Integration of healthcare and financial information: Evaluation in a public hospital using a comprehensive approach

Escobar‐Pérez, Bernabé; Escobar‐Rodríguez, Tomás; Bartual-Sopena, Lourdes

doi:10.1177/1460458215595259

Cited by 6 publications

(4 citation statements)

References 71 publications

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“…The study finds that the extent of IT systems' integration, including billing management, referral letters and decision support, significantly reduces the time to recover CIS operations post a data disaster. Hospitals can either opt for complete or partial integration of clinical, administrative and financial subsystems (Escobar-P erez et al, 2016). Each subsystem becomes part of a parent system with a centralized database and communication in the complete integration.…”

Section: Contribution and Recommendationsmentioning

confidence: 99%

“…These subsystems and instruments either independently maintain their information in a separate database and operate in a silo or are integrated with a hospital-wide EMR system. The integration with the EMR system leads to a unified view of the patient data for all CIS components (Escobar-P erez et al, 2016). The complete integration of heterogenous systems demands process reengineering or adopting new technology to assist with integrating legacy systems into system environments.…”

Section: Introductionmentioning

confidence: 99%

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Restoring clinical information system operations post data disaster: the role of IT investment, integration and interoperability

Shrivastava

Hazarika

Rea

2021

IMDS

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PurposeDelay in the clinical information system (CIS) restoration overseeing critical health-care operations after an unexpected data loss can be fatal for patients under care. Investment in information technology (IT) capabilities and synergy between various computerized systems has been argued as the resilient information system's enablers. The purpose of this study is to empirically quantify the influence of IT investment, integration and interoperability in recovering the CIS from a data disaster.Design/methodology/approachAn archival dataset sourced from a European Commission-sponsored survey of 773 hospitals across 30 countries in Europe is utilized to study the relationships. The study adopts a quasi-experimental research design approach where sample observations are weighted based on their propensity to be selected in treatment groups. The artificial weighing allows attaining a pseudo-random sample to counter the effects of selection bias.FindingsThe study finds that hospitals with more than 5% of the budget dedicated to IT have 100% higher odds of recovering immediately from a critical data loss in comparison to those that have less than 1% investment in IT. The greater extent of IT integration significantly reduces the time to recover the CIS, while interoperability problems at the organizational level lessen the odds of immediate recovery by 19%. Interoperability problems at the technical and semantic levels do not significantly impact recovery times of the CIS.Originality/valueThe study proposes several empirically quantified and scientifically tested recommendations for health-care providers for faster restoration of critical CIS operations post data loss. The differential impact of the interoperability problems at the technical, semantic and organizational levels has also been highlighted.

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Section: Contribution and Recommendationsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Restoring clinical information system operations post data disaster: the role of IT investment, integration and interoperability

Shrivastava

Hazarika

Rea

2021

IMDS

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“…1 Division of Non-communicable Diseases, Ministry of Health, Kenya; 2 Faculty of Medicine, University of Geneva, SwitzerlandGeneva; 3 Department of Medicine, Moi University School of Medicine, KenyaEldoret; 4 AMPATH, KenyaLondon; 5 MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom; 6 National AIDS Control Council, KenyaLondon; 7 Division of Primary Care Medicine, Geneva University Hospital and University of Geneva, Geneva, Switzerland; 8 Division of Tropical and Humanitarian Medicine, University of Geneva and Geneva University Hospitals, Geneva, Switzerland; 9 John Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; 10 Fogarty International Center, National Institutes of Health, Bethesda, MD, USA…”

Section: A U T H O R S ' a F F I L I A T I O N Smentioning

confidence: 99%

“…An example of where this is taking place is Kenya, whose National Strategy for Prevention and Control of NCDs 2015 to 2020 emphasizes linkage of care between major NCDs and communicable diseases such as human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) and tuberculosis (TB) [4]. Separate care models can result in redundancies at the system, service and patient level, such as separate training programmes, laboratory infrastructure and data systems [5,6]. Integration is premised on the assumption that these redundant edges in well financed primary care platforms can be leveraged for under-resourced and under-developed programmes such as those for NCDs and that there exists potential for synergies and shared benefits for both provider and user in delivering integrated and comprehensive care packages.…”

Section: Introductionmentioning

confidence: 99%

Recommendations for the use of mathematical modelling to support decision‐making on integration of non‐communicable diseases into HIV care

et al. 2020

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Introduction: Integrating services for non-communicable diseases (NCDs) into existing primary care platforms such as HIV programmes has been recommended as a way of strengthening health systems, reducing redundancies and leveraging existing systems to rapidly scale-up underdeveloped programmes. Mathematical modelling provides a powerful tool to address questions around priorities, optimization and implementation of such programmes. In this study, we examine the case for NCD-HIV integration, use Kenya as a case-study to highlight how modelling has supported wider policy formulation and decision-making in healthcare and to collate stakeholders' recommendations on use of models for NCD-HIV integration decisionmaking. Discussion: Across Africa, NCDs are increasingly posing challenges for health systems, which historically focused on the care of acute and infectious conditions. Pilot programmes using integrated care services have generated advantages for both provider and user, been cost-effective, practical and achieve rapid coverage scale-up. The shared chronic nature of NCDs and HIV means that many operational approaches and infrastructure developed for HIV programmes apply to NCDs, suggesting this to be a cost-effective and sustainable policy option for countries with large HIV programmes and small, un-resourced NCD programmes. However, the vertical nature of current disease programmes, policy financing and operations operate as barriers to NCD-HIV integration. Modelling has successfully been used to inform health decision-making across a number of disease areas and in a number of ways. Examples from Kenya include (i) estimating current and future disease burden to set priorities for public health interventions, (ii) forecasting the requisite investments by government, (iii) comparing the impact of different integration approaches, (iv) performing cost-benefit analysis for integration and (v) evaluating health system capacity needs. Conclusions: Modelling can and should play an integral part in the decision-making processes for health in general and NCD-HIV integration specifically. It is especially useful where little data is available. The successful use of modelling to inform decision-making will depend on several factors including policy makers' comfort with and understanding of models and their uncertainties, modellers understanding of national priorities, funding opportunities and building local modelling capacity to ensure sustainability.

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Routine Health Information System (RHIS) improvements for strengthened health system management

Leon

Balakrishna

Hohlfeld

et al. 2020

Cochrane Database of Systematic Reviews

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Background A well‐functioning routine health information system (RHIS) can provide the information needed for health system management, for governance, accountability, planning, policy making, surveillance and quality improvement, but poor information support has been identified as a major obstacle for improving health system management. Objectives To assess the effects of interventions to improve routine health information systems in terms of RHIS performance, and also, in terms of improved health system management performance, and improved patient and population health outcomes. Search methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library, MEDLINE Ovid and Embase Ovid in May 2019. We searched Global Health, Ovid and PsycInfo in April 2016. In January 2020 we searched for grey literature in the Grey Literature Report and in OpenGrey, and for ongoing trials using the International Clinical Trials Registry Platform (ICTRP) and ClinicalTrials.gov. In October 2019 we also did a cited reference search using Web of Science, and a ‘similar articles’ search in PubMed. Selection criteria Randomised and non‐randomised trials, controlled before‐after studies and time‐series studies comparing routine health information system interventions, with controls, in primary, hospital or community health care settings. Participants included clinical staff and management, district management and community health workers using routine information systems. Data collection and analysis Two authors independently reviewed records to identify studies for inclusion, extracted data from the included studies and assessed the risk of bias. Interventions and outcomes were too varied across studies to allow for pooled risk analysis. We present a 'Summary of findings' table for each intervention comparisons broadly categorised into Technical and Organisational (or a combination), and report outcomes on data quality and service quality. We used the GRADE approach to assess the certainty of the evidence. Main results We included six studies: four cluster randomised trials and two controlled before‐after studies, from Africa and South America. Three studies evaluated technical interventions, one study evaluated an organisational intervention, and two studies evaluated a combination of technical and organisational interventions. Four studies reported on data quality and six studies reported on service quality. In terms of data quality, a web‐based electronic TB laboratory information system probably reduces the length of time to reporting of TB test results, and probably reduces the overall rate of recording errors of TB test results, compared to a paper‐based system (moderate certainty evidence). We are uncertain about the effect of the electronic laboratory information system on the recording rate of serious...

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Integration of healthcare and financial information: Evaluation in a public hospital using a comprehensive approach

Cited by 6 publications

References 71 publications

Restoring clinical information system operations post data disaster: the role of IT investment, integration and interoperability

Restoring clinical information system operations post data disaster: the role of IT investment, integration and interoperability

Recommendations for the use of mathematical modelling to support decision‐making on integration of non‐communicable diseases into HIV care

Routine Health Information System (RHIS) improvements for strengthened health system management

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