Healthcare Information System

Credits : 03.00

Sem : III

Instructors : Prof. Vithal S Sukhathankar.

Prerequisite : 1. Brief knowledge about the ICT.

2. Hand on experience with Office productivity tools.
3. IT development and History of IT development for last 3 decades.
( NO KNOWLEDGE ABOUT PROGRAMMING IS NEEDED )
Reference : ( as the course is of its type. There are no standard text books available in Indian
market. So, course work will be developed for this course.)

1. M. Abdelhak (Managing Editor), S. Grostick, M.A. Hanken, E. Jacobs

(Eds.), Health Information: Management of a Strategic Resource,
W.B. Saunders Company, 1996.
2. B.I. Blum and K. Duncan (Eds.), A History of Medical Informatics,
ACM Press, Addison-Wesley Publishing Company, 1990.
3. M.K. Bourke, Strategy and Architecture of Health Care Information
Systems, Springer-Verlag New-York, Inc., 1994.
4. R.S. Dick and E.B. Steen (Eds.), The Computer-Based Patient
Record: An Essential Technology for Health Care (Revised Edition),
National Academy Press, Washington, D.C., 1997.
5. M.S. Donaldson and K.N. Lohr (Eds.), Health Data in the Information
Age: Use, Disclosure, and Privacy, National Academy Press,
Washington, D.C., 1994.
6. D.E. Goldstein, Alliances: Strategies for Building Integrated Delivery
Systems (Aspen Executive Reports), Aspen Publishers, Inc., 1995.
7. S. Khoshafian and B. Baker, Multimedia and Imaging Databases,
Morgan Kaufmann Publishers, 1995.
8. M.E.S. Loomis, Object Databases: The Essentials, Addison-Wesley
Publishing Company, 1995.
9. J.A. Osheroff (ed.), Computers in Clinical Practice: Managing
Patients, Information, and Communication, The ACP Information
Technology Series, 1995.
10. E.H. Shortliffe, L.E. Perreault, G. Wiederhold and L.W. Fagan (eds.),
Medical Informatics: Computer Applications in Health Care, Addison-
Wesley Publishing Company, 1990.
11. J.K.H. Tan, Health Management Information Systems: Theories,
Methods, and Applications, Aspen Publishers, Inc., 1995.
12. U.S. Congress, Office of Technology Assessment, Bringing Health
Care Online: The Role of Information Technologies, OTA-ITC-624
(Washington, DC: US Government Printing Office, September 1995).
13. Microsoft Office 97 Integration Step By Step, Catapult, Microsoft
Press, 1997.

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Sample Internet Resources

 sci.med.informatics
 sci.med.telemedicine
 comp.lang.mumps
 comp.protocols.dicom
 MEDINF-L (LISTSERV mailing list)
 Artificial Intelligence in Medicine - FAQ
 Medical Informatics at Stanford
 http://vumclib.mc.vanderbilt.edu/
 Healthcare Information and Management Systems Society
 The "Virtual" - Medical Center
 Medical Matrix
 Electronic Data Interchange Standards
 Advantage Health Plan

An excellent example of a commercial health plan site (an HMO in Luisiana).

 American Medical Association

 American Medical Informatics Association
 Arent Fox Telemedicine
 Artificial Intelligence Systems in Routine Clinical Use
 Behavioral Health Web Sites:

www.samhsa.gov
www.nimh.nih.gov
www.cmhc.com
www.apa.org
www.mentalhealth.com
www.psych.org

 Biomedical and Health Care Ethics Resources on WWW

A good starting point for biomedical ethics research on the Internet.

 Case Management: Decision-Making Simulations for Rehabilitation Counselors

 Clinical Cue Cards
 Collaboration Technology for Real-Time Treatment of Patients
 Community Health Information Resources
 Computer-based Patient Record Institute
 Cyberspace Telemedical Office (sm)

A full-fledged office offering a range of services to both providers and patients.

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 Decision Systems Group
 Diabetes Guidelines
 Dicom 3.0: The ACR/NEMA Standard Home Page
 Doctors Guide to the Internet
 DoD Telemedicine Home Page

Department of Defence Telemedicine Testbed; a gateway to some of the most

innovative telemedicine work being done on the Internet.

 Duke HL7 Home Page

 Health on the Net Foundation

Includes a complete list of Hospitals on the Web, Internet medical support

communities, free MEDLINE access, and extensive telemedicine resources.

 IBM Healthcare

A very good example of a marketing site.

 Interactive Patient

One of the most robust sites on the Internet, healthcare or otherwise.

 Internet Greatful Med

 Healtheon
 Managed Health Care Overview

An excellent, consumer oriented overview of managed care fron New York's PBS
station program, "Your Money & Your Life."

 MedicineNet (TM) Home Page

 Medsearch
 MedSmart
 National Library of Medicine HyperDOC
 New England Journal of Medicine On-line
 North Carolina Healthcare Information and Communications Alliance
 Organizations Supporting Information Technology
 Patient Care Technologies - The Home Care Page
 Patient Drug Education Leaflets
 Telemedicine Bibliography
 The CHMIS Resource Center
 U.S. Healthcare (Aetna)
 Unified Medical Language System (UMLS) Project

National Library of Medicine effort to standardize medical vocabulary for health

information systems and networks.

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  Virtual Medical Center - Martindale's Health Science Guide
 Virtual Nursing Center - Martindale's Health Science Guide
 Virtual Pharmacy Center - Martindale's Health Science Guide
 Visible Human Project
 World-Wide Web Electronic Medical Record System

Sample Journals/Proceedings/Trade Magazines

1. Journal of the Americal Medical Informatics Association (JAMIA)

2. Proceedings of the 1996, 1997, 1998 AMIA Annual Fall Symposium
3. Symposium on Computer Applications in Medical Care (SCAMC) Annual Proceedings,
1990-1995
4. Proceedings of the AMIA Spring Congress, 1990-1998
5. MD Computing
6. Methods of Information in Medicine
7. Computers and Biomedical Research
8. Yearbook of Medical Informatics
9. MEDINFO Proceedings
10. Health Data Management
11. Healthcare Informatics

Course Objectives
In this new era of managed care, with its emphasis on improving cost efficiency without risking
quality of care, information technology has emerged as a powerful force in helping to achieve
multiple goals within health care organizations. The explosive advances in information
technology in recent years combined with the current climate for health care reform has created
the need for skilled individuals who can develop, understand, manage, and integrate medical and
administrative information systems in organizations. This course will provide a broad overview
of the application of major information systems methodologies and approaches in the delivery
and administration of modern health care systems. The development and use of imaging
applications, electronic data interchange, integrated delivery systems, artificial intelligence and
expert medical systems, decision support systems, and internet based applications in the context
of the computerized patient record will be the major focus of the course. Immerging new
technology and its application in the industry will be felicitated ( ex RFID technology in e-
patient). Strategic use IT and development of new business models will be encouraged.

The specific goals of the course are

1. To understand the historical context for today's health care information systems.
2. To get a broad overview of the major enabling information technologies that can
significantly impact the delivery and administration of health care.

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 3. To understand the major players, problems, issues and challenges facing the healthcare
industry and the role of information technology in enhancing quality of care while
controlling the costs of providing it.
4. To develop a perspective on appropriate strategies and architectures for health care
information systems.
5. Easy Access to Patient Data to generate varied records, including classification based on
demographic, gender, age, and so on. It is especially beneficial at ambulatory (out-
patient) point, hence enhancing continuity of care. As well as, Internet-based access
improves the ability to remotely access such data.
6. It helps as a decision support system for the hospital authorities for developing
comprehensive health care policies.
7. Efficient and accurate administration of finance, diet of patient, engineering, and
distribution of medical aid. It helps to view a broad picture of hospital growth
8. Improved monitoring of drug usage, and study of effectiveness. This leads to the
reduction of adverse drug interactions while promoting more appropriate pharmaceutical
utilization.
9. Enhances information integrity, reduces transcription errors, and reduces duplication of
information entries.

Components of the Course

Component 1 : IT as a strategy tool. Advancement in ICT. ICT Structure.

Component 2 : Use of ICT in Healthcare system development, e-Healthcare,

Some HIS systems cases.

( There are various titles and acronyms which all declare

similar approaches to managing the information flow and storage in
hospital routine services, as

 Hospital Information System (HIS), or

 Healthcare Information System, or
 Clinical Information System (CIS), or
 Patient Data Management System (PDMS)

are comprehensive, integrated information systems designed to

manage the medical, administrative, financial and legal aspects of a
hospital and its service processing. Traditional approaches
encompass paper-based information processing as well as resident
work position and mobile data acquisition and presentation.)

Class Format

Class time will be primarily devoted to lecture, demonstration of software, presentations and
case discussions. You are strongly encouraged to ask questions and/or initiate discussions on
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topics of interest. The value of the lecture and presentations and the ability to ask meaningful
questions depends upon thorough class preparation. It is assumed that you will have read the
assigned class material before coming to class.

Assignments
Both cases and journal articles will be assigned. They will be discussed a week from the day they
are assigned. All assignments have to be completed individually. Please put down your student
id(s) on all pages and staple them together. The reports should be clear, legible and precise. If
there are questions on grading, you can send me e-mail or set up an appointment.

Projects
Projects are the integral part of the course. There will be full term A project. It will be a group activity
with minimum 3 submission and class presentation. Sample topics (i) The Role of Information
Technology for a Private Medical Practice, (ii) Surgical Information Systems: A Clinical Perspective, (iii)
Information Technology in the Long Term Care Industry.

1. The first project involves the investigation of the issues associated with a specific
healthcare industry problem from the perspective of either providers, insurers, state and
central Governments, or the consumer. The report should address who are the players,
what is the problem, why is this a problem, what proposals have been made for
resolution, what is the status of the proposal, and what is the role of IT. Examples include
“abcd?”. Discussion of the role of IT requires identification of a major vendor of
software products for the problem, and identification of the gaps in existing solutions to
the problem.

This report should include

(1) Description of the problem and the context (30%)

(2) Analysis of the requirements of the problem (30%),
(3) Identification of a major software vendor and product which is a potential solution to
the problem (10%),
(4) Discussion of the gaps in existing information systems approaches and solutions to
the problem (10%)

The report, composed as a Word document in Times roman 12” and 1½ spaced, should
not exceed 15 pages. It should be justified on both sides and include page numbering,
appropriate section titles, and references. (Ref to this report)

Submissions should include a hard copy of the Word document, presentation slides, and a
copy on disk (to include on the course web pages), due on the day of your presentations.

Grading points: 30% overall.

Content: 80% (as indicated above); Style (syntax, organization, references, etc. and
presentation): 20%

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2. The second project should explore the role of information technology (IT) in providing an
effective decision support solution strategy for a significant health care industry problem. A
decision support system (DSS) can be defined as any computer system, composed of data
management and analysis tools, designed to support decision-making. In health care, one can
broadly think of two main types of decision support systems: clinical and administrative. Clinical
decision support systems help to improve delivery of healthcare by supporting health
professionals make more informed clinical decisions. Administrative decision support systems
help administrative professionals, such as finance and human resource management, make
decisions to improve management and organization of healthcare resources.
The underlying conceptual architecture of a generic decision support system is depicted in the
diagram below.

The presentation and language systems comprise the user interface component of a DSS. They
help the user access the system (for instance, a mini electronic medical record) and interact with
it. The knowledge system is a systematically organized collection of knowledge that is accessible
electronically and interpretable by the computer. A database, data warehouse, or a medical
knowledge base consisting of a vocabulary with relationships that capture the medical literature
and expert domain knowledge, are examples of knowledge system. The problem processing
system provides a reasoning strategy or analytical approach to harness the knowledge system.
For example, drug-drug interaction rules can be applied to a database of drugs before a
transaction takes place. Patient data in the form of an electronic patient medical record makes
up the final database component.
You will use the Microsoft Office suite (Word, Excel, Access, and PowerPoint) to implement a
healthcare-related decision support system. The project will include a written report (using
Word), an in class presentation (using PowerPoint), and a prototype application (using Access
and/or Excel). In order to share your work with current and future classmates, you must also
prepare a simple Web page that provides access to each of these project components. Note:
additional information and instruction for web enabling your project will be provided later in the
semester.
In the past, successful prototypes have taken advantage of Microsoft Access/Microsoft Excel
integration. For example, Microsoft Access can serve as the database, with embedded links to
Microsoft Excel to provide the analytical decision support capabilities. An in-class tutorial on
Microsoft Office Suite integration is scheduled for March 1 st. It is also possible to develop the
entire prototype DSS in Microsoft Access, but this may require some Visual Basic for Applications
coding. In this latter case, the architectural distinctions between patient database, knowledge
base, and analysis engine are blurred, as Access integrates these services.
The written report should be composed in Word using 12 point, double-spaced text and should
not exceed 15 pages. It should be justified on both sides and include page numbering,
appropriate section titles, and references.

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Paper Due: -------
Presentation Due: when group scheduled on -------
Grading points:
Content: 80%:
(1) Describe the big picture and the context (20%),
(2) Describe your specific problem (10%),
(3) Analyze the decision support requirements of the problem (20%),
(4) Identify the major components of the IT solution (10%),
(5) Examine the solution for sample "what-if" scenarios (15%),
(6) Conclusions and recommendations (5%)
Style (executive summary, syntax, organization, references, etc., and presentation): 20%

Some topics for Project 1

 Selecting a Behavioral Health Information System

 Medical Records Systems
 Community Hospital Laboratory Information System
 HEDIS System
 Home Health Care System
 Imaging Systems
 Healthcare Scheduling Information System
 Surgical Information System

Some topics for Project 2

 Home Health Care

 Computerized Decision Support in a Perioperative
Environment
 Choice Health Plan (Information Technology Solutions)
 Implementation of Computer-based Patient Records
 Keep it Confidential: An Overview of Healthcare Information Security from a Systems
Approach

Course Schedule
Session
Date Topic
no
1 Introduction and Overview

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2 Introduction to digital economy
3 Electronic Medical Records
4 Healthcare Data and Standards
5 Healthcare Technologies: Databases;
6 Healthcare Technologies: Databases;
7 Client-Server Computing
8 Healthcare Technologies: Data Mining and Decision Support
9 Healthcare Technologies: Data Mining and Decision Support
Healthcare Technologies: Artificial Intelligence and Expert
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Systems;
11 Internet Technology and HealthCare ( stress on social media)
12 Electronic Commerce and HealthCare
13 First Project Presentation
14 IT for strategic advantage in Healthcare
15 IT for strategic advantage in Healthcare
16 Confidentiality, Privacy and Security Issues In e_Healthcare
17 BioInformatics – Visiting leacture
18 Telemedicine and Telehealth – Visiting leacture
19 Second Project Presentation
20 Second Project Presentation