Health Information Systems: Technological and Management Perspectives

✍ Scribed by Alfred Winter, Elske Ammenwerth, Reinhold Haux, Michael Marschollek, Bianca Steiner, Franziska Jahn

• Publisher: Springer
• Year: 2023
• Tongue: English
• Leaves: 285
• Series: Health Informatics
• Edition: 3
• Category: Library

✦ Synopsis

This heavily revised open access edition provides a thorough overview of the technologies available to assemble, manage and assess the quality of health information systems. It details a variety of scenarios in the context of both health and heath care, including where prevention and wellness are related, such as the treatment of both acute and chronic diseases. Stakeholder requirements are also described to provide perspectives for describing the architectures and management techniques associated with health information systems, enabling the reader to develop a detailed holistic overview of the subject.   

 

Health Information Systems: Technological and Management Perspectives features a detailed overview of how information systems in health care can be managed and is a vital resource for medical informatics students seeking an up-to-date text on the topic.

✦ Table of Contents

Preface to the Third Edition
About the Book
Contents
About the Authors
Abbreviations
List of Figures
List of Tables
Chapter 1: Introduction
1.1 Motivation and Objective of the Book
1.2 Life Situations
1.2.1 Prevention
1.2.2 Wellness
1.2.3 Emergencies
1.2.4 Acute Diseases
1.2.5 Chronic Diseases
1.2.6 Care
1.2.7 Rehabilitation
1.2.8 Research for Life
1.3 Stakeholders’ Requirements
1.3.1 Requirements of Patients
1.3.2 Requirements of Health care Professionals
1.3.3 Requirements of Informal Caregivers
1.3.4 Requirements of Researchers in Biomedicine
1.3.5 Requirements of Management Staff
1.3.6 Requirements of Insurance Companies
1.3.7 Requirements of Governmental Bodies
1.3.8 Requirements of Sponsors
1.3.9 Requirements of Vendors
1.3.10 Requirements of Housing Companies
1.3.11 Coinciding and Contradicting Requirements between Stakeholders
1.4 Example
1.5 Exercises
1.5.1 Life Situations
1.5.2 Requirements of Various Stakeholders
Reference
Chapter 2: Basic Concepts and Terms
2.1 Introduction
2.2 Data, Information, and Knowledge
2.3 Health care Settings
2.4 Systems and Subsystems
2.5 Information Systems
2.6 Health Information Systems
2.7 Information Logistics in Health Information Systems
2.8 Functions, Processes, and Entity Types in Health care Settings
2.9 Application Systems, Services, and Physical Data Processing Systems in Health Information Systems
2.10 Electronic Health Records as a Part of Health Information Systems
2.11 Architecture and Infrastructure of Health Information Systems
2.12 Management of Information Systems
2.13 Modeling Information Systems
2.14 3LGM2: A Metamodel for Information System Architectures
2.14.1 Domain Layer
2.14.2 Logical Tool Layer
2.14.2.1 Application Systems
2.14.2.2 Message-Oriented Communication
2.14.2.3 Service-Oriented Communication
2.14.3 Physical Tool Layer
2.14.4 Inter-layer Relationships
2.14.5 First Steps of 3LGM2 Modeling
2.14.5.1 Installation of the 3LGM2 Tool
2.14.5.2 Modeling the Domain Layer
2.14.5.3 Modeling the Logical Tool Layer
2.14.5.4 Modeling the Physical Tool Layer
2.14.5.5 Modeling Inter-layer Relationships
2.15 Example
2.16 Exercises
2.16.1 Data, Information, and Knowledge
2.16.2 Systems and Subsystems
2.16.3 Information Logistics
2.16.4 3LGM2 Metamodel
2.16.5 Interpreting 3LGM2 Models
References
Chapter 3: Technological Perspective: Architecture, Integration, and Standards
3.1 Introduction
3.2 Domain Layer: Data to be Processed and Provided
3.2.1 Personal vs. Non-personal Data
3.2.2 Standardized vs. Non-standardized Data
3.2.3 Entity Types
3.2.3.1 Entity Types About Individuals
3.2.3.2 Entity Types About Patients’ Diseases and Their Treatment
3.2.3.3 Entity Types About Managing Health Care
3.2.3.4 Entity Types About Knowledge
3.3 Domain Layer: Functions to Be Supported
3.3.1 Functions to Be Performed by Patients and Informal Caregivers
3.3.1.1 Medical Knowledge Management by Non-professionals
3.3.1.2 Self-Diagnostics
3.3.1.3 Self-Treatment
3.3.1.4 Arrange Appointments
3.3.1.5 Filling Physician’s Orders
3.3.2 Functions to Be Performed by Health care Professionals and Other Staff in Health care Facilities
3.3.2.1 Patient Care
Patient Admission
Appointment Scheduling
Patient Identification
Administrative Admission
Medical Admission
Nursing Admission
Visitor and Information Service
Decision-Making, Planning, and Organization of Patient Treatment
Decision-Making and Patient Information
Medical and Nursing Care Planning
Order Entry
Preparation of an Order
Appointment Scheduling
Execution of Diagnostic, Therapeutic, and Nursing Procedures
Execution of Diagnostic and Therapeutic Procedures
Execution of Nursing Procedures
Coding of Diagnoses and Procedures
Patient Discharge and Transfer to Other Facilities
Administrative Discharge and Billing
Medical Discharge and Medical Discharge Summary Writing
Nursing Discharge and Nursing Discharge Summary Writing
3.3.2.2 Supply and Disposal Management, Scheduling, and Resource Allocation
Supply and Disposal Management
Scheduling and Resource Allocation
Human Resources Management
3.3.2.3 Administration of Health care Facilities
Patient Administration
Archiving of Patient Information
Quality Management
Cost Accounting
Controlling
Financial Accounting
Facility Management
Management of Information Systems
3.3.2.4 Management of Health care Facilities
3.3.2.5 Clinical Documentation: A Function?
3.4 Logical Tool Layer: Types of Application Systems in Health care Facilities
3.4.1 Patient Administration Systems
3.4.2 Medical Documentation and Management Systems (MDMS)
3.4.3 Nursing Management and Documentation Systems (NMDS)
3.4.4 Computerized Provider Order Entry Systems (CPOE)
3.4.5 Radiology Information Systems (RIS)
3.4.6 Picture Archiving and Communication Systems (PACS)
3.4.7 Laboratory Information Systems (LIS)
3.4.8 Operation Management Systems (OMS)
3.4.9 Patient Data Management Systems (PDMS)
3.4.10 Enterprise Resource Planning Systems (ERPS)
3.4.11 Data Warehouse Systems (DWS)
3.4.12 Document Archiving Systems (DAS)
3.4.13 Application Systems for Patients and Informal Caregivers
3.4.13.1 Patient Portals
3.4.13.2 Telemonitoring Systems
3.4.13.3 Self-Diagnosis Systems
3.4.13.4 Self-Treatment Systems
3.4.14 Other Application Systems
3.4.15 Clinical Information Systems (CIS) and Electronic Health Record Systems (EHRS) as Composite Application Systems
3.5 Logical Tool Layer: Data Integrity
3.6 Logical Tool Layer: Architectural Styles
3.6.1 Number of Databases: Central vs. Distributed
3.6.1.1 DB1 Architecture
3.6.1.2 DBn Architecture
3.6.1.3 Mixed DB1/DBn Architectures
3.6.2 Number of Application Systems: Monolithic vs. Modular
3.6.3 Number of Application Software Products and Vendors: All-in-One vs. Best-of-Breed
3.6.4 Communication Pattern: Spaghetti vs. Star
3.7 Logical Tool Layer: Interoperability and Standards
3.7.1 Aspects of Interoperability
3.7.1.1 Technical Interoperability
3.7.1.2 Syntactic Interoperability
3.7.1.3 Semantic Interoperability
3.7.1.4 Process Interoperability
3.7.2 Interoperability Standards
3.7.2.1 Health Level 7 Version 2 (HL7 V2)
3.7.2.2 Clinical Document Architecture (CDA)
3.7.2.3 Health Level 7 Fast Health care Interoperability Resources (HL7 FHIR)
3.7.2.4 Digital Imaging and Communications in Medicine (DICOM)
3.7.2.5 Integrating the Health care Enterprise (IHE)—Integration Profiles
3.7.2.6 IHE Cross-Enterprise Document Sharing (XDS)
3.7.2.7 ISO/IEEE 11073
3.7.2.8 open Electronic Health Record (openEHR)
3.7.2.9 Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT)
3.7.2.10 Logical Observation Identifiers Names and Codes (LOINC)
3.7.2.11 Clinical Data Interchange Standards Consortium (CDISC)
3.8 Logical Tool Layer: Types of Integration
3.8.1 Data Integration
3.8.2 Semantic Integration
3.8.3 User Interface Integration
3.8.4 Context Integration
3.8.5 Feature Integration
3.8.6 Process Integration
3.9 Logical Tool Layer: Integration Technologies and Tools
3.9.1 Transaction Management
3.9.2 Communication Server
3.9.3 Open Platforms and Vendor-Neutral Archives
3.9.4 Service-Oriented Architectures
3.10 Physical Tool Layer
3.10.1 Physical Data Processing Systems
3.10.1.1 Servers
3.10.1.2 Clients and Personal Devices
3.10.1.3 Storage
3.10.2 Physical Interoperability and Integration by Communication Networks
3.10.3 Data Centers
3.10.4 Data Security
3.11 Examples
3.11.1 A Reference Model for the Domain Layer of Hospital Functions
3.11.2 The Domain Layer of CityCare
3.11.3 The Logical Tool Layer of CityCare
3.11.4 The Physical Tool Layer of CityCare
3.12 Exercises
3.12.1 Domain Layer: Differences in Hospital Functions
3.12.2 Domain Layer: Different Health care Professional Groups and Health care Facilities
3.12.3 Domain Layer: The Patient Entity Type
3.12.4 Logical Tool Layer: Communication Server
3.12.5 Logical Tool Layer: Integration from the User’s Point of View
3.12.6 CityCare
References
Chapter 4: Management Perspective: Scopes and Tasks of Managing Health Information Systems
4.1 Introduction
4.2 Dimensions of Managing Health Information Systems
4.3 Strategic Management of Information Systems
4.3.1 Strategic Planning
4.3.1.1 Strategic Alignment of Business Goals and Information Management Goals
4.3.1.2 Strategic Information Management Plan
4.3.1.3 Annual Project Portfolio
4.3.2 Strategic Monitoring
4.3.2.1 Permanent Monitoring Activities by Key Performance Indicators (KPI)
4.3.2.2 Benchmarking of Health Information Systems
4.3.2.3 Ad hoc Monitoring Activities by Evaluation Projects
4.3.3 Strategic Directing
4.4 Tactical Management of Information Systems
4.5 Operational Management of Information Systems
4.6 Organizational Structures for the Management of Health Information Systems
4.6.1 IT Governance and Organizational Structures for Information Management
4.6.2 Chief Information Officer (CIO)
4.6.3 Information Management Board (IT Steering Committee)
4.6.4 Information Management Department
4.7 Balance as a Challenge for the Management of Health Information Systems
4.7.1 Balance of Homogeneity and Heterogeneity
4.7.2 Balance of Computer-Based and Paper-Based Tools
4.7.3 Balance of Data Security and Working Processes
4.7.4 Balance of Functional Leanness and Functional Redundancy
4.7.5 Balance of Documentation Quality and Documentation Efforts
4.8 Examples
4.8.1 Strategic Information Management Plan of Ploetzberg Hospital
4.8.2 Health Information System Key Performance Indicators (KPIs) of Ploetzberg Hospital
4.8.3 Organization of the Management of the Ploetzberg Hospital Information System
4.9 Exercises
4.9.1 Activities of Managing Information Systems
4.9.2 Strategic Alignment of Hospital Goals and Information Management Goals
4.9.3 Structure of a Strategic Information Management Plan
4.9.4 An Information-Processing Monitoring Report
4.9.5 Relevant Key Performance Indicators (KPIs)
4.9.6 Organizing User Feedback
4.9.7 Information Systems Managers as Architects
References
Chapter 5: Quality of Health Information Systems
5.1 Introduction
5.2 Quality of Management of Information Systems
5.2.1 Quality of IT Governance
5.2.2 Quality of Strategic Management of Information Systems
5.2.3 Quality of Tactical Management of Information Systems
5.2.4 Quality of Operational Management of Information Systems
5.3 Quality of Architectures and Infrastructures
5.3.1 Quality at the Domain Layer
5.3.2 Quality at the Logical Tool Layer
5.3.3 Quality at the Physical Tool Layer
5.3.4 Quality of Integration
5.4 Evaluating the Quality of Health Information Systems
5.4.1 Identifying the Evaluation Question
5.4.2 Deciding on the Study Design
5.4.3 Collecting Quantitative Data
5.4.4 Collecting Qualitative Data
5.4.5 Answering the Evaluation Questions
5.5 Examples
5.5.1 Unintended Effects of a Computerized Physician Order Entry Nearly Hard-Stop Alert
5.5.2 Clinical Decision Support for Worker Health: A Five-Site Qualitative Needs Assessment in Primary Care Setting
5.5.3 Certification of Health Information Systems
5.6 Exercises
5.6.1 Quality of Integration
5.6.2 Data Collection in Evaluation Studies
5.6.3 Study Design in Evaluation Studies
References
Chapter 6: Information Systems for Specific Health Care and Research Settings
6.1 Introduction
6.2 Information Systems in Hospitals
6.2.1 Characteristics of Hospitals
6.2.2 Technological Perspective
6.2.3 Management Perspective
6.3 Information Systems in Nursing Homes
6.3.1 Characteristics of Nursing Homes
6.3.2 Technological Perspective
6.3.3 Management Perspective
6.4 Information Systems in Medical Offices
6.4.1 Characteristics of Medical Offices
6.4.2 Technological Perspective
6.4.3 Management Perspective
6.5 Information Systems in Ambulatory Nursing Organizations
6.5.1 Characteristics of Ambulatory Nursing Organization
6.5.2 Technological Perspective
6.5.3 Management Perspective
6.6 Information Systems in Medical Research Facilities
6.6.1 Characteristics of Medical Research Facilities
6.6.2 Technological Perspective
6.6.3 Management Perspective
6.7 Information Systems in Other Health care Settings
6.7.1 Characteristics of Other Health care Settings
6.7.1.1 Pharmacies
6.7.1.2 Therapeutic Offices
6.7.1.3 Inpatient and Outpatient Rehabilitation Facilities
6.7.1.4 Hospices
6.7.1.5 Wellness Facilities
6.7.1.6 Sports Centers and Leisure Parks
6.7.2 Technological Perspective
6.7.3 Management Perspective
6.8 Information Systems in Personal Environments
6.8.1 Characteristics of Personal Environments as Health care Settings
6.8.2 Technological Perspective
6.8.3 Management Perspective
6.9 Information Systems in States and Regions
6.9.1 Characteristics of States and Regions as Health care Settings
6.9.2 Technological Perspective
6.9.3 Management Perspective
6.10 Life Situations and Their Consequences for Orchestrating Services in Transinstitutional Health Information Systems
6.11 Example
6.12 Exercises
6.12.1 Research Architecture
6.12.2 Medical Admission
References
Solutions to Exercises
Chapter 1: Introduction
Chapter 2: Basic Concepts and Terms
Chapter 3: Technological Perspective
Chapter 4: Management Perspective
Chapter 5: Quality of Health Information Systems
Chapter 6: Information Systems for Specific Health Care and Research Settings
Glossary
Index