Posted: August 6th, 2022

WEEK ONE DISCUSSION #1

2-3 paragraphs. Use APA FORMAT

Week One Discussion: Health Tech – Past, Present, and Future

Health, innovation, and technology are all a journey. History repeats itself, and the past becomes a prologue to our future. Tap into the rich collective wisdom of those who have gone before us. Build upon these foundations to recommend priorities today. 

· Start by describing what you consider most significant in the evolution of health information technology in healthcare management and delivery.

· From the lessons learned from the evolution of health information systems,  share insights – possible solutions to growing and emerging healthcare challenges we face today.      

HCA 626 – Healthcare Information Systems
Week One – Lecture 2

Developer Notes: Continue button to continue to next slide. No left-hand menu, please. Menu drop down on top left corner with various topics and notes on top left corner with narration.
Vo: Welcome to the Week One – Lecture 2 for HCA 626 – Healthcare Information Systems.
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Healthcare Information Systems (HIS)
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06

Developer Notes: There are 2 icons for each Chapter, chapters 1&2. This will be a clickable navigational menu. Chapter 1 will link to slide 3. Chapter 6 begins on slide 14, . Student cannot move onto next chapter until the previous one has been completed. Each chapter and icon will darken once completed.
VO: This is the main navigational menu. Click on Chapter 2 to begin.

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Chapter 2:
The Scope, Definition, and Conceptual Model of HIS

Developer Notes: Chapter 2 begins. Align text with VO. Add continue button to continue to next slide.
VO: Chapter 2 – The Scope, Definition, and Conceptual Model of HIS
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Systems & Their Management

Scope of HIS Model for the Health Professions

Developer Notes: Align text with VO. Add continue button to continue to next slide.
VO: Scope of HIS Model for the Health Professions
View this diagram for a better understanding of Scope of HIS Model for the Health Professions.

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Processes (end-to-end methods) of healthcare providers and organizations, patients, and public health professionals​
Workflows (sequences of common tasks)
Data are created and captured in HIS that provide features and functions to support
Systems & Their Management

Developer Notes: Make this a click to reveal activity with the Systems and Their Management. When the student clicks on each point the text and vo will play. Align text with VO. Add continue button to continue to next slide.
VO:
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Meaningful health information and data are only as good as the HIS platform and technical foundation that serves as the data source

*Click each photo to reveal activity

Health Informatics

Focus on certain quality- or process-improvement objectives, which vary based on the setting.
Comprise the “use” of the computer capabilities HIS provide to end users.

Developer Notes: Align text with VO. Add continue button to continue to next slide.
VO: Health informatics:
The use of information systems and technology to redesign, improve, and recreate the way work is done in medicine, nursing, medical imaging, and public health.
Focus on certain quality- or process-improvement objectives, which vary based on the setting.
Comprise the “use” of the computer capabilities HIS provide to end users.
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Data

Must be aggregated and compiled to create meaningful information.

Developer Notes: Align text with VO. Add continue button to continue to next slide.
VO: Data:
Primary uses involve transactions that support day-to-day activities of professionals and organizations.
Must be aggregated and compiled to create meaningful information.
Creating of information and ability to conduct analysis and gain knowledge are dependent upon the creation and capture of individual data elements.
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Research, Policy, & Public Health
Data captures in electronic health record (EHR) systems are aggregated into databases.

Developer Notes: Align text with VO. Add continue button to continue to next slide.
VO: Research, policy, and public health:
Data created and captured in HIS become available for research.
Fuel the work of university researchers and enable analysts to measure health and provide evidence for improving efficiency and effectiveness of healthcare processes and outcomes.
Policy makers rely on researchers’ findings.
Data captures in electronic health record (EHR) systems are aggregated into databases.
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Progression & Maturation of HIS Through the HIS Conceptual Model

Developer Notes: Align text with VO. Add continue button to continue to next slide.
VO: Scope of HIS Model for the Health Professions
View this diagram for a better understanding of Scope of Progression & Maturation of HIS.

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HIS Uses in Organizational & Community Settings

Mobile computing and use of Internet allow patients to access their records and providers, monitor personalize health data
Health-related information is accessible

Developer Notes: Align text with VO. Add continue button to continue to next slide.
VO: Patients’/consumers’ homes:
Mobile computing and use of Internet allow patients to access their records and providers, monitor personalize health data.
Health-related information is accessible.
Best outcomes in organizational performance and clinical care involve patient engagement.
People expect to be part of their own healthcare process.
Innovators are embracing means of personal connectivity and engagement using IT tools widely applied in other industries.
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HIS Uses in Organizational & Community Settings

Developer Notes: Align text with VO. Add continue button to continue to next slide.
VO:
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Payers, insurance companies, & government programs & agencies

Private insurance companies, government programs, self-pay

Public Health Organizations

Exist to monitor, protect, and improve public health

Serve as “safety net” by providing health care for uninsured/underinsured patients

Typically funded by government programs

Some exist to measure, monitor, and report statistics (CDC, Public Health Institute)

HIS Uses in Organizational & Community Settings
Secondary uses of data: data originally created and captured in the clinical and administrative transactions systems of health provider organizations
Primary uses of data: data created and housed in these providers’ HIS

Developer Notes: Add imagery and make more visual. Maybe a chart to show the differences between Secondary uses of data and Primary uses of data. Align text with VO. Add continue button to continue to next slide.
VO: External regulatory, reporting, research, and public health organizations:
Secondary uses of data: data originally created and captured in the clinical and administrative transactions systems of health provider organizations.
Primary uses of data: data created and housed in these providers’ HIS.

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Primary & Secondary Uses of HIS Data

Developer Notes: Add back button for student to return to the main menu on slide 2 so they may continue onto Chapter 6. Align text with VO. Animated text?
VO: View this diagram for a better understanding of Primary & Secondary Uses of HIS Data.

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Chapter 6:
Application Systems and Technology

Developer Notes: Chapter 6 begins. Align text with VO. Add continue button to continue to next slide.
VO: Chapter 6 – Application Systems and Technology
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HIS Applications

Developer Notes: Align text with VO. Add continue button to continue to next slide.
VO:
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Programming languages

Databases

Vendor applications

Software Development Life Cycle

Developer Notes: Align text with VO. Add continue button to continue to next slide.
VO: View this diagram for a better understanding of Software Development Life Cycle.

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HIS Applications

Developer Notes: Align text with VO. Add continue button to continue to next slide.
VO:
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Application interfaces

Can bridge disparate systems

Create silos

Difficult and complex to maintain

Application integration

Allows data to be shared between disparate systems

Uses a common data elements and database

Clinical Applications

A clinical application is defined as any system that supports clinical care (e.g., electronic health record systems), ancillary clinical support processes (e.g., laboratory testing, radiology), clinicians (e.g., computerized physician order entry, clinical decision support) and patient flow (e.g., registration, scheduling).

Developer Notes: Align text with VO. Add continue button to continue to next slide.
VO: A clinical application is defined as any system that supports clinical care (e.g., electronic health record systems), ancillary clinical support processes (e.g., laboratory testing, radiology), clinicians (e.g., computerized physician order entry, clinical decision support) and patient flow (e.g., registration, scheduling).

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Medication administration records (MARs)
Computerized physician order entry (CPOE)​
Pharmacy information systems (PISs)
Laboratory information systems (LISs)
Clinical information systems (CISs)
Electronic health records (EHRs)
Clinical Applications

*Click each photo to reveal activity
This Photo by Unknown Author is licensed under CC BY-ND

Developer Notes: Make this a click to reveal activity with the Clinical Applications. When the student clicks on each bullet the text and vo will play. Align text with VO. Add continue button to continue to next slide.
VO: Types of clinical applications:
Electronic health records (EHRs)
Clinical information systems (CISs)
Laboratory information systems (LISs)
Pharmacy information systems (PISs)
Medication administration records (MARs)
Computerized physician order entry (CPOE)
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Personal health records (PHRs)
Long-term care systems (LTC)
Outpatient systems
Picture archive communications systems (PACSs)
Medical imaging systems (MISs)
Radiology information systems (RISs)

Clinical Applications
*Click on each photo to reveal acitvity

Developer Notes: Make this a click to reveal activity with the Clinical Applications. When the student clicks on each bullet the text and vo will play. Align text with VO. Add continue button to continue to next slide.
VO:
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Administrative Applications

Developer Notes: Align text with VO. Add continue button to continue to next slide.
VO:
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Administrative and financial applications

Enterprise resources planning (ERP) systems

Customer resource management (CRM) systems

Supply chain management (SCM) systems

Other applications

Home Health Care

Summary

Developer Notes: Developer Notes: Make this a click to reveal activity with the Summary bullets. When the student clicks on each bullet the text and vo will play. Align text with VO. Add continue button to continue to next slide.
You have concluded with the Week One Interactive Presentation. Please proceed back to Week One in Blackboard to continue the curriculum for Week One.
VO:
The layers of the HIS conceptual model provide a comprehensive view of the total scope of HIS activity.
HIS are used extensively in a wide variety of organizational and community settings.
HIS applications are critical for delivery of quality patient care.
You have concluded with the Week One Interactive Presentation. Please proceed back to Week One in Blackboard to continue the curriculum for Week One.
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HIS applications are critical for delivery of quality patient care.

HIS are used extensively in a wide variety of organizational and community settings.

The layers of the HIS conceptual model provide a comprehensive view of the total scope of HIS activity.

HCA 626 – Healthcare Information Systems
Week One – Lecture 1

Developer Notes: Continue button to continue to next slide. No left-hand menu, please. Menu drop down on top left corner with various topics and notes on top left corner with narration.
Vo: Welcome to the Week One – Lecture 1 for HCA 626 – Healthcare Information Systems.
1

Chapter 1:
Health Information Systems Fundamentals

Developer Notes: Chapter 1 begins. Align text with VO. Add continue button to continue to next slide.
VO: Chapter 1 – Health Information Systems Fundamentals (HIS).
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HIS Strategic Planning

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

Developer Notes: Align text with VO. Add continue button to continue to next slide.
VO: 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
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Governance
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

Developer Notes: Make this a click to reveal activity with the HIS fundamentals. When the student clicks on each fundamental the text and vo will play. Align text with VO. Add continue button to continue to next slide.
VO: Governance:
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
4

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

Developer Notes: Align text with VO. Add continue button to continue to next slide.
VO: 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)
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Managing HIS, cont.

One of the most essential functional areas of a HC organization
Warrants attention from highest levels of the organization

Developer Notes: Align text with VO. Add continue button to continue to next slide.
VO:
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
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HIS Planning & 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

Developer Notes: Align text with VO. Add continue button to continue to next slide.
VO: HIS Planning & 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 the HIS Strategies Plans.
Annual plans drive the annual HIS capital and operating budgets.

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HIS Planning & Budgeting, cont.

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

Developer Notes: Align text with VO. Add continue button to continue to next slide.
VO:
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
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 HIS Selection
Process by which decisions are made about which new software systems to bring into the organization
Methodologies are widely known, repeatable processes

Developer Notes: Align text with VO. Add continue button to continue to next slide.
VO: 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
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Implementing 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

Developer Notes: Align text with VO. Add continue button to continue to next slide.
VO: 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
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​
Keep others not involved in the process in the loop​
Closely collaborate with end users, management, clinical staff
Work with interdisciplinary teams on design, requirements, training, testing, activation, and use
The reality of what happens with a new HIS
Managing Change

*Click each photo to reveal activity

Developer Notes: Make this a click to reveal activity with the changes. When the student clicks on each change the text and vo will play. Align text with VO. Add continue button to continue to next slide.
VO: 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

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Managing Vendors

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

Developer Notes: Make this a click to reveal activity with the changes. When the student clicks on each change the text and vo will play. Align text with VO. Add continue button to continue to next slide.
VO: 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

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Harvesting the Yield from HIS

Increases the value and Return on Investment (ROI) in the core HIS
Value garnered is widely underachieved

Developer Notes: Make this a click to reveal activity with the changes. When the student clicks on each change the text and vo will play. Align text with VO. Add continue button to continue to next slide.
VO: 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 Return on Investment (ROI) in the core HIS
Value garnered is widely underachieved
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Business, Clinical, and Artificial Intelligence
 

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

Developer Notes: Align text with VO. Add continue button to continue to next slide.
VO: 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.
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Data Management & Stewardship
To gain yield and value from data, they must be carefully and continuously tended
Must be managed according to the goals of the organization

Developer Notes: Align text with VO. Add continue button to continue to next slide.
VO: 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
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Creating New Knowledge
Needs of patients evolve
Healthcare organizations must adapt
Must be data driven to put new knowledge into practice

Developer Notes: Align text with VO. Add continue button to continue to next slide.
VO: 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.
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HIS Regulatory Compliance & Risk Management

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

Developer Notes: Align text with VO. Add continue button to continue to next slide.
VO: 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.
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HIS Security

Hackers, black market, and ransomware experts threaten HIS
Prevention is among the highest priorities for any HIS agenda

Developer Notes: Align text with VO. Add continue button to continue to next slide.
VO: HIS Security:
Security of HIS, data, and protected health information (PHI) is a primary goal in healthcare.
Hackers, black market, and ransomware experts threaten HIS.
Prevention is among the highest priorities for any HIS agenda.
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HIS Standards

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

Developer Notes: Align text with VO. Add continue button to continue to next slide.
VO: 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

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Common Fundamental Failures

Background
The challenges needing a solution
The solution

Developer Notes: Align text with VO. Add continue button to continue to next slide.
VO: Common Fundamental Failures
Background
The challenges needing a solution
The solution

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HIS Model for the Health Professions

Developer Notes: Align text with VO. Add continue button to continue to next slide.
VO: HIS Model for the Health Professions:
View this diagram for a better understanding of H.IS Model for the Health Professions.
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HIS Terminology

Developer Notes: Align text with VO. Add continue button to continue to next slide.
VO: View this table for a better understanding of HIS Terminology.
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Health Information Systems (HIS)

Technology Infrastructure

Hardware

Software

Middleware

Networks

End-users

Activation/implementation
Communication
HIS development
Design
HIS management
HIS governance
HIS planning

Ongoing maintenance
Roles

*Click on each photo to reveal activity

Developer Notes: Make this a click to reveal activity with the roles. When the student clicks on each role the text and vo will play. Align text with VO. Add continue button to continue to next slide.
VO: Roles:
HIS planning
HIS governance
HIS management
Design
HIS development
Activation/implementation
Ongoing maintenance
Communication
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Vendor & Provider Relations

Developer Notes: Align text with VO. Add continue button to continue to next slide.
VO: View this table for a better understanding of Vendor & Provider Relations.
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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

Vendor marketplace is dynamic

History of HIS
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)

Developer Notes: Make this a click to reveal activity with the History of HIS. When the student clicks on each bullet the text and vo will play. Align text with VO. Add continue button to continue to next slide.
VO: 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).
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History of HIS
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

Developer Notes: Make this a click to reveal activity with the History of HIS. When the student clicks on each bullet the text and vo will play. Align text with VO. Add continue button to continue to next slide.
VO: 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
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History of HIS
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)
Through the 1990s, advent of the Internet transformed healthcare computing

Developer Notes: Make this a click to reveal activity with the History of HIS. When the student clicks on each bullet the text and vo will play. Align text with VO. Add continue button to continue to next slide.
VO: Evolution of Clinical Systems and the HER:
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)
Through the 1990s, advent of the Internet transformed healthcare computing
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History of HIS

IOM To Err Is Human 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

Developer Notes: Make this a click to reveal activity with the History of HIS. When the student clicks on each bullet the text and vo will play. Align text with VO. Add continue button to continue to next slide.
VO: The Current Climate:
IOM To Err Is Human 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.
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Summary
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

Developer Notes: You have concluded with the Week One Interactive Presentation. Please proceed back to Week One in Blackboard to continue the curriculum for Week One.
VO:
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.
You have concluded with the Week One Interactive Presentation. Please proceed back to Week One in Blackboard to continue the curriculum for Week One.
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