Strategic information management in hospitals: an introduction to hospital information systems
Gespeichert in:
| Format: | Buch |
|---|---|
| Sprache: | English |
| Veröffentlicht: |
New York
Springer
2004
|
| Schriftenreihe: | Health informatics series
|
| Schlagworte: | |
| Online-Zugang: | Inhaltsverzeichnis |
| Beschreibung: | XXIII, 272 S. Ill., graph. Darst. |
| ISBN: | 0387403566 |
Internformat
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| 245 | 1 | 0 | |a Strategic information management in hospitals |b an introduction to hospital information systems |c Reinhold Haux ... |
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| 300 | |a XXIII, 272 S. |b Ill., graph. Darst. | ||
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| 650 | 7 | |a Ziekenhuizen |2 gtt | |
| 650 | 4 | |a Hospital Information Systems | |
| 650 | 4 | |a Information Management | |
| 650 | 4 | |a Information storage and retrieval systems |x Hospitals | |
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Datensatz im Suchindex
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| adam_text | Contents
Foreword by Reed M. Gardner v
Series Preface vii
Preface ix
Acknowledgments xi
1. Introduction 1
1.1 Significance of Information Processing in Hospitals 1
1.2 Progress in Information and Communication Technology 6
1.3 Importance of Systematic Information Management 11
1.4 Examples 17
1.5 Exercises 22
1.6 Summary 23
2. Basic Concepts 25
2.1 Introduction 25
2.2 Data, Information, and Knowledge 25
2.3 Information Systems and Their Components 26
2.4 Hospital Information Systems 30
2.5 Health Information Systems 33
2.6 Information Management in Hospitals 35
2.7 Examples 36
2.8 Exercises 39
2.9 Summary .42
3. What Do Hospital Information Systems Look Like? .45
3.1 Introduction 45
3.2 Hospital Functions 45
3.3 Modeling Hospital Information Systems 62
3.4 A Metamodel for Modeling HIS: 3LGM 79
3.5 Information Processing Tools in Hospitals 88
3.6 Architectures of Hospital Information Systems 112
3.7 Integrity and Integration Within Hospital Information Systems 123
3.8 Example 139
3.9 Exercises 149
3.10 Summary 149
4. What Are Good Hospital Information Systems? 151
4.1 Introduction 151
4.2 Quality of Structures 152
4.3 Quality of Processes 159
4.4 Outcome Quality 164
4.5 Balance as a Challenge for Information Management 168
4.6 Examples 171
4.7 Exercise 175
4.8 Summary 176
5. How to Strategically Manage Hospital Information Systems 177
5.1 Introduction 177
5.2 Strategic, Tactical, and Operational Information Management 177
5.3 Organizational Structures for Information Management 187
5.4 Strategic Planning of Hospital Information Systems 194
5.5 Strategic Monitoring of Hospital Information Systems 204
5.6 Strategic Directing of Hospital Information Systems 213
5.7 Examples 215
5.8 Exercises 218
5.9 Summary 219
6. Final Remarks 221
Appendix A: Thesaurus 223
Appendix B: Bibliography 251
Appendix C: List of Examples and Exercises 255
About the Authors 259
Index 263
List of Tables and Figures
Tables
Table 1.1: Example of Simpson s paradox. Success rates of Novum and
Verum treatments for patients with diagnosis A, treated during the
years 8 at the Plotzberg Medical Center and Medical
School (PMC) 21
Table 3.1: An extract from the functional HIS model, describing
hospital functions relevant for nursing at the Plotzberg Medical
Center and Medical School (PMC) 65
Table 3.2: The Zachman enterprise architecture framework 72
Table 3.3: An example of a reference model for hospital functions 76
Table 5.1: Dimensions to be considered for operational information
management of the computer supported part of hospital
information systems 191
Table 5.2: Structure of the strategic information management plan
(2002 2007) of the Plotzberg Medical Center and Medical
School (PMC) 202
Table 5.3: A structure for an information processing
monitoring report 210
Figures
Figure 1.2: An example of an electronic patient record, comprising
documents as well as images 4
Figure 1.3: A paper based patient record archive as one information
storing part of the hospital s memory and nervous system 5
Figure 1.4: A server room of a hospital as one information processing
part of the hospital s memory and nervous system 6
Figure 1.5: Radiological conference using a picture archiving and
communication system for image presentation 7
Figure 1.6: A computer based training system for critical care,
simulating a patient and various intensive care parameters 10
Figure 1.7: A mobile computer on a ward to support medical
documentation and information access 10
Figure 1.8: Writing a discharge summary using speech recognition 11
Figure 1.9: Multitude of paper based forms in an outpatient unit 12
Figure 1.10: Searching for patients records in a patient
record archive 13
Figure 1.11: Regular clinical round by different healthcare
professionals on a ward 14
Figure 1.12: A physician in an examination room of an
outpatient unit 15
Figure 1.13: A medical technical assistant and a microbiologist
in a laboratory unit 15
Figure 1.14: A nurse on an ophthalmology ward 16
Figurel.15: Prof. Otwin Linderkamp, head of the Department of
Pediatrics in Heidelberg, working with the medical
knowledge server 18
Figure 1.16: The Heidelberg quintuplets 19
Figure 2.1: Typical physical data processing components (e.g.,
computer, printer telephone, paper based patient record,
blackboards) on a ward 29
Figure 2.2: A healthcare professional accessing patient information 31
Figure 2.3: Different people working in a hospital (here, nurses and
physicians in an emergency department) 33
Figure 2.4: A general practitioner contacting a hospital by phone 34
Figure 2.5: The office of a senior physician 39
Figure 2.6: The office of a general practitioner .40
Figure 2.7: An intensive care unit 40
Figure 2.8: A laboratory unit .41
Figure 3.1: A patient being admitted in a patient admission department 46
Figure 3.2: Typical organizational media: a magnetic card and
stickers with patient identification data 47
Figure 3.3: Informing patient s relatives on a ward 48
Figure 3.4: Infrastructure to access medical knowledge in
a clinical library .49
Figure 3.5: Regular meeting of healthcare professionals to discuss
the next diagnostic and therapeutic steps for a patient .49
Figure 3.6: Extracts from paper based order entry forms for
laboratory testing .51
Figure 3.7: Clinical examination conducted by a pediatrician 52
Figure 3.8: Paper based nursing documentation on a ward 53
Figure 3.9: Dictation of findings in a radiological unit 54
Figure 3.10: Preparing for the discharge of a patient from a ward 55
Figure 3.11: Analysis of a paper based patient record 57
Figure 3.12: Documenting the lending of patient records that have
been ordered by clinical departments in a patient
records archive 57
Figure 3.13: The stock of drugs on a hospital ward 59
Figure 3.14: The central pharmacy of a hospital 59
Figure 3.15: A physician communicating with a general practitioner
by phone 60
Figure 3.16: An extract of a technical HIS model with some
physical data processing components and their data transmission
links of the hospital information system of the Plotzberg Medical
Center and Medical School (PMC). The oval in the middle
symbolizes the network 66
Figure 3.17: An extract of a technical HIS model with some
application components and their communication links of the
hospital information system of the Plotzberg Medical Center
and Medical School (PMC) 67
Figure 3.18: An extract from the organizational model of Plotzberg
Medical Center and Medical School (PMC) 68
Figure 3.19: A simplified data model (UML class diagram),
describing the relationships between the entity types patient,
case, and procedure, as extract from the data model of the
HIS of the Plotzberg Medical Center and
Medical School (PMC) 69
Figure 3.20: Example of a business process model, based on a
UML activity diagram, describing a part of the admission
process in the Department of Child and Juvenile Psychiatry
at Plotzberg Medical Center and Medical School (PMC) 71
Figure 3.21: The Heidelberg reference model for hospital functions 75
Figure 3.22: 3LGM domain layer 80
Figure 3.23: Example of a 3LGM domain layer 80
Figure 3.25: Example of a 3LGM logical tool layer 82
Figure 3.26: 3LGM physical tool layer. Dotted lines denote interlayer
relationships between logical tool layer and physical tool layer 83
Figure 3.27: Example of a 3LGM physical tool layer 84
Figure 3.28: Example of two application component configurations of a
hospital function 85
Figure 3.29: Example of two data processing component
configurations of an application component 87
Figure 3.30: Screen shot of an application component for patient
admission. Some basic data such as name and date of birth
have just been entered .90
Figure 3.31: Screen shot of an application component for
documenting the patient s history, supporting structured data
entry with check boxes, as well as offering free text fields .91
Figure 3.32: Screen shot of an application component for writing
endoscopy reports, including both images and fields for free
text data entry 91
Figure 3.33: Screen shot of an application component for coding of
diagnoses using the International Classification of Diseases
(ICD 10) .92
Figure 3.34: Screen shot of an application component for the
presentation of results (here: chemistry) 93
Figure 3.35: Application component, listing new results (top) as
well as unsigned orders (bottom) for a selected patient 93
Figure 3.36: Screen shot from a clinical knowledge server, offering
clinical references 94
Figure 3.37: Screen shot of an application component for scheduling
in an outpatient unit 95
Figure 3.38: Presentation of radiological images at a radiological
unit using a PACS 97
Figure 3.39: Screen shot from a PACS application component,
presenting different archived images of a patient 97
Figure 3.40: Screen shot of an application component for an
intensive care unit, showing, among other parameters, heart
frequency, lab results, and blood pressure 99
Figure 3.41: Typical paper based data processing components 101
Figure 3.42: A server room for the electronic patient record system
and other clinical application components 102
Figure 3.43: Using a mobile terminal during physician s rounds on
award 103
Figure 3.44: A typical HIS infrastructure on a ward, comprising
computer based as well as paper based information
processing tools 103
Figure 3.45: A healthcare professional workstation on a neurological
intensive care ward 104
Figure 3.46: The main screen of a (mobile) healthcare professional
workstation, showing patient lists on the lower and upper right,
and available functionality on the left 105
Figure 3.47: Screen shot from an electronic patient record of a patient,
comprising both documents and images 106
Figure 3.48: Screen shot from the electronic patient record of a
patient, showing open procedures on the right, and executed
procedures on the bottom 107
Figure 3.49: At an ophthalmology unit (1) 108
Figure 3.50: At an ophthalmology unit (2) 109
Figure 3.51: At an ophthalmology unit (3) 109
Figure 3.52: At an ophthalmology unit (4) 110
Figure 3.53: A ward in a paperless hospital 110
Figure 3.54: DB1 architectural style with one computer based
application component, using 3LGM symbols. The gray
rectangle denotes the computer based application component
that contains a database system (denoted by the cylinder) 113
Figure 3.55: DB1 architectural style with multiple computer based
application components, using 3LGM symbols. Only one
computer based application component (in the center)
contains a database system 114
Figure 3.56: DB architectural style with multiple computer based
application components, each with its own database system, using
3LGM symbols. The cloud in the center indicates that some as
yet unknown means is needed to link the components 115
Figure 3.57: DB architectural style with multiple computer based
application components, using 3LGM symbols, with several
bidirectional communication interfaces. This representation is
also called a spaghetti architectural style 116
Figure 3.58: DB architectural style with multiple computer based
application components, using 3LGM symbols, connected by a
specific application component for communication (the
communication server). This representation is also called
the star architectural style 117
Figure 3.59: The communication between different application
components in the context of a radiological examination, using
3LGM symbols 120
Figure 3.60: DB architectural style with multiple computer based
application components, connected by a specific application
component, using 3LGM symbols 122
Figure 3.61: Assignment of results to cases, and of those cases to a
particular patient, in a data model 125
Figure 3.62: Event driven communication with HL7 133
Figure 3.63: In the patient administration department, during
admission of a patient 140
Figure 3.64: Nurses preparing a nursing care plan at the healthcare
professional workstation 142
Figure 3.65: Recording findings from the physician s patient history
in the healthcare professional workstation 143
Figure 3.66: A physician reviewing data and entering orders at
the ward s mobile healthcare professional workstation during
the physician s round 144
Figure 3.67: Machine readable labels on blood samples 145
Figure 3.68: A physician reviewing digital radiological images in an
examination room 146
Figure 4.1: Paper based documentation at the patient s bedside,
using an easy to use, stable, mobile, paper based information
processing tool 155
Figure 4.2: A bed as a flexible tool, also supporting information
processing tasks 156
Figure 4.3: In a senior physician s office, special organization
of work using paper based tools 156
Figure 4.4: Example of a transcription (1) 161
Figure 4.5: Example of a transcription (2) 161
Figure 4.6: Example of a transcription (3) 163
Figure 4.7: Example of a transcription (4) 163
Figure 4.8: Extract from the business process meal ordering. 164
Figure 5.1: Relationship among planning, directing, and monitoring
during strategic, tactical, and operational information
management 179
Figure 5.2: Three dimensional classification of information
management activities 180
Figure 5.3: Strategic, tactical, and operational information
management in hospitals, HIS operation, and their
relationships 181
Figure 5.4: Typical phases of tactical information
management projects 183
Figure 5.5: Monitoring of the server of a hospital
information system 185
Figure 5.6: An information management board meeting. Participants
are (from the left): the vice director of administration, the vice
director of nursing, the director of the medical informatics
department as chairman, the head of the center for information
management, the medical director, and the vice head of the
center for information management 189
Figure 5.7: An immediate support center for third level support of
a vendor 191
Figure 5.8: Organization of information management at the
Plotzberg Medical Center and Medical School (PMC) 192
Figure 5.9: Strategic information management planning of hospitals 198
The authors of this book. From left: Reinhold Haux, Alfred Winter,
Birgit Brigl, and Elske Ammenwerth 261
Annotation to the Figures
All persons shown in the photos have given their permission. With the ex¬
ception of the Heidelberg quintuplets, no real patients are shown. The pa¬
tients in the figures are mostly the authors, their families, or medical infor¬
matics VIPs.
We have partly used screen shots from commercial software products in
this book. This use cannot be regarded as a recommendation for those prod¬
ucts. We only want to illustrate typical functionality and typical user inter
List of Tables and Figures xxiii
faces of software products that support specific hospital functions. Therefore,
we did not mention the product names.
Figure Credits
• Centre Hospitalier Universitaire de Sherbrooke, Quebec, Canada:
3.35, 3.48
• Cerner Immediate Support Services, Kansas City, Missouri: 5.7
• Diakonissehjemmets Sykehus Haraldsplass, Bergen, Norway: 4.5
• German Cancer Research Center, Heidelberg, Germany: 4.4
• LDS Hospital, Salt Lake City, Utah: 1.11, 3.5
• National Library of Medicine, Bethesda, Maryland: 3.4, 3.36
• One of the author s home office, Meckesheim, Germany: 3.41
• Selayang Hospital, Kuala Lumpur, Malaysia: 1.7, 3.10, 3.38, 3.53, 5.5
• Siemens Medical Solutions Health Services, Malvern, Pensylvania:
3.34,3.46
• Specialist Practice Dr. Frohlich, Bammental, Germany: 2.6, 3.7, 3.65
• University Medical Center Erlangen, Germany: 1.4, 2.1, 2.2, 2.3, 3.8,
3.11,3.44
• University Medical Center Heidelberg, Germany: 1.1, 1.2, 1.3, 1.8,
1.10, 1.12, 1.13, 1.14, 1.15, 2.4, 2.5, 2.7, 2.8, 3.1, 3.2, 3.6, 3.12, 3.13,
3.15, 3.30, 3.33, 3.40, 3.45, 3.47, 3.49, 3.50, 3.64, 3.67, 4.1, 4.2, 4.3,
4.7, 5.6
• University Medical Center Innsbruck, Austria: 1.5, 1.9, 3.9. 3.14, 3.37,
3.39, 3.42, 3.43, 3.51, 3.52, 3.63, 3.66, 3.68, 4.6
• University Medical Center Munich Grosshadern, Germany: 1.6
• University Medical Center Munster, Germany: 3.32
• Weinberg Cancer Center Johns Hopkins, Baltimore, Maryland: 3.3
• Ziircher Hohenkliniken Wald Davos, Switzerland: 3.31
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| series2 | Health informatics series |
| spelling | Strategic information management in hospitals an introduction to hospital information systems Reinhold Haux ... New York Springer 2004 XXIII, 272 S. Ill., graph. Darst. txt rdacontent n rdamedia nc rdacarrier Health informatics series Informatiemanagement gtt Informatiesystemen gtt Ziekenhuizen gtt Hospital Information Systems Information Management Information storage and retrieval systems Hospitals Medical informatics Models, Theoretical Krankenhausinformationssystem (DE-588)4135634-2 gnd rswk-swf Krankenhausinformationssystem (DE-588)4135634-2 s DE-604 Haux, Reinhold 1953- Sonstige (DE-588)118011154 oth HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=012774734&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | Strategic information management in hospitals an introduction to hospital information systems Informatiemanagement gtt Informatiesystemen gtt Ziekenhuizen gtt Hospital Information Systems Information Management Information storage and retrieval systems Hospitals Medical informatics Models, Theoretical Krankenhausinformationssystem (DE-588)4135634-2 gnd |
| subject_GND | (DE-588)4135634-2 |
| title | Strategic information management in hospitals an introduction to hospital information systems |
| title_auth | Strategic information management in hospitals an introduction to hospital information systems |
| title_exact_search | Strategic information management in hospitals an introduction to hospital information systems |
| title_full | Strategic information management in hospitals an introduction to hospital information systems Reinhold Haux ... |
| title_fullStr | Strategic information management in hospitals an introduction to hospital information systems Reinhold Haux ... |
| title_full_unstemmed | Strategic information management in hospitals an introduction to hospital information systems Reinhold Haux ... |
| title_short | Strategic information management in hospitals |
| title_sort | strategic information management in hospitals an introduction to hospital information systems |
| title_sub | an introduction to hospital information systems |
| topic | Informatiemanagement gtt Informatiesystemen gtt Ziekenhuizen gtt Hospital Information Systems Information Management Information storage and retrieval systems Hospitals Medical informatics Models, Theoretical Krankenhausinformationssystem (DE-588)4135634-2 gnd |
| topic_facet | Informatiemanagement Informatiesystemen Ziekenhuizen Hospital Information Systems Information Management Information storage and retrieval systems Hospitals Medical informatics Models, Theoretical Krankenhausinformationssystem |
| url | http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=012774734&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA |
| work_keys_str_mv | AT hauxreinhold strategicinformationmanagementinhospitalsanintroductiontohospitalinformationsystems |