Health Care Information Systems

Module 16 - Senior Manager Role in Information Technology Management

The following objectives should be met by the end of this module:

These notes are intended only to supplement your readings. The best way to ensure each module is absorbed is to complete all the readings prior to reviewing these lecture notes. I will try to highlight what I believe to be the most important topics from your module readings. If you have any questions or concerns or there is something you do not understand, please ask me. You can either post on the webboard the question you have (that way others can benefit from the response), or you can e-mail me if you want a more private response. Either way it is extremely important that you have a complete and thorough understanding of the material for the module.

This module focuses on the management of information systems in a healthcare organization. We also briefly look at some of the regulatory guidelines that might affect management of these systems.

The life cycle of IS development (as previously discussed) includes systems analysis, selection of a design approach, systems design, and system acquisition or construction. The final steps include system implementation, operation and maintenance, and system evaluation and improvement. Implementation includes:

System operation and maintenance takes place after the IS is on-line and functional. Both scheduled and unscheduled maintenance will be required no matter how much planning and preparation has taken place. Changes to the system will also be needed on a regular basis to support: new programs initiated by the organization, changes in the population served, expansion of the facilities to meet increased demand, and changing regulations by external agencies. Finally, ongoing evaluation and improvement in the system can take place within an organization's continuous quality improvement (CQI) program. Total quality management principles can be applied to IS to improve performance and increase productivity. Functionality, user satisfaction, costs and benefits, and errors/exceptions should be included in a regular formal review of the system.

In overall management of an IS department, staffing requirements are essential as well as the hierarchy of the group. Professional, technical and clerical people are all need to ensure smooth operations of this department. The chief information officer (CIO) is usually in charge of this department and will report to the CEO of the organization. A typical structure of an IS department is found on page 253 of your text. The size and complexity of this department is dependent upon factors within the organization. These include:

Executive management responsibilities for managing the IS within the organization are found on pages 256-257. These tasks as well as a solid relationship between the CIO and the CEO will further increase the changes of a successful IS operation.

The Health Care Financing Administration (HCFA) is the federal agency which administers the Medicare and Medicaid programs. The Medicare Act of 1965 requires that health care organizations be certified by HCFA in order to receive funds. to ensure quality care HCFA has developed a quality indicator system to continuously monitor patient care and services in HSOs that receive federal funds. The data needed for this program is gathered from four major areas in health care organizations, these are billing or administrative data, institutional data, medical record data, and patient survey data.

The Occupational Safety and Health Administration (OSHA) is responsible for the provision of the health and safety of employees on the job. OSHA conducts workplace inspections and compliance checks for regulations set to ensure safety of workers. The major activities of OSHA include:

  1. development of standards relating to occupational safety and health
  2. development of regulations
  3. investigations and inspections to determine the status of compliance
  4. citations and proposals of penalties for noncompliance

OSHA requires that organizations keep a record-keeping system that includes records of training programs and employees' medical records. They also require an "OSHA 200 log", which is a summary of occupational injuries and illnesses.

The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) is not a regulatory agency, but a voluntary organization. It is an "independent, not-for-profit organization that is the nation's oldest and largest standards-setting body that provides voluntary accreditation for health care organizations". JCAHO includes standards for information management that must be met by organizations to be credentialed. These standards are listed on page 155 of your reading and are essential to the functioning of an IS department. The "indicator measurement system" and "ORYX" are two more projects headed by JCAHO that uses data collected by hospitals to evaluate service and outcomes.

That is it for notes for module #16! Let me know if you have any questions.
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