Architectures of Health �Information Systems
Unit 3 Lecture 2
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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:
Laboratory
Management
Pharmacy
Management
Billing
Patient�Admission
Patient
Trajectory
Management
Radiology
Management
HIS
Architectures of Hospital Information Systems
Main functions to be supported by a HIS:
Architectures of Hospital Information Systems
Patient care includes:
Patient care
1. Patient admission
* This hospital function can be decomposed as follows:
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.
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 is a permanent enterprise function which is triggered by new information about the patient
Decisions about clinical procedures must be documented
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.
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:
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
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.
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
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.
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.
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.
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:
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.
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:
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
…..
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�
Supply and disposal management
Supply and disposal management, �scheduling and resource allocation�
Scheduling and Resource Allocation
Supply and disposal management, �scheduling and resource allocation�
Human resource management:
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:
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:
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:
Hospital administration�
Archiving of patient information:
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
Hospital administration�
Cost accounting:
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
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
Hospital administration�
Facility Management & Informational Management
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
Research and education�
Architectures of Hospital Information Systems
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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