Healthcare Information Management Systems: Cases, Strategies, and Solutions PDF
Preview Healthcare Information Management Systems: Cases, Strategies, and Solutions
Health Informatics Charlotte A. Weaver Marion J. Ball George R. Kim Joan M. Kiel Editors Healthcare Information Management Systems Cases, Strategies, and Solutions Fourth Edition Health Informatics For further volumes: http://www.springer.com/series/1114 This series is directed to healthcare professionals leading the transformation of healthcare by using information and knowledge. For over 20 years, Health Informatics has offered a broad range of titles: some address specifi c professions such as nursing, medicine, and health administration; others cover special areas of practice such as trauma and radiology; still other books in the series focus on interdisciplinary issues, such as the computer based patient record, electronic health records, and networked healthcare systems. Editors and authors, eminent experts in their fi elds, offer their accounts of innovations in health informatics. Increasingly, these accounts go beyond hardware and software to address the role of information in infl uencing the transformation of healthcare delivery systems around the world. The series also increasingly focuses on the users of the information and systems: the organizational, behavioral, and societal changes that accompany the diffusion of information technology in health services environments. Developments in healthcare delivery are constant; in recent years, bioinformatics has emerged as a new fi eld in health informatics to support emerging and ongoing developments in molecular biology. At the same time, further evolution of the fi eld of health informatics is refl ected in the introduction of concepts at the macro or health systems delivery level with major national initiatives related to electronic health records (EHR), data standards, and public health informatics. These changes will continue to shape health services in the twenty-fi rst century. By making full and creative use of the technology to tame data and to transform information, Health Informatics will foster the development and use of new knowledge in healthcare. Charlotte A . Weaver • Marion J. Ball George R. Kim • Joan M. Kiel Editors Healthcare Information Management Systems Cases, Strategies, and Solutions Fourth Edition Editors Charlotte A. Weaver George R. Kim Gentiva Health Services Division of Health Sciences Informatics Atlanta , Georgia The Johns Hopkins University USA Baltimore , Maryland USA Marion J. Ball Healthcare Informatics Joan M. Kiel IBM Research Duquesne University Baltimore , Maryland Pittsburgh , Pennsylvania USA USA ISSN 1431-1917 ISSN 2197-3741 (electronic) Health Informatics ISBN 978-3-319-20764-3 ISBN 978-3-319-20765-0 (eBook) DOI 10.1007/978-3-319-20765-0 Library of Congress Control Number: 2015950749 Springer Cham Heidelberg New York Dordrecht London © Springer International Publishing Switzerland 2016 T his work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifi cally the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfi lms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. T he use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specifi c statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. T he publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, express or implied, with respect to the material contained herein or for any errors or omissions that may have been made. Printed on acid-free paper Springer International Publishing AG Switzerland is part of Springer Science+Business Media (www.springer.com) To John and Trish, dear colleagues and cherished friends throughout it all; and as always – to my much treasured son, Kevin. Charlotte A. Weaver To Dr. Joseph Jasinski who has been my guiding light, advisor, and supporter for the past several years. Marion J. Ball To my co-editors and co-authors in this effort, in gratitude for the honor of participation, with special acknowledgment to Marion and John Ball, dear friends and mentors. George R. Kim To Thomas D. Kiel, M.D. Joan M. Kiel Foreword to the Fourth Edition I n the previous edition of H ealthcare Information Management Systems (2004), the late Morris F. Collen, MD, FACMI (1914–2014), Director Emeritus of Kaiser Permanente Medical Care’s Division of Research and pioneer/historian of health- care informatics, noted that “the hospital and its associated information system is the most complex organizational structure created by people.” He concluded it should be no surprise that healthcare information management systems lagged those used in non-healthcare industries and cited the continual advances in care and tech- nology, the “vicissitudes of healthcare legislation,” and the need for intensive train- ing and re-training of healthcare professionals who use information systems as contributors to that lag. Still, he fi rmly believed that effi cient information manage- ment systems are essential for high-quality, cost-effi cient patient care. A decade later, the US healthcare industry fi nds itself redesigning healthcare to achieve the Institute for Healthcare Improvement’s Triple Aim of: • Improving the patient experience of care (including quality and satisfaction) • Improving the health of populations • Reducing the per capita cost of healthcare These, and the goal of building a continuously learning healthcare system, rein- force Dr. Collen’s belief that effi cient and effective information management sys- tems are necessary to implement effective and effi cient care. C onvergent with this vision is the growing, diffusing ecosystem of pervasive data, analytics and Big Data techniques, and personal/social technologies for cap- turing and managing electronic health data: • I ncreasing adoption of electronic health records and health information exchange • Common use of wearable and mobile technologies and infrastructures that gen- erate, collect, store, and share many forms of personal and exogenous data • A ctive research, development, and deployment of platforms, analytics and cog- nitive computing for processing and visualizing population data for prediction and planning vii viii Foreword to the Fourth Edition • Focus of standards development organizations and regulatory agencies on improving interoperability to connect systems and measure outcomes T he turbulent confl uence of healthcare redesign and IT innovation is forming the foundation for achieving the Triple Aim. The chapters of this book provide current snapshots of active work in this process from many facets: technical, organizational, workfl ow, and policy. To quote computer scientist Alan Kay, “The best way to predict the future is to invent it.” Shahram Ebadollahi, PhD Vice President Innovation & Chief Science Offi cer IBM Watson Health New York, USA Pref ace T his is the 4th edition of H ealthcare Information Management Systems, a book that started in 1991 as a practical guide to preparing clinicians and healthcare organiza- tions for electronic health record adoption. With each edition, the scope has evolved and broadened to include other health information technologies, with shared experi- ences of healthcare redesign and the role of IT from multiple perspectives. The 3rd edition (2004) included descriptions of comparative experiences from Sweden, Malaysia, Australia, and France. The 4th edition refocuses its scope to the United States, with the aim of capturing a bold and honest description of the current state of electronic health record (EHR) technologies in acute and primary care settings. In the decade since the 3rd edition, EHRs have achieved widespread US adoption in response to legislation and regulatory policy that linked meaningful health IT use to payment incentives and reimbursement penalties. As the country has reached a “tip- ping point” in EHR adoption under Meaningful Use, agencies, healthcare organiza- tions, and clinicians have not found anticipated gains in effi ciency, quality, and costs. Rather, there has been frustration, dissatisfaction, and growing concerns regarding the impact of IT use on patient safety and health outcomes and a not-so-q uiet rebel- lion in the ranks of frontline clinicians. Many informaticists and clinicians suggest that a technology sea change is needed with a second generation of EHRs developed on twenty-fi rst century architectures that more closely match the fl exibility and power of mobile and web-based applications available in the general marketplace. And a number of these new technologies and solutions are included here. Interoperability and data sharing has become another hot topic that has spilled over into the political and public arenas. Starting in 2014, it became not unusual to fi nd stories in the New York Times or Wall Street Journal on the limitations of data sharing of EHR systems, as the lay public have also become engaged users of these medical record systems. This increasing involvement of consumers and other key stakeholders in healthcare is a major theme threaded throughout this 4th edition. Payers, clinicians, the quality and safety, community, the federal government, and consumers are all mobilizing the healthcare industry to achieve the Institute of Healthcare Improvement’s Triple Aim: to improve the experience of care, to improve ix
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