Information Information ManagementManagement In The In The Egyptian HospitalsEgyptian Hospitals

Prof. Nagwa El HosseinyProf. Nagwa El HosseinyQuality Consultant MOHQuality Consultant MOH

April 2009April 2009

Management of Communication Management of Communication and Information and Information

Providing patient care is a complex process that is highly dependent on the communication of information.

Management of Communication Management of Communication and Information and Information

This communication is : To and with the community, To patients and their families, and to other health

professionals.

Failures in communication are one of the most common root causes of patient safety incidents.

Management of Communication Management of Communication and Informationand Information

To provide, coordinate, and integrate services, health care organizations rely on Information about :

the science of care, individual patients, care provided, results of care, and their own performance. as well as individual and overall

organization performance.

Information managementInformation management

The creation, use, sharing, and disposal of data or information across an organization.

This practice is critical to the effective and efficient operation of organization activities.

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Information managementInformation management

Like human, material, and financial resources, information is a resource that must be managed effectively by the organization’s leaders.

Every organization seeks to obtain, manage, and use information to improve patient outcomes

Information Information managementmanagementAlthough computerization and

other technologies improve efficiency , the principles of good information management apply to all methods, whether paper based or electronic.

Types of information Types of information systems in a health care systems in a health care organizationorganization

Clinical information systems

Administrative information systems

Management support systems

Clinical Information Clinical Information SystemsSystems

1. Electronic/paper Medical Records

It’s a useful source of patient information

Important criteria: Storage Data availability Accessibility Security

2. Patient Care and Departmental Clinical Systems:

Laboratory Information Systems: document and/or directly capture

information from Laboratory machines.

Pharmacy Information Systems : a) dispensing of medications, b) control inventory, c)automatically compare drug orders

with dosages d) provide information about

contraindications, e)online order entry and drug

compatibility checks

2. Patient Care and Departmental Clinical Systems:

Radiology Information Systems : generate, analyze, and manage

images (PACSs) - Filmless Department Nursing Information Systems : features include scheduling for

medication distribution and other nursing duties.

3. Clinical Decision Support 3. Clinical Decision Support SystemsSystems This systems analyze data from clinical

information systems, search for unusual patterns or possible adverse effects, recommend alternative actions to remedy the situation, predict and alert for drug—drug interactions.

The system could also provide a complete plan of care based on the patient's health history and clinical assessment.

CDS systems can save lives, reduce healthcare costs, improve communication, increase clinician and patient satisfaction, and enhance the overall process of care

B- Administrative B- Administrative Information systemInformation system

1. Patient Registration Systems cover admission, discharge and transfer systems.

Also includes diagnostic and length of stay (LOS) and demographic and insurance information.

B- Administrative B- Administrative Information systemInformation system

2. Financial Information Systems

First computer systems used by healthcare organizations include payroll preparation and accounting, accounts payable, patient accounting including billing and accounts receivable processing, cost accounting, general ledger accounting, budgeting and financial statement preparation.

B- Administrative B- Administrative Information systemInformation system

3. Human Resource Management Systems

Personnel expenses make up 60 to 70 percent of the operating budgets of health- care institutions.

These systems report staff productivity, labor expense by cost center, monitor turnover and absenteeism, assess training and continuing education needs, forecast staffing needs and review applicants' qualifications

B- Administrative B- Administrative Information systemInformation system

4. Materials Management Systems

The functions cover electronic purchasing and inventory control, bar coding and wireless devices for tracking supplies and materials. Its benefits include savings, reductions in inventory, greater efficiency, fewer lost charges and lower labor costs.

B- Administrative B- Administrative Information systemInformation system 5. Facilities Management

Systems Well-maintained physical facilities

are critical to providing high-quality patient care and a safe comfortable environment for patients and their families. Common functions include preventative maintenance, energy management, and project management and scheduling.

C- Management support C- Management support systems:systems:

1- Management Information Systems These modules cover day-to-day

operations of the organization. Its types include periodic, scheduled

reports of the daily hospital census and financial monthly reports of the organization.

They also cover exception reports when exceptional or out-of-the-ordinary conditions occur. On-demand reports could also be generated.

C- Management support C- Management support systems:systems:

2- Strategic Decision Support System

It allows managers to manipulate data It also monitors and evaluates key

performance indicators and trends, perform simulations of revenue and expense patterns based on various assumptions and estimate potential demand for services within different market areas.

C- Management support C- Management support systems:systems:

3- Executive Information SystemsThese are decision support system used

by high-level managers. It draws data from the organization's other databases.

It reorganizes and distills large quantities of data into a form that meets the executive's information needs.

It presents information on the summary level, but it also allows a user to "drill down", e.g., :EIS typically provides yearly length-of-stay and average daily census statistics in addition to financial data

Current Situation in Current Situation in HospitalsHospitals 1-No unified medical number for every

patient 2-Incomplete paper medical records for

inpatients 3-No medical number and medical file for

outpatients 4-Manual ordering for labs, radiology 5-Manual reports 6-Manual incomplete, inaccurate and

illegible drug ordering and dispencing 7-Multiple langauges in the medical file 8-Incomplete manual HR and inventory files 9-No data collection/analysis

AccordinglyAccordingly

There is high incidence medical and medication errors

Lack of patient safetyLack of performance evaluation

system

Egypt Ministry of Egypt Ministry of HealthHealthNational health information

technology coordinator, recently called for expansion of such interoperability to the flow of clinical and other administrative data, citing its importance for encouraging health care IT investment and facilitating health care reform

Egypt Ministry of Egypt Ministry of HealthHealth Ministry of health in collaboration with

Ministry of Information planned to introduce electronic information system in the governmental hospitals

Centrally at MOH, there is a complete renewal of the information system to ensure direct communication with governorates, collect data and improve accordingly

National Quality results: Results of PHC accredited units , results of

hospital inspection , results of indicators will be available online for patients, in addition to topics for patients awareness and to enhance compitition between health care organizations

New Insurance SystemNew Insurance SystemA complete Information

management system is a cornerstone of the insurance system

Communication of patients data between the primary care ,investigation sites and the hospital wherever the patient goes.

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