Analysis of the Clinical Nutrition Information System and the Medication Reconciliation Application

Abstract

Health organizations are in continuing need for up-to-date health information systems that are needed to assist healthcare professionals in order to deliver good quality patient care. This report presents the work done by the author during her internship period at the Information and Informatics Department (ISID) of King Abdulaziz Medical City (KAMC).The ISID is responsible for the development and the improvement of the medical information management systems and sub-systems required for ensuring the best quality healthcare in KAMC. Medical program analysis is a crucial part of any health informatics project due to the importance of ensuring the interoperability between the different medical information systems and sub systems at a hospital. The author has worked with medical sub system division of ISID where she was responsible for analyzing the new clinical nutrition information system. She contributed in the workflow design and solution introduction for the problems faced during the testing period of the project. The clinical nutrition department at KAMC requested a health information system that is specially customized to fit the clinical and non–clinical tasks performed at the hospital by the clinical nutrition department as a part of the hospital’s core workflow. The objective of this project is to automate these tasks in order to eliminate the use of papers during the day-to-day work of the department. Also, this project aims to insure the integration of the new system with the main hospital information system: QuadraMed® Computerized- Patient Record System (QCPR). The main problem faced during the testing period of the clinical nutrition information system was the integration between the new system (VersaSuite) and QCPR. To insure interoperability, the new system should fully integrate with QCPR via the HL7 integration engine. The problem was in a segment of the HL7 observation message sent from QCPR to VersaSuite. The author joined the team in solving this problem by modifying the message to delete the segment during transfer via the integration engine due to the fact that the segment is not needed in the nutritional assessment therefore, not needed to be received by the VersaSuite system. The author also had the opportunity to participate in the project of medication reconciliation application operated by the clinical information management system division of ISID. She developed workflows and helped in solving problems found during the planning stage of the project. 4 Medication reconciliation has become a routine duty of any physician. Medication reconciliation is essential to decrease medication errors that could happen during patient admission or discharge. The goal of the project of medication reconciliation application is to computerize the medication reconciliation process using the tools provided by the main hospital information system (QCPR). The author took part in solving the problems faced during the planning of the medication reconciliation project. These problems included change resistance and integration barriers. The change resistance was solved by using change management concepts. The out-patient pharmacy legacy system created an integration barrier. This integration barrier was overcome by modifying the workflow to capture the medication dispensed to patients in order to properly track medication history. The author concludes this report with recommendations that could be used to improve the clinical nutrition information system and the medication reconciliation application. These recommendations include ideas to increase efficiency of the medication reconciliation application and of the clinical nutrition information system. The author achieved her tasks during the internship by applying the principles and knowledge that she acquired while taking the Masters of Health Informatics (MHI) academic courses at Dalhousie University.