Hospital information system
Hospital Information System ( HIS) is the class of the totality of all information processing systems of information technology to capture, edit and share medical and administrative data at the hospital.
At KIS include server roles, job functions and mobile features of data provision. In a broader sense among the KIS and conventional methods of paper documentation and end of voice communication. In general, we restrict the term today rather on the computer-based components of the HIS.
In this context one also speaks of " KIS- producers " and the " KIS- market ", in which case with " HIS " in deviation from the generally accepted definition is not an instance of an information system is meant in a particular hospital, but a software product, the essential covering functional areas of a typical hospital information system.
The term KIS is also used to denote all less specific server functions of a hospital network and this of special systems, such as the radiology information system (RIS ), the Laboratory Information System (LIS or LIMS), the ICU Information System ( IIS) etc. delineate. After a takeover from the Anglo-American parlance is referred to as HIS HIS ( Hospital Information System).
- 2.1 paradigm of coordination in self- control
- 2.2 System Integration
- 2.3 Model Systems
- 5.1 General Literature
- 5.2 Literature on the historical development
- 5.3 Literature on data protection in the use of HIS systems
Functions
The fundamental goal of HIS is to meet the requirements of the SGB V. After that, it is not enough information to simply write on a piece of paper or typing. The KIS is to improve communication between staff and organize and manage the whole system in a hospital. The administration of patient data and case data are also included.
The functions of hospital information systems are backup, change and presentation of information and data. This has the potential advantage that each authorized employee of a hospital has in its assigned user role access to relevant information for him.
The focus of the functions located in the administrative area, especially the collection of disease data (eg history), documentation and planning medical and nursing care, ie care planning and nursing documentation as well as the medical reports and medical reports. The prescribing of examinations or treatments ( order entry ) by the physician and the management and documentation of the test results are to be met.
KIS functions are increasingly being provided in the context of mHealth applications on mobile devices ..
Planning, management and accounting
The planning and control of medical services (such as clinical pathways, Eng. Clinical pathways ) is facilitated with modern HIS. The hospital information system supports the creation of documents ( medical reports, surgery reports ), etc., with parts of these documents can often be proposed on the basis of the data previously collected. Summary evaluations of the statutory and internal reporting are essential.
For the purpose of billing to health insurance, health insurance and self-pay patients are case data according to the ICD- key, provided medical benefits under the OPS key (formerly ICPM key ) or DRGs Diagnosis Related Groups classified and for the calculation of the invoice data (including material and labor) used for cost accounting.
Data acquisition
Known KIS afford the operating data in different detail. An exact outcry yellowing of the individual services is usually only for the benefits in kind. For personnel services, which account for the lion's share of the remaining costs, usually no support is provided.
Last but not least logistical functions such as supporting the material orders ( bearing and special material ) on the station (if necessary with approval workflow ), the documentation of the flow of consumables in the hospital ( eg, in the operating room or in the radiology department ) together with the assignment of material costs to support specific case.
Reached levels of maturity
Depending consider to be fully integrated systems are not expected to long installation routines, not desirable or not possible. In fact the constant increase in complex new functions requires a constant expansion of the existing definition of scope, so that a complete solution will always correspond only to the definitions earlier article.
A hospital information system is highly complex. There are no mandatory standards. Only for the data exchange formats and protocols are standardized, or the appropriate standards are in preparation.
A task for KIS provider is the continuous change of statutory accounting rules, quality assurance, etc., which forces manufacturers and operators to permanent care. This care ties up resources that could otherwise be used for further developments.
Depending on the strategy of the seller is more integration strategy ( everything from a single source ) or the communication strategy ( variety of interfaces ) its own KIS software propagated. Smaller manufacturers offer more specialized or niche solutions that larger manufacturers can not quickly adapt to the specific requirements of a house.
Data availability and data protection
KIS be considered always skeptical under a data protection perspective, as in the systems large amounts are administered to be protected and very sensitive personal data. The skeptics have no ready recommendation as to how the balance between data protection and data availability to be solved without the HIS.
First, in medical emergencies must have access to all the data (such as allergies, current medication) by each hospital doctor who is first on the spot, be possible. This is true even if it is not to the primary treating physician. Currently, this is usually possible through "emergency access permissions " whose accesses are strictly logged.
Statically defined restrictive access rights limit the use of KIS may in its necessary work, with over-generous allocation of rights could be too many divulge sensitive information. A defined in the current context dynamically limited access rights management is implemented yet in any established system. Special solutions for role- compliant access control are sold separately and offer the same interface for all systems operated.
Market diversity
On the German market for hospital software is continuously held a strong consolidation. As a result, always appear new suppliers, all of which use solutions for smaller organizations or with highly specialized solutions lower market shares of the incumbents or open up new functional areas. The life of such smaller new provider is usually associated with that of the initial market success gradient. However, the major manufacturers introduced are also not immune from break-ins.
Increasingly, modern concepts of mobile information appliances input in the equipment concepts of clinics. A leading role have been doing over major university hospitals and private clinic composites. The interest in mobile solutions is growing steadily but also for smaller and medium-sized facilities. In contrast, just the willingness to invest in a full spread of such concepts in the clinics in public ownership because of the cameral budgeting totally inadequate.
Paradigm of coordination in self- control
Until now, the transmission of the actual experienced coordinating practice self- control by the competent staff has not succeeded with a flat hierarchy in the system concepts of hospital software.
System Integration
The patient-centered part of a HIS ( Clinical workstation system, KAS) is playing an increasing role in the coordination of the services of a hospital, while previously the administrative part of the KIS is pushed back to the background processes and arranges with his process remote functionality into the overall process of service delivery and billing.
In general, the innovative components for use are directly weakly disseminated by the patients and the medical components weakly crosslinked at the bedside.
Model systems
For the successful implementation and operation of the HIS software modeling and optimization of clinical processes of central importance. There are no hard templates. So far, traditional concepts of hierarchical control are represented dominant. The portions of the solution for a flow - oriented coordination ( workflow management ) are usually poorly developed or unfit for the daily routine.
Must be a critical analysis of the requirements with a distinction between essential functions and special requirements form the basis for the design of clinical information systems for the selection of software products and for the management and operation of information systems.
Therefore, methods and models for the description of KIS are developed in the medical computer science. The diverse and complex requirements of KIS are grouped together in catalogs and reference models ..