Module Two

According to Hebda and Czar, an information system can be defined as the use of computer software to process data into organized information to solve a common problem (2009). When specific to a hospital setting, the information system can be referred to as a hospital information system and can be further divided into two systems including a clinical information system and an administrative information system. A clinical information system is used to directly manage patient care and can include nursing, lab, radiology, pharmacy, medical information and physician practice management systems. An administrative information system is used to provide support and resources to patient care and can include patient registration, payroll, scheduling, human resources, risk management and quality assurance systems (Hebda and Czar, 2009).

Many information systems are currently in use in the Emergency Department at Intermountain Medical Center. We use a nursing information system to chart patient care and responses. We use an order entry system for lab, radiology and pharmacy orders and we use an Emergency Department system to allow for patient tracking and discharge and follow up instructions. On the administrative side, information systems that are used include patient registration, scheduling systems, human resources and payroll.

There are several ways that I could become involved in designing, selecting, evaluating or implementing an information system in the Emergency Department at Intermountain Medical Center. First of all, designing a monitoring system for patients within the Emergency Department would be a project that would save time and improve patient care and documentation. In the department, we currently have monitors in each of the rooms. The monitors may be programmed to automatically check certain patient measurements such as heart rate, respiratory rate and blood pressure. It is the responsibility of the nurse to manually type in each measurement every time that it is checked. By having a system that automatically uploads these measurements to the patient’s computer chart, it would ensure that measurements were not forgotten, it would allow for a more precise documentation and it would guarantee that the measurements are part of the patient’s chart, regardless of how busy the nurse is. By having a complete list of these measurements in a patient chart gives physicians remote access to the measurements and allows for admitting physicians to see trends within the measurements.

Second, designing an information system within the patient chart that allows the computer to ‘remember’ patient history would save time and money. In the Emergency Department, we triage each patient as they come in to be seen. This can sometimes be a tedious process as we must enter past medical history, medications and allergies each time the patient comes in to be seen. For some patients, a list of medications is unheard of and this triage process can turn from 3 minutes to 15 minutes, wasting valuable time that could be spent talking to the physician. By having a system that ‘remembers’ patient history, the only necessary information on subsequent visits would be the reason for the visit and an update to the medication list. This would ultimately shorten patient length of stays and improve door to doctor times in the Emergency Department.

Finally, an information system that could be evaluated in the Emergency Department is the sepsis alert system that notifies the nurse based on triage vital signs as to whether the patient may be at an increased risk for sepsis. I believe that this system could be evaluated for several reasons. The alert system does not take into account the age of the patient, so often times we get a sepsis alert on pediatric patients with normal vital signs. Second, the alert system only makes the alert during the triage process; it would be interesting to audit the charts that did get the alert to see if the patient did in fact have sepsis and to see if the patients did in fact get treated within the three hour time frame. Finally, a test system could be put into effect to have the sepsis alert come up in both triage and for the patient care nurse. This could serve as a reminder to the patient care nurse about the sepsis protocol and we could evaluate if the treatment of sepsis happened more consistently.

There are many places for information systems within the hospital setting. Information systems can allow for better communication, better patient tracking and ultimately safer patient care.

References
Hebda, T. & Czar, P. (2009). Handbook of informatics for nurses and healthcare professionals (4th ed.). Upper Saddle River, NJ: Pearson Prentice Hall.