Clinical Information Systems - Essay Example

Clinical Information Systems al Affiliation Clinical Information Systems A clinical information system is a computerised system designed mainly with the goal of collecting, storing, processing and manipulation of healthcare information in a medical facility. The information stored in a clinical information system is varied. It includes patient bio data, patient’s clinical history, the drugs the patient is using and the doctors with whom the patient has interacted with in the hospital (Aragon Penoyer et al. 2014). It gives a detailed short chronological history of the patient from the first time he or she sought the hospital services to the prevailing time. It provides a simple way of having all the information at one point in a situation where a decision has to be made spontaneously or at the bedside (Tiwari, Tsapepas, Powell & Martin, 2013). There has been continuous development of clinical information systems since the invention of medicine. Current equipment used includes personal computers, tablets and mobile phones (for mobile computing). Clinical information systems are of different sizes. They might just be for a segment of the hospital. For example, the individual departments (laboratory, paediatric, cardiology, administration, pharmacy and catering department) (Tiwari, Tsapepas, Powell & Martin, 2013). The system can also be made to be one large entity of information subserving all of the units at the same time. Clinical information systems have developed with the growth of technology transitioning from paper charts of the past to complex digital hubs of information. The chief of Information department runs the CIS in my hospital by supervising a group of hardware and software engineers who ensure that the system keeps running. My hospital clinical information system is organised into groups each serving a role beginning at the time the patient visits the medical facility to the time he or she is discharged. Its aim is to store not only information relating to the patients, but also information that can help medical staff in the hospital (Hughes & Hamer, 2012). First there is the ‘Electronic Patient Information (EPI)’ part of the system. The EPI has two subgroups: the inpatient part and the outpatient part. Soon after the patient arrives in the hospital, his or her details are keyed into the computer at the receptionist’s office. Once that is over, they become part of the data in the hospital’s information (EPI) hub (Hughes & Hamer, 2012). These details include the name, age, sex, residence, occupation, marital status, next of kin, date of admission and previous hospital(in case of any referral). One of the hospital staff scans relevant identification documents that prove the validity of the above-listed data. Such include the national identification document or passport, a passport-sized photograph of the patient and the patient’s social security card. The receptionist then asks the patient to provide any radiological data he or she might have on her. These include copies of radiological images. For instance x-rays, CT scans, Magnetic Resonance Imaging pictures, PET scans or any other radiological image the patient might have heard regarding his past medical history (Tomasallo, Hanrahan, Tandias, Chang, Cowan & Guilbert, 2014). It is crucial as patients’ current conditions are almost always related to their previous medical conditions. The radiographic images are then availed into the computer where they can be accessed either as part of the EPI or through the PACS (Picture Archiving Communication System).The PACS also contain images of previous Electrocardiograms (ECG) and electroencephalograms (EEGs) (Tiwari, Tsapepas, Powell & Martin, 2013). Keying in the name of the patient in the PACS system automatically results in the display of all the images related to the patient in question. The collection and storage of images are done with utmost care and precision to prevent any mismatch that may occur. A mismatch is dangerous as this might lead to incorrect diagnosis and consequently wrong treatment that may lead to spiral downfall of the patient’s health. Consequently, it is imperative that the staff be sure of the informations accuracy before it goes into the system. For an outpatient, also known as an ambulatory patient, additional details are also included in the EPI. These include the creation of an online patient portal to which only the patient has the password. The doctor caring for the patient uploads the information pertaining to such a patient into the portal (Hughes & Hamer, 2012). These include the drugs he or she will go home on and the necessary dosage and the next date of treatment (for example insulin injection for a diabetic patient).Pending laboratory results are uploaded into the portal immediately they are out in a case where the patient did not get them while still in the hospital. The portal also provides an online communication means through which the patient can converse with his or her doctor. It may also involve the medical personnel in charge of the case. Such conversations may entail the progress of the patient and any new developments that may arise after the patient left the hospital. In the event of any new situation arising (that is not urgent), the doctor advises the patient on what steps to take while he or she is at home. For instance, in case of an allergy arising from the medication the patient is taking in which case the doctor can advise the patient on what alternative drugs to buy while he is still at home (Mitchell, Revere & Ayadi, 2014). However, the conversations are kept strictly official, and physicians advise against cultivating any personal or intimate relationships with their patients. The outpatient section has all the other components of inpatient details in addition to these that is, Radiology, Laboratory, pathology reports and other dictated hospital reports. Additionally, the Clinical Information System in my hospital provides for storage and access to information relating to available medical resources in the hospital (Hughes & Hamer, 2012). The medical doctor or nurse can check if the hospital contains any equipment needed for a diagnosis or treatment of their patients and if it is available at the time. Such equipment includes MRIs, PET scanners, CT scanners or any other radiology equipment that are in demand. It is because these equipment’s are costly and, for this reason, available in a limited number in the hospital. Since the hospital is large and receives at least a thousand patient visits per day, it is important that there is order in the utilisation of this equipment. Through the CIS, doctors and nurses can know if particular equipment is not being used at that particular time or if a given theatre has not been booked by someone and therefore is free to use (Aragon Penoyer et al. 2014). The CIS also has an inbuilt scheduling catalogue that displays various activities going on in the hospital at any one time. Such activities include meetings that are supposed to take place, their venue and time and those required to attend. The list of doctors and nurses on call during the week is also updated in this category every day. Such a schedule ensures that there is no collision in the hospital’s activities (Or, Dohan & Tan, 2014). Such might happen when a doctor on leave, in retirement or for another reason, is no longer practising is given a case. The same system also allows for the hospital administration to pass across important announcement to the staff. For instance, the promotion of a colleague or if one of its personnel has won a prestigious award for a role in the medical field. Any significant upcoming events are also relayed by the same means, for example, medical conferences and seminars or volunteering program in which the medical staff are urged to participate. The clinicians can access all these information from their computers or mobile phones at any place they are (Mitchell, Revere & Ayadi, 2014). Lastly, the hospital’s clinical information system is crucial to the advancement of research in the hospital. Annual medical reports published all around the world by other doctors are uploaded into the system and made available for the staff to read. Intriguing patient’s cases in the hospital are also available in the CIS (Tomasallo, Hanrahan, Tandias, Chang, Cowan & Guilbert, 2014). Through this system, the members of staff get ideas for various research topics that might be interested in and follow up on the same. CIS contains a lot of information aimed to advance research interests of anyone in the hospital. For instance, there are medical textbooks, updated journals and description of previous clinical trials as well as online medical resources. Essentially, the CIS is an example of a virtual library. New techniques for the treatment of a variety of conditions are available in the CIS from which the doctors can borrow ideas. Such conditions include Heart Failure, Pneumonia, Acute Myocardial Infarction, Asthma, Stroke, AIDS and cancer (Simpao, Ahumada, Gálvez & Rehman, 2014). The CIS provides updates on the above critical clinical conditions in the world today. The medical personnel can also upload some questions in the CIS asking for advice about their research work or update on the progress they are making. The above information is available in the ‘Research’ part of the CIS (Nutley & Reynolds, 2013). There are a variety of private measures aimed to protect the identity of the patients visiting the hospital. The CIS system in the hospital can only be accessed using a password is personal for every medical staff in the hospital. It includes the staff’s employment number and his or her password. There are layers of security put in place by the Information Technology (IT) department staff to protect against hacking. There are also alarm systems that are automatically triggered in case any unauthorised personnel trespass into the Information room in the hospital (Simpao, Ahumada, Gálvez & Rehman, 2014). One can only access the patients portal site via a password that self-generate when the patients get registered into the hospitals Clinical information system. The patients access these passwords through their emails. Logging into the Portal requires the patient to use his or her email and the individual password thus protecting against any external access to his or her information. Finally, all doctors all over the world are sworn to secrecy by the Hippocratic Oath. It requires them to respect their patients and give them priority over everything else (Scherb et al. 2013). For this reason, sharing any information pertaining to the patient to a third party is punishable by law hence ensuring the security of the patient’s details. Technology and Informatics have enabled a great deal of progress and growth in nursing practices (Price & Lau, 2014). Informatics in nursing entails integrating technology in nursing to promote proper management of information and communication in the hospital. Nurses play a significant role in the hospital since they take care of the patients after the doctor has made his or her diagnosis. It is essential, for this reason, that they know all about their patients details to provide them with optimum care. Modern information systems make it possible for all the details of the patient to be in one place, the computer (Tomasallo, Hanrahan, Tandias, Chang, Cowan & Guilbert, 2014). The diagnosis, treatment plan and necessary drugs are all available just on pressing a button. It saves nurses a lot of time that would have been wasted having to peruse through handwritten sheets of paper. It also saves costs that arise when the hospital decides to invest in books or hard paper material for writing down patients’ information. Faster treatment and care means that patients get to be discharged sooner paving way for other sick people. Informatics in Nursing ensures there are fewer chances of patient’s information getting misplaced or lost. Hospitals receive a lot of patients every day as someone falls sick almost every day. Storing information for such patients manually is an enormous risk. Losing a patient’s information means repeating all the tests done initially on the patient (Mitchell, Revere & Ayadi, 2014). Most of the tests are expensive and hence this is costly for both the hospital and patient. It is also tiring for the patient and also may delay the treatment that the patient was to have. However for digital storage of information, there is provision for backing up the information so that in case of any system error, the hospital can recover the information. Informatics in Nursing ensures longer storage of information that may be referred to by future nurses in unique conditions (Aragon Penoyer et al. 2014). The information does not deteriorate like it does when books or papers get torn up or get old. The nurse can easily refer to a similar situation that occurred in the past and what measures were taken at the time that would help the current patient. Monitoring patient’s vitals (temperature, blood pressure, pulse et cetera) is also accessible with modern information technology. The patient’s vitals are keyed into the computer, and it is easy to monitor their trends by any nurse that has access to the hospital’s Clinical Information System (Kierkegaard, Kaushai & Vest, 2014). Programmes exist that make it easy for anyone to follow the progress of the patient. For example, through the use of graphs, one can easily discern the trend at which the temperature of a patient is rising or falling and then make reasonable deductions. It is easy for nurses to make quick decisions regarding rapidly deteriorating patients after ‘at-a-glance’ careful analysis of the data in the computer (Mitchell, Revere & Ayadi, 2014). These decisions are critical in situations in which doctors are not around or are busy with more emergent situations and for this reason it is left with the nurse to make a quick decision. Informatics in Nursing has its disadvantages. Modern technology has room for error and such errors come at a costly price especially when dealing with human lives. Breakdown of the hospitals clinical information system could lead to loss of a massive amount of information about the patient’s data if it were not backed up (Simpao, Ahumada, Gálvez & Rehman, 2014). Collecting another such an amount of data is time-consuming and next to impossible to a large hospital. Consequently, this gives nurses a difficult task in monitoring their patient’s conditions as there is no previous data to refer. Errors also occur in the interpretation of patients’ data. There is, for this reason, need for constant checking and cross-checking of the data fed into the digital devices to avoid errors that might lead to miss handling of patients. Such errors include putting wrong units after vitals such as temperature (degree Celsius or Fahrenheit) or time (minutes or seconds).The result might be an over-estimation or an under-estimation, both of which can lead to wrong management of a patient (Hughes & Hamer, 2012). Nursing informatics also provides for less room for communication and socialization between the patient and the nurse. The nurses may end up relying completely on computers or technology instead of using their abilities (Mitchell, Revere & Ayadi, 2014). Personal and emotional involvement is an integral factor in nursing as a way of showing care to patients, and this disappears with over-dependence on technology. There are hidden costs involved in the utilization of informatics in nursing. Such costs come about in staff training in both money and time, buying additional hardware and constant upgrading of the existent software and hardware. The maintenance costs are additional costs to the medical facility (Kierkegaard, Kaushai & Vest, 2014). These costs may be carried forward to the patients in that the cost of healthcare starts to rise. Such an occurrence discourages patients to seek treatment in hospitals and tend to prefer nursing themselves at home. Also, others might opt to discharge themselves in order to avoid costs that might arise with admission for longer periods. Technology is encroaching on every field in the world including nursing. Informatics is likely to be integrated more into nursing with the advancement in technology (Tiwari, Tsapepas, Powell & Martin, 2013). Colleges and universities are currently offering degrees in nursing informatics that only affirms how informatics has become an integral part of nursing. The field is already flourishing. The Americans Nursing Association has endorsed principles to enable clinical outcomes by incorporating technology. The Technology Informatics Guiding Education Reform Initiative Foundation-TIGER recommends educators to reform the curriculum of nursing by integrating healthcare information technology (Tomasallo, Hanrahan, Tandias, Chang, Cowan & Guilbert, 2014). More collaboration between technological companies and nursing colleges is likely to happen in the future. In healthcare, this is likely to reduce the medical costs both in time and money for patients and to help provide more efficient health services. In order to cope with these possible developments, my hospital must invest additional capital in technology (Kierkegaard, Kaushai & Vest, 2014). Members of the medical staff need to be encouraged to enrol in educational courses that make them more adept at using modern technology in health care provision. Money ought to be put aside to buy more recent technological information facilities and to employ necessary personnel that would maintain the same. A system needs to be available to ensure the equipment is always up to date. There is also need for the hospital to give priority to the recruitment of staff that have a degree in nursing informatics. The rationale is to minimize the costs of training their personnel on integration of technology and nursing (Aragon Penoyer et al. 2014). In order to do this, the hospital can partner with nursing colleges that teach their students in both nursing and informatics. All in all, informatics is integral in health care provision and adopting it will go a long way in improving the efficiency of medical facilities. References Aragon Penoyer, D., Cortelyou-Ward, K. H., Noblin, A. 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