient care

6. Patient Discharge and Transfer to Other Institutions

When patient treatment is terminated, the patient is discharged and then sometimes referred to other institutions (e.g., a general practitioner, or a rehabilitation center)

Patient discharge and transfer to other institutions (short: discharge) covers administrative, medical and nursing discharge

This hospital function can be decomposed as follows:

    • Administrative discharge and billing
    • Medical discharge and medical report writing
    • Nursing discharge and report writing

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Patient care

Extract of the domain layer of the 3LGM² based reference model describing the enterprise function patient admission, its subfunctions and interpreted and updated entity types.

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Supply and disposal management, �scheduling and resource allocation�

Supply and disposal management, scheduling and resource allocation:

The hospital must offer sufficient and well-organized resources for patient care. This is true for:

    • wards (ward management),
    • outpatient units (outpatient management), and
    • service units (department management)

Efficient process organization is extremely important for hospitals and it can be supported, for example, by providing working lists for individual staff members, by issuing reminders about appointments, or by visualizing actual process flow

…..

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Supply and disposal management, �scheduling and resource allocation�

The hospital function supply and disposal management, scheduling and resource allocation can be decomposed as follows:

    • Supply and disposal management
    • Scheduling and resource allocation
    • Human resourch management

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Supply and disposal management, �scheduling and resource allocation�

Supply and disposal management

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Supply and disposal management, �scheduling and resource allocation�

Scheduling and Resource Allocation

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Supply and disposal management, �scheduling and resource allocation�

Human resource management:

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Hospital administration�

Hospital administration supports the organization of patient care and guarantees the financial survival and the economic success of the hospital

Hospital administration can be decomposed as follows:

    • Patient administration
    • Archiving of patient information
    • Quality management
    • Cost accounting
    • Controlling
    • Financial accounting
    • Facility management
    • Information management

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Hospital administration�

Patient administration:

Patient administration comprises the administrative tasks in a hospital dealing more or less immediately with patients.

Thus it is an aggregation of the subfunctions administrative admission, patient identification and checking for recurrent, visitor and information service and administrative discharge and billing

Archiving of patient information:

Relevant data and documents containing patient information must be created, gathered, presented, and stored such that they are efficiently retrievable during the whole process of patient treatment.

The storage of these data and documents is primarily done in patient records. Today, usually a mixture of paper-based and computer-based patient records is used. Certain legal requirements usually must be considered

This hospital function can be decomposed as follows:

    • Opening the patient record
    • Administration and allocation of patient records
    • Long term archiving

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Hospital administration�

Archiving of patient information:

Relevant data and documents containing patient information must be created, gathered, presented, and stored such that they are efficiently retrievable during the whole process of patient treatment.

The storage of these data and documents is primarily done in patient records. Today, usually a mixture of paper-based and computer-based patient records is used. Certain legal requirements usually must be considered

This hospital function can be decomposed as follows:

    • Opening the patient record
    • Administration and allocation of patient records
    • Long term archiving

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Hospital administration�

Archiving of patient information:

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Hospital administration�

Quality management:

Quality management comprises all activities of a health care institution's management to assure and continuously improve the quality of patient care

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Hospital administration�

Cost accounting:

  • For controlling purposes, it is necessary to keep track of services, their costs, and who has received them

  • Cost accounting usually investigates which costs incur (cost-type account- ing), where costs incur (cost center accounting) and for what activities or services costs incur (cost unit accounting)

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Hospital administration�

Controlling:

The hospital must be able to gather and aggregate data about the hospital's operation in order to control and optimize it

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Hospital administration�

Financial accounting:

Financial accounting comprises, for example, debtor accounting, credit accounting, and asset accounting. It needs information from bills and creat-es new values for key performance

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Hospital administration�

Facility Management & Informational Management

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Hospital management

Hospital management decides on questions of fundamental importance for the hospital development (hospi- tal goals, strategic decisions, person-nel decisions and decisions about budget, investments or key treatments)

Hospital management has to focus on high quality of patient care taking into account economic as well as legal and other requirements

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Research and education�

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Architectures of Hospital Information Systems

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References:

Haux, R., Winter, A., Ammenwerth, E., Brigl, B. (2010). Strategic Information Management in Hospitals:

An Introduction to Hospital Information Systems

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