Health 305 Health Information Management

Bakheet Aldosari, Ph.D.Bakheet Aldosari, Ph.D.

Health 305Health 305Health Information ManagementHealth Information Management


E-mail: E-mail: [email protected]@gmail.com


Introduction to Introduction to

Health Informatics &Health Informatics &

Information Management Information Management


Healthcare Informatics Defined

• Informatics: the science of information management

• Variety of automation techniques that use computers to manage data and information in support of decision making

• Healthcare informatics: information science concerned with all aspects of health-related data and information


What is Health Informatics• Health Informatics is

• Health informatics is the science that underlies the fusion of health care, information technology, and business administration,

• Guides its integration into all aspects of the patient health experience, including clinical care, nursing, pharmacy and public health.

• Focus on the implementation and optimization of the information systems that support clinical practice,

• Creates the infrastructure that connects and enables the flow of critical information to and from each of the stakeholders in a patient’s care.


The Difference Between Health Informatics and HIM

• Health Informatics is the study of the…• Structure, Dynamics, Design, Implementation and

Maintenance• …of information systems used to support processing

of health data into information suitable for decision making

• … the people, technology, and organizational factors that are applied to those systems


Status of HI in Saudi Arabia• National strategies for adoption and use of EHR

Kingdom-wide• Shift to Electronic (Medical or Health) Records• ICD-10 implementations• Medical Insurance Companies• Public Health Informatics• Consumers Informatics• Summits and Conventions, i.e. Saudi E-Health, Arab

Health, E-HIM, etc… • Associations, i.e. SAHI• Academic Programs


Challenges To HI Professionals• Shortage in HI Professionals• Underestimating the value of HI / HIM

Professionals comparing to other IT or Health related specialties.

• NO Associate Degree, i.e. Coding and HIT• Undergraduate Degree, i.e. HIM


The Difference Between Health Informatics and HIM

• Health information management is the science of managing patient health information and medical records (Paper based or Electronic).

• Health Information Management• HIM FOCUS ON the Dissemination, Communication,

Presentation, Utilization, Transmission and Privacy….. of DATA & INFORMATION and its use

• HIM IS CONCERNED WITH… the Collection, Organization, Validation, Analysis, Storage and Maintenance …..…of DATA

• The Goal of HIM is Quality information = Quality Healthcare


Functions of Health Records Functions of Health Records


Early History of the Profession

• Hospital standardization– American College of Surgeons

– 1918

– Raise standards of surgery by establishing hospital standards

– Importance of a complete and accurate record of care

• Organization of the Association of Records Librarians– Formed in 1928

– Recognized allied health discipline

– Approval of first education curriculum in 1932

– Board of Registration established in 1933


Why do we keep health records?

• Purposes of the health record– Primary purposes

• To support patient care delivery• To provide patient care management• To provide information to run the organization (patient care

support)• To determine and validate payment and reimbursement for

care and services provided• To assist individuals in management of their own health


Why do we keep health records? (continued)

• Purposes of the health record– Secondary purposes:

• To support education• To comply with regulations• To conduct clinical and other research• To monitor public health and homeland security• Business purposes


Who uses the health record?

• Two categories of users:– Individual users: Individuals who need to use the

health record to perform their jobs– Institutional users: Organizations who need the

information in the health record to perform various analyses


Who uses the health record? (continued)

• Individual users– Patient care providers– Consumers– Patient care management and support– Patient care reimbursement– Others



• Individual users– Patient care providers– Consumers– Patient care management and support– Patient care reimbursement– Others



• Institutional users– Healthcare delivery organizations– Management and review of care organizations– Reimbursement of care organizations– Research organizations– Schools– Accreditation and licensing agencies– Policy makers


What is the main function of the health record?

• Storage of Information– Attributes of the storage function

• Accessibility• Quality• Security• Flexibility• Connectivity• Efficiency


What is meant by accessibility?

• Accessibility means that users must be able to:• Get information easily• When they need it• In a format that is appropriate


What does quality mean in a health record?

• Quality attributes that every health record must have:– Data must be:

• Accurate• Accessible• Comprehensive• Defined appropriately• Consistent• Defined• Defined at the appropriate level (granular)• Precise• Relevant• Timely


What does security mean in a health record?

• Security– Protects privacy of individuals and confidentiality of

health records • Privacy -- Right of individuals to control access to their

health information• Confidentiality -- Expectation that personal information is

kept private


What conditions must be met so that a health record can fill its purposes?

• Accessibility• Flexibility• Connectivity• Efficiency


Strengths of the paper based record:

• Ease of use.• Portable.• Does not need to downtime.• Flexible in recording data.• Ease of browsing and scanning.


Weakness of the paper based record:

• Problems with content:• Missing data.• Spelling.• Errors.• Follow up directions.

• Problems with format.• Problem with access, availability, and retrieval.


Weakness of the paper based record: (Continue)

• Problems with outpatient clinics record.• Problems with storage.

• Miss files.• Lost of charts.• Large space area for the MR.• Separate patient record data such as X-ray reports and

films.


Benefits of the EHR:

• Can improve Healthcare delivery:• Better data access.• Faster data retrieval.• High quality data.• Support medical and non-medical decision-making.• Enhance quality assurance.


Benefits of the CPR: (Continue)

• Can enhance out-come researches program.• Can increase healthcare organization efficiency.

• Reducing cost and achieves quality of healthcare.• Improve staff productivity.


Benefits of the CPR: (Continue)

• Can moderate the cost of healthcare. • Reduce redundant tests and services.• Manage billing and payment system.


Good Luck to You All,,,,Bakheet Aldosari, Ph.D.

[email protected]

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Health 305 Health Information Management