2.Health Information Systems Flashcards
goal of an HIS
to collect, store, process, retrieve, and communicate
patient care and administrative information for all hospital-affiliated activities and to satisfy the functional requirements of all authorized user
Information system elements
1.Human
2.Machine
a. application
-data
-function
-interconnections
b. hardware
Electronic Health Record (EHR) defn
longitudinal electronic record of patient health information
EHR contents
patient demographics, progress notes, problems, medications,
vital signs, past medical history, immunizations,
laboratory data and radiology reports
EHR purpose
to generate a complete record of a clinical patient including evidence-based decision support, quality management, and outcomes reporting
Computerized vs. Paper-based Record EHR
comp:
Better availability and access time
Improvement of completeness
Chance for better organization and presentation of data
Source of feedback
paper based:
Highly adapted medium
IT tends to be over-systematized
In certain cases, readability and availability may be better on paper
Documentation: Free Text vs. Structured Data Entry
Free text:
+ flexible
+ fast to dictate/enter
- often: not complete
- ambiguous
- extraction of semantics?
e.g. “allergy” hidden in a word document
» nlp, text mining
Structured data entry:
+ less/not ambiguous, depending on vocabulary and options offered
+ inherent reminder effect in structured forms
+ potentially more complete
- potentially time consuming – choice of granularity is difficult
- bias towards pre-formulated (or even default) options
types of Distribution, Heterogeneity, Autonomy
Distribution:
physical, logical
Autonomy:
Design autonomy
Execution autonomy
Interface autonomy
Access autonomy, …
Heterogeneity:
Technical
Syntactic
Semantic
type and instance
data model, structure (schema)
autonomy types explanation
Design autonomy
Independent definition and modification of local schemas
Independent specification of local integrity constraints
Independent selection of local data model
Independent selection of data structures, synchronization algorithms and access structures
Association autonomy
Free to join or leave a distributed system
Interface autonomy
Free to decide about how the data technically can be accessed
Access autonomy
Free to define external access functionality (authentication, authorization)
Communication autonomy
Free to choose communication partners
Execution autonomy
Local operations are independent of remote operations
Free to choose order of execution
Autonomy and Heterogeneity relation
Design autonomy leads to heterogeneity, standards restrict autonomy
Runtime Environment
-Hardware
-Operating system
-Communication protocol
Data management
-DBMS (producer, version)
-Data model (relational, object-relational, other)
-Query language
-Transaction management (synchronization, logging, recovery)
Schema and data ( -> semantic heterogeneity)
-„Overlapping“ schemas
-Inconsistent schemas
-Inconsistent data
HIS architecture domains
- Business Architecture
- Application Architecture
- Data Architecture
- Technical Architecture
HIS Layers
Processes and procedures (medical, organizational)
* Presentation layer
* Application logic layer (programs offering services)
* Resource management layer (data sources, databases, other
information systems)
Infrastructure
Conceptual decision: holistic vs best of breed
Holistic/modular: different modules connected to one database
+ consistency, no or less problems with heterogeneity
+ no redundancy
+ may be easier to extend
+ clear responsibility
- lack of flexibility
- potential lack of functionality
- vendor dependance
BoB: the best software for each purpose will result in the best system
+ flexibility
+ easier adaptation to users and their domain knowledge
- risk of inconsistency, cost of interfaces
- administration may be difficult, error search?
+ new standards may make the decision much easier
What does SOAP stand for in medical documentation?
Subjective, Objective, Assessment, and Plan.
What does the architecture of HIS involve
message-based standards like HL7, central hub systems, and clinical data repositories
