PHARMACY INFORMATION SYSTEMS

Pharmacy information systems (PIS) are complex computer systems that have been designed to meet the needs of a pharmacy department. Through the use of such systems, pharmacists can supervise and have inputs on how medication is used in a hospital.

Some of the activities which Pharmacy Information Systems have been employed in pharmacy departments include:

Clinical Screening: The Pharmacy Information System can assist in patient care by the monitoring of drug interactions, drug allergies and other possible medication-related complications.

When a prescription order is entered, the system can check to see if there are any interactions between two or more drugs taken by the patient simultaneously or with any typical food, any known allergies to the drug, and if the appropriate dosage has been given based on the patient’s age, weight and other physiologic factors. Alerts and flags come up when the system picks up any of these.

• Prescription Management: The Pharmacy Information System can also be use to mange prescription for inpatients and/or outpatients. When prescription orders are received, the orders are matched to available pharmaceutical products and then dispensed accordingly depending on whether the patient is an inpatient or outpatient.

  It is possible to track all prescriptions passed through the system from who prescribed the drug, when it was prescribed to when it was dispensed.

  It is also possible to print out prescription labels and instructions on how medication should be taken based on the prescription.

• Inventory Management: Pharmacies require a continuous inventory culture in order to ensure that drugs do not go out of stock. This is made even more difficult when there are multiple dispensing points. When don manually it is very difficult to maintain an accurate inventory.

  Pharmacy Information Systems aid inventory management by maintaining an internal inventory of all pharmaceutical products, providing alerts when the quantity of an item is below a set quantity and providing an electronic ordering system that recommends the ordering of the affected item and with the appropriate quantity from approved suppliers.

• Patient Drug Profiles: These are patient profiles managed by the Pharmacy Information System and contain details of their current and past medications, known allergies and physiological parameters. These profiles are used for used for clinical screening anytime a prescription is ordered for the patient.
  
  
• Report Generation: Most Pharmacy Information Systems can generate reports which range from determining medication usage patterns in the hospital to the cost of drugs purchased and /or dispensed.
  
  
• Interactivity with other systems: It is important that Pharmacy Information Systems should be able to interact with other available systems such as the clinical information systems to receive prescription orders and financial information system for billing and charging.

NURSING INFORMATION SYSTEM

Nursing information systems (NIS) are computer systems that manage clinical data from a variety of healthcare environments, and made available in a timely and orderly fashion to aid nurses in improving patient care.

To achieve this, most Nursing Information Systems are designed using a database and at least one nursing classification language such as North American Nursing Diagnosis (NANDA), Nursing Intervention Classification (NIC) and Nursing Diagnosis Extension and Classification (NDEC).

Some of the features that are provided by Nursing Information Systems include:

• Patient Charting: A patient’s vital signs, admission and nursing assessments, care plan and nursing notes can be entered into the system either as structured or free text. These are the stored in a central repository and retrieved when needed.
  
  
• Staff Schedules: Nurse can self schedule their shifts using scheduling rules provided in shift modules. The shifts can later be confirmed or changed by a scheduling coordinator or manager. Shift modules are designed to handle absences, overtime, staffing levels and cost-effective staffing.
  
  
• Clinical Data Integration: Here clinical information from all the disciplines can be retrieved, viewed and analysed by nursing staff and then integrated into a patient’s care plan.
  
  
• Decision Support: Decision support module can be added to Nursing Information Systems, and they provide prompts and reminders, along with guides to disease linkages between signs/symptoms, etiologies/related factors and patient populations. Online access to medical resources can also be made available.
  
  

There are benefits to be enjoyed by implementing Nursing Information Systems and they include:

• Improved workload functionality: Staffing levels and appropriate skill mix per shift can be more easily determined by the shift modules. This leads to less time spent in designing and amending rosters.
  
  
• Better care planning: Time spent on care planning is reduced, while the quality of what is recorded is improved. This makes for more complete care plans and more complete assessments and evaluations.
  
  
• Better drug administration: Electronically prescribed drugs are more legible, thus making it less likely that drugs would be wrongly administered to patients.
  
  

Despite the benefits Nursing Information Systems have to offer, they are not widely used in healthcare and where they have been installed, they have not been readily accepted. This could probably due to lack of adequate training and failure of educate the end-user what the reasons are for its introduction. Moreover, very little research has been done to determine the cost benefits or cost effectives of such information systems.

CLINICAL INFORMATION SYSTEM

A Clinical Information System (CIS) is a computer based system that is designed for collecting, storing, manipulating and making available clinical information important to the healthcare delivery process.

Clinical Information Systems may be limited in extent to a single area (e.g. laboratory systems, ECG management systems) or they may be more widespread and include virtually all aspects of clinical information (e.g. electronic medical records).

Clinical Information Systems provide a clinical data repository that stores clinical data such as the patient’s history of illness and the interactions with care providers. The repository encodes information capable of helping physicians decide about the patient’s condition, treatment options, and wellness activities as well as the status of decisions, actions undertaken and other relevant information that could help in performing those actions.

Some of the areas addressed by Clinical Information Systems are:

• Clinical Decision Support: This provides users with the tools to acquire, manipulate, apply and display appropriate information to aid in the making of correct, timely and evidence-based clinical decisions.
  
  
  
• Electronic Medical Records (EMRs): this contains information about the patient, from their personal details, such as their name, age, address and sex to details of every aspect of care given by the hospital (from routine visits to major operations)
  
  
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• Training and Research: Patient information can be made available to physicians for the purpose of training and research. Data mining of the information stored in databases could provide insights into disease states and how best to manage them.

For years, research has been done to show the value of Clinical Information Systems, and these have highlighted not just the benefits but also the barriers that might be faced by hospitals who implement such systems.

Some of the benefits are:

• Easy Access to Patient Data: Clinical Information Systems can provide convenient access to medical records at all points of care. This is especially beneficial at ambulatory points, hence enhancing continuity of care. Internet-based access improves the ability to remotely access such data.
  
  
  
• Structured Information: The clinical information captured in Clinical Information Systems is well organised, thus making I easier to maintain and quicker to search through for relevant information. The information is also legible, making it less likely that mistakes would be made due to illegible writing.
  
  
  
• Improved Drug Prescription and Patient Safety: Clinical Information Systems improve drug dosing and this leads to the reduction of adverse drug interactions while promoting more appropriate pharmaceutical utilisation.

Despite the benefits being offered by Clinical Information Systems, they are not without the barriers that prevent them from being rolled out in every hospital. These include some of the following:

• Initial cost of acquisition: the high cost of basic infrastructure of clinical information technology can be a stumbling block to many healthcare organisations.
  
  
  
• Privacy and Security: There are still huge concerns in the healthcare industry about the privacy of patient data on computer systems and how to keep such information secure. The HIPAA and Data Protection Act passed by respective governments in the US and the UK were introduced to address some of these concerns.
  
  
  
• Clinician Resistance: Clinicians usually have 10-20 minutes to see their patients and if their interactions with a CIS during these sessions proves to be counterintuitive by taking up more time than is necessary, there is bound to resistance to it use.
  
  
  
• Integration of Legacy Systems: This poses a stiff challenge to many organisations.

source : biohealthmatics.com

HOSPITAL INFORMATION SYSTEMS

A hospital information systems (HIS) is a computer system that is designed to manage all the hospital’s medical and administrative information in order to enable health professional perform their jobs effectively and efficiently.

Hospital information systems were first developed in the 1960s and have been an essential part in hospital information management and administration. Early systems consisted of large central computers connected to by dumb terminals, which are now being replaced by networked microcomputers. The systems were used to manage patient finance and hospital inventory.

Hospital information systems now focus on the integration of all clinical, financial and administrative applications and thus could also be called an integrated hospital information processing systems (IHIPS).

Components of a hospital information system consist of two or more of the following:

• Clinical Information System (CIS)
  
  
• Financial Information System (FIS)
  
  
• Laboratory Information System (LIS)
  
  
• Nursing Information Systems (NIS)
  
  
• Pharmacy Information System (PIS)
  
  
• Picture Archiving Communication System (PACS)
  
  
• Radiology Information System (RIS)

A look at the list above shows how complex a hospital information system can be. Advancement in computer technology and the development of information exchange standards such HL7 and DICOM, make the task administering and integrating such systems a little more easier.

No hospital information system can be regarded as a success unless it has the full participation of its users. Thus human and social factors would have to be considered in its design, more often than not, they can be easily addressed by providing adequate training and education about the system.

source : www.biohealthmatics.com