Health Care Information Systems A Practical Approach for Health Care Management

This most widely used textbook in the field has been thoroughly revised and updated to reflect changes in the health care industry and the renewed focus on health care information technology initiatives. Two new chapters cover Federal efforts to enhance quality of patient care through the use of health care information technology and strategy considerations. Additionally, reflecting the increased focus on global health, the book features an international perspective on health care information technology. Case studies of organizations experiencing management-related information system challenges have been updated and several new cases have been added. These reality-based cases are designed to stimulate discussion among students and enable them to apply concepts in the book to real-life scenarios. The book's companion Web site features lecture slides, a test bank, and other materials to enhance students' understanding.

Karen A. Wager, DBA, is professor and associate dean for student affairs in the College of Health Professions at the Medical University of South Carolina (MUSC). She currently serves on the Accreditation Council for the Commission on Accreditation of Healthcare Management Education (CAHME) and is a past Fellow of CAHME.

Frances Wickham Lee, DBA, is professor and director of instructional operations for Healthcare Simulation South Carolina at the Medical University of South Carolina (MUSC). She is a member of a pioneering team charged with bringing health care simulation to students and practicing professionals across the state of South Carolina.

John P. Glaser, PhD, is chief executive officer (CEO) of the Health Services Business Unit of Siemens Healthcare, where he is responsible for heading Siemens' global health care IT business. He previously was vice president and chief information officer, Partners HealthCare, Inc. Glaser was the founding chairman of the College of Healthcare Information Management Executives (CHIME), and is the former chairman of the eHealth Initiative Board and the Board of the National Alliance for Health Information Technology.

Tables, Figures, and Exhibits xi

Foreword  xv

Preface  xix

Acknowledgments xxxi

The Authors xxxiii

Part 1 Health Care Information  1

1 Introduction to Health Care Information  3

Learning Objectives

Types of Health Care Information

Internal Data and Information: Patient Specific—Clinical

Internal Data and Information: Patient Specific—Administrative

Internal Data and Information: Patient Specific—Combining Clinical and Administrative

Internal Data and Information: Aggregate—Clinical

Internal Data and Information: Aggregate—Administrative

Internal Data and Information: Aggregate—Combining Clinical and Administrative

External Data and Information: Comparative

External Data and Information: Expert or Knowledge Based

Summary

Key Terms

Learning Activities

2 Health Care Data Quality  49

Learning Objectives

Data versus Information

Problems with Poor-Quality Data

Ensuring Data and Information Quality

Summary

Key Terms

Learning Activities

3 Health Care Information Regulations, Laws, and Standards  67

Learning Objectives

Licensure, Certification, and Accreditation

Patient Safety Organizations

Legal Aspects of Managing Health Information

Summary

Key Terms

Learning Activities

Part 2 Health Care Information Systems  101

4 History and Evolution of Health Care Information Systems  103

Learning Objectives

Definition of Terms

History and Evolution

Summary

Key Terms

Learning Activities

5 Clinical Information Systems  133

Learning Objectives

The Electronic Health Record

Other Major HCIS Types

Fitting Applications Together

Overcoming Barriers to Adoption

Summary

Key Terms

Learning Activities

6 Federal Efforts to Enhance Quality of Patient Care through the Use of Health Information Technology  179

Learning Objectives

HITECH Act

Health Care Reform: New Modes of Care and Payment Reform

Health Information Exchange

Information Technology Ramifications of New Models of Care and Payment Reform

Summary

Key Terms

Learning Activities

7 System Acquisition  209

Learning Objectives

System Acquisition: A Definition

Systems Development Life Cycle

System Acquisition Process

Project Management Tools

Things That Can Go Wrong

Summary

Key Terms

Learning Activities

8 System Implementation and Support  241

Learning Objectives

System Implementation Process

Managing the Organizational Aspects

System Support and Evaluation

Summary

Key Terms

Learning Activities

Part 3 Information Technology  271

9 Technologies That Support Health Care Information

Systems  273

Learning Objectives

Information Technology Adoption Challenges

Data Management and Access

Networks and Data Communications

Information Distribution Schemes

Remote Access Technologies

Internet and Web Concepts and Applications

E-Commerce in Health Care

Clinical and Managerial Decision Support

Information Systems Architecture

Summary

Key Terms

Learning Activities

10 Health Care Information System Standards  317

Learning Objectives

Standards Development Process

Classification Standards

Vocabulary and Terminology Standards

Health Record Content and Functional Standards

Summary

Key Terms

Learning Activities

11 Security of Health Care Information Systems  351

Learning Objectives

The Health Care Organization’s Security Program

Threats to Health Care Information

Overview of the HIPAA Security Rule

Outline of the HIPAA Security Rule

HITECH Expansion of the HIPAA Security Rule

Administrative Safeguards

Physical Safeguards

Technical Safeguards

Security in a Wireless Environment

Remote Access Security

Summary

Key Terms

Learning Activities

Part 4 Senior Management IT Challenges  393

12 Organizing Information Technology Services  395

Learning Objectives

Information Technology Functions

Organizing IT Staff and Services

In-House versus Outsourced IT

Evaluating IT Effectiveness

Summary

Key Terms

Learning Activities

13 IT Alignment and Strategic Planning  437

Learning Objectives

IT Planning Objectives

Overview of Strategy

Vectors for Arriving at IT Strategy

The IT Asset

A Normative Approach to Developing Alignment and IT Strategy

IT Strategy and Alignment Challenges

Characteristics of Strategic Thinking

Summary

Key Terms

Learning Activities

14 Strategy Considerations  467

Learning Objectives

Complementary Strategies

Strategy Evolution

Governing Concepts

The Competitive Value of IT

Summary

Key Terms

Learning Activities

15 IT Governance and Management  491

Learning Objectives

IT Governance

IT Effectiveness

IT Budget

Summary

Key Terms

Learning Activities

16 Management’s Role in Major IT Initiatives  521

Learning Objectives

Managing Change Due to IT

Managing IT Projects

Understanding IT Initiative Failures

Summary

Key Terms

Learning Activities

17 Assessing and Achieving Value in Health Care

Information Systems  555

Learning Objectives

Definition of IT-Enabled Value

The IT Project Proposal

Steps to Improve Value Realization

Why IT Fails to Deliver Returns

Analyses of the IT Value Challenge

Summary

Key Terms

Learning Activities

18 Health IT Leadership: A Compendium of Case Studies  595

Appendixes

A. Overview of the Health Care IT Industry  641

B. Sample Project Charter  653

C. International Adoption and Use of Health Information Technology  665

Index 681

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