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Health Care Information System Evolution

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Health Care Information Systems

Health care Information systems have become more prevalent in the current US Health Care system than it was 20 years ago. Computer systems were not used to the extent as it is today in regard to patient care, documentation, billing, education, and etc. This paper will describe in detail regarding the comparisons and contrasts of the use of Health Care Information systems in a contemporary physician office versus a physician office 20 years ago. The technological advantages and major events that influence our current HCIS practices are also included in this paper.

Comparisons and Contrasts

In the early 1990s, physician offices were mainly using a paper-based patient record that was stored in filing cabinets. These records are to be locked with limited access to the records for information on follow-up or emergency situations. Physicians wrote all their orders and prescriptions out by hand which made it hard for the pharmacist and a nurse to decipher what is requested. Lab work and radiology reports took several days to receive back to be reviewed because the report had to be had written out and films developed to be sent to the physician for review as well. Appointments were written on calendars at the doctor's office and a card with the date of the appointment was given to the patient as a reminder. Very little information was computerized except for billing purposes in the physician's office. Even with billing many of the insurance companies received the bills on a UB04 or HCFA 1500. Since then computers have become more widely used in the physician's office from scheduling appointments, reviewing lab work and radiology tests, ordering prescriptions, documentation of the patients visit and education. Billing and processing claims through the computer have also been incorporated in the daily activities in the office. Sending the billing through the computer electronically has cut down the wait time on reimbursement from insurance companies, Medicare and, Medicaid. Efficiency and accuracy have increased with the use of the computer because of increased timing by typing, immediate access to test results, prompts that will show if something does not match up with the patient record to notify the proper individual of a possible entry error, electronic prescription reordering, medical coding and, billing. Although with the use of computers, there have been privacy issues because of the accessibility of patient information. This will be discussed in detail later in the paper. Therefore, although there are similarities in the workflow, very little else is similar in the physician offices. Next are two major events that have occurred over the past 20 years that have influenced our current HCIS practices.

Two Major Events that Influenced Current HCIS Practices

A major event that occurred in the 1990s was President Clinton signing a law regarding Health Insurance and Portability and Accountability Act (HIPAA) of 1996. This law was created to provide more affordable and accessible health insurance, provisions to simplify administrative processes and to provide protection of Personal Health Information (Wager, 2009). In regard to simplifying administrative processes, this law mandates development of a central electronic data base to contain health records for every patient in the United States. This law did not mandate a federal policy that protects this information if misused or stolen until February 21, 2000 (Bacon, 1997, pg. 317). Because many medical records that use to be stored in filing cabinets with minimal access are simply stored on computer networks, information can be easily copied, accessed and, redistributed. This has resulted in the development of increased information system security practices, in place to protect patient information from hackers and unauthorized personnel. Penalties and repercussions for misuse of this information are in place to increase protection



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