Over the past several decades, health care and information technology have undergone a
period of dramatic change caused by a multitude of pressures and opportunities, many of
which continue to persist and evolve. As we have moved into globalization of
communication, technology, and information, Health Information Systems need to reflect
what is happening to ensure optimal use of clinical information.
In 2-3 (full) pages, discuss key historical trends involving the evolution of Health
Information System and respective health care environments. Describe how clinical
information systems and applications can fit together to provide comprehensive care. In
your discussion be sure to include both the benefits and challenges to the integration of
information systems and exchange of health information. Include reference to literature,
expert opinion and case examples from your research involving various health care
disciplines to support your position, key points, and explanations.
Health info systems
During the previous few decades, there have been dramatic changes in information
technology and healthcare as a result of a multitude of opportunities and pressures. These
changes continue evolving and persisting. Since there is globalization of information,
technology, and communication, there is a need of the Health Information Systems to reflect the
occurrences so that clinical information is used optimally. The aim of this paper is exploring the
historical trends of Health Information System in the respective healthcare environment.
Key historical trends- Health Information System evolution and the respective healthcare
Healthcare information systems and computing tools emerged several centuries back.
However, healthcare electronic computer systems began being used only about forty years ago.
The earlier information and computing systems emerged from the views of Von Liebnitz on the
classification and codification of human behavior. During the 1990s, there were market-driven
healthcare reforms in the healthcare environment, and these fueled the Health Information
Systems’ demand. Managed care expansion, integrated delivery systems’ development, and the
insurance reimbursement and billing processes’ major changes have prompted the exchange and
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integration of data and information, leading to development of the relevant information
technologies health informatics. Health informatics’ significance in healthcare has been
increasing as technology advances and as the available information’s abundance continues
growing (Tang & Lansky, 2005).
Electronic medical records are the basis for decision support systems. It evolved about
twenty years ago, and its uptake is increasing in the western countries. It is a health information
system that is computerized, and is used in the entire healthcare setting. The real history of EMS
started during the 1960s with the problem-oriented medical records. These were a breakthrough
in the medical recording. Until, now, doctors record the treatment and diagnosis they provide.
The CPOE (Computerized Provider Order Entry) is a system used by clinicians for
entering medication orders into the computer system. The order is then transmitted to the
pharmacy directly. In inpatient settings, medication errors are reduced significantly. Lockheed
Martin developed the pioneer CPOE in 1971 at El Camino hospital (Mountain View, Califonia).
It enabled the physicians to order medications quickly with just some few clicks. The
commercial CPOE grew fundamentally between 1994 and 2004. In 2009, less than ten percent of
the US hospitals had CPOE systems that were fully operational.
Telemedicine involves telecardiology, teleradiology, telepsychiaty, and telepediatrics,
and there is videoconferencing use. This technology is not new as its use started in the 1920s.
Therefore, the resent rapid growth period started about one decade ago. Hillestad et al. (2005)
noted that although there is still no detailed telemedicine evaluation and research, the current
history has a lot to tell, particularly in relation to the improvements needed.
Personal Health Record is a record that details the healthcare of an individual across
providers. It enables the coordination of lifelong health information. This technology has patient-
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provider messaging, online appointment calendars, and patients can annotate and view their
health records (Ross & Banchy, 2007). PHR first appeared in 1969 in some academic journal in
Germany. In the historical context in PHR represents notes in a very simple form containing
information needed so as to acquire information about the health of a person.
Telehealth involves healthcare delivery from a distance. Telehealth’s history can be
traced back to 1977. During this time, high-priced broadband systems transmitting the two-way
video/ audio communication between doctors and patients were assessed for quality.
How clinical information applications and systems can fit together for the provision of
Since the beginning of 1960s, Health Information Systems have rose rapidly. Presently,
the applications and systems touch on every healthcare aspect, affecting professionals from
different medical-related practice areas and disciplines. This means that the professionals from
these departments are able to use their various technologies when collaboration to offer care,
which would definitely translate to high quality, safe, and competent care. With the emergence
of the healthcare information technology, information systems are being developed so as to work
in union across patients, agencies, and providers (Herrick & Patterson, 2000). With this diversity,
it has been possible to enhance the patient-centered healthcare since there is better management
of medical information and information is being exchanged more securely.
Pros and cons of integrating information systems
The need to have the information systems integrated in turn leads to more information
and power, in addition to novel medical procedures and technology advancement. As a result to
the integration, there is an ever-expanding medical knowledge body, which changes quickly. At
the same time, knowledge and information are abandoned and generated in continually shorter
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cycles. The implication of this is that there is ever new information in the healthcare sector, an
indication that the state-of-the-art is known, promoting more appropriate solutions to the
challenges being faced (Stead et al., 2000).
The integration of the information systems has also played a cardinal role in ensuring that
there is an improved relationship between providers and patients, as the quality of care improves.
Other benefits that have been realized with this integration includes medical errors reduction,
increased care efficiency, expanding affordable care access, minimizing unnecessary healthcare
costs, and improving the population health (Herrick & Patterson, 2000).
A disadvantage of integrating the information systems is that at times, the result might be
an abundance of complex medical information and data, emerging from various departments. As
a result, it becomes too difficult to make sense of the information, meaning that it might not be
useful at the end. If the healthcare institution decides to amply a data analyst, then this becomes
an extra cost.
Pros and cons of health information exchange
One of the benefits of health information exchange is that care can be coordinated in a
better way, as every member of the interdisciplinary team is able to access and analyze the
information. As a result, the patients are able to benefit from the most appropriate evidence-
based care. Exchange of the health information has been very essential in ensuring that the
different departments increase their collaboration and teamwork in applying the information. As
a result, the general healthcare environment improves, there are better patient outcomes and
satisfaction, low turnover rates, and the employees’ satisfaction levels improve. Information
exchange helps in minimizing medication and other errors in the healthcare setting (Stead et al.,
2000). Exchanging the healthcare information has greatly ensured that efficiency is increased
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and better care offered to patients. Needs of patients and the organization are also being met
If the healthcare information is exchanged, it would be equally necessary to ensure that it
is being applied in the healthcare settings as intended. Failure to do this would make the
information and data useless, implying that all the efforts taken and resources used previously
would be wasted.
Herrick, M. W. & Patterson, A. (2000). Megatrends you need to know about (Healthcare trends
special report). Journal of AHIMA, 71(5), 26-31.
Hillestad R., Bigelow J., Bower A., Girosi F., Meili R., Scoville R., Taylor R. (2005). Can
Electronic Medical Systems Transform Health Care? Potential Health Benefits, Savings
and Costs. Health Affairs, 24 (5): 1103-1117.
Tang, P. C. & Lansky, D. (2005). The Missing Link: Bridging The Patient-Provider Health
Information Gap. Health Affairs, 24(5), 1290-1295.
Ross, C., & Banchy, P. (2007). The Key to CPOE. Health Management Technology, 28(11), 22,
Stead, W. W., Miller, R. A., Musen, M. A., & Hersh, W. R. (2000). Integration and beyond.
Journal of the American Medical Informatics Association, 7, 135-145.