Defining Health Information System (HIS)
A health information system collects data as a part of the patient care process. This data can be used across a number of systems of many different purposes and as with all patient data, it must be subject to confidentiality and security safeguards. Patient data must integrate with data from other facilities and it must meet the needs of various professional groups. Health information systems generally comprise several different applications that support the needs of the organizations. Some of the concepts and terminologies related to HIS are as follows.
- Health/Medical Informatics and Telemetics. Health informatics (Conrick, 2006) is the field that concerns itself with the cognitive, information processing, and communication tasks of medical practice, education, and research including the information science and technology to support those tasks. It deals with the resources, devices, and methods required to optimize acquisition, storage, and retrieval. Health informatics tools include computers as well as clinical guidelines, formal medical terminologies, and information and communication systems. More broadly speaking, its emphasis is on clinical and biomedical applications with the added possibility of the integrating these clinical components either among themselves or to more administrative-type health information system. In this regard, the field of health informatics and telematics has evolved very rapidly over the past several years.
- Health information technology (HIT). Health information technology (HIT) is the application of information processing involving both computer hardware and software that deals with the storage, retrieval, sharing, and use of health care information, data, and knowledge for communication and decision making (Goldschmidt, 2005).
- Electronic medical record (EMR), Electronic health record (EHR), Electronic patient record (EPR). Electronic medical record (EMR) is a medical record in digital format, whereas electronic health record (EHR) refers to an individual patient’s medical record in digital format. EHR systems co-ordinate the storage and retrieval of individual records with the aid of computers, which are usually accessed on a computer, often over a network. One of the important trends is the move towards a universal electronic patient record (EPR). EPR is defined as electronically stored health information about one individual uniquely identified by an identifier. Essentially, EPR technology entails capturing, storing, retrieving, transmitting, and manipulating patient-specific, healthcarerelated data singly and comprehensively, including clinical, administrative, and biographical data (Protti et al., 2009).
Theories Applied to HIS
There are several theories such as general systems theory, chaos theory, and activity system theory that can be applied to healthcare systems. General systems theory (GST) (Bertalanffy, 1968) begins with the observation that what we see, hear, and interact with may be rationalized as a hierarchical network of systems and subsystems. In this regard, systems, which must have a purpose, can be whole and be part of other systems (subsystems) at the same time. Systems can also be characterized as being open or closed.
Open complex systems are characterized by input-process-output triads and feedback loops. GST easily describes the flow of appropriate and relevant information about sick patients (input), who are placed into the different subsystems of the acute health care system to be treated and cared for (process) until they are ready, perhaps, to be transferred to another subsystem such as a group home (intermediate output) before being discharged as healthy individuals who can continue to contribute to their work organizational systems (final output). Continual monitoring of the health status of these patients becomes the feedback loop in the system. These loops ensure the reliability and quality of health services provided, including those before and after the patients are discharged. A common example of an information system that controls this acute patient care process in a hospital setting is the admission-discharge-transfer (ADT) system. In earlier works (Tan, 2001), the principles of GST concerning the behaviors of organizational systems and subsystems were used to think about the design of different classes of clinical and administrative health management information systems required to run hospitals and health provider organizations. Previous work has demonstrated that systems that are interactively complex and coupled are prone to failure. Tan et al. (Tan et al., 2005) have analyzed how the parts of networks connect and interact to produce outcomes, and according to their research factors and challenges have been identified to consider when designing future-oriented healthcare networks. Their work discusses a chaos theory view of healthcare systems, which divides the causes of chaos into internal and external origins. Each origin is further subdivided into a human or individual level, an organizational level and a system level, and stages ranging from static to chaos. When either etiology, internal or external, surpasses the static stage, the potential for error increases. Ideally, a health information framework should support and facilitate interventions to shift and maintain the complexity towards the static stage. In addition, it is very important that healthcare information systems are created with checks and balances to prevent system-induced chaos. Conceptually, a global health information system should provide efficient access to patient information, comprehensive surveillance, expert systems to facilitate decision-making and computational power. Information networks can be used to manage the complexity of ealthcare. The adaptive system theory identifies the following
source
Health Information Systems: Concepts, Methodologies, Tools and Applications
Joel J. P. C. Rodrigues Instituto de Telecomunicações, Portugal & University of Beira Interior,
Covilhã, Portugal
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