Discussion: Homegrown HIS
Discussion: Homegrown HIS
A hospital already has a homegrown HIS that includes basic patient registration and billing functions. It also supports nursing personnel in order to facilitate corrununication with the laboratory, pharmacy, and radiology departments so they may receive and process orders. The LIS is interfaced with the HIS so that laboratory results can be viewed from it. A special program was developed recently to supply clinical guidelines for the treatment of diabetes and heart disease that are printed out by nursing personnel for each applicable patient and placed in his or her paper health record. The HIM department is scanning the contents of the medical record for coding and archival purposes. However, the scanned documents cannot be viewed through tbe HIS because the two systems do Dot corrununicate with one another. Access to archived documents is made available through dedicated workstations on the nursing units, selected other areas of the hospital, and to physician offices through a Web portal. The hospital also has several other, smaller and independent systems for its emergency department, nutrition services,
surgery scheduling, and rehab, although these are also all stand-alone systems. Physicians who are members of the hospital’s medical staff have access to the HIS from their offices to review lab results, electronically fed dictation and scanned documents, and to schedule patients for surgery. The physicians have also started using an e-prescribing system supplied to them by the health plan, which is contributing to significant savings through encouraged use of generic
equivalents for brand name drugs, as well as a patient safety improvement with better drug knowledge that helps them avoid contraindications. Clinical components that comprise an EHR have been acquired, starting with the basic CCHIT requirements for foundational systems, CPOE and EMAR. It is important that the hospital plan be interoperable with existing systems and with future acquisition of ERRs by their medical staff members. The hospital also anticipates joining
the newly formed HIE organization to extend its ability to care for patients across the continuum of care, even when that care is provided by a different care delivery organization.
Why is a migration path important to EHR acquisition? If you were the Chief Information Officer (CIO) of this organization, what issues would you need to consider before putting the hospital on a path to interoperability? Which areas might you first focus on, and why?
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