Final Term Paper : Clinical Decision Support Systems

In Stage 3, enhancements to the UMUC Family Clinic business process will be proposed by recommending HIT (health information technology) solution, consisting of a certified EHR (electronic health system)/EMR (electronic medical records) system. Once this system is implemented, it will immediately improve the current process. Customer complaints are high, and the focus is on the long wait times and redundant processes when a patient arrives to be checked in. Moreover, some nurses are not readily available, because they are preoccupied with other administrative duties within the practice. Inconsistent record keeping practices lead to additional time searching for patient records. A HIPPA violation may be detected if a patient’s record is misfiled or lost; henceforth, creating a need for supplemental time and possible duplication of another medical record may be required. This process can be greatly improved by the HIT solution using a terminal loaded with the EHR solution. This will allow patients the ability to enter all of their health record information upon their arrival and that information will be instantly available to the nurses and doctors. This process will also give the patient the opportunity to validate the information and make any necessary changes (benefit information, addresses, phone numbers, and medications).

The identified barriers are financial cost, physician and organizational resistance due to low computer literacy skills and disturbance of workflow caused by CPOE systems. The resistance can be overcomed by strategies such as strong leadership, providing trainings, addressing workflow concerns and advocating related policy changes. (Poon, Blumenthal, & Honour et al. 2004). Currently, Canada Health Infoway ( 2016) has promoted CPOE implementation among health care organizations across Canada. For example, North York General Hospital in Toronto has partnered with Canada Health Infoway to develop CPOE systems and share the order sets freely ( Zeidenberg, 2013). With public awareness of the CPOE gradually increasing, now most physicians recognize the positive impact of using CPOE system to improve patient safety , and they are willing to accept the application (Jung, Hoerbst, & Massari, et al. 2013).

Health care providers as well as nurses must keep track of all pertinent patient information and failure to do so leads to detrimental effect on the patient's life. CIS clinical information systems are "large, computerized database management systems that support several types of activities that include physician order entry, result retrieval, documentation and decision support". CIS is intended to replace medical records department of a hospital or any other medical institution. Physicians and clinicians can safely and quickly access information, order medication and treatments and implement appropriate care. CIS will hopefully improve productivity, increase quality care and reduce costs across the organization.

During the 1980’s and 90’s there were many studies done that showed that medical errors were occurring in inpatient and outpatient settings at a very high rate. Computer Provider Order Entry (CPOE) systems were designed to reduce or eliminate mistakes made by using hand written orders. The CPOE system allows users to directly enter their orders into the system on computers which are then sent directly to the healthcare providers that will be implementing the orders. Previously orders were placed by writing on order sheets on patient charts. This was sometimes done by the doctor or by a nurse acting on behalf of the doctor. Order sheets were then signed by the doctor and then the information was input into the patient’s record. This left

Unfortunately providers do not have a choice when it comes to utilizing CPOE since it is a requirement for Stage 1 meaningful use (Step 5, 2015). The benefits of CPOE outweigh providers’ reluctance since CPOE has been shown to be safer than written orders (Step 5, 2015). However, health organizations and IT departments cannot ignore provider reluctance. Training is vital. When I led the implementation of an EMR system at my skilled nursing facility – training superusers was key. We ensured that nurses who were comfortable and knowledgeable with the software worked each shift. The presence of superusers gave the staff an

The current and consistent incompatibility of systems and the ability to share information must be resolved through modifying the system so that it works to share information. The goal of the UMR system was to have shared access while assuring privacy, quality and security to patient. To date that goal has not been achieved. The key to facilitating access is providing effective and efficient treatment to patients and secondary is cos effectiveness. Discontinuing use of the current UMR is no longer an option. Considerations should be given to outsourcing the task to a vendor in which we have outlined our needs. This information will be internet based for more flexibility in which data can be managed and consulted by authorized physicians, specialists, and staff across more than one healthcare organization. This will allow for the information to move with the patient to the physician, specialist, nursing home, laboratory, state and/or across the country. Ultimately resulting in improved quality of care for the

The Computerized Provider Order Entry is effective program to help organization improve quality measures and financial margins. The CPOE is effective program; which monitors a hospitals current performance and calculates methods of improvement. For example, Trinity Hospital a leader in clinical intelligence to track and report across it members hospitals on systems wide quality measures (Balgrosky, 2015). The Clinical Provider Order Entry will help patients compare programs graded by the Center for Medicare & Medicaid and Hospital Quality Assurance. This program will further enhance the patient-centric model because patients will have comprehensive comparison of hospitals to make informed medical decision as to where they would like to receive treatment. The quality measures monitor readmission, complications, patient’s experience surveys and other categories. Patients are interested in receiving health care in top-notched care facilities that address their needs. Consumer needs are very important because translating into referrals by word-of-mouth or rankings. Technology plays a major role in an organization's success with supports Judy Murphy idea of enhancing patient’s health information technology

Hospitals utilize healthcare technology such as electronic health records to enhance patients care and the development of clinical decision and support systems to stretch that goal. There are a selection of tools that are put into place to enhance the decision making in the clinical workforce. Different CDS tools consist of computerized alerts and reminders to care providers and patients, clinical guidelines, condition specific order sets, diagnostic support, among other tools (“Policy Researchers &

There are a lot of problems and challenges involved in implementing a clinical decision support system. It is important for medical staff (doctors, administrators etc.) to be an integral part in the implementation and development of CDSS. Our limited research concluded that acceptance of such technology is not easy amongst physicians. One of the main reasons for non acceptance is that the physicians want to be a standalone entity. We plan to investigate many challenges such as lack of technical expertise, cost, integration, misdiagnosis, speed etc involved in implementation of different types of CDSS in the health care industry today. Our research paper will focus on the different decision problems involved in these challenges.

Furthermore, a health information system that would be viable for Dr. Pittman’s vision is using computerized Physician Order Entry Systems (CPOE) for entering orders for tests, drugs, and other procedures.5 This can help in leading to reductions in transcription errors and have demonstrable improvements in patient safety. One component of a CPOE system is computerized decision support. CPOE systems that include data on patient diagnoses, current medications, and history of drug interactions or allergies can significantly reduce prescribing errors.5 In addition, CPOE systems can also improve the quality of care by increasing clinician compliance with

Health Informatics created two main categories such as clinical and administrative information systems to meet the needs of one or more department within the health care organization. For the clinical information system, it is set to meet the needs in improving patient care. Therefore, the clinical information system (CIS) categories provide nurses information systems (NIS) that support the way nurses documents the care that given to the patients. However, to improve the delivery of nursing care, the healthcare organization must adopt a computer system that can successfully incorporate tools that will benefit nursing. There is two vendors’ software that implies these characteristics for the

The Department of Veterans Affairs (VA) operates one of the largest nationwide healthcare systems. (Tsai, 2012). In 1998 the Computerized Patient Record System (CPRS) was released at a national level. (Lovis, 2011). CPRS has been made possible because of the extensive set of clinical and administrative application within VistA.

The aim of this report is to present information about assessment of the database architecture and design of various clinical information systems like administrative system, clinical decision making system, electronic health record and computer based health record system, nursing system, ancillary service system, patient numbering systems at master and enterprise level.

When it comes to health care, diagnostic errors have been occurring since the beginning of time and most of the time they go unreported. As technology and medical knowledge increases between both the patient and provider diagnostic errors are becoming more frequent. One solution that was presented to help eliminate or decrease the frequency of these errors were the development of health information systems. In my opinion, I believe that information systems are ready to take on the challenge of reducing diagnostic errors, especially cognitive issues by the health professional (Croskerry, 2003). These systems will be able to help providers find the patient’s medical history faster, as well as contributing to the overall care of the patient in any facility across the region increasing efficiency in allocating resources regarding the delivery of care in all departments.

Definitions state that a hospital is a health care facility where patients suffering from all forms of ailments receive treatment. The word treatment is not specific about the kind of treatment one receives whether right or wrong. A landmark survey suggests that millions of injuries occur in the United States’ hospitals. Over 70% of the injuries are as a result of errors in patient management (Glaser & Salzberg, 2011). The information on the survey spread to many hospitals across the US hence prompting some to prepare and implement Physician order entry system (POE). This is one among many aspects of healthcare technology where hospitals seek to improve their technological expertise for better patient management. The POE system will replace the bulky paper-based as well as verbal medication procedures with a digital information system. The doctors will serve the system with patient’s medication. The system will transfer that order to the internal pharmacy. Regardless of the challenges associated with the implementation of the system in hospitals, there are guaranteed benefits as a result of the application. This paper seeks to provide a review of the POE in respect to the healthcare system. Errors that occur in hospitals will be discussed including the positive impacts of the POE system and the limitations about the system.