scholarly journals Clinical Information Systems Integration in New York City's First Mobile Stroke Unit

2018 ◽  
Vol 09 (01) ◽  
pp. 089-098 ◽  
Author(s):  
Benjamin Kummer ◽  
Michael Lerario ◽  
Babak Navi ◽  
Adam Ganzman ◽  
Daniel Ribaudo ◽  
...  
Keyword(s):  
New York ◽  
Information Systems ◽  
Patient Care ◽  
Clinical Information ◽  
The United States ◽  
Clinical Information Systems ◽  
Order Entry ◽  
Technical Problems ◽  
Mobile Stroke Unit ◽  
Network Failures

Background Mobile stroke units (MSUs) reduce time to thrombolytic therapy in acute ischemic stroke. These units are widely used, but the clinical information systems underlying MSU operations are understudied. Objective The first MSU on the East Coast of the United States was established at New York Presbyterian Hospital (NYP) in October 2016. We describe our program's 7-month pilot, focusing on the integration of our hospital's clinical information systems into our MSU to support patient care and research efforts. Methods NYP's MSU was staffed by two paramedics, one radiology technologist, and a vascular neurologist. The unit was equipped with four laptop computers and networking infrastructure enabling all staff to access the hospital intranet and clinical applications during operating hours. A telephone-based registration procedure registered patients from the field into our admit/discharge/transfer system, which interfaced with the institutional electronic health record (EHR). We developed and implemented a computerized physician order entry set in our EHR with prefilled values to permit quick ordering of medications, imaging, and laboratory testing. We also developed and implemented a structured clinician note to facilitate care documentation and clinical data extraction. Results Our MSU began operating on October 3, 2016. As of April 27, 2017, the MSU transported 49 patients, of whom 16 received tissue plasminogen activator (t-PA). Zero technical problems impacting patient care were reported around registration, order entry, or intranet access. Two onboard network failures occurred, resulting in computed tomography scanner malfunctions, although no patients became ineligible for time-sensitive treatment as a result. Thirteen (26.5%) clinical notes contained at least one incomplete time field. Conclusion The main technical challenges encountered during the integration of our hospital's clinical information systems into our MSU were onboard network failures and incomplete clinical documentation. Future studies are necessary to determine whether such integrative efforts improve MSU care quality, and which enhancements to information systems will optimize clinical care and research efforts.

scholarly journals Clinical Information Systems – From Yesterday to Tomorrow

2016 ◽  
Vol 25 (S 01) ◽  
pp. S62-S75 ◽  
Author(s):  
R. M. Gardner
Keyword(s):  
Patient Safety ◽  
Information Systems ◽  
Patient Care ◽  
Clinical Information ◽  
Clinical Decision ◽  
The United States ◽  
Clinical Information Systems ◽  
The Past ◽  
Clinical Computing

Summary Objectives: To review the history of clinical information systems over the past twenty-five years and project anticipated changes to those systems over the next twenty-five years. Methods: Over 250 Medline references about clinical information systems, quality of patient care, and patient safety were reviewed. Books, Web resources, and the author’s personal experience with developing the HELP system were also used. Results: There have been dramatic improvements in the use and acceptance of clinical computing systems and Electronic Health Records (EHRs), especially in the United States. Although there are still challenges with the implementation of such systems, the rate of progress has been remarkable. Over the next twenty-five years, there will remain many important opportunities and challenges. These opportunities include understanding complex clinical computing issues that must be studied, understood and optimized. Dramatic improvements in quality of care and patient safety must be anticipated as a result of the use of clinical information systems. These improvements will result from a closer involvement of clinical informaticians in the optimization of patient care processes. Conclusions: Clinical information systems and computerized clinical decision support have made contributions to medicine in the past. Therefore, by using better medical knowledge, optimized clinical information systems, and computerized clinical decision, we will enable dramatic improvements in both the quality and safety of patient care in the next twenty-five years.

History and Trends in Clinical Information Systems in the United States

2001 ◽  
Vol 33 (1) ◽  
pp. 75-81 ◽  
Author(s):  
Nancy Staggers ◽  
Cheryl Bagley Thompson ◽  
Rita Snyder-Halpern
Keyword(s):  
United States ◽  
Information Systems ◽  
Clinical Information ◽  
The United States ◽  
Clinical Information Systems

scholarly journals Rapid Assessment of Clinical Information Systems in the Healthcare Setting

2011 ◽  
Vol 50 (04) ◽  
pp. 299-307 ◽  
Author(s):  
J. S. Ash ◽  
D. F. Sittig ◽  
A. Bunce ◽  
K. Guappone ◽  
R. Dykstra ◽  
...  
Keyword(s):  
Health Care ◽  
Information Systems ◽  
Multidisciplinary Team ◽  
Rapid Assessment ◽  
Clinical Information ◽  
The United States ◽  
Small Towns ◽  
Clinical Informatics ◽  
Assessment Process ◽  
Clinical Information Systems

SummaryObjective: Recent legislation in the United States provides strong incentives for implementation of electronic health records (EHRs). The ensuing transformation in U. S. health care will increase demand for new methods to evaluate clinical informatics interventions. Timeline constraints and a rapidly changing environment will make traditional evaluation techniques burdensome. This paper describes an anthropological approach that provides a fast and flexible way to evaluate clinical information systems.Methods: Adapting mixed-method evaluation approaches from anthropology, we describe a rapid assessment process (RAP) for assessing clinical informatics interventions in health care that we developed and used during seven site visits to diverse community hospitals and primary care settings in the U. S.Setting: Our multidisciplinary team used RAP to evaluate factors that either encouraged people to use clinical decision support (CDS) systems or interfered with use of these systems in settings ranging from large urban hospitals to single-practitioner, private family practices in small towns.Results: Critical elements of the method include: 1) developing a fieldwork guide; 2) carefully selecting observation sites and participants; 3) thoroughly preparing for site visits; 4) partnering with local collaborators; 5) collecting robust data by using multiple researchers and methods; and 6) analyzing and reporting data in a structured manner helpful to the oraganizations being evaluated.Conclusions: RAP, iteratively developed over the course of visits to seven clinical sites across the U.S., has succeeded in allowing a multidisciplinary team of informatics researchers to plan, gather and analyze data, and report results in a maximally efficient manner.

From Nursing Information Systems to Patient Information Systems

1994 ◽  
Vol 33 (03) ◽  
pp. 302-303 ◽  
Author(s):  
P. M. Coward
Keyword(s):  
Health Care ◽  
Information Systems ◽  
Patient Care ◽  
Health Care System ◽  
Patient Information ◽  
Clinical Information ◽  
Systems Development ◽  
Clinical Information Systems ◽  
Patient Centered ◽  
The Future

Abstract:Clinical information systems, developed for specific disciplines, reinforce the fragmentation of patient care and fail to support integrated, patient centered approaches. Fundamental restructuring of systems development is required to prepare the health care system and the practice of nursing for the future.

Effectivness of Health Information System Applications: Clinical Information and Diagnosis-Treatment Systems in Turkey

2017 ◽  
Vol 5 (1) ◽  
pp. 122
Author(s):  
Assist. Prof. Dr. Demokaan DEMİREL
Keyword(s):  
Decision Making ◽  
Information System ◽  
Information Systems ◽  
Management Information System ◽  
Health Sector ◽  
Health Information System ◽  
Clinical Information ◽  
Clinical Decision ◽  
Clinical Information Systems ◽  
Management Information

The distinctive quality of the new social structure is that information becomes the only factor of production. In today's organizations, public administrators are directly responsible for applying information to administrative processes. In addition to his managerial responsibilities, a knowledge based organization requires every employee to take responsibility for achieving efficiency. This has increased the importance of information systems in the decision-making process. Information systems consist of computer and communication technology, data base management and model management and include activity processing system, management information system, decision support systems, senior management information system, expert systems and office automation systems. Information systems in the health sector aim at the management and provision of preventive and curative health services. The use of information systems in healthcare has the benefits of increasing service quality, shortening treatment processes, maximizing efficiency of the time, labour and medical devices. The use of information systems for clinical decision making and reducing medical errors in the healthcare industry dates back to the 1960s. Clinical information systems involve processing, storing and re-accessing information that supports patient care in a hospital. Clinical information systems are systems that are directly or indirectly related to patient care. These systems include electronic health/patient records, clinical decision support systems, nurse information systems, patient tracking systems, tele-medicine, case mix and smart card applications. Diagnosis-treatment systems are information-based systems used in the diagnosis and treatment of diseases. It consists of laboratory information systems, picture archiving and communication system, pharmacy information system, radiology information system, nuclear medicine information system. This study aims to evaluate the effectiveness of health information system applications in Turkey. The first part of the study focuses on the concept of information systems and the types of information systems in organization structures. In the second part, clinical information systems and applications for diagnosis-treatment systems in Turkey are examined. Finally, the study evaluates applications in the health sector qualitatively from the new organizational structure, which is formed by information systems.

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