Alignment of an intra-operating management process to a health information system: a Lean analysis approach

摘要

Health information systems (HISs) are widely used in the healthcare domain for different purposes. To assess the integration between the newly applied HIS and the clinical process, an evaluation of both is necessary. This study focuses on the evaluation of a HIS adoption in the field of intra-operating management in the anesthesia process in heart operation. The HIS which is known as "IntelliVue Clinical Information Portfolio" (ICIP) was designed to assist anesthetists in the pre-operating and intra-operating management process. According to the anesthetist's feedback, some incidents were identified: The patient's vital signs recorded in the system, during the intra-operating process, have not been recorded from the beginning of the operation. To investigate the root of the problems and delays, we conducted a case study and applied the Lean method to the intra-operating management process. This paper represents the case study and the application of the Lean method in intra-operating management process after ICIP implementation. We applied the value stream map and the A3 method as the common tools of the Lean method to evaluate how the ICIP and clinical process fit are integrated. Application of Lean concept increased process integration which resulted in higher "value-added" activities to the patients. In addition, analysis of the process by Lean method identified the areas for improvement which reduced the "non-value-added" activities. Based on the findings, in order to increase integration and alignment of implemented HISs to clinical workflow, we recommend evaluating the implemented HISs and clinical process in unison.