Evolution of Health Care Information Systems

Running head: EVOLUTION OF HEALTH CARE INFORMATION SYSTEMS 1

Evolution of Health Care Information Systems

Debbie Fernando

HCS/533

April 29, 2013

Jacqueline Sommerville

EVOLUTION OF HEALTH CARE INFORMATION SYSTEMS 2

Evolution of Health Care Information SystemsThis paper will discuss the evolution of health care information systems and how they

affect the day to day operations in hospitals today compared to years ago. It will discuss the

effect it has on patient care and reimbursement. It will compare the collection of data today,

using technology, and how data was collected years ago.

Past Health Care Information Systems

Health Care Information Systems have been a part of health care since patient care

became a business. Twenty years ago, the majority of charting and documentation was all hand

written. From the physician writing the admitting orders to the nurse charting the care given and

the patient’s condition, ink was the method of choice. At one time, the ink used was a different

color depending on the time of day. The 7-3 shift used black ink. The 3-11 shifts used green ink,

and the 11-7 shifts used red ink. At the time, this seemed to be a fast way to determine an

approximate time as to what was happening with the patient. A care giver could just look at the

color and know if an event occurred during the day, evening, or night. Eventually, the only color

ink allowed was black or maybe blue. It turned out that green and red ink did not show up well

when a document was copied on a copy machine. In a way, the copy machine was the beginning

of a whole new era in health care information systems.

Past Health Care Information Systems

In the past, when a patient came into the hospital, the physician would locate in a filing

cabinet the document labeled “physician orders”. He would then take this sheet, which was in

usually in triplicate, and handwrite orders for the patient. The very first order was usually the

diagnosis. He might write something like “Admit pt (patient) to 5413 – Dx (diagnosis) of CHF

(congestive heart failure). The importance of the diagnosis was apparent. This is the main way

the person doing the coding could find the diagnosis. The rest of the physician orders would


follow which he would hand write. Included would be the type of diet the patient could have, any

medications, IV (intravenous) fluids, activity, lab work, etc… He would then “flag” the chart so

the nurse would know there were new orders. The nurse would then read the orders, sign them

off, (to let others know she had read and implemented them) and tear off the remaining 2 parts of

the triplicate and send them to their destination, whether it is pharmacy, lab, or wherever it

should be sent. The physician did this for every patient that was admitted. Today, the physician

sits at the computer and prints out a copy of his orders for a particular disease. These are orders

that he and his partners had previously agreed upon for this particular diagnosis. Barring any

would be complications, all patients with the same diagnosis would receive the same orders.

There are usually only slight variations. This saves time for all heath care providers. The

physician doesn’t have to hand write everything; and the nurse already knows (with minimal

possibility of change) whether to get her supplies to start and IV, or what diet to order for the

patient. When the pharmacy receives its copy of the orders, the staff doesn’t have to decipher any

illegible handwriting or check drug dosages. They will, however, still have to check for patient

allergies.

Data Use

According to “American Hospital Association” (2013), “Adding new technology can reduce

health care costs by minimizing complications, reducing duplicative tests and improving

outcomes” (Adopting technological innovation in hospitals). The community as a whole benefits

by disease surveillance and health care information exchange. If there is a communicable disease

outbreak, it can be monitoring and contained much faster with the proper technology. The data

collected today is gathered and shared so quickly, it is an asset to health care. A patient can be

seen by his physician, get lab work completed, x-rays completed, and the results can be sent to a


specialist, if needed. His information can already be in the hands of the specialist before his

appointment. The data gathered in regards to the population can watch patterns emerge whether

good or bad, and the people can be better informed. In the past, the patient would not have his

results ready before his appointment with the specialist. Also, in the past, the gathering of

population data would probably take too long to be of any help to the majority of people.

Two major technological advantages that influenced HCIS

One major technological advantage that influenced HCIS is Health Information

Exchanges (HIEs). HIEs are entities that bring together health care stakeholders within a defined

geographic area and govern the electronic sharing of health information among them for the

purpose of improving health care in that community. The main reason for creating HIEs is that

the ability to exchange health care information electronically plays a large part in the efforts to

improve health care delivery in the nation (“American Medical Association”, 2013). The speed

and accuracy in which HIEs allow the necessary information to be gathered and exchanged make

a considerable difference in the health of the communities. In the past, there could be an outbreak

of a disease in several neighboring counties. With the patients going to different hospitals, it

could take days for someone to realize that many counties were involved in having patients

present with the same symptoms. For example, a new famous restaurant opens and people from

miles away come for dinner. One employee fails to wash his hands properly and all the salads

become contaminated with e-coli. After the patrons go home, they become ill, and go in various

hospital ER’s in their own counties. Today, that information would be gathered and shared in a

matter of hours. In the past, it could take days for the same information to be gathered. The speed

of which this information is gathered can allow the proper authorities to investigate the restaurant

thus causing any further contaminated salads being served.


Health Information Technology is a second technological advance that has influenced HCIS

practices. With the introduction of health information technology, patients can go from the

physician’s office to the hospital and their orders can be there waiting. Any tests or procedures

ordered can be scheduled sooner, results obtained sooner, the patient treated, health improved,

discharged, third party billed, and reimbursement collected sooner.

Conclusion

EHRs focus on the total patient. They go beyond clinical data and include a broader view

of the patient’s care. They are designed to reach beyond the original collectors of the information

and to share the information with other providers. The biggest benefit is that all this sharing

results in more open communication and patient involvement ("Health Care IT News", 2013) .

The evolution of health care information systems has made a huge difference in the way patients

receive care and the hospitals reimbursed. The new technology makes the gathering of health

care information fast and simple thus possibly preventing epidemics or pandemics across our

states. The information gathered can also predict health problems that can be prevented if the

patients listen and heed the warnings of the ill effects certain habits can have on the health of a

person. Health care information systems will continue to evolve as technology advances as we,

as health care providers and patients, attempt to keep up with the amount of information

provided.

References:


American medical association. (2013). Retrieved from

http://www.ama-assn.org/ama/pub/physician-resources/practice-management-center/

practice-operations/health-information-technology/hie.page

American hospital association. (2013). Retrieved from http://www.aha.org/search?

q=evolution+of+health+information+systems&site=redesign_aha_org

Health care IT news. (2013). Retrieved from

http://www.healthcareitnews.com/directory/electronic-health-record-ehr

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Evolution of Health Care Information Systems