Health Care Information Systems

Module 8: Management & Enterprise Systems

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

• Explain how an information system can provide information to better administer an HSO in areas of
  • Finance
  • Human Resources
  • Facility Utilization and Scheduling
  • Materials Management
  • Facilities Management
  • Office Automation
• List specific areas in the organization that can benefit from the system
• Describe ethical dilemmas regarding electronic mail in the workplace

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 web board 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.

Administrative applications can be categorized as follows:

• Financial Information Systems
• Human Resource Information Systems
• Facility Utilization and Scheduling Systems
• Materials Management Systems
• Facilities Management systems
• Office automation, groupware, and Intranet Systems

Financial information systems have become important in the health care industry due to the rising concerns about cost. Increased competition and regulation have caused tight monitoring and control of the organization's finances. Information systems and aide in this management process. Financial information systems (FIS) require input from a variety of sources to do their job, these include transaction-processing systems (TPS), external sources, and strategic management plans. Figure 12.1 on page 295 of your text outlines the FIS. A fully integrated system will bring financial information together for planning, monitoring, and control. Individual financial subsystems perform functions such as:

• payroll preparation and accounting
• patient accounting, third-party billing, and accounts receivable processing
• budgeting and budget control
• general ledger accounting
• financial forecasting

The FIS must have the ability to convert, or link, cost and net revenue information among multiple units of payment. These units of payment can range from a per patient fee (capitation) to fee-for-service. It is not unusual to have a FIS package that also include human resources, materials management, purchasing, and general ledge function. The more integrated the system is with all of the financial functions, the more efficient it becomes.

Human Resource Information Systems (HRIS) are important to health care due to the huge reliance health care has on its employees. As stated before, health care is a service industry and between 60-70% of the operating budget is usually spent on employee salaries and benefits. Due to this, close attention is necessary to the data and information generated from the human resource department. A good HRIS can assist management in workforce planning and productivity analysis. A fully integrated system must interface with external government reports and management reports as well as with internal functions such as payroll, budgeting, benefits, and employee records.

Utilization review is a process whereby the facility reviews services performed, materials used, and tests done to ensure there was no waste or under utilization. Utilization management (UM) has become an important skill to health care administrators today. Administrators must also ensure that services are available when needed and scheduled in an appropriate time when they are needed. Information systems can be used to aide in these two functions. Measurements such as inpatient occupancy rates, as well as clinic and emergency room activity can be continuously monitored to study utilization. Pre-admission programs and advance bed booking can be used to ensure proper services and personnel are available when needed. Admissions monitoring and scheduling can improve staff efficiency by reducing daily fluctuations in bed occupancy and improving staff scheduling. Census data can be used against projected budgets to adjust for supply and demand of services.

Management of supplies and materials can be more effectively controlled with computerized purchasing, electronic data interchange, inventory control, and computerized menu planning and food service management. In a materials management system, requisitions for supplies are entered into the computer and matched against budget authorizations. Once the requisition is cleared the purchase order is generated, when the materials are received notices are entered against an open order file. Direct linkages can be made for payment and reordering in an integrated system. A "just-in-time system" allows for continual ordering reducing the need for large inventory and the space needed to store the inventory, thus controlling costs and maintaining inventory control.

Facilities management systems can help to organize, plan, maintain, and manage the physical plant of the organization. Preventive management techniques utilized by these types of IS can help to extend the life of equipment and the facility itself. Energy management systems, project scheduling and control systems are all types of facilities management IS used in health care.

Office automation systems are another example of administrative applications useful in HSOs. Word processing, e-mail, meeting schedules and maintenance of calendars are uses of office automation systems. Groupware is "a broad term that refers to the specifically designed combination of software and hardware that enables managers to share information in an interactive environment". E-mail, teleconferencing, databases, and group calendars are all examples of a networked system to enhance the function of the organization.