Clinical information systems: 25-year history and the future.

Clinical information Systems have not advanced rapidly enough to meet the growing needs for clinical data. This is due primarily to the industry's past focus on financial information processing. Pressure is increasing for clinical data to support health-care professionals in the delivery of patient care, and in the establishment and monitoring of quality of care indicators. This article summarizes the history of clinical systems, and presents key issues regarding future clinical information systems.

Leading the change process. Interview by Michael L. Laughlin and Carolyn Dunbar.

'Change or cease to exist.' In interviews with Computers in Healthcare six industry leaders agree that increasing market pressures will force many organizations to drastically modify the way they do business. Those that don't will eventually fail.

Multihospital integration issues: it doesn't get much harder than this.

Multihealthcare organizations face unique challenges when it comes to providing information services for all of their entities. They must consider corporate philosophy, geography, computing configurations and whether their I/S approach capitalizes on centralized economies of scale or regional flexibility and control. Multisystem experts George Kennedy and Stan Jaworksi of The Kennedy Group, Redwood City, Calif., describe system integration trends in multihealthcare organizations and provide an overview of the implications for information systems executives.

Info systems head toward central decisionmaking.

Information system vendors are moving away from consolidation and merger, while more multihospital systems that buy from the vendors are moving toward centralized decisionmaking, says George Kennedy.

Selecting patient accounting systems: what are the key criteria?

A recent survey of healthcare finance executives on patient accounting system usage provided information on how key decisions about systems are made. Results show that decision makers are handicapped in the decision-making process because they are aware of only a subset of available systems, decreasing the likelihood of selecting the best possible system.

Patient accounting systems: needs and capabilities.

In the first article of this series, it was stated that most finance executives are not very satisfied with the performance of their current patient accounting systems. What steps can a patient accounting system planner take to help ensure the system selected will garner high ratings from managers and users? Two primarily steps need to be taken. First, the planner needs to perform a thorough evaluation of both near- and long-term patient accounting requirements. He should determine which features and functions are most critical and ensure they are incorporated as selection criteria. The planner should also incorporate institutional planning into that process, such as planned expansion of facilities or services, to ensure that the system selected has the growth potential, interfacing capabilities, and flexibility to respond to the changing environment. Then, once system needs are fully charted, the planner should educate himself about the range of patient accounting system solutions available. The data show that most financial managers lack knowledge about most of the major patient accounting system vendors in the marketplace. Once vendors that offer systems that seemingly could meet needs are identified, the wise system planner will also want to obtain information from users about those vendors, to determine whether the systems perform as described and whether the vendor has been responsive to the needs of its customers. This step is a particularly important part of the planning process, because the data also show that users of some systems are significantly more satisfied than users of other patient accounting systems.

Selecting patient accounting systems that stand out from the rest.

How satisfied is the average finance executive with the performance of his institution's patient accounting system? Not very. What causes this dissatisfaction? A variety of factors: Not enough flexibility, the inability to modify or expand the system, the lack of system interfaces, and inadequate support. These are all leading contributors to the finance executive's dissatisfaction. How much information does he have about the alternative patient accounting system vendors in the marketplace? On average, limited information. Many vendors who offer patient accounting systems have not done enough to disseminate information about their products to hospital decision makers. If the finance executive were more knowledgeable about the alternatives available, would he then be able to select a patient accounting system that fully meets the institution's needs? It would improve the odds. However, merely knowing about the alternatives is only the first step. He must be able to fully evaluate the institution's near and long-term needs to create the best match possible. The finance executive must also accept the possibility that there may not be a single system in the marketplace that can accommodate every perceived need. Only by knowledge of the marketplace will he be in a position to fully evaluate the potential benefits of the available systems.