The objective of this study is to compare and contrast a contemporary healthcare facility or physician's office health care facility or physician's office operation of 20 years ago and to identify at least two major events and technological advantages that influenced current HCIS practices. The physician's office and health care facility of 20 years ago was a paper-based operation. All records were paper records, appointments were written on calendars and prescriptions were handwritten, notations on the patient's health records was done by writing on the physical paper record and all hospital orders were written by hand. During the 1970s hospital growth and expansion occurred and the expenditures for Medicare and Medicaid were on the rise. At this time mainframes were still in use and microcomputers became available and not only were they smaller but they were also less expensive. However, transformation did not come until the 1980s when two things happened. First the microcomputer or the PC was unveiled and secondly, the local area network came into being. Following close behind was the capacity for distributed data processing, expansion of clinical information systems in hospitals, introduction of billing systems by physician practices, affordable powerful computers being available to smaller organizations and the ability to integration financial and clinical information becoming increasingly important. In the 1990s there was a call for reform of the health care system and this resulted in changes in the way that physician reimbursement to Medicare and growth of managed care and integrated delivery systems as well as the Institute of Medicine calling for adoption of computer-based patient records. (History and Evolution of Health Care Information Systems, nd, paraphrased) In addition, the 1990s was characterized by the Internet's introduction, which resulted in a revolution in how organizations communicate with one another, how services were marketed, and how business was conducted. The cost of hardware also became less expensive. Health care organizations make good use of the Internet by the 1990s and the vendor community expands rapidly with a diverse array of HCIS products and services becoming available with a growing emphasis on clinical applications. During the 1990s, adoption of CPR/EMR systems was small in nature. By the 2000s decade the entire health care environment had transformed. (History and Evolution of Health Care Information Systems, nd, paraphrased) Health care information systems are one of two types: (1) practice management; (2) electronic health records (EHR). ( ) Practice management software enables the organization of patient information including "appointments, lab results, and referrals." (History and Evolution of Health Care Information Systems, nd, paraphrased) Electronic health records contain the same information, as would the traditional patient health record. Today's health care information system is highly integrated with service providers, hospitals, and pharmacies. The physician can order hospital and clinical testing via a handheld device that is linked to the hospital network linking all departments of the hospital together enabling communication in and among this group of providers. A cost-benefit analysis conducted and reported upon states that when analyzing the usefulness of implementing HIT the various factors that must be considered include:
(1) The potential of this technology to improve health care quality, safety, and patient satisfaction -- and how this potential has been demonstrated.
(2) The cost-effectiveness of the technology -- the business case for adoption of the technology -- including the total costs of implementation (both financial and in terms of resources) and any cost savings that accrue. Concerns exist that those who bear the greatest share of such costs are not able to recoup those costs.
(3) The ability to generalize the effects of an HIT intervention on costs and benefits in existing systems (using published experience with or research on these systems) to the technology's use by other health care organizations. (Southern California Evidence-based Practice Center, nd, p.1)
The costs of implementing an HER system is reported and it is stated that five studies "quantitatively assessed the costs of implementing an EHR system" and that the costs are categorized as follows:
(1) cost of the system itself (hardware, software, license, maintenance, and support) and (2) implementation cost (training, temporary loss of productivity, etc.). (Southern California Evidence-based Practice Center, nd, p.)
The reports following the study states that the evidence indicated that implementation of EHR…