Winter / Haux / Ammenwerth Health Information Systems

Architectures and Strategies
2. Auflage 2011
ISBN: 978-1-84996-441-8
Verlag: Springer
Format: PDF
Kopierschutz: 1 - PDF Watermark

E-Book, Englisch, 340 Seiten

Reihe: Health Informatics

Previously published as Strategic Information Management in Hospitals; An Introduction to Hospital Information Systems, Health Information Systems Architectures and Strategies is a definitive volume written by four authoritative voices in medical informatics. Illustrating the importance of hospital information management in delivering high quality health care at the lowest possible cost, this book provides the essential resources needed by the medical informatics specialist to understand and successfully manage the complex nature of hospital information systems. Author of the first edition's Foreword, Reed M. Gardner, PhD, Professor and Chair, Department of Medical Informatics, University of Utah and LDS Hospital, Salt Lake City, Utah, applauded the text's focus on the underlying administrative systems that are in place in hospitals throughout the world. He wrote, 'These challenging systems that acquire, process and manage the patient's clinical information. Hospital information systems provide a major part of the information needed by those paying for health care.' their components; health information systems; architectures of hospital information systems; and organizational structures for information management.

Autoren/Hrsg.

Winter, Alfred

Haux, Reinhold

Ammenwerth, Elske

Brigl, Birgit

Hellrung, Nils

Jahn, Franziska

Inhaltsverzeichnis

1;Health Information Systems: Architectures and Strategies;2
1.1;Foreword from the 1st Edition in 2004;6
1.2;Series Preface;8
1.3;Preface for the 2nd Edition;9
1.4;Acknowledgements for the 2nd Edition;11
1.5;Acknowledgements for the 1st Edition;12
1.6;Annotation to the Figures;13
1.7;Contents;14
1.8;List of Figures;21
1.9;Figure Credits;31
1.10;List of Tables;33
1.11;About the Authors;35
1.12;1: Introduction;38
1.13;2: Health Institutions and Information Processing;40
1.13.1;2.1Introduction;40
1.13.2;2.2 Significance of Information Processing in Health care;40
1.13.2.1;2.2.1 Information Processing as Quality Factor;40
1.13.2.2;2.2.2Information Processing as Cost Factor;41
1.13.2.3;2.2.3Information as Productivity Factor;43
1.13.2.4;2.2.4Holistic View of the Patient;43
1.13.2.5;2.2.5Hospital Information System as Memory and Nervous System;44
1.13.3;2.3 Progress in Information and Communication Technology;45
1.13.3.1;2.3.1Impact on the Quality of Health Care;45
1.13.3.2;2.3.2Impact on Economics;47
1.13.3.3;2.3.3Changing Health care;48
1.13.4;2.4 Importance of Systematic Information Management;49
1.13.4.1;2.4.1Affected People and Areas;49
1.13.4.2;2.4.2Amount of Information Processing;50
1.13.4.3;2.4.3Sharing the Same Data;51
1.13.4.4;2.4.4Integrated Information Processing to Satisfy Information Needs;52
1.13.4.5;2.4.5Raising the Quality of Patient Care and Reducing Costs;53
1.13.4.6;2.4.6Basis of Systematic Information Processing;53
1.13.5;2.5 Examples;54
1.13.5.1;2.5.1Knowledge Access to Improve Patient Care;54
1.13.5.2;2.5.2Nonsystematic Information Processing in Clinical Registers;55
1.13.5.3;2.5.3The WHO eHealth Resolution15;56
1.13.5.4;“The Fifty-Eighth World Health Assembly …;57
1.13.5.5;2.5.4Estimated Impact of eHealth to Improve Quality and Efficiency of Patient Care;58
1.13.6;2.6 Exercises;59
1.13.6.1;2.6.1Amount of Information Processing in Typical Hospitals;59
1.13.6.2;2.6.2Information Processing in Different Areas;59
1.13.6.3;2.6.3Good Information Processing Practice;60
1.13.7;2.7 Summary;60
1.14;3: Information System Basics;61
1.14.1;3.1 Introduction;61
1.14.2;3.2 Data, Information, and Knowledge;61
1.14.3;3.3 Information Systems and Their Components;62
1.14.3.1;3.3.1Systems and Subsystems;62
1.14.3.2;3.3.2Information Systems;62
1.14.3.3;3.3.3Components of Information Systems;63
1.14.3.4;3.3.4Architecture and Infrastructure of Information Systems;65
1.14.4;3.4 Information Management;66
1.14.5;3.5 Exercises;66
1.14.5.1;3.5.1On the Term Information System;66
1.14.5.2;3.5.2On Enterprise Functions;67
1.14.5.3;3.5.3On Application Components;67
1.14.5.4;3.5.4On Architectures and Infrastructures;67
1.14.5.5;3.5.5On Information Management;67
1.14.6;3.6 Summary;67
1.15;4: Health Information Systems;69
1.15.1;4.1 Introduction;69
1.15.2;4.2 Hospital Information Systems;69
1.15.3;4.3 Transinstitutional Health Information Systems;72
1.15.4;4.4 Electronic Health Records as a Part of Health Information Systems;74
1.15.5;4.5 Challenges for Health Information Systems;74
1.15.6;4.6 Example;76
1.15.6.1;4.6.1 Architecture of a Hospital Information System;76
1.15.7;4.7 Exercises;77
1.15.7.1;4.7.1 Hospital Information System as a System;77
1.15.7.2;4.7.2 Buying a Hospital Information System;77
1.15.7.3;4.7.3 Transinstitutional Health Information Systems;77
1.15.8;4.8 Summary;78
1.16;5: Modeling Health Information Systems;79
1.16.1;5.1 Introduction;79
1.16.2;5.2 On Models and Metamodels;79
1.16.2.1;5.2.1Definitions;79
1.16.2.2;5.2.2Types of Models;81
1.16.2.2.1;5.2.2.1Functional Models;81
1.16.2.2.2;5.2.2.2Technical Models;82
1.16.2.2.3;5.2.2.3Organizational Models;82
1.16.2.2.4;5.2.2.4Data Models;84
1.16.2.2.5;5.2.2.5Business Process Models;85
1.16.2.2.6;5.2.2.6Information System Models;87
1.16.3;5.3 A Metamodel for Modeling Health Information Systems on Three Layers: 3LGM²;87
1.16.3.1;5.3.1UML Class Diagrams for the Description of 3LGM²;88
1.16.3.2;5.3.23LGM²-B;91
1.16.3.2.1;5.3.2.1Domain Layer;91
1.16.3.2.2;5.3.2.2Logical Tool Layer;94
1.16.3.2.3;5.3.2.3Physical Tool Layer;96
1.16.3.2.4;5.3.2.4Interlayer Relationships;98
1.16.3.3;5.3.33LGM²-M;102
1.16.3.4;5.3.43LGM²-S;103
1.16.4;5.4 On Reference Models;104
1.16.5;5.5 A Reference Model for the Domain Layer of Hospital Information Systems;106
1.16.6;5.6 Exercises;107
1.16.6.1;5.6.1Typical Implementation of Hospital Functions;107
1.16.6.2;5.6.23LGM² as a Metamodel;107
1.16.6.3;5.6.3Modeling with 3LGM²;108
1.16.6.3.1;5.6.3.1HIS Components;108
1.16.6.3.2;5.6.3.2Create the Model;108
1.16.6.3.3;5.6.3.3Interlayer Relationships;108
1.16.6.3.4;5.6.3.4New Enterprise Function;108
1.16.7;5.7 Summary;109
1.17;6: Architecture of Hospital Information Systems;110
1.17.1;6.1 Introduction;110
1.17.2;6.2 Domain Layer: Data to Be Processed in Hospitals;110
1.17.2.1;6.2.1 Entity Types Related to Patient Care;111
1.17.2.2;6.2.2 Entity Types About Resources;112
1.17.2.3;6.2.3 Entity Types Related to Administration;113
1.17.2.4;6.2.4 Entity Types Related to Management;113
1.17.3;6.3 Domain Layer: Hospital Functions;114
1.17.3.1;6.3.1 Patient Care;114
1.17.3.1.1;6.3.1.1 Patient Admission;114
1.17.3.1.1.1;Appointment Scheduling;116
1.17.3.1.1.2;Patient Identification and Checking for Recurrent;116
1.17.3.1.1.3;Administrative Admission;116
1.17.3.1.1.4;Medical Admission;118
1.17.3.1.1.5;Nursing Admission;118
1.17.3.1.1.6;Visitor and Information Service;118
1.17.3.1.2;6.3.1.2 Decision Making, Planning, and Organization of Patient Treatment;118
1.17.3.1.2.1;Decision Making and Patient Information;120
1.17.3.1.2.2;Medical and Nursing Care Planning;120
1.17.3.1.3;6.3.1.3 Order Entry;121
1.17.3.1.3.1;Preparation of an Order;121
1.17.3.1.3.2;Appointment Scheduling;123
1.17.3.1.4;6.3.1.4 Execution of Diagnostic, Therapeutic and Nursing Procedures;123
1.17.3.1.4.1;Execution of Diagnostic and Therapeutic Procedures;124
1.17.3.1.4.2;Execution of Nursing Procedures;125
1.17.3.1.5;6.3.1.5 Coding of Diagnoses and Procedures;125
1.17.3.1.6;6.3.1.6 Patient Discharge and Transfer to Other Institutions;126
1.17.3.1.6.1;Administrative Discharge and Billing;127
1.17.3.1.6.2;Medical Discharge and Medical Report Writing;127
1.17.3.1.6.3;Nursing Discharge and Nursing Report Writing;128
1.17.3.2;6.3.2 Supply and Disposal Management, Scheduling, and Resource Allocation;128
1.17.3.2.1;6.3.2.1 Supply and Disposal Management;128
1.17.3.2.1.1;Catering;128
1.17.3.2.1.2;Material and Medication Management;128
1.17.3.2.1.3;Laundry Management;128
1.17.3.2.1.4;Management of Medical Devices;130
1.17.3.2.2;6.3.2.2 Scheduling and Resource Allocation;130
1.17.3.2.3;6.3.2.3 Human Resources Management;130
1.17.3.3;6.3.3 Hospital Administration;131
1.17.3.3.1;6.3.3.1 Patient Administration;132
1.17.3.3.2;6.3.3.2 Archiving of Patient Information;132
1.17.3.3.2.1;Opening of a Patient Record;133
1.17.3.3.2.2;Administration and Allocation of Patient Records;133
1.17.3.3.2.3;Long-Term Archiving;134
1.17.3.3.3;6.3.3.3 Quality Management;134
1.17.3.3.3.1;Internal Quality Management;134
1.17.3.3.3.2;Performance of Legal Notification Requirements;135
1.17.3.3.4;6.3.3.4 Cost Accounting;135
1.17.3.3.5;6.3.3.5 Controlling;135
1.17.3.3.6;6.3.3.6 Financial Accounting;136
1.17.3.3.7;6.3.3.7 Facility Management;136
1.17.3.3.8;6.3.3.8 Information Management3;136
1.17.3.3.8.1;Strategic Information Management;136
1.17.3.3.8.2;Tactical Information Management;139
1.17.3.3.8.3;Operational Information Management;139
1.17.3.4;6.3.4 Hospital Management;139
1.17.3.5;6.3.5 Research and Education;139
1.17.3.5.1;6.3.5.1 Research Management;141
1.17.3.5.2;6.3.5.2 Execution of Clinical Trials and Experiments;141
1.17.3.5.3;6.3.5.3 Knowledge Retrieval and Literature Management;141
1.17.3.5.4;6.3.5.4 Publishing and Presentation;141
1.17.3.5.5;6.3.5.5 Education;141
1.17.3.6;6.3.6 Clinical Documentation: A Hospital Function?;141
1.17.3.7;6.3.7 Domain Layer: Exercises;142
1.17.3.7.1;6.3.7.1 Differences in Hospital Functions;142
1.17.3.7.2;6.3.7.2 Different Health Care Professional Groups and Hospital Functions;142
1.17.3.7.3;6.3.7.3 Support of Hospital Functions;142
1.17.3.7.4;6.3.7.4 The Patient Entity Type;143
1.17.3.8;6.3.8 Domain Layer: Summary;143
1.17.4;6.4 Logical Tool Layer: Application Components;145
1.17.4.1;6.4.1 Patient Administration System;146
1.17.4.2;6.4.2 Medical Documentation System;148
1.17.4.3;6.4.3 Nursing Management and Documentation System;150
1.17.4.4;6.4.4 Outpatient Management System;151
1.17.4.5;6.4.5 Provider or Physician Order Entry System (POE);153
1.17.4.6;6.4.6 Patient Data Management System (PDMS);155
1.17.4.7;6.4.7 Operation Management System;157
1.17.4.8;6.4.8 Radiology Information System;159
1.17.4.9;6.4.9 Picture Archiving and Communication System (PACS);160
1.17.4.10;6.4.10 Laboratory Information System;162
1.17.4.11;6.4.11 Enterprise Resource Planning System;163
1.17.4.12;6.4.12 Data Warehouse System;164
1.17.4.13;6.4.13 Document Archiving System;166
1.17.4.14;6.4.14 Other Computer-Based Application Components;168
1.17.4.15;6.4.15 Clinical Information System and Electronic Patient Record System as Comprehensive Application Components;169
1.17.4.16;6.4.16 Typical Non-Computer-Based Application Components;170
1.17.4.16.1;6.4.16.1 The Paper-Based Patient Chart System;170
1.17.4.16.2;6.4.16.2 The Paper-Based Patient Record System;172
1.17.5;6.5 Logical Tool Layer: Integration of Application Components;172
1.17.5.1;6.5.1 Taxonomy of Architectures at the Logical Tool Layer;173
1.17.5.1.1;6.5.1.1 Number of Databases: Central Versus Distributed;173
1.17.5.1.1.1;DB1 Style;174
1.17.5.1.1.2;DBn Style;174
1.17.5.1.1.3;Mixed DB1/DBn Style;175
1.17.5.1.2;6.5.1.2 Number of Application Components: Monolithic Versus Modular;175
1.17.5.1.3;6.5.1.3 Number of Software Products and Vendors: All-in-One Versus Best-of-Breed;176
1.17.5.1.4;6.5.1.4 Communication Pattern: Spaghetti Versus Star;177
1.17.5.2;6.5.2 Integrity;179
1.17.5.2.1;6.5.2.1 Object Identity;179
1.17.5.2.2;6.5.2.2 Referential Integrity;180
1.17.5.2.3;6.5.2.3 Consistency;180
1.17.5.3;6.5.3 Types of Integration;181
1.17.5.3.1;6.5.3.1 Data Integration;181
1.17.5.3.2;6.5.3.2 Semantic Integration;181
1.17.5.3.3;6.5.3.3 Access Integration;182
1.17.5.3.4;6.5.3.4 Presentation integration;182
1.17.5.3.5;6.5.3.5 Contextual Integration;183
1.17.5.3.6;6.5.3.6 Functional integration;183
1.17.5.3.7;6.5.3.7 Process Integration;183
1.17.5.4;6.5.4 Standards;184
1.17.5.4.1;6.5.4.1 Health Level 7 (HL7) Version 2;184
1.17.5.4.2;6.5.4.2 Health Level 7 (HL7) Version 3;186
1.17.5.4.3;6.5.4.3 Digital Imaging and Communications in Medicine (DICOM);187
1.17.5.4.4;6.5.4.4 ISO/IEEE 11073;188
1.17.5.4.5;6.5.4.5 Standard for Contextual Integration;188
1.17.5.4.6;6.5.4.6 Integrating the Healthcare Enterprise (IHE);188
1.17.5.4.7;6.5.4.7 Electronic Data Interchange for Administration, Commerce, and Transport (EDIFACT);189
1.17.5.4.8;6.5.4.8 Clinical Document Architecture (CDA);189
1.17.5.5;6.5.5 Integration Technologies;190
1.17.5.5.1;6.5.5.1 Federated Database System;190
1.17.5.5.2;6.5.5.2 Transaction Management: 2-phase commit protocol and master application components;190
1.17.5.5.3;6.5.5.3 Middleware;191
1.17.5.5.3.1;Message Exchange by Communication Servers;192
1.17.5.5.3.2;Remote Function Calls;194
1.17.5.5.3.3;Service-Oriented Architectures (SOAs) and Portals;195
1.17.5.6;6.5.6 Logical Tool Layer: Example;196
1.17.5.6.1;6.5.6.1 Typical Realizations: Centralized, Monolithic and All-in-One HIS;196
1.17.5.7;6.5.7 Logical Tool Layer: Exercises;198
1.17.5.7.1;6.5.7.1 Data Distribution Style at the Logical Tool Layer;198
1.17.5.7.2;6.5.7.2 HIS Infrastructures;198
1.17.5.7.3;6.5.7.3 A Paperless Hospital;201
1.17.5.7.4;6.5.7.4 Introducing a Departmental Computer-Based Application Component;201
1.17.5.7.5;6.5.7.5 Loose and Close Coupling;202
1.17.5.7.6;6.5.7.6 Integrating Nursing Documentation;202
1.17.5.8;6.5.8 Logical Tool Layer: Summary;202
1.17.6;6.6 Physical Tool Layer: Physical Data-Processing Systems;203
1.17.6.1;6.6.1 Servers and communication networks;204
1.17.6.2;6.6.2 Clients;204
1.17.6.3;6.6.3 Storage;205
1.17.6.4;6.6.4 Typical Non-computer-Based Physical Data-Processing Systems;205
1.17.6.5;6.6.5 Infrastructure;206
1.17.7;6.7 Physical Tool Layer: Integration of Physical Data-Processing Systems;207
1.17.7.1;6.7.1 Taxonomy of Architectures at the Physical Tool Layer;207
1.17.7.1.1;6.7.1.1 Distribution of Computing Power: Mainframes vs. Client-Server;208
1.17.7.2;6.7.2 Physical Integration;209
1.17.7.3;6.7.3 Computing Centers;210
1.17.7.4;6.7.4 Physical Tool Layer: Example;211
1.17.7.4.1;6.7.4.1 The Amount of Data to Be Processed at a Hospital’s Computing Center;211
1.17.7.5;6.7.5 Physical Tool Layer: Exercises;212
1.17.7.5.1;6.7.5.1 HIS Infrastructure;212
1.17.7.6;6.7.6 Physical Tool Layer: Summary;212
1.17.8;6.8 Summarizing Example;213
1.17.8.1;6.8.1 Health Information Systems Supporting Clinical Business Processes;213
1.17.8.1.1;Patient Treatment at a Physician’s General Practice;213
1.17.8.1.2;Sec154_6;213
1.17.8.1.3;Arrival at ward;213
1.17.8.1.4;Nursing Admission;213
1.17.8.1.5;Medical Admission;214
1.17.8.1.6;Medical Care Planning and Order Entry;214
1.17.8.1.7;Execution of Diagnostic, Therapeutic, and Nursing Procedures;214
1.17.8.1.8;Review of Findings;215
1.17.8.1.9;Decision Making;215
1.17.8.1.10;Sec162_6;215
1.17.8.1.11;Transfer to Another Department;215
1.17.8.1.12;Discharge from Hospital and Aftercare;216
1.17.9;6.9 Summarizing Exercises;216
1.17.9.1;6.9.1 Hospital Functions and Processes;216
1.17.9.2;6.9.2 Application Components and Hospital Functions;216
1.17.9.3;6.9.3 Multiprofessional Treatment Teams;217
1.17.9.4;6.9.4 Information Needs of Different Health Care Professionals;217
1.17.9.5;6.9.5 HIS Architectures;217
1.17.9.6;6.9.6 Communication Server;217
1.17.9.7;6.9.7 Anatomy and Physiology of Information Processing;217
1.17.10;6.10 Summary;218
1.18;7: Specific Aspects for Architectures of Transinstitutional Health Information Systems;219
1.18.1;7.1 Introduction;219
1.18.2;7.2 Domain Layer;220
1.18.2.1;7.2.1 Specific Aspects for Hospital Functions;220
1.18.2.1.1;7.2.1.1 Patient Admission;220
1.18.2.1.2;7.2.1.2 Decision Making, Planning, and Organization of Patient Treatment;221
1.18.2.1.3;7.2.1.3 Execution of Diagnostic and Therapeutic Procedures;221
1.18.2.2;7.2.2 Additional Enterprise Functions;222
1.18.3;7.3 Logical Tool Layer;222
1.18.3.1;7.3.1 Integration of Application Components;222
1.18.3.2;7.3.2Strategies for Electronic Health Record Systems;224
1.18.3.2.1;7.3.2.1The Provider-Centric Strategy;225
1.18.3.2.2;7.3.2.2The Patient-Centric Strategy;225
1.18.3.2.3;7.3.2.3The Regional- or National-Centric Strategy;226
1.18.3.2.4;7.3.2.4The Strategy of Independent Health Banks;226
1.18.4;7.4 Physical Tool Layer;226
1.18.5;7.5 Examples;227
1.18.5.1;7.5.1“Gesundheitsnetz Tirol (GNT)”: The Tyrolean Health Care Network;227
1.18.5.1.1;7.5.1.1Background and Overall Functionality;227
1.18.5.1.2;7.5.1.2System Architecture and Workflows;227
1.18.5.1.3;7.5.1.3 Important Lessons Learned;229
1.18.5.2;7.5.2 Veterans Health Information Systems and Technology Architecture (VISTA)7;230
1.18.5.3;7.5.3 The Hypergenes Biomedical Information Infrastructure9, 10;230
1.18.5.4;7.5.4 The National Health Information System in Korea11, 12;231
1.18.6;7.6Exercises;232
1.18.6.1;7.6.1Challenges of Transinstitutional Health Information Systems;232
1.18.6.2;7.6.2Strategies for Transinstitutional Electronic Health Records;232
1.18.6.3;7.6.3 The Term “Electronic Health Record”;233
1.18.6.4;7.6.4 Transinstitutional Information Systems in other Sectors;233
1.18.7;7.7 Summary;233
1.19; 8: Quality of Health Information Systems;234
1.19.1;8.1 Introduction;234
1.19.2;8.2 Quality of Structures;235
1.19.2.1;8.2.1 Quality of Data;235
1.19.2.2;8.2.2 Quality of Computer-Based Application Components and Their Integration;236
1.19.2.3;8.2.3 Quality of Physical Data Processing Systems;238
1.19.2.4;8.2.4 Quality of the Overall HIS Architecture;239
1.19.2.5;8.2.5 Exercises;239
1.19.2.5.1;8.2.5.1 Quality Criteria in 3LGM² Models;239
1.19.2.5.2;8.2.5.2 Quality of Computer-Based Application Components;240
1.19.2.5.3;8.2.5.3 Usability of Software Products;240
1.19.2.5.4;8.2.5.4 Quality of HIS Architectures;240
1.19.2.6;8.2.6 Summary;240
1.19.3;8.3 Quality of Processes;241
1.19.3.1;8.3.1 Single Recording, Multiple Usability of Data;241
1.19.3.2;8.3.2 No Transcription of Data;241
1.19.3.3;8.3.3 Leanness of Information Processing Tools;241
1.19.3.4;8.3.4 Efficiency of Information Logistics;243
1.19.3.5;8.3.5 Patient-Centered Information Processing;243
1.19.3.6;8.3.6 Exercises;244
1.19.3.6.1;8.3.6.1 Quality of Processes in an Intensive Care Unit;244
1.19.3.6.2;8.3.6.2 Transcription of Data;244
1.19.3.6.3;8.3.6.3 Leanness of Information Processing Tools;244
1.19.3.6.4;8.3.6.4 Quality of Processes;244
1.19.3.7;8.3.7 Summary;245
1.19.4;8.4 Quality of Outcome;245
1.19.4.1;8.4.1 Fulfillment of Hospital’s Goals;246
1.19.4.2;8.4.2 Fulfillment of the Expectations of Different Stakeholders;246
1.19.4.2.1;8.4.2.1 Patients and Relatives;247
1.19.4.2.2;8.4.2.2 Health Care Professionals;247
1.19.4.2.3;8.4.2.3 Administrative Staff;247
1.19.4.2.4;8.4.2.4 Hospital Management;248
1.19.4.3;8.4.3 Fulfillment of Information Management Laws;248
1.19.4.4;8.4.4 Exercises;249
1.19.4.4.1;8.4.4.1 Expectation of Patients and Relatives;249
1.19.4.4.2;8.4.4.2 National Laws for Information Processing;249
1.19.4.5;8.4.5 Summary;249
1.19.5;8.5 Balance as a Challenge for Information Management;249
1.19.5.1;8.5.1 Balance of Homogeneity and Heterogeneity;250
1.19.5.2;8.5.2 Balance of Computer-Based and Non-Computer-Based Tools;250
1.19.5.3;8.5.3 Balance of Data Security and Working Processes;251
1.19.5.4;8.5.4 Balance of Functional Leanness and Functional Redundancy;252
1.19.5.5;8.5.5 Balance of Documentation Quality and Documentation Efforts;252
1.19.5.6;8.5.6 Exercises;253
1.19.5.6.1;8.5.6.1 Best-of-Breed Versus All-in-One;253
1.19.5.7;8.5.7 Summary;253
1.19.6;8.6 Evaluation of Health Information Systems Quality;254
1.19.6.1;8.6.1 Typical Evaluation Phases;254
1.19.6.1.1;8.6.1.1 Study Exploration;255
1.19.6.1.2;8.6.1.2 First Study Design;256
1.19.6.1.3;8.6.1.3 Operationalization of Methods and Detailed Study Plan;256
1.19.6.1.4;8.6.1.4 Execution of Study;257
1.19.6.1.5;8.6.1.5 Report and Publication of Study;257
1.19.6.2;8.6.2 Typical Evaluation Methods;257
1.19.6.2.1;8.6.2.1 Quantitative Evaluation Methods;257
1.19.6.2.1.1;Time Measurements;257
1.19.6.2.1.2;Event Counting;258
1.19.6.2.1.3;Quantitative Questionnaires;258
1.19.6.2.2;8.6.2.2 Qualitative Evaluation Methods;258
1.19.6.2.2.1;Qualitative Interviews;259
1.19.6.2.2.2;Qualitative Observations;259
1.19.6.2.2.3;Qualitative Content Analysis;259
1.19.6.2.3;8.6.2.3 Special Evaluation Studies;259
1.19.6.3;8.6.3 Exercises;260
1.19.6.3.1;8.6.3.1 Selection of Evaluation Criteria;260
1.19.6.3.2;8.6.3.2 Planning of an Evaluation Study;260
1.19.6.3.3;8.6.3.3 The Baby CareLink Study;261
1.19.6.4;8.6.4 Summary;261
1.19.7;8.7 Summarizing Examples;261
1.19.7.1;8.7.1 The Baldrige Health Care Information Management Criteria;261
1.19.7.2;8.7.2 Information Management Standards of the Joint Commission;262
1.19.7.3;8.7.3 The Baby CareLink Study18;263
1.19.7.4;8.7.4 In-Depth Approach: The Functional Redundancy Rate;263
1.19.8;8.8 Summarizing Exercises;268
1.19.8.1;8.8.1 Evaluation Criteria;268
1.19.8.2;8.8.2 Joint Commission Information Management Standards;268
1.19.9;8.9 Summary;268
1.20;9: Strategic Information Management in Hospitals;270
1.20.1;9.1 Introduction;270
1.20.2;9.2 Strategic, Tactical and Operational Information Management;271
1.20.2.1;9.2.1Information Management;271
1.20.2.2;9.2.2Information Management in Hospitals;274
1.20.2.3;9.2.3Strategic Information Management;275
1.20.2.4;9.2.4Tactical Information Management;276
1.20.2.5;9.2.5Operational Information Management;277
1.20.2.6;9.2.6Relationship Between IT Service Management and Information Management;279
1.20.2.7;9.2.7Example;281
1.20.2.7.1;9.2.7.1Typical Projects of Tactical Information Management;281
1.20.2.8;9.2.8Exercises;281
1.20.2.8.1;9.2.8.1Influences on HIS Operation;281
1.20.2.8.2;9.2.8.2Typical Projects of Tactical Information Management;281
1.20.2.8.3;9.2.8.3Diagnostics and Therapy of HIS;281
1.20.2.9;9.2.9Summary;282
1.20.3;9.3 Organizational Structures of Information Management;282
1.20.3.1;9.3.1Chief Information Officer;282
1.20.3.2;9.3.2Information Management Department;284
1.20.3.3;9.3.3Example;284
1.20.3.3.1;9.3.3.1Organizational Structures for Information Management;284
1.20.3.4;9.3.4Exercises;285
1.20.3.4.1;9.3.4.1Information Systems Managers as Architects;285
1.20.3.4.2;9.3.4.2Organizational Structures for Information Management in a Hospital;286
1.20.3.4.3;9.3.4.3Centralization of Organizational Structures;286
1.20.3.4.4;9.3.4.4Organizational Structures for Information Management at PMC;286
1.20.3.5;9.3.5Summary;286
1.20.4;9.4 Strategic Planning;287
1.20.4.1;9.4.1Tasks;287
1.20.4.1.1;9.4.1.1Aligning Business Plans and Information Management Plans;287
1.20.4.1.2;9.4.1.2Long-Term HIS Planning;288
1.20.4.1.3;9.4.1.3Short-Term HIS Planning;288
1.20.4.2;9.4.2Methods;289
1.20.4.2.1;9.4.2.1Strategic Alignment;289
1.20.4.2.2;9.4.2.2Portfolio Management;289
1.20.4.3;9.4.3The Strategic Information Management Plan;290
1.20.4.3.1;9.4.3.1Purpose of Strategic Information Management Plans;290
1.20.4.3.2;9.4.3.2Structure of Strategic Information Management Plans;292
1.20.4.3.2.1;Strategic Goals of the Hospital and of Information Management;292
1.20.4.3.2.2;Description of the Current State of the Hospital Information System;293
1.20.4.3.2.3;Analysis and Assessment of the Current State of the Hospital Information System;293
1.20.4.3.2.4;Description of the Planned State of the Hospital Information System;293
1.20.4.3.2.5;Migration Path from the Current to the Planned State;293
1.20.4.4;9.4.4Example;294
1.20.4.4.1;9.4.4.1Structure of a Strategic Information Management Plan;294
1.20.4.5;9.4.5Exercises;294
1.20.4.5.1;9.4.5.1Life Cycle of a Strategic Information Management Plan;294
1.20.4.5.2;9.4.5.2Deviation from a Strategic Information Management Plan;294
1.20.4.5.3;9.4.5.3Strategic Information Management and Strategic Hospital Management;294
1.20.4.5.4;9.4.5.4Establishing a Strategic Information Management Plan;296
1.20.4.6;9.4.6Summary;296
1.20.5;9.5 Strategic Monitoring;296
1.20.5.1;Root;296
1.20.5.2;9.5.1Tasks;297
1.20.5.2.1;9.5.1.1Permanent Monitoring Activities;297
1.20.5.2.2;9.5.1.2Ad Hoc Monitoring Activities;298
1.20.5.2.3;9.5.1.3Certification of HIS;299
1.20.5.3;9.5.2Methods;300
1.20.5.3.1;9.5.2.1HIS Benchmarking;300
1.20.5.3.2;9.5.2.2HIS Certification;300
1.20.5.4;9.5.3Examples;301
1.20.5.4.1;9.5.3.1A HIS Benchmarking Report;301
1.20.5.4.2;9.5.3.2COBIT;301
1.20.5.4.2.1;Plan and Organize;303
1.20.5.4.2.2;Acquire and Implement;303
1.20.5.4.2.3;Deliver and Support;303
1.20.5.4.2.4;Monitor and Evaluate;303
1.20.5.4.3;9.5.3.3CCHIT Functional Quality Criteria;304
1.20.5.5;9.5.4Exercises;305
1.20.5.5.1;9.5.4.1An Information Processing Monitoring Report;305
1.20.5.5.2;9.5.4.2COBIT;305
1.20.5.5.3;9.5.4.3Most Relevant Key Performance Indicators;305
1.20.5.5.4;9.5.4.4Organizing User Feedback;305
1.20.5.6;9.5.5Summary;305
1.20.6;9.6 Strategic Directing;306
1.20.6.1;Sec75_9;306
1.20.6.2;9.6.1Tasks;306
1.20.6.3;9.6.2Methods;306
1.20.6.4;9.6.3Example;307
1.20.6.4.1;9.6.3.1Project Management Boards at PMC;307
1.20.6.5;9.6.4Exercise;307
1.20.6.5.1;9.6.4.1A Project Management Board at PMC;307
1.20.6.6;9.6.5Summary;307
1.20.7;9.7Last But Not Least: Education!;308
1.20.8;9.8 Summarizing Examples;308
1.20.8.1;9.8.1Deficiencies in Information Management;308
1.20.8.2;9.8.2Computer Network Failures14;309
1.20.8.3;9.8.3Information Management Responsibilities15;310
1.20.8.4;9.8.4Safely Implementing Health Information and Converging Technologies;311
1.20.8.5;9.8.5Increased Mortality After Implementation of a Computerized Physician Order Entry System17;312
1.20.9;9.9 Summarizing Exercises;312
1.20.9.1;9.9.1Management of Other Information Systems;312
1.20.9.2;9.9.2Beginning and End of Information Management;312
1.20.9.3;9.9.3Cultivating Hospital Information Systems;313
1.20.9.4;9.9.4Hospital Information System Failure;313
1.20.9.5;9.9.5Increased Mortality;313
1.20.9.6;9.9.6Relevance of Examples;313
1.20.9.7;9.9.7Problems of Operational Information Management;313
1.20.10;9.10 Summary;314
1.21;10: Strategic Information Management in Health Care Networks;316
1.21.1;10.1 Introduction;316
1.21.2;10.2 Description of Health Care Networks;317
1.21.3;10.3 Organizational Structures of Information Management in Health Care Networks;317
1.21.3.1;10.3.1Centrality of Information Management in Health Care Networks;317
1.21.3.2;10.3.2Intensity of Information Management in Health Care Networks;319
1.21.4;10.4 Types of Health Care Networks;319
1.21.5;10.5 Example;320
1.21.5.1;10.5.1Regional Health Information Organizations;320
1.21.6;10.6Exercise;321
1.21.6.1;10.6.1The Plötzberg Health Care Network;321
1.21.7;10.7 Summary;321
1.22;11: Final Remarks;323
1.23;Thesaurus;325
1.24;Recommended Further Readings;358
1.25;Index;361