Implementation of a regional health information system - Overview of selected outcomes in one hospital district Tarja Suominen, PhD, professora Tiina Mäenpää, PhD studentb, Paula Asikainen, PhDc, Ilmari Rostila, PhD, professord a
University of Tampere, Department of Nursing Science, Finland University of Kuopio, Department of Nursing Science, MNSc, Research Assistant, Satakunta Hospital District, Finland c Administrative Head, Satakunta Hospital District, Finland d University of Tampere, Faculty of Social Sciences, Department of Pori, Finland b
Abstract. The aim of this paper is to give an overview of some selected outcomes after the implementation of a Regional Health Information System (RHIS) in one hospital district in Finland. The implementation project of the Regional Health Information Systems (SALPA) administered by Satakunta Hospital District in 2004 – 2007 is comprised of integrated services between primary, secondary and tertiary care. The general aim was to provide the member municipalities’ access to specialised health care information and sustain seamless care, and to enhance organisational information exchange regardless of time and place. The data were collected by using computer-based statistics and reports in 2004 – 2007 of the selected outcomes: laboratory and radiology tests and appointments in the member municipalities of the hospital district area. Preliminary results of the selected outcomes indicate that the laboratory tests seem mainly to have increased. However, the radiographic tests and the clinicians’ appointments seem mainly to have reduced. A deeper investigation should be done in order to determine the outcomes in the field under investigation. Keywords: Regional Health Information System (RHIS), health information exchange, outcome
1. Introduction The development of regional electronic health information exchange among healthcare organisations is viewed as an important step in the development of health information technology. The implementation of such a technology would improve the coordination of care and information among hospitals, health centres, physician offices, and other ambulatory care providers [1-2], [6]. The major improvements will require the application of health information technology to provide physicians and other heath professionals with immediate and effective access to both information about individual patients and current medical knowledge at the point of care, and assure continuity of care. It should deliver complete medical information immediately for patient care when and where needed, including both patient-specific information and relevant decision support based on the scientific findings and guidelines [3], [5-7]. According to previous research, a computerized physician order entry reduced charges and costs, and decreased serious medication errors [3-4], [7]. This reduction is the result of decreases in laboratory and radiographic tests, fewer admissions for observation, [7] redundant examinations and re-appointments caused by a lack of diagnostic information [9]. The health information exchange enabled computable interoperability, which is the key to many of the initiatives underway, including the development of a regional health information exchange, to provide secure, ubiquitous access to complete health care
information and improve health care quality, reduce health care cost, prevent medical errors, and improve administrative efficiencies [10-12]. SALPA, the implementation project of the Regional Health Information Systems administered by the Satakunta Hospital District in 2004 – 2007 is comprised of integrated services between primary, secondary and tertiary care. The general aim was to provide member municipalities with access to specialised health care information and to sustain seamless care, and enhance organisational information exchange regardless of time and place. The clinicians and nurses may access real-time specialized health care information, crossing over organizational boundaries, viewing referrals by using a Reference Repository System (RRS) including security management services, consent management and identification (Salpa-card) services for health professionals. Referrals of medical reports, laboratory and radiology tests, treatments and courses of treatment can be viewed through the Regional Information System. At all points, there is a significant need for evaluation of the value of services from the health information exchange to various groups such as provider, payers, and employers [6.] 2. Objectives The aim of this paper is to give an overview of some selected outcomes after the implementation of a Regional Health Information Systems (RHIS) in one hospital district in Finland. The purpose of the outcome measurements is to study how the RHIS has influenced healthcare delivery, investigating the particular outcomes from the point of view of the organisation, professionals and patients, and how the implementation of an RHIS with a difference in utilization rates has impacted on the outcomes in the healthcare delivery. 3. Materials and Methods The research material composed of viewed referrals, utilization rate of the Regional Health Information Systems, and computer-based statistics and reports of some selected outcomes in 2004 – 2007 such as laboratory and radiology tests and appointments. The aim was to collect the data from all municipality health care centres in the hospital district. However, the research data received represents 83 % of the whole data of the area. 4. Results The impact of the use of the Regional Health Care Information System on health care delivery was investigated with regard to particular outcomes. Preliminary results of the selected outcomes indicate that the laboratory tests seem mainly to have increased in the municipal health centres. Reviews of the other preliminary results of outcomes, radiographic tests and the clinicians’ appointments indicate that they have mainly been reduced in the hospital district municipalities. (Table 1.) 5. Discussion and Conclusions According to previous research, this reduction [e.g. 13 and 14] is the result of decreases in laboratory and radiographic tests, and fewer admissions for observation. In this study, the preliminary results obtained indicate the opposite of the outcome results in laboratory tests, which had increased in the municipalities under review. The preliminary results of outcomes in radiology tests and appointments indicate parallel
results to the previous results [e.g. 13 -15], i.e. a reduction in tests and appointments in the member municipalities in one hospital district in 2004 – 2007. Preliminary results of the selected outcomes are present in general in the municipalities in one hospital district in 2004 - 2007. It is essential to investigate the impacts of the Regional Health Care Information System on healthcare delivery extensively and in the long term in member municipalities health centres. Furthermore, it is essential to investigate what are the other variables affecting healthcare delivery in the member municipalities. References [1]
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Table 1- The preliminary results of outcomes in laboratory, radiology tests and appointments Laboratory tests Municipality 1 2 3 4 5 6 7 8 9 10 Municipality
2005 2005
1 2 3 4 5 6 7 8 9 10
Municipality
2005
1 2 3 4 5 6 7 8 9 10
2006 Radiographic tests 2006 Appointments 2006
2007
2004 - 2007
2007
2004 - 2007
2007
2004 - 2007
