Study for 1 covering chapters 1 – 3 will post on Monday. Make sure that you study before you begin this . It is timed and designed to gauge how much inform

Study for 1 covering chapters 1 – 3 will post on Monday. Make sure that you study before you begin this . It is timed and designed to gauge how much inform

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Study for 1 covering chapters 1 – 3 will post on Monday. Make sure that you study before you begin this . It is timed and designed to gauge how much information that you have retained from this course (readings and presentation).  This is NOT an open note, book, or any other resource. Chapter 1: Health Information Systems Fundamentals


HIS fundamentals

Ideas, methods, practices, and principles necessary to build more advanced, elegant, complex initiatives and capabilities

Fundamentals are important

Key skills, training, methods, standards, and principles must guide the planning, design, testing, implementation, maintenance, and enhancement of HIS

HIS Fundamentals

HIS Strategic Planning

The HIS Strategic Plan aligns the HIS and technologies to strategic business directions and initiatives

Supports and enables the strategies to be accomplished

Produces actionable, balanced portfolio of systems that support and enable clinical, business and administrative, and connectivity needs of the organization

Covered in Chapters 2, 3, and 4

HIS Fundamentals


Use of consistent management methods, policies, decision rights, and processes across all units and departments

Structural methods: steering committees, standards, auditability, consistent policies and processes

Culture of ethics, integrity, and personal accountability

HIS Fundamentals

Managing HIS

Techniques and activities deployed to achieve HIS goals and objectives

Methods include generally accepted methods and standards for planning, implementing, supporting, and managing core HIS

Activities involve the IT Department (information services, information resources, technology, and information systems)

HIS Fundamentals

Managing HIS, cont.

Plan and manage HIS and infrastructure, data, analytics, people, implement systems/manage change, train tech staff and end users, and more

One of the most essential functional areas of a HC organization

Expenditures comprise significant portion of the organization’s capital and operating budgets

Warrants attention from highest levels of the organization

HIS Fundamentals

HIS Planning and Budgeting

Uses organization’s strategic business plan as a guide

Should reflect exactly the forward movement and enablement of the organization toward its business and clinical strategies

Annual or near-term plans and budgets are established based on 5- to 10- to 15-year view of the HIS Strategies Plans

Annual plans drive the annual HIS capital and operating budgets

HIS Fundamentals

HIS Planning and Budgeting, cont.

HIS plans and budgets must include everything needed and feasible to accomplish in the coming fiscal year

Agenda for each year is planning in concert with strategic and operational needs of the organization

Plans and budgets must stay in exact tune with the HIS Strategic Plan

Deviations are dangerous

HIS Fundamentals

HIS Selection

Process by which decisions are made about which new software systems to bring into the organization

Methodologies are widely known, repeatable processes

Must justify why a new system is best rather than using something that already exists in the HIS portfolio

HIS Steering Committee oversees the process

HIS Fundamentals

Implementing HIS

Set of activities that results in software system going from a business plan to a fully utilized HIS

Requires a disciplined methodology that drives a carefully executed, highly detailed project plan

Requires activating new software, training for end users, transition from the old system to the new

Also involves testing and evaluating the new system to make sure it functions as designed

HIS Fundamentals

Managing Change

The reality of what happens with a new HIS

Work with interdisciplinary teams on design, requirements, training, testing, activation, and use

Closely collaborate with end users, management, clinical staff

Keep others not involved in the process in the loop

HIS Fundamentals

Managing Vendors

Organizations rely heavily on external companies who produce, deliver, and support HIS software, hardware, and services

For-profit corporations that exist to create value for shareholders or returns for their owners and investors

Covered in Chapters 5 and 7

HIS Fundamentals

Harvesting the Yield from HIS

Magnitude of the work often prevents an organization from taking full advantage of the data and information resources it is creating

HIS produces and captures data resources to create new knowledge through analytics, business intelligence, and clinical intelligence

Increases the value and ROI in the core HIS

Value garnered is widely underachieved

Covered in Chapters 10 and 11

HIS Fundamentals

Business, Clinical, and Artificial Intelligence

Business intelligence, clinical intelligence, and artificial intelligence systems provide analytical systems, resources, data management, and personnel capabilities

Allows organization to gain insights and knowledge

Allows them to apply knowledge and insights to improve processes and outcomes

Covered in Chapter 11

HIS Fundamentals

Data Management and Stewardship

To gain yield and value from data, they must be carefully and continuously tended

Definition of each data element must be accurate and consistent in its use

Must be managed according to the goals of the organization

Consistency, accuracy, accessibility, and safety must be checked regularly

HIS Fundamentals

Creating New Knowledge

Health care is a function of information and knowledge workers coming together to help patients, healthcare organizations, patient populations, and communities

Needs of patients evolve

Healthcare organizations must adapt

Must be data driven to put new knowledge into practice

Organizational culture must embrace adaptation and thirst for new knowledge

HIS Fundamentals

HIS Regulatory Compliance and Risk Management

Actions, systems, policies, and management techniques used to accomplish these initiatives must be done in compliance with HC regulations

HIPAA, MACRA, CMS, MIPS, APMs, DHS regulations, Joint Commission

Health care is highly regulated because it is paid for by government/third-party insurance; fraud comprises ~10% of healthcare costs; and patient safety, data, and privacy must be protected

HIS Fundamentals

HIS Security

Security of HIS, data, and protected health information (PIH) is a primary goal in healthcare

Hackers, black market, and ransomware experts threaten HIS

Prevention is among the highest priorities for any HIS agenda

HIS Fundamentals

HIS Standards

HIS technical and data standards must be in place to communicate across providers, insurers, and users of HC

Common protocols and terminology

Proprietary software systems strategically withhold opportunity and flexibility for healthcare organizations to use different vendor products simultaneously

Case Example: Common Fundamental Failures


The challenges needing a solution

The solution

HIS Fundamentals

HIS Model for the Health Professions

HIS Terminology

Health Information Systems (HIS)

Technology Infrastructure






“user interface”

HIS Terminology


HIS planning

HIS governance

HIS management


HIS development


Ongoing maintenance


Vendor and Provider Relations

HIS development began in the 1960s

Beginnings were local, humble, and rooted in data processing departments of hospitals

There was no Internet to connect capabilities

Unintended consequences of new technology:

Collision of business interests of wealthy publicly traded or private vendor corporations vs. health provider, community, and patient interests

Vendor marketplace is dynamic

Covered in Chapter 8

History of HIS

The Early Days

HIS followed the advent of computerization of U.S. society in general

1960s: Early software applications focused on accounting and financial applications

”Data” of finance and accounting involved dollars and cents (standardized and universally understood data elements)

1970s: Early HIS and tech vendors (SMS, now Cerner)

History of HIS

The Early Days, cont.

Hospitals began to develop their own software

Gave rise to first HIS professional organizations (HISSG, ECHO)

Members “shared”/exchanged software programs and applications

ECHO for IBM hardware, HISSG for non-IBM

First HIS were extensions of charge-capture systems for patient billing

First comprehensive system was created by Lockheed Martin (Technicon)

History of HIS

The Early Days, cont.

SAIC created early clinical information system for VA hospitals

1980s: Minicomputer (H-P, Digital Equipment Corporation, IBM)

More efficient, less expensive, fewer people needed to operate

Many early software systems sold by vendors were originally developed in hospital DP departments

History of HIS

Evolution of Clinical Systems and the EHR

First-generation HIS clinical order entry systems were extensions of charge-capture systems for patient billing

Initial clinical systems included “order entry” systems, early versions of computerized provider order entry (CPOE)

Software was modeled after hotel software

Through the 1990s, advent of the Internet transformed healthcare computing

History of HIS

The current climate

Watershed To Err Is Human HDM report drove desire to improve quality and efficiency of care

HIS and technology are essential tools in that process

Government legislation: Title XIII

Challenge: Change from fee-for-service reimbursement methodology to value-based reimbursement system

Reliance on vendor marketplace increases cost of automation

Prevention, wellness, chronic care, and care coordination are replacing acute-care model


The task for health professionals is to provide the education and support needed to create the kinds of HIS we need in today’s challenging and changing healthcare environment

Clinical, business, and technology health professions now can only be done proficiently with HIS knowledge, ability, and activity

Reliance on vendors and change from acute, medical, sickness-based, institutional scenario to new model based on prevention, wellness, chronic care management, and care coordination create HIS challenges

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