Integrated information management platform supporting the collection, access, use and sharing of information supporting the delivery of health services to persons and populations in multiple settings across the continuum of care. In addition to EHR and EMR functions, a CIS facilitates the management of services delivered by organizations, such as registration, bed management, transition tracking, and resource allocation. Decision support and analytics are embedded to realize a comprehensive continuum-of care collection of records supporting both health care and health care improvement (ie. MEDITECH, Sunrise Clinical Manager, eCLINICIAN, eCritical, etc.).
Manner in which a software system is prepared for a particular implementation or use. Modification of currently available foundation features, functions or properties to prepare the CIS for use throughout a particular jurisdiction; resulting in a useable platform on which further changes, in the form of customizations or personalizations, may be applied. When subsequent changes, additions or enhancements affect the system for all users, they are configuration changes. CIS configurations may include component or suggested workflow adaptations for compliance with Canadian units, standards and conventions; adjustment for common workflows and norms; and local assurance of functional capabilities required by AHS and committed by the vendor. The CIS configuration expresses common design principles and includes defined data, interfaces, forms and elements that are not altered by customization or personalization. The CIS configuration will include the default state of all modules and will persist across upgrades and updates.
Changes or adaptations to the features of a software system required when the standard configuration will not meet the needs of a particular domain, group or activity. Creation of one or more alternative implementations of a clinical information system – modifications affecting the user interface, information management, inputs or outputs – to address the business rules and workflow needs of a defined group, area or business activity. CIS customizations are anticipated for different clinical and operational domains that have internally consistent workflows and needs that differ significantly from the workflows and needs of others. The informational and interface challenges of a transplant service, for example, may be different enough from those of a medical inpatient service to merit customized information capture, organization, presentation, validation and analytics. CIS customizations must be governed, managed and designed such that they persist safely across system upgrades or configuration changes.
The longitudinal collection of personal health information supporting multiple health service providers across the continuum of care with appropriate information securely delivered to authorized individuals. An EHR offers a cradle-to-grave, read-only, aggregated view of information from multiple databases about key health events in an individual’s life; information that any health care provider may need in order to serve an individual (ie. Alberta Netcare Portal)
Record of health services and related information maintained by health care providers in an electronic system for access and use by the providers. An EMR helps healthcare providers manage the services that they are accountable for, including read-write provisions for local documentation, ordering, scheduling, result tracking, communications and billing (ie. MedAccess, HealthQuest, Wolf EMR, etc.).
Default configuration provided by a system vendor for typical use. A CIS vendor may produce an offering optimized for a particular country, customer type, standards-mix or context. This common foundation should work for all customers of that type in that context but would not be adapted to any specific client needs. However, a foundation offering may include multiple modules that address the needs of specific contexts or users. The foundation is the starting point for AHS. Configuration must occur before the CIS is AHS-ready. Further customization may add value for particular programs. Degrees of personalization may be supported by the foundation, and limited by the configuration and customizations, to add value for individuals.
The act of uniting separate systems or replacing them with a new system, such that the result performs all the same functions within a single system. A single seamless CIS performs the same functions previously performed by multiple discrete health information systems. Seamless connotes a common code set, dataset and configuration controls. A fully integrated CIS does not have to have derived from a single software development pathway. It is possible for different components from different development pathways, or even products, to have been sufficiently integrated that they behave as if working from a common code set, with unified data management and user interface controls. Integration implies that all parts of the system can reference the same taxonomies, terminologies and components.
Ability of a system to work with or use the parts or functions of another system. Interoperability describes the extent to which independent systems interact with a CIS to exchange and interpret data or information. For a system to interoperate with a CIS, it must be able to exchange data with the CIS and both systems must be able to present that data, without loss of context or meaning, so that it can be understood by respective users. Although unique data translation schemes may facilitate data exchange and interpretation, interoperability is strongest when standards based and capable of crossing multiple system-to-system divides. Interoperation presumes systems that can perform their functions independently and only interoperate to facilitate information sharing.
Ability of one system to complement the functions of another system by consuming or providing information in order to perform a particular function. A CIS interface will allow another software system or device to access, and possibly return information in order to provide a unique user experience, automate information capture or otherwise enhance functionality not already provided by the CIS. Medical devices may be optimized for capture of health data that is transferred to the CIS using a standards-based interface. Interfaces can be at the level of discrete data entry or more deeply at the level of large data structures. The CIS may interface with systems or devices through a standards-based middle layer, such as a health information exchange. Apple Health Kit and Google Fit are examples of middle layers allowing multiple applications and devices developed by multiple vendors to share a common data protocol and even a common data set. A CIS capable of interfacing with either could receive personal information from mobile health applications; or possibly publish health data to those applications.
Individual access to specific elements and functions of an EMR or CIS. A PP is tethered to an EMR or CIS, leveraging that product to engage individuals as participants in healthcare service management through meaningful access to such functions as scheduling, communications, health maintenance, health status tracking and other EMR or CIS assets (ie. eCLINICIAN MyChart).
Individually curated record of personal health history and ongoing health events which may be shared with health service providers. A PHR allows individuals to record and track their own health history, observations and outcomes (ie. HealthVault).
Individually managed access to health information and resources, including all or part of a PHR and/or EHR. A PHP provides access to health information, resources, one or more types of EHR content, all possibly integrated with PHR content (ie. MyHealth.Alberta.ca).
Changes or adaptations to the features of a software system to fit the needs of a particular person or group of persons. Adaptation or adjustment of base configuration or customized interfaces and activities to improve usability, convenience, efficiency and safety for a particular user. One user may share helpful personalizations with other users. Constraints on what can be personalized, to what degree, and how personalizations might be shared, can be set at the foundation, configuration or customization level. Personalizations are essential for adapting a CIS to the specific needs of end-users; without endangering data, function, content or standards. Personalizations might involve saved frequently-used documentation blocks, particulars of commonly administered medications, or lists of favorite functions. Support for personalization must not affect configuration or customization settings and must be capable of persisting across system upgrades. This may mean that elements like order-sets and other decision supports cannot be personalized; for lack of safe means to update them when CIS content or decision supports are modified.
