A Clinical Information System (CIS) is a computer based system that is designed for collecting, storing, manipulating and making available clinical information important to the healthcare delivery process.
Clinical Information Systems may be limited in extent to a single area (e.g. laboratory systems, ECG management systems) or they may be more widespread and include virtually all aspects of clinical information (e.g. electronic medical records).
Clinical Information Systems provide a clinical data repository that stores clinical data such as the patient’s history of illness and the interactions with care providers. The repository encodes information capable of helping physicians decide about the patient’s condition, treatment options, and wellness activities as well as the status of decisions, actions undertaken and other relevant information that could help in performing those actions.
Some of the areas addressed by Clinical Information Systems are:
Clinical Decision Support: This provides users with the tools to acquire, manipulate, apply and display appropriate information to aid in the making of correct, timely and evidence-based clinical decisions.
Electronic Medical Records (EMRs): this contains information about the patient, from their personal details, such as their name, age, address and sex to details of every aspect of care given by the hospital (from routine visits to major operations).
Training and Research: Patient information can be made available to physicians for the purpose of training and research. Data mining of the information stored in databases could provide insights into disease states and how best to manage them.
For years, research has been done to show the value of Clinical Information Systems, and these have highlighted not just the benefits but also the barriers that might be faced by hospitals who implement such systems.
Some of the benefits are:
Easy Access to Patient Data: Clinical Information Systems can provide convenient access to medical records at all points of care. This is especially beneficial at ambulatory points, hence enhancing continuity of care. Internet-based access improves the ability to remotely access such data.
Structured Information: The clinical information captured in Clinical Information Systems is well organised, thus making I easier to maintain and quicker to search through for relevant information. The information is also legible, making it less likely that mistakes would be made due to illegible writing.
Improved Drug Prescription and Patient Safety: Clinical Information Systems improve drug dosing and this leads to the reduction of adverse drug interactions while promoting more appropriate pharmaceutical utilisation.
Despite the benefits being offered by Clinical Information Systems, they are not without the barriers that prevent them from being rolled out in every hospital. These include some of the following:
Initial cost of acquisition: the high cost of basic infrastructure of clinical information technology can be a stumbling block to many healthcare organisations.
Privacy and Security: There are still huge concerns in the healthcare industry about the privacy of patient data on computer systems and how to keep such information secure. The HIPAA and Data Protection Act passed by respective governments in the US and the UK were introduced to address some of these concerns.
Clinician Resistance: Clinicians usually have 10-20 minutes to see their patients and if their interactions with a CIS during these sessions proves to be counterintuitive by taking up more time than is necessary, there is bound to resistance to it use.
Integration of Legacy Systems: This poses a stiff challenge to many organizations.