Evolution of Health Care Information Systems

Evolution of Health Care Information Systems

Every day, health care technology continues to change. In the past 20 years, a dramatic change has been seen in how and individual's information is stored, used, and seen in one's primary cares' office and in a hospital setting. To promote effective, proficient, safe, and patient-focused care in a timely manner, the gap in health care information technology must occur. In this paper the subject is to compare and contrast a health care facility 20 years ago and now. The features examined will include the information systems and an analysis of how data was used 20 years ago and today. In addition, this paper will cover two major events and technological advantages that have influenced current HCIS practices.

Comparison/Contrast of Skilled Nursing Facilities

According to Wager, Lee, and Glaser, there are five clinical information systems or applications related to health care. The five systems or applications are as follows: "computerized provider order entry (CPOE), medication administration, telemedicine, telehealth, and the personal health (PHR)," (Wager, Lee, & Glaser, 2009, p. 121). These five systems are used in skilled nursing facilities around the world. When used, each system can be cost effective, improve quality, and improve patient safety.

Over the last 20 years, skilled nursing facilities have made significant changes in comparison to what they were before. The skilled nursing facility that will be the subject of this paper is Dunseith Community Nursing Home. With the implementing of new rules, putting new regulations into place, skilled nursing facilities are required to focus on organizational standards and quality patient care. With those above mentioned standards and changes, the patients' needs and rights become prominent.

Investigations among nursing homes have been many in the past and present. In the 1980s, nursing home investigations began and out of those investigations a bill was created. The bill is known as the Nursing Home Reform bill, OBRA '87. OBRA stands for the Omnibus Budget Reconciliation Act of 1987. This bill ensures that a checklist is done in each and every nursing home facility across the country. The checklist is as follows:

* "Each resident must be fully evaluated upon admission an each year thereafter in regard to health, memory, hobbies, habits, etc. They must gauge the ability to walk, talk, eat, dress, bathe and understand other people and be able to communicate with them. Further, a plan must be drawn up to maintain and potentially improve their condition.

* Patients have rights to a doctor and if they can't find one on their own, the home's medical doctor will help them find one. They have a right to be informed about treatment and refuse if desired. They have a right to privacy and a right to complain without reprisal. They can demand not to be restrained. In 1989 about 40% of patients were restrained and by the end of 1992, that had dropped to 22%,"

(Moody, 2011, p. 1).

Slowly, the introduction to information technology began 20 years ago. The documentation within a skilled nursing facility was hand-written or done by a typewriter.

A distant memory from 20 years ago are slow computer system implementations. Today the understanding of information technology, its expansion in development, and implementation is rapid. With the implementation of new technology, skilled nursing facilities could grow and provide patients with the quality care he or she deserves.

Twenty years ago, skilled nursing facilities were failing by not recognizing and implementing information systems. Today, skilled nursing facilities located in rural areas are not able to survive without the help of telehealth and telemedicine implementation. These facilities have now added billing operating systems, financial software programs, and administrative software programs to the daily operations. Skilled nursing facilities rely on these programs to do daily reports, process payroll, maintain employee records, input patient insurance information, update patient care and treatment plans, and update employee and patient personal information.

Examination of Information Systems within the Workplace

The two information systems that will be examined are telemedicine and teleheatlh. Both forms of information systems are being utilized in health care organizations today. "Telemedicine is the use of medical information exchanged from one site to another via electronic communications to improve patients' health status," (American Telemedicine Association, 2012, p. 1). Telehealth is considered as "the use of telecommunication technologies to provide health care services and access to medical and surgical information for training and educating health care professionals and consumers, to increase awareness and educate the public about health-related issues, and to facilitate medical research across distances," (The Free Dictionary, 2012, p. 1). There are several parts of telemedicine and telehealth that help many health care organizations today. The parts are as follows:

* Transmission of still images

* Videoconferencing

* Remote monitoring of vital signs

* E-health including patient portals

* Continuing medical education

* Nursing Call Centers,

(American Telemedicine Association, 2012).

How Data was used 20 years ago and Today

Twenty years ago, the telemedicine and telehealth advancements were not thought of and this made communication between physicians hard. Without updated communication systems, a tempo was not there when a valuable diagnosis of a patient's condition was needed. The lack of updated communication caused a patient's condition to worsen because the telecommunication system was not updated between the hospital and physicians. Updating the communication systems would allow lifesaving treatments to be discussed, immediate medical treatment to happen, and prevention methods to take place.

Telemedicine

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