Hospital Information Technology Research Articles

Smart hospital: achieving interoperability and raw data collection from medical devices in clinical routine.

Today, modern technology is used to diagnose and treat cardiovascular disease. These medical devices provide exact measures and raw data such as imaging data or biosignals. So far, the Broad Integration of These Health Data into Hospital Information Technology Structures-Especially in Germany-is Lacking, and if data integration takes place, only non-Evaluable Findings are Usually Integrated into the Hospital Information Technology Structures. A Comprehensive Integration of raw Data and Structured Medical Information has not yet Been Established. The aim of this project was to design and implement an interoperable database (cardio-vascular-information-system, CVIS) for the automated integration of al medical device data (parameters and raw data) in cardio-vascular medicine. The CVIS serves as a data integration and preparation system at the interface between the various devices and the hospital IT infrastructure. In our project, we were able to establish a database with integration of proprietary device interfaces, which could be integrated into the electronic health record (EHR) with various HL7 and web interfaces. In the period between 1.7.2020 and 30.6.2022, the data integrated into this database were evaluated. During this time, 114,858 patients were automatically included in the database and medical data of 50,295 of them were entered. For technical examinations, more than 4.5 million readings (an average of 28.5 per examination) and 684,696 image data and raw signals (28,935 ECG files, 655,761 structured reports, 91,113 x-ray objects, 559,648 ultrasound objects in 54 different examination types, 5,000 endoscopy objects) were integrated into the database. Over 10.2 million bidirectional HL7 messages (approximately 14,000/day) were successfully processed. 98,458 documents were transferred to the central document management system, 55,154 materials (average 7.77 per order) were recorded and stored in the database, 21,196 diagnoses and 50,353 services/OPS were recorded and transferred. On average, 3.3 examinations per patient were recorded; in addition, there are an average of 13 laboratory examinations. Fully automated data integration from medical devices including the raw data is feasible and already creates a comprehensive database for multimodal modern analysis approaches in a short time. This is the basis for national and international projects by extracting research data using FHIR.

Structure and Funding of Clinical Informatics Fellowships: A National Survey of Program Directors.

In 2011, the American Board of Medical Specialties established clinical informatics (CI) as a subspecialty in medicine, jointly administered by the American Board of Pathology and the American Board of Preventive Medicine. Subsequently, many institutions created CI fellowship training programs to meet the growing need for informaticists. Although many programs share similar features, there is considerable variation in program funding and administrative structures. The aim of our study was to characterize CI fellowship program features, including governance structures, funding sources, and expenses. We created a cross-sectional online REDCap survey with 44 items requesting information on program administration, fellows, administrative support, funding sources, and expenses. We surveyed program directors of programs accredited by the Accreditation Council for Graduate Medical Education between 2014 and 2021. We invited 54 program directors, of which 41 (76%) completed the survey. The average administrative support received was $27,732/year. Most programs (85.4%) were accredited to have two or more fellows per year. Programs were administratively housed under six departments: Internal Medicine (17; 41.5%), Pediatrics (7; 17.1%), Pathology (6; 14.6%), Family Medicine (6; 14.6%), Emergency Medicine (4; 9.8%), and Anesthesiology (1; 2.4%). Funding sources for CI fellowship program directors included: hospital or health systems (28.3%), clinical departments (28.3%), graduate medical education office (13.2%), biomedical informatics department (9.4%), hospital information technology (9.4%), research and grants (7.5%), and other sources (3.8%) that included philanthropy and external entities. CI fellowships have been established in leading academic and community health care systems across the country. Due to their unique training requirements, these programs require significant resources for education, administration, and recruitment. There continues to be considerable heterogeneity in funding models between programs. Our survey findings reinforce the need for reformed federal funding models for informatics practice and training.

Acute care disruptions due to information technology failures in the Netherlands from 2000 to 2020

Background and aimHealthcare organizations are becoming increasingly dependent on Information technology (IT) for the provision of routine services. IT failures within hospital systems can impact acute patient care, including emergency department (ED) closure operating room (OR) stops.. The aim of this study is to gain insight into the impact of hospital IT failures in the Netherlands on acute care delivery and to provide recommendations for improved IT failure preparedness and hospital resilience during such an event. MethodsThis is a systematic scoping review of major acute care disruptions in Dutch hospitals between 2000 and 2020. Incidence of etiology, duration, ED diversion, and closure of multiple locations was evaluated. IT failures were included when associated with the closure of hospital departments and/or evacuations. ResultsThirty-nine IT failures resulting in acute care disruption were identified. The majority occurred between 2010 and 2020 (n = 37, 95 %). Of the 39 events, 33 (85 %) were primary IT failures and were mainly caused by computer network and/or hospital software failure. Secondary events predominantly resulted from power failure. Most events (n = 36, 92 %) were resolved within minutes to hours. All events were associated with an ED closure, 27 (69 %) with an operating room (OR) stop and two (5 %) with external hospital evacuation of one or more patients. Furthermore, 17 incidents (44 %) involved multiple hospital locations, and seven (41 %) of these involved closure of multiple locations with an ED. ConclusionThe impact of IT failures on acute care disruptions in the Netherlands has considerably increased since 2010. This stresses the urge to improve IT security and business continuity in today's hospitals.

Penerapan Tata Kelola Teknologi Informasi Dengan Menggunakan Framework Cobit 4.1 Pada RSUP. Cipto Mangunkusumo Jakarta

Information Technology is a combination of computerization and telecommunication for procurement, processing, storage and dissemination of information. Utilization of Information Technology has become a necessity in efforts to increase the effectiveness and efficiency of business activities. Information technology in hospitals can be applied as a computer-based hospital service system (Computer-Based Library Systems) to manage administrative and service functions. The fundamental role of information technology in a company is needed to prevent problems that can occur within the company such as data loss, data leakage, inaccurate information available due to incorrect data making data integrity untenable, computer misuse and procurement of high-value information technology investments but not offset by an appropriate return on value. For this reason, it is necessary to have an information system audit control mechanism for the management of information technology
 This study raises cases at RSUP. Cipto Mangunkusumo which is currently in the stage of implementing Information Technology governance as a way to achieve business goals so that the investment that has been issued is comparable to the business goals to be achieved by the hospital.
 Based on the research that has been done, the results of the analysis of most of the process implementation of the COBIT 4.1 Framework in hospitals. Cipto Mangunkusumo is at this level of maturity throughout the IT process in the hospital. Cipto Mangunkusumo is on an average scale of 4, namely Manager, which means it is possible to monitor and measure adherence to procedures so that action can be easily taken if existing processes are not running effectively. Process improvements are carried out regularly and provide best practices.

Associations Between Lean IT Management and Financial Performance in US Hospitals.

To understand the relationship between Lean implementation in information technology (IT) departments and hospital performance, particularly with respect to operational and financial outcomes. Primary data were sourced from 1222 hospitals that responded to the National Survey of Lean (NSL)/Transformational Performance Improvement, which was fielded to 4500 general medical-surgical hospitals across the United States. Secondary sources included hospital performance data from the Agency for Healthcare Research and Quality (AHRQ) and the Centers for Medicare & Medicaid Services (CMS). We performed 2 sets of multivariable regressions using data gathered from US hospitals, linked to AHRQ and CMS performance outcomes. We examined 10 different outcomes measuring financial performance, quality of care, and patient experience, and their associations with Lean adoption within hospital IT departments. We then focused only on those hospitals that adopted Lean in IT to identify specific practices associated with performance. Controlling for other factors, adoption of Lean IT management was associated with lower length of stay ( b = -0.098, P = .018) and inpatient expense per discharge ( b = -0.112, P = .090). Specifically, use of visual management tools (eg, A3 storyboards, status sheets) was associated with lower adjusted inpatient expense per discharge ( b = -0.176, P = .034) and higher earnings before interest, taxes, depreciation, and amortization margin ( b = 0.124, P = .042). Such tools were also associated with hospital participation in bundled payment programs (odds ratio = 2.326; P = .046; 95% confidence interval, 0.979-5.527) and percentage of net revenue paid on a shared risk basis ( b = 0.188, P = .031). Lean IT management was associated with positive financial performance, particularly with hospital participation in value-based payment. More detailed study is needed to understand other influential factors and types of work processes, activities, or mechanisms by which high-functioning IT can contribute to financial outcomes.

Evaluation of Information Technology Governance Using BAI Domain In Hospital

The governance of information technology in hospitals is a crucial component in facilitating the alignment of information technology initiatives with the strategic objectives of XYZ hospital, thereby contributing to the achievement of its organizational goals. XYZ hospital is currently facing a number of challenges, one of which pertains to the Information System utilized for delivering services to visitors. The resolution of this problem can be achieved through the implementation of an assessment using the Cobit 5 framework, specifically targeting the BAI domain. This approach aims to offer recommendations for enhancing the value of capability levels, thereby improving information technology governance within the hospital setting. The results of the investigation conducted on the evaluation of information technology governance utilizing the Cobit 5 framework at "XYZ" hospital demonstrate that the BAI Domain, particularly BAI Domain 05, has attained a maturity level of 3, whereas BAI Domain 08 has attained a maturity level of 2. The two domains in question demonstrate the least developed levels of maturity when compared to the remaining domains. In contrast, BAI Domains 02, 03, 06, 09, and 10 have attained a maturity level of 4, denoting a heightened level of maturity. Finally, BAI Domains 01, 04, and 07 have successfully attained the intended level of maturity.

Facilitators and barriers of routine psychosocial distress assessment within a stepped and collaborative care model in a Swiss hospital setting.

Stepped and Collaborative Care Models (SCCMs) have shown potential for improving mental health care. Most SCCMs have been used in primary care settings. At the core of such models are initial psychosocial distress assessments commonly in form of patient screening. We aimed to assess the feasibility of such assessments in a general hospital setting in Switzerland. We conducted and analyzed eighteen semi-structured interviews with nurses and physicians involved in a recent introduction of a SCCM model in a hospital setting, as part of the SomPsyNet project in Basel-Stadt. Following an implementation research approach, we used the Tailored Implementation for Chronic Diseases (TICD) framework for analysis. The TICD distinguishes seven domains: guideline factors, individual healthcare professional factors, patient factors, professional interactions, incentives and resources, capacity for organizational change, and social, political, and legal factors. Domains were split into themes and subthemes, which were used for line-by-line coding. Nurses and physicians reported factors belonging to all seven TICD domains. An appropriate integration of the psychosocial distress assessment into preexisting hospital processes and information technology systems was the most important facilitator. Subjectivity of the assessment, lack of awareness about the assessment, and time constraints, particularly among physicians, were factors undermining and limiting the implementation of the psychosocial distress assessment. Awareness raising through regular training of new employees, feedback on performance and patient benefits, and working with champions and opinion leaders can likely support a successful implementation of routine psychosocial distress assessments. Additionally, aligning psychosocial distress assessments with workflows is essential to assure the sustainability of the procedure in a working context with commonly limited time.

Analisis SIMRS Terhadap Peningkatan Pelayanan Kesehatan Di Era Digital Dalam Mendukung Implementasi Rekam Medis Elektronik

HIMS is a solution for hospitals for digital transformation. HIMS is also a strategic step in improving the quality of health services. With HIMS where the data will be better organized and integrated, besides that it makes administrative processes and other data management in the hospital easier and more efficient. The purpose of this study is to find out how HIMS can improve health services. The method used is a theoretical study by analyzing and comparing existing theories. The results of this study are that HIMS in hospitals also provides many benefits in increasing the efficiency and quality of health services. Implementation in EMR with treatment information management, statistical data research, administrative evidence, financing and service quality improvement. It can be concluded that HIMS can improve a health service. HIMS is also an indicator of good and efficient data storage and is included in the health service quality component. In the digitalization era, hospital agencies aim to avoid unwanted errors, such as incorrect data input, failed integration, human error, and slow information. So that the information system that facilitates the hospital can be a reference for the rate of business growth and the development of hospital information technology. Hospital Agencies are expected to always develop new management information systems in accordance with the times. With HIMS, hospital services will be more optimal because they are already digital-based. Digitalization exists because of increasingly advanced technological developments.

Building resilient hospital information technology services through organizational learning: Lessons in CIO leadership during an international systemic crisis in the United States and Abu Dhabi, United Arab Emirates

BackgroundThe COVID-19 pandemic was an international systemic crisis which required an unprecedented response to quickly drive the digital transformation of hospitals and health care systems to support high quality health care while adhering to contagion management protocols. ObjectiveTo identify and assess the best practices during the COVID-19 pandemic by Chief Information Officers (CIOs) about how to build resilient healthcare IT (HIT) to improve pandemic preparedness and response across global settings and to develop recommendations for future pandemics. MethodsWe conducted a qualitative, interview-based study to sample CIOs in hospitals. We interviewed 16 CIOs from hospitals and health systems in the United States and Abu Dhabi, United Arab Emirates. We used in-depth interviews to capture their perspectives of the preparedness of hospitals’ information technology departments for the pandemic and how they lead their IT department out of the pandemic. ResultsResults showed that healthcare CIOs were ambidextrous IT leaders who built resilient HIT by rapidly improving existing digital business practices and creating innovative IT solutions. Ambidextrous IT leadership involved exploiting existing IT resources as well as exploring and innovating for continuous growth. IT resiliency focused on four inter-related capabilities: ambidextrous leadership, governance, innovation and learning, and HIT infrastructure. ConclusionsWe propose conceptual frameworks to guide the development of healthcare IT resilience and highlight the importance of organizational learning as an integral component of HIT resiliency.

Pharmacogenomics in practice: a review and implementation guide.

Considerable efforts have been exerted to implement Pharmacogenomics (PGx), the study of interindividual variations in DNA sequence related to drug response, into routine clinical practice. In this article, we first briefly describe PGx and its role in improving treatment outcomes. We then propose an approach to initiate clinical PGx in the hospital setting. One should first evaluate the available PGx evidence, review the most relevant drugs, and narrow down to the most actionable drug-gene pairs and related variant alleles. This is done based on data curated and evaluated by experts such as the pharmacogenomics knowledge implementation (PharmGKB) and the Clinical Pharmacogenetics Implementation Consortium (CPIC), as well as drug regulatory authorities such as the US Food and Drug Administration (FDA) and European Medicinal Agency (EMA). The next step is to differentiate reactive point of care from preemptive testing and decide on the genotyping strategy being a candidate or panel testing, each of which has its pros and cons, then work out the best way to interpret and report PGx test results with the option of integration into electronic health records and clinical decision support systems. After test authorization or testing requirements by the government or drug regulators, putting the plan into action involves several stakeholders, with the hospital leadership supporting the process and communicating with payers, the pharmacy and therapeutics committee leading the process in collaboration with the hospital laboratory and information technology department, and healthcare providers (HCPs) ordering the test, understanding the results, making the appropriate therapeutic decisions, and explaining them to the patient. We conclude by recommending some strategies to further advance the implementation of PGx in practice, such as the need to educate HCPs and patients, and to push for more tests' reimbursement. We also guide the reader to available PGx resources and examples of PGx implementation programs and initiatives.

Intelligent Construction of Hospital Management Organization Based on Communication Technology and Information Fusion

With the mature application of 5G communication and the development of artificial intelligence, the deep integration of modern hospital management and information technology has been fully realized. Therefore, this paper explores the organizational structure and system design of our institute and implements the construction and operation of the information system according to the concept of “management institutionalization, organization informatization, and form computerization.” The construction of information management departments was strengthened, the entire 69 information systems with systematic thinking were managed, the dynamic management mechanism of information system operation and maintenance was established, and the fine closed-loop management of hospital processes was realized. The results show that the information system based on institutional management will improve the management efficiency of the hospital and ensure the real-time, accuracy, and security of hospital data information.

Creating bespoke end-of-treatment summaries

Introduction The NHS Long Term Plan states that by 2021, every person diagnosed with cancer should have access to personalised care including an end-of-treatment summary. This summary document aims to provide both patients and their general practitioners with accessible information regarding all treatment received and potential side effects, signs/symptoms of disease recurrence and contact details for addressing concerns. Producing an individualised document meeting all the patient’s needs (considering the many different breast cancer pathways) is, however, both challenging and time consuming. Methods Work was conducted with the hospital information technology (IT) department to produce a breast cancer database and proforma that were built in to existing hospital IT systems. Patient information is entered on this database by the clinical team via the electronic proforma. Results Using this breast cancer database for the last 2.5 years has allowed the creation of personalised and detailed end-of-treatment summaries for patients and general practitioners (currently 765), and will facilitate accurate data collection for service quality improvement. In addition, 24 individual issues in the patient pathway have been identified and opportune identification of these issues allows for timely correction to minimise harm to patients. Conclusions The described approach utilises existing hospital IT systems to build a prospective, accessible, customised breast cancer patient database to generate quick but detailed and accessible end-of-treatment summaries. The implemented system has been found to be efficient and accurate while also rapidly identifying errors and areas for improvement in the patient pathway.

An evaluation of the risk factors associated with implementing projects of health information technology by fuzzy combined ANP-DEMATEL.

Application of a Clinical Information System (CIS) like Electronic Patient Record (EPR), PACS system and CPOE has turned into one of the most important criteria of priorities of health care systems. The aims of the clinical information system include improving the physicians' efficiency level, integrating the caring process, and expanding the fuzzy quality of the services offered to patients. Achievement of these benefits in reality is not an easy task, and there are lots of plans in this field which are doomed to failure. About 50% of the implementation plans of clinical information systems in health care organizations have failed, and this trend is significantly affecting industrial countries. Proper implementation of hospital information systems lies in identifying and assessing the relationships among the most important risk factors of fuzzy. The present study aimed to provide an applicable model for identifying, ranking and evaluating the risk factors associated with projects of clinical information technology in hospitals of Shiraz University of Medical Sciences. This is an applied study which evaluates the risk factors associated with implementation of clinical information technology projects in hospitals of Shiraz Medical Sciences University. The participants consisted of professionals and senior experts of clinical information technology. Fuzzy logic was used in this study. We also applied ANP-DEMATEL combined model with fuzzy procedure to provide the analytic model of the study. According to the study findings, lack of top-executive supports, and unstable organizational environment were the two most important risk factors, while the main organizational factors and technology were also highly important. In addition, the factors associated with technology had the highest influence on the other studied risk factors. Hospital authorities can benefit from this proposed model to reduce the risk of implementing the projects of clinical information technology and improve the success coefficient of the risk of such projects.

Measuring the Impact of a Blood Supply Shortage Using Data Science.

Transfusion medicine is the only section of the clinical laboratory that performs diagnostic testing and dispenses a drug (blood) on the basis of those results. However, not all of the testing that informs the clinical decision to prescribe a blood transfusion is performed in the blood bank. To form a holistic assessment of blood bank responsiveness to clinical needs, it is important to be able to merge blood bank data with datapoints from the hematology laboratory and the electronic medical record. We built an interactive visualization of the time from hemoglobin result availability to initiation of red blood cell (RBC) transfusion and monitored the result over a 2-year period that coincided with several severe blood shortages. The visualization runs entirely on free software and was designed to be feasibly deployed on a variety of hospital information technology platforms without the need for significant data science expertise. Patient factors, such as hemoglobin concentration, blood type, and presence of minor blood group antibodies influenced the time to initiation of transfusion. Time to transfusion initiation did not appear to be significantly affected by periods of blood shortage. Overall, we demonstrate a proof of concept that complex, but clinically important, blood bank quality metrics can be generated with the support of a free, user-friendly system that aggregates data from multiple sources.

164 OLDER PATIENTS AT THE PREOPERATIVE ASSESSMENT CLINIC: CHANGING THE FOCUS FROM FIT FOR SURGERY TO OPTIMISATION FOR SURGERY

Abstract Background The Pre-operative Assessment Clinic (PAC) is run by the Anaesthetic Department and assesses older patients undergoing elective orthopaedic surgery. The aim of this study was to examine how PAC currently assesses older patients and how effective it is in assessing for likelihood of postoperative complications and requirement for rehabilitation. Methods A single-centre, retrospective study that received approval from the local ethics committee. Data were collected on all patients post elective orthopaedic surgery admitted to the on-site specialist rehabilitation unit for older persons, between 1st May 2020 and 31st December 2021. Data were collected from hospital Information Technology platform, Bluespiers. Results Seventy-six patients (58 female; median age: 80 years) were included. Median time from PAC to surgery was 95 days. Functional assessment was completed in 63.16% of cases, formal cognitive assessment was done in 13% of cases. Number of falls in the preceding year was recorded in 31% of patients. Baseline mobility was recorded in 93% of cases. Whilst smoking and alcohol history was recorded in 96% of cases, number of units was not calculated. 45% (n=34) of patients were correctly identified as likely to require post-operative inpatient rehabilitation. PAC did not record sarcopaenia, polypharmacy or delirium risk factors. From our dataset, at least 13% had sarcopaenia, 80% had polypharmacy and 23% required opiate medications. Post-operatively, 16% of patients developed a delirium and 12% had an acute kidney injury. Conclusion In its current format, PAC fails to optimally risk stratify frail, older patients. Attention concentrates on fitness for surgery rather than optimisation of patients. Failure to record frailty, sarcopenia, cognitive impairment and risk factors for delirium is leading to missed opportunities in terms of delirium prevention, and peri-operative optimisation of older patients as well as discharge planning before surgery. Collaboration with specialist geriatric services at PAC should improve patient outcomes.

248 BENEFITS OF POST-OPERATIVE SPECIALIST GERIATRIC CARE FOR OLDER PATIENTS UNDERGOING ELECTIVE ORTHOPAEDIC SURGERY

Abstract Background The Covid-19 pandemic changed work practices across many different healthcare institutions. The difficulties with cross-site transfers created an opportunity in our institution to provide on-site post-operative rehabilitation for older patients undergoing elective orthopaedic surgery. The aim of this study is to assess the impact of post-operative specialist geriatric care on older patients. Methods This is a single-centre, retrospective study that received approval from the local hospital ethics committee. Data were collected on all patients admitted to the on-site specialist rehabilitation unit post-elective orthopaedic surgery between 1st May 2020 and 31st December 2021. Two patients in this group were excluded as they had not attended a pre-operative assessment clinic. Data were collected from hospital Information Technology platform, Bluespiers. Results 76 patients, 18 males and 58 females, were included in this study. The median age was 80 years. In the specialist rehabilitation unit, evidence of cognitive impairment was established in 40.79% of cases, there were 3 cases of newly diagnosed dementia, a history of falls was identified in 32.89% of patients and 13.16% of patients were found to have sarcopaenia. The median length of stay in the rehabilitation unit was 25 days. 51.32% of patients were discharged home independently, 23.68% of patients went home with a new Home-Care Package (HCP), 15.79% of patients were discharged home with an existing HCP, 6.58% of patients were transferred for further treatment and 2.63% patients were discharged to residential care units. Conclusion This data demonstrates a clear role for specialist geriatric care in elective rehabilitation, with a significant proportion of patients being discharged home independently. The benefits of a comprehensive geriatric assessment in the peri-operative setting include increased identification of cognitive impairment allowing appropriate implementation of brain health as well as identification of a history of falls, enabling falls risk assessment and management including bone health assessment.

The Introduction of Robotics to an Outpatient Dispensing and Medication Management Process in Saudi Arabia: Retrospective Review of a Pharmacy-led Multidisciplinary Six Sigma Performance Improvement Project.

BackgroundOutpatient pharmacy management aims for improved patient safety, improved quality of service, and cost reduction. The Six Sigma method improves quality by eliminating variability, with the goal of a nearly error-free process. Automation of pharmacy tasks potentially offers greater efficiency and safety.ObjectiveThe goal was to measure the impact that integration of automation made to service, safety and efficiency, staff reallocation and reorientation, and workflow in the outpatient pharmacy department. The Six Sigma problem definition to be resolved was as follows: The current system of outpatient dispensing denies quality to patients in terms of waiting time and contact time with pharmacy professionals, incorporates risks to the patient in terms of mislabeling of medications and the incomplete dispensing of prescriptions, and is potentially wasteful in terms of time and resources.MethodsWe described the process of introducing automation to a large outpatient pharmacy department in a university hospital. The Six Sigma approach was used as it focuses on continuous improvement and also produces a road map that integrates tracking and monitoring into its process. A review of activity in the outpatient department focused on non-value-added (NVA) pharmacist tasks, improving the patient experience and patient safety. Metrics to measure the impact of change were established, and a process map analysis with turnaround times (TATs) for each stage of service was created. Discrete events were selected for correction, improvement, or mitigation. From the review, the team selected key outcome metrics, including storage, picking and delivery dispensing rates, patient and prescription load per day, average packs and lines per prescription, and lines held. Our goal was total automation of stock management. We deployed 2 robotic dispensing units to feed 9 dispensing desks. The automated units were integrated with hospital information technology (HIT) that supports appointments, medication records, and prescriptions.ResultsPostautomation, the total patient time in the department, including the time interacting with the pharmacist for medication education and counseling, dropped from 17.093 to 11.812 digital minutes, with an appreciable increase in patient-pharmacist time. The percentage of incomplete prescriptions dispensed versus orders decreased from 3.0% to 1.83%. The dispensing error rate dropped from 1.00% to 0.24%. Assessed via a “basket” of medications, wastage cost was reduced by 83.9%. During implementation, it was found that NVA tasks that were replaced by automated processes were responsible for an extensive loss of pharmacist time. The productivity ratio postautomation was 1.26.ConclusionsThe Six Sigma methodology allowed for rapid transformation of the medication management process. The risk priority numbers (RPNs) for the “wrong patient-wrong medication error” reduced by a ratio of 5.25:1 and for “patient leaves unit with inadequate counseling” postautomation by 2.5:1. Automation allowed for ring-fencing of patient-pharmacist time. This time needs to be structured for optimal effectiveness.

The refined management of medical finance combined with information technology construction

AbstractBased on the information construction and taking a hospital as an example, this paper analyzes the current situation, existing problems, and reasons for financial management. This paper puts forward the scheme of optimizing hospital financial management and points out that accounting, asset management, cost management, and performance are all based on accounting. Even though with the continuous improvement and development of hospital informatization, various infrastructures have been built, the problems are more prominent. This can be solved by improving the focus on the products, and processes by reducing waste, or by increasing the quality. In hospitals, the core layer of hospital information technology is the financial management construction and development, and it is also an indispensable factor. It is better to improve the hospital's financial fine management level and promote the hospital's sustainable development. It is not enough to improve the assessment management and comprehensive budget management. It is necessary to integrate the perfect Health Information System, enterprise resource planning system, scientific research system, and structured query language database, establish a comprehensive financial management platform, and obtain data information and indicators of various economic operations in hospitals. Experiments show that the consumables sorting optimization algorithm in this paper can improve the equipment management of medical finance to some extent. In other aspects, this system also incorporates information technology to make enhancements to the original financial management.

E-Claim System For Health Insurance And Social Security (BPJS) Types In Indonesia: Innovation And Effectiveness Of Services

There are four situations in the use of Hospital Information Technology applications or better known as SIMRS in Indonesian hospitals, first, the hospital has not had SIMRS yet, second, the hospital already has SIMRS but it has not been integrated, third, the hospital has an integrated SIMRS based on non-web service but has not bridged with E-claim application, and fourth, the hospital already has SIMRS based on Web Services and bridged with INA-CBG's E-Claim Application. The purpose of this study was to discuss the effectiveness of the National Health Insurance ( JKN ) Inpatient Claim using an integrated SIMRS web-based (Bridging System) with the INA-CBG'S E-Claim application Version 5.2 at Indonesia. Electronic Claims (E-Claims) or the INA-CBG's application is one of the patient data entry tools used to group rates based on data derived from medical resumes. The INA-CBG's E-Claim application has been installed in hospitals that serve JKN participants.

Reevaluating Gendered Language in Surgery.

Reevaluating Gendered Language in Surgery.