What is the overall information systems operations health and future within the organization?

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Operations Management

What is the overall information systems operations health andfuture within the organization?

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Information and Communications Systems The Backbone of the Health Care Delivery System The preceding chapter describes an array of systemsengineering tools and associated techniques for analyzing designing controlling and improving health care delivery processes and systems This chapter is focused on the application of information and communications technologies to the delivery of safe effective timely patientcentered efficient and equitable health care a review of progress toward the establishment of a National Health Information Infrastructure NHII and a description of the tasks that lie ahead The committee highlights the complementary nature of information communications technologies and systems engineering THE CENTRALITY OF INFORMATION TO HEALTH CARE DELIVERY Information and information exchange are crucial to the delivery of care on all levels of the health care delivery systemthe patient the care team the health care organization and the encompassing politicaleconomic environment To diagnose and treat individual patients effectively individual care providers and care teams must have access to at least three major types of clinical informationthe patients health record the rapidly changing medicalevidence base and provider orders guiding the process of patient care In addition they need information on patient preferences and values and important administrative information such as the status and availability of supporting resources personnel hospital beds etc To integrate these critical information streams they will also need trainingeducation decisionsupport informationmanagement and communications tools For individual patients to participate as informed controlling partners in the design and administration of their own care they must also have access to much the same kind of information and education decisionsupport and communications toolsin a patientaccessibleusable form At the organizational level hospitals and clinics need clinical financial and administrative datainformation to measure assess control and improve the quality and productivity of their operations At the environmental level federalstate funding and regulatory agencies and research institutions need information on the health status of populations and the quality and productivityperformance of care providers and organizations to execute regulatory oversight protect and advance the public health surveillancemonitoring evaluate new forms of care accelerate research and disseminate new medical knowledgeevidence As discussed information and information exchange are also critical to the tactical and strategic applications of systemsengineering tools at all four levels of the system especially for strategic applications of enterprisemanagement tools and risk analysis and management tools at the organizational and environmental levels The Information Technology Deficit and Its Proximate Causes Although information gathering processing communication and management are essential to health care delivery the health care sector as a whole has historically trailed far behind most other industries in investments in information communications technologies Moreover most health carerelated informationcommunications technologies investments to date have been concentrated on the administrative side of the business rather than on clinical care As a result of this prolonged underinvestment little overall progress has been made toward meeting the information needs of patients providers hospitals clinics and the broad regulatory financial and research environment in which they operate A number of localized efforts have been made to develop and implement electronic patient records and other clinical applications of informationcommunications technologies since the 1960s but little progress has been made in closing the gap Many factors have contributed to the information communications technology deficit 1 the atomistic structure of the industry the prevalence of relatively undercapitalized small businessesprovider groups 2 paymentreimbursement regimes and the lack of transparency in the market for health care services both of which have discouraged privatesector investment in informationcommunications systems 3 historical weaknesses in the managerial culture for health care 4 cultural and organizational barriers related to the hierarchical nature and rigid division of labor in health professions and 5 the relative technicalfunctional immaturity until very recently of available commercial clinical informationcommunications systems FROM ELECTRONIC MEDICAL RECORDS TO A NATIONAL HEALTH INFORMATION INFRASTRUCTURE The idea of transforming paper medical records into electronic medical records EMRs was first considered in the mid1960s when early prototype systems were developed A number of large integrated health care provider organizations were early adopters of EMR systems including Massachusetts General Hospital COSTAR in the 1960s Indiana University Medical School Regenstrief Medical Record System in the early 1970s and others However there was little diffusion of these systems in the next two decades In 1991 and 1997 IOM issued reports documenting the magnitude and implications of the large informationtechnology gap in US health care and called for the adoption of EMRs as a first critical step in moving health care delivery toward informationcommunicationstechnologysupported improvements in quality performance achieved in other industries Building on these studies a series of reports by IOM the National Committee on Vital and Health Statistics NCVHS and other organizations in the past five years have documented the profound negative impact of the information communications technology deficit on patient safety the number of medical errors and the quality and cost of care every one of See Answer

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