Health Care Information Systems

Module 3: Information Technology and Managerial Control

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

1. Define and discuss general systems theory.
2. List the different types of systems and how they work.
3. Discuss the role of information in a health care system.

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. Good luck and have a great semester!

General systems theory is the conceptual foundation that this field relies upon. A complete understanding of this theory is essential to your progress in this course. This approach concentrates on the process in its entirety rather than focusing on the parts. It also relates the parts to each other in order to achieve total system goals. This can be related to health care and its current focus on holistic medicine. The holistic approach focuses on the whole person in sickness and in illness to ensure complete treatment for the patient. Traditional approaches focus on just the parts that are in need. Factors such as social, psychological, financial, spiritual, and medical must be examined in the holistic approach. Holistic care can be defined as a systems approach to patient care.

A health service organization can be broken down into three parts, or systems. These are mechanical systems, human systems, and man-machine systems. The most important system of an HSO is the human systems. This is due to the fact that the health care industry is a service heavy industry, providing health services. This aspect of the system is highlighted in human resource management and can be studied in much more detail in the course offered at FGCU by the same name. The development of technology would not be successful without the human component to operate, maintain and repair the technology in use. That is why information systems must not exclude the human portion and is actually referred to as the man-machine system. Information systems themselves can also be strictly human systems, without the machine component and these are called manual systems. This course will focus primarily on those information systems that use a man-machine system.

A system can be defined as "a set of objects and the relationships between the objects and their attributes". This definition dates back to 1968 by Hall and Fagan. They stated that objects constitute the component parts of the system and attributes are the properties of these objects. They are abstract descriptors that characterize and define the component parts of the system. The objects are related in a system which enables the parts to equal something greater together than alone. These relationships must exist to constitute a system. An analogy that is used quite often is the human body, which can be called the "perfect system". Another example can be found on page 26 in you text. This is a systems approach to defining a health service organization.

Systems must have unity or integrity. The system itself must be viewed as an entity in it's own right with a distinct purpose, goal or function. HSO systems are complex, composed of an intricate web of relationships, and hierarchical in structure. The systems are dynamic, but most possess some stability and equilibrium. They must continue to function in the face of continuous external and internal changes. External and internal changes stem from the health care environment and include social, economic, political and physical factors.

Systems may be either simple (composed of three essential components: input, output, and a conversion process) or complex as described above. The system may also include feedback , when output "feeds back" as input. Systems may be either open or closed. Open systems interact with the environment and are influenced by it. Closed systems are completely self-contained and eventually will terminate. Only an open system that adjusts to the environment can survive over time. A self-regulating system is called a "cybernetic system". A cybernetic system needs additional elements to ensure an automatic control. An example of this system would be a thermostatic control system for automatic heating and cooling. Health service organization systems should be designed as cybernetic systems with formal management controls that are built in (page 32 provides an example of this system).

Information that is used as a management control in a cybernetic system is discussed in detail in the rest of the chapter. Other areas covered are principles of information resource management and the need for management of change. These are all essential to continued development of a systems approach to information management in the health care field.