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Chapter 14 Clinical Information Systems

 

Correction for Figure 14-1 on page 233.

Additional Information For This Chapter

Computerized Physician Order Entry Systems - Things to Consider

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Helpful Websites For This Chapter

(The links in this section are off this site. Inclusion here is for your convenience in locating more information about a topic. Inclusion does not indicate endorsement.)

Assessing Staff Attitudes Towards a Clinical Information System

This site provides free access to a family of measurement instruments used to assess staff involvement in and attitudes toward Clinical Information system implementation. (Added October 13, 2004)
http://informatics.umaryland.edu/cisq/

Computerized Physician Order Entry

Metzger, J. & Turisco, F. (2001). Computerized Physician Order Entry: A Look at the Vendor Marketplace and Getting Started. A report for the Leap Frog group on this topic. This link is to the Executive Summary, a link there goes to the entire report.
http://www.leapfroggroup.org/media/file/Leapfrog-CPOE_Guide.pdf

Research from the CPOE organization. The research was done by the physician order entry team at Oregon Health & Science University. They are funded by a grant from the National Library of Medicine to study success factors for implementing Physician Order Entry (POE).
http://www.ohsu.edu/dmice/research/cpoe/

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Design Issues

Ambler, S. (2001). Active Stakeholder Participation. An excellent white paper addressing the need for both management and users to be part of this process. Ends with a list of the rights and responsibilities of stakeholders.
http://www.agilemodeling.com/essays/activeStakeholderParticipation.htm

Chart of nursing data presented in layers with links to other factors which impinge on it as well as tasks that are based on each layer. Well worth a visit!
http://www.mieur.nl/mihandbook/r_3_3/figures/f14_04t.htm

Hughes, S. (1970). Time for New Thinking. Healthcare Informatics. An article that provides a good description of four assignments to perform before purchasing an information system. (Added 2/25/03)
http://www.healthcare-informatics.com/issues/1997/02_97/nurse.htm

IT Selection Strategies. This site contains many excellent articles on many aspects of selecting an IT system including how to write an rfp, common mistakes, planning a site visit, how to write a contract and many more. Very valuable!
http://www.health-infosys-dir.com/select.htm

Although not dated( the latest reference is 1997 - so this probably dates from 1997 or 1998) this study developed a framework that combines views from different disciplines to use in system evaluation. The article suggests that the impact of health information systems should be assessed on the quality of information provided, the impact on user’s thinking, decisions or actions and the impact on costs and benefits. A pdf file. Salmela H. & Turunen, P. (n.d.) Evaluation of information systems in health care: A framework and its application. Retrieved September 24, 2003 from http://www.tukkk.fi/tjt/TUTKIMUS/HCISS/Julkaisusivut/dokumentit/pekka/final.pdf

Snyder, Carolyn (2003). Six Signs You Should Use Paper Prototyping. An excellent paper explaining not only when to use paper prototyping, but how. (Added May 26, 2006)
http://today.java.net/pub/a/today/2003/12/23/sixSigns.html

Strachan, H. (n.d.). Issues for future nursing information systems: Delhpi study results. (Judging from references, probably written in 1995 or 96.)
http://www.bcsnsg.org.uk/itin08/strach2.htm

Shotton, C. (2002). Doctors vs. Geeks. An interesting look at the reluctance of the medical discipline to accept informatics help.
http://www.informatics-review.com/thoughts/geeks.html

Studach, J. (2001). Information Systems in Healthcare: Trends, Issues, Barriers, and Preparing for the Future. A good description of these problems, with some recommendations. A PDF File.
http://www.american.edu/academic.depts/cas/health/nchf/archives/pubsindstudy1.pdf

Tips for Selecting Systems. A description of several tips for selecting systems including defining your needs, starting a selection committee, identifying vendors, and site visits. Also includes links to how to write an RFP (request for proposal) and how to make a site visit.
http://www.olcsoft.com/tips.htm

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Evaluation of Systems

This section was added on August 6, 2003.

Bannister, F., & Remenyi, D. (2001). The Societal Value of ICT: First Steps Towards an Evaluation Framework. Journal of Information Systems Evaluation, 5(1). A full text article that although not healthcare oriented, provides some good perspectives on overall problems. Addresses difficulties in getting a handle on costs, and various approaches. Added August 24, 2004
http://www.ejise.com/volume6-issue2/issue2-art21.htm

Littlejohns, P. Wyatt, J. C., Garvican, L. (2003). Evaluating computerised health information systems: Hard lessons still to be learnt. British Medical Journal 326, 860-863. [Electronic Version]. This article reviews a project in South Africa, but is equally applicable anywhere.
http://bmj.bmjjournals.com/cgi/content/full/326/7394/860?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=1&titleabstract=evaluating%252Bcomputerised%252Bhealth%252Binformation

Stanton, J. M. (n.d.) Behavioral Information Security: Two End User Survey
Studies of Motivation and Security Practices. Article reports the results of national survey studies exploring some of the motivational antecedents surrounding the practices of information security by end users.
http://www.denistn.mine.nu/pdf2html.php?url=http://sise.syr.edu/AMCISstanton2004.pdf

Sensmeirer, J., Raiford, R., Taylor, S., Weaver, C. (2002). Using Innovative Technology to Enhance Patient Care Delivery
American Academy of Nursing Technology and Workforce Conference. [Electronic version]. Present information about challenges, current available technology and the ideal care-delivery system for nurses. Very interesting article. http://www.himss.org/content/files/AANNsgSummitHIMSSFINAL_18770.pdf

Electronic Journal of Information Systems Evaluation. An open access online journal with articles covering all aspects of evaluation, not just limited to healthcare.
http://www.ejise.com/

Flow Chart (See also chapter 16 - data flow diagrams)

Basic tutorial on flowcharting. Covers many topics. (Added January 6, 2006)
http://home.att.net/~dexter.a.hansen/flowchart/flowchart.htm#FLOWCHARTING

Overview of flow charting. Is from the Clemson Engineering School. Is short, simple, and to the point. (Added July 6, 2007)
http://deming.eng.clemson.edu/pub/tutorials/qctools/flowm.htm

Flowcharting: Mastering the Details. Covers the use of flowcharts, how to draw one, tracking handovers, and standard symbols. (Added January 6, 2006)
http://www.hci.com.au/hcisite2/toolkit/flowchar.htm

 

Government Initiatives

Health information technology initiative major accomplishments: 2004-2006. A summary of the accomplishments of the various HHS groups working on the Electronic Health Record. (Added May 4, 2007)
http://www.hhs.gov/healthit/news/Accomplishments2006.html

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Information Systems

Bower, A. G. The Diffusion and Value of Healthcare Information Technology. A 127 page report sponsored by the Rand Corporation that examines how much healthcare technology might be worth to society.
http://www.rand.org/pubs/monographs/2005/RAND_MG272.pdf

DeClaris, J. W., VandenBerg, E. J. & Calvin, J. E. (n. d.) Biomedical Engineering Aspects of Critical Care Information Systems Based on User Requirements. A look at the problems inherent in designing information systems.
http://www.ee.umd.edu/medlab/papers/jwd/jw-emb94.html

Gaither, C. (July 14, 2002). What your doctor doesn't know could kill you. Boston Globe Sunday Magazine Online. A review of the PROMIS system and description of the Problem Knowledge Coupler (PKC) which could revolutionize healthcare.
http://www.freerepublic.com/focus/news/716038/posts

Introduction to Hospital Information Systems. A detailed outline addressing such topics as purpose, advantages, development, types, and how these systems affect nursing.
http://courses.wccnet.edu/computer/mod/m30c.htm

IT Innovation: In this transcript, Robert Langreth, senior editor at Forbes, discusses IT innovation in health care. Some very interesting points.
http://www.forbes.com/business/healthcare/2002/08/26/0826langrethchat.html

Medical Records Institute. Results of surveys of the use of electronic health records. (added October 5, 2003)
http://www.medrecinst.com/

This online booklet discusses system evaluation in the planning stage and describes the basic points of preparing the analysis needed in purchasing a clinical information system (CIS). This 8 page booklet from a vendor says the life span of an information system is 7 to 10 years, but I think you will find that a more accurate estimate is 3 to 5 years. Still a helpful booklet for what should be considered in purchasing a system. (Added September 24, 2003) Deio Corporation (2003, February). A quick guide for getting started to purchase the clinical information system. Retrieved September 23 from
http://www.deio.net/Services/Guick%20Guide%20Critical%20Care%20Business%20Case_%2028Feb2003.pdf

Testing Scripts. Examples of scripts to be used in testing a clinical information system. From HIMSS. Added May 9, 2006)
http://www.himss.org/ASP/topics_FocusDynamic.asp?faid=125

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Project Management

Site for more information on project management.
http://sparc.airtime.co.uk/users/wysywig/prinpm_1.htm

Return on Investment (ROI)

Bannister, F., McCabe, P., & Remenyi, D. (2001). How much did we really pay for that? The awkward problem of information technology costs. Journal of Information Systems Evaluation, 5(1). A full text article that although not healthcare oriented, provides some good perspectives. Addresses difficulties in getting a handle on costs, and various approaches. Added September 16, 2003
http://www.ejise.com/volume-5/volume5-issue1/issue1-art1.htm

Vendors

Directory of all health care computer vendors. Searchable in several different ways. Useful for comparing systems. Many white papers on various subjects pertaining to informatics.
http://www.health-infosys-dir.com/

How to perform Software Vendor Checks. Description of things to do before deciding on a vendor.
http://www.olcsoft.com/select_references.htm

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Online References For This Chapter

(These references are from the chapter. This list only include the ones that are still available. Please report broken links to Linda Q. Thede)

Goldszmidt, E. (1996). Applications of Medical Informatics in Antibiotic Therapy. Retrieved March 5, 1998. from http://mystic.biomed.mcgill.ca/~goldszmi/camel-2.html. (Sorry, this is no longer available.)

 

Last updated January 6, 2006

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Copyright 2003/2008 Linda Q. Thede
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