Management Decisions and

Related Information Requirement

&
Clinical Information System (CIS)
 Session Objectives

• Discusses about Information System

• Discusses about Operation and Managerial Information System

• To know the use of CIS

• To know the advantage and disadvantage of CIS

 Session Outcomes

At the end of this session, participants will be able to

• Describe the purpose of information system for management decision making.
• Explain the use of CIS.
 Agenda

• Information system
• Operations information systems
• Management Information systems
• CIS
• Vision and Benefits of CIS
• Advantage and Disadvantage of CIS
 Introduction
• For decision makers the type of information required directly related to
1. The level of management decision making
2. The amount of structure in the decision situation mangers face

• The level of management decision making that must be supported by information.

Strategic management:
• As part of strategic planning the top executive will develop overall organisation
goals, strategic, policies, and monitor the strategic performance and its over all
direction in the political, economic, and competitive business environment.

Tactical management:
• Unit manger and business professionals in self directed teams short and medium
range plans, schedules, budgets and specific policy, procedure and analysing it
performance.
.
Operational management:
• Operational manger and members of self directed teams develops short range plans (e.g.
weekly production, use of human resource, and analysis of performance task, within budget
and schedules they establish for the team.
• Decision makers at different levels of the organisation makes more or less structured
decisions. Typically there are three types of decision structure:
1. Unstructured decision – related to long term plan
2. Semi structured decision – some decision procedures can be pre specified but not
enough to lead to a definite recommended decision
3. Structured decision – the procedure to follow when a decision is needed, can be
specified in advance
• business professionals in self directed teams short and medium range plans, schedules,
budgets and specific policy, procedure and analysing it performance.
.
• Three vital roles that information system can perform for a organisation
1. Support of business processes and operations
2. Support of decision making by employee and managers
3. Support of strategies for competitive advantage.

• The applications of information system that are implemented in todays business

world can be classified in to
1. Operations information systems
2. Management Information systems

• Operations Support System (OSS) – produces variety of info. For internal and
external use
1. Processing business transactions
2. Controlling hospital process
3. Supporting hospital communication and collaborations
4. Updating hospital database effectively

•
 Management Information systems (MIS) – provides information to support
decision making based on level and responsibility of managers.

1. Supports day to day decision making needs.

2. Supporting information on operational and tactical level of needs
3. Helps in making decision more structured and better defined

Decision Support System (DSS)

• Computer based info system that provide interactive into support to managers and
professionals during the decision making process.
• DSS using analytical models, specialised databases, judgements and computer
based modelling process to support semi structured business decisions.
Executive Support System (ESS) or Executive Information System (EIS)
• EIS combines many of the futures of MIS and DSS.

• Here the information is presented in tailored forms based on the user needs.
• Graphical user interface
• Exception reporting
• Trend analysis
• Abilities t drill down
• Retrieve information quickly at lower level of details
• Computer based info system that provide interactive into support to managers and
professionals during the decision making process.
Specialised Processing System (SPS)
• Are info characterised as functional business systems, strategic information system,
knowledge management system and expert system
Clinical Information System (CIS)
 Introduction
• CIS is a computerised system that organises, stores and double checks all your
medical info.
• Your health history, prescriptions, doctors notes and dictations and all others info
are kept together, electronically.
• This replaces the paper charts of the past.
How does using COS improves my care?
• The system has many inbuilt features that greatly reduces the chance of errors.
• Caregivers are required to entire accurate info
• The CIS project aims to remediate the existing clinical applications which will
provide:
 A single consolidated, state-wide system
 Enable health to maintain a health record for all patients
 Reduce the need for paper based records
 Improved functionality like
 User ID and password for security
 Ability to view discharge summary, reports, referrals etc
 Computerised provider order entry for pathology and radiology tests.
 Result acknowledge and review
 Vision
The future state of CIS:
• Will have an integrated and complete view of patient health info at the point of care
• Will be able to share info electronically in a timely and secure manner across locations.
• Will have access to data that allow them to more effectively monitor and evaluate service
delivery outcomes.
• Will be able to electronically order tests, prescribe medications and refer individual to other
providers
• Care decisions will be supported by access to appropriate info source and decision support
tool at the point of care
• Will be able to collaborate with other professionals by more easily sharing expertise and
evidence.
• Will have access to clinical knowledge and evidence sources to assist with skill
development.
Are my medical records secure and private?
CIS only allows qualified caregivers to access. The system is more secure than a paper
chart.
How CIS helps us provide you with better care?
• In an emergency, your doctor has immediate access to your complete medical history

• During your visit, doctor can schedule and order the tests you need directly.

• Doctor can access the test results immediately

• Doctors can send your prescriptions directly to the pharmacy, where you can pick
them up as you leave the clinic.
 Benefits

• Automation of repetitive task

• Improved accuracy
• Bedside access to other clinical information: pathology, radiology, etc
• Automated recording of bedside observation
• Electronic record of orders
• Records simultaneously available
• Clinical data for review and research
 System Components

• Clinical workstation
• Bedside device
• LAN
• Server
• Integrating software
• Back up and recovery facilities
• Annual recurrent costs are significant
• Rapid changing technology
• Short shelf life
• Integration with other system (always problematic)
 Implementation Issues

• Implementation Cost
• Lack of computer literacy among users
• High training costs
• Post implementation review is essential
 Evidence

CSI shows no evidence that it affects workloads or outcomes

• It is a technology based system that is applied at the point of care.
• It is the collection of various information that provides centralised repository for
patient care
Who are key players?
1. IT department
2. Project support Staff
 Safety

• Data storage
• Protection of files
• Major software upgrades includes new antivirus protection
Ways to back up data
• DVD
• A zip drive
• Change of pwd often
• Use letters and numbers
• Never give your pwd to anyone
 Electronic Medical Records

• Data that are kept in computer rather than on paper.

• EMR includes patients general health, current and past illnesses and medical
conditions, diagnostic test results and treatments and medication prescribed.
• They are owned by hospital or providers that offers CIS. The information accessing
should be done only after authorization
• EMB guidelines should be updated frequently, as little as 3 months but no longer than
1 year
Advantage of EMR
1. Accuracy of data. Eliminates possibility of mistakes as the result of misreading a
doctors handwriting.
2. Easy accessible to all care providers and to more than one care provider at a time
3. Easy to store and takes less space than paper records
 Electronic Medical Records

Advantage of EMR
4. Their use can lead to cost saving, since keeping EMR is more efficient than retaining
paper records.

Disadvantage of EMR
1. Incompatibility of computer system among various health care provider - difficulty
in sharing the data.
2. Privacy and security can be an issue.
3. Computer crashes can make records inaccessible
4. The cost of implementation as well as maintenance is expensive
 Test your understanding

1. What is the Information System?

2. Role of Information System in management decision making

3. Purpose of CIS

4. List the advantage and disadvantage of CIS.

 References
1. R.C. Goyal, Hospital Administration and Human Resource Management,
PHI, 4th Edition, 2006.