There is a lot of confusion in concepts and terminology regarding HIS. In 1999-2000 when I was first introduced to the subject of Total Hospital Information System, my own exposure to it was minimal and I wrote (and rewrite) various articles to clarify in my own mind what a hospital information system is meant to be.
I have been a user of HIS for more than twelve years because the hospital that I worked in as a clinician is computerized from the start. At the same time, I have worked with IT and Medical records personnel in various capacities including applications analyst, the Clinical-IT Coordinator and chairman of the hospital’s Medical Records Executive Committee. Also, I volunteered to provide help to other hospitals and their vendors in developing and implementing their HIS. I have also been invited to evaluate systems being proposed and also those already implemented.
The ideas and content of the current article has been used by some people as the basis for preparing the request for proposal (RFP) document for HIS as well as Operations and Maintenance contracts. From time to time I revised my ideas and only now I consider them worth sharing with others through a website.
These set of articles is an exposition of HIS as it is known to-day together with some of my own ideas which may be considered as radical by some. Foremost, is the proposal for differentiating Patient Information Database from the Electronic Medical Record (EMR). The concept proposed, requires differentiation of the two not only in data content and structure but also in the system architecture and system administration. However, I belief that this approach will provide answers as to what the EMR should contain and how it is going to be made available without the necessity of accessing it through a Clinical Information System (CIS). It can be saved and read as a document or image (e.g. PDF).
This approach calls for defining the pertinent data, from the myriad of data that is collected in CIS that is required to be retained or migrated to a new system. I am putting forward suggestions for re-examining our policies and procedures concerning data migration. Personally I belief, from a medico-legal perspective and for continuity of care, it is mandatory only to retain the EMR. The retention of other data is guided by epidemiological, research and business considerations.
I am sharing these articles with you in the hope of a better understanding, on my part, of the subject. If it helps you in any way I would be much elated.