Clinical Support Information Systems (CSISs)

Abstract

Operating within a larger medical information system (MIS), clinical support information systems (CSISs) process the specialized subsystem information used in support of the direct care of patients. Most of these CSISs were developed as stand-alone systems. This chapter highlights the early efforts to combine data from disparate departmental data systems into more "integrated ones" that support the full spectrum of data management needs of multi-hospital and ambulatory health systems. In the 1960s and 1970s, institutions incorporated clinical laboratory and medication subsystems into their MISs; more subsystems were added (pathology, imaging, etc.); and systems with integrated CSIS were developed for ambulatory care settings. Despite all the progress made over the past 40 years, two key challenges remain unsolved: fi rst is the lack of data interoperability among myriad systems; second is the lack of a useful point of care system. Both threaten to make the clinician's work harder; overcoming them is key to transforming the health care system. Keywords Clinical support information system s • Integrated CSIS • Interoperability • Point of care system s • Clinical subsystem s • Dietary information system sTaking care of a patient in 1950 or 2010 usually involved a physician seeing the patient in a medical offi ce or in a hospital. To evaluate the patient's health status, the physician took a history of the patient's medical problems (symptoms), performed a physical examination to discover any physical abnormalities (signs), and combined the symptoms and signs to see if they fi tted any syndrome. He then recorded the patient's history and examination fi ndings and any preliminary impressions of any syndromes in the patient's medical record, which was usually a paper-based chart. The physician often referred the patient for tests and procedures that involved clinical laboratory, radiology, and other clinical support services. Upon reviewing the results from these services, the physician could make a preliminary diagnosis

Mobile Decision Support Tool for Emergency Departments and Mass Casualty Incidents (EDIT): Initial Study

“…Historically, Health Information Systems (HIS) and the medical community, in general, have been slow to adapt to new technologies [1]. However, healthcare institutions are now seeking to develop integrated computer-based information management environments with various informatics tools that aid care-givers in decision-making [2].…”