Updated for the New Era of Health Care IT
"This is the most comprehensive and authoritative book available for the field today."
—Mark L. Diana, PhD, assistant professor and MHA program director, School of Public Health and Tropical Medicine, Tulane University
"With health care information technology now in the national policy spotlight, this book should be required reading for every health care administrator and student."
—Mark Leavitt, MD, PhD, chairman, Certification Commission for Healthcare Information Technology
"The book provides an excellent overview of foundational principles and practical strategies—a valuable reference for health administration and health informatics students and professionals."
—Eta S. Berner, EdD, professor, Department of Health Services Administration, University of Alabama, Birmingham
"The authors skillfully provide the tools necessary to facilitate movement from a paper-based to an electronic health record environment while championing the importance of managing in such an environment."
— Melanie S. Brodnik, PhD, director and associate professor, School of Allied Medical Professions, Ohio State University
"Deploying health care information technology today is like navigating whitewater in the midst of a raging storm. Leveraging investments while introducing significant change is no easy task. It requires focused attention, a spirit of collaboration, and a willingness to learn from others. This book is written for the IT leader who is willing to tackle these challenges."
—Stephanie Reel, CIO and vice provost for Information Technologies, Johns Hopkins University
PART 1 HEALTH CARE INFORMATION.
1 INTRODUCTION TO HEALTH CARE INFORMATION.
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.
2 HEALTH CARE DATA QUALITY.
Data Versus Information.
Problems with Poor-Quality Data.
Ensuring Data and Information Quality.
Testing the Use of IT.
3 HEALTH CARE INFORMATION REGULATIONS, LAWS, AND STANDARDS.
Licensure, Certification, and Accreditation.
Legal Aspects of Managing Health Information.
Recent Health Care Privacy Violations.
PART 2 HEALTH CARE INFORMATION SYSTEMS.
4 HISTORY AND EVOLUTION OF HEALTH CARE INFORMATION SYSTEMS.
Definition of Terms.
History and Evolution.
Why Health Care Lags in IT.
5 CURRENT AND EMERGING USE OF CLINICAL INFORMATION SYSTEMS.
The Electronic Medical Record.
2007 Davies Award Recipients: Ambulatory Care Category.
2007 Davies Award Recipient: Organizational Category.
Other Major HCIS Types.
Guidelines for Clinical Electronic Mail Communication.
Fitting Applications Together.
Information Exchange Across Boundaries.
Overcoming Barriers to Adoption.
6 SYSTEM ACQUISITION.
System Acquisition: A Definition.
Systems Development Life Cycle.
System Acquisition Process.
Project Management Tools.
Sample Contents of a Project Repository.
Things That Can Go Wrong.
7 SYSTEM IMPLEMENTATION AND SUPPORT.
System Implementation Process.
Managing the Organizational Aspects.
System Support and Evaluation.
PART 3 INFORMATION TECHNOLOGY.
8 TECHNOLOGIES THAT SUPPORT HEALTH CARE INFORMATION SYSTEMS.
Data Management and Access.
Relational Data Modeling.
Networks and Data Communications.
Information Processing Distribution Schemes.
The Internet, Intranet, and Extranets.
Clinical and Managerial Decision Support.
Trends in User Interactions with Systems.
Information Systems Architecture.
Choosing the System Architecture.
9 HEALTH CARE INFORMATION SYSTEM STANDARDS.
Standards Development Process.
Classification, Vocabulary, and Terminology Standards.
Health Record Content Standards.
10 SECURITY OF HEALTH CARE INFORMATION SYSTEMS.
The Health Care Organization’s Security Program.
Threats to Health Care Information.
Overview of HIPAA Security Rule.
Outline of HIPAA Security Rule.
Password Do's and Don'ts.
Security in a Wireless Environment.
Remote Access Security.
PART 4 SENIOR MANAGEMENT IT CHALLENGES.
11 ORGANIZING INFORMATION TECHNOLOGY SERVICES.
Information Technology Functions.
Organizing IT Staff and Services.
In-House Versus Outsourced IT.
Evaluating IT Effectiveness.
Assessing the IT Function.
Managing Core IT Processes.
12 IT ALIGNMENT AND STRATEGIC PLANNING.
Overview of Strategy.
Areas Requiring IT Strategy.
IT Strategy Vectors.
The IT Asset and Governing Concepts.
A Normative Approach to IT Strategy.
Sample IT Agenda for a Strategy to Improve Patient Scheduling Service.
Sample IT Agenda for a Strategy to Improve Health Information Access and Self-Service for Patients.
Sample of Recommendations for IT Nursing Documentation Support to Improve Patient Safety.
IT Strategy and Alignment Challenges.
IT as a Competitive Advantage.
How Great Companies Use IT.
13 IT GOVERNANCE AND MANAGEMENT.
The Foundation of IT Governance.
Principles for IT Investments and Management.
Improving Coordination and Working Relationships.
Archetypes of IT Governance Decision Making.
Principles for High Performance.
14 MANAGEMENT'S ROLE IN MAJOR IT INITIATIVES.
Managing Change Due to IT.
Managing IT Projects.
Understanding IT Initiative Failures.
Critical Success Factors.
IT Project Implementation Checklist.
15 ASSESSING AND ACHIEVING VALUE IN HEALTH CARE INFORMATION SYSTEMS.
Definition of IT-Enabled Value.
Four Types of IT Investment.
The IT Project Proposal.
Steps to Improve Value Realization.
Why IT Fails to Deliver Returns.
Analyses of the IT Value Challenge.
16 HEALTH IT LEADERSHIP.
Case 1: Board Support for a Capital Project.
Case 2: The Decision to Develop an IT Strategic Plan.
Case 3: Selection of a Patient Safety Strategy.
Case 4: Strategic IS Planning for the Hospital ED.
Case 5: Planning an EMR Implementation.
Case 6: Considerations for Voice over IP Telephony.
Case 7: Implementing a Capacity Management Information System.
Case 8: Implementing a Telemedicine Solution.
Case 9: Replacing a Practice Management System.
Case 10: Conversion to an EMR Messaging System.
Case 11: Concerns and Workarounds with a Clinical Documentation System.
Case 12: Strategies for Implementing CPOE.
Case Study 13: Implementing a Syndromic Surveillance System.
Case Study 14: The Admitting System Crashes.
Case Study 15: Breaching the Security of an Internet Patient Portal.
Case Study 16: Assessing the Value and Impact of CPOE.
A Overview of the Health Care IT Industry.
B Sample Project Charter.
Frances Wickham Lee, DBA, is director of instructional operations for the Clinical Effectiveness and Patient Safety Center and associate professor, College of Health Professions and College of Medicine, Medical University of South Carolina.
John P. Glaser, PhD, is vice president and chief information officer, Partners HealthCare, Boston, Massachusetts.