www.research.ibm.com/hc/CIS/cis.html
Clinical Information System
Patient care has become increasingly complex with the widespread use of advanced technologies in routine care. Healthcare providers must keep track of a staggering amount of information -- and their failure to do so can have a detrimental effect on patient care. Clinical Information System (CIS) is a solution to this dilemma. CIS is designed to bring the management of patient data into the information age. It is intended to replace the Medical Records Department of a medical institution, supporting the acquisition, storage, manipulation, and distribution of clinical information throughout the organization.
Before designing the specific features of CIS, IBM researchers, working with a group of physicians at Kaiser Permanente of Colorado, determined that the optimal system would be very flexible and easily adaptable to changing procedures and regulations. It would be easily scalable -- to grow with the institution -- and integrate easily with pre-existing ancillary systems such as the pharmacy management system, the laboratory management system, and the radiology management system. It would also be very flexible in terms of what can go in a patient record, but be strict enough to facilitate analysis of outcomes.
IBM's researchers then applied advanced software engineering concepts to create CIS. To allow CIS to easily evolve as work procedures change, CIS is driven by knowledge which is stored outside the system. Such information may be dynamically modified by the medical personnel, while at the same time being dynamically interpreted by the "software agents" within CIS. By using a distributed computing model, with optimistic concurrency control and advanced fault-tolerance schemes, the system is reliable and easily scalable. Open communications standards allow for easy exchange of information between CIS and ancillary systems. Object oriented programming techniques were used for maximal robustness, and maintainability.
While CIS can take the place of a Medical Records Department, it is not designed to replace departmental ancillary systems. Rather, CIS establishes direct electronic communications with each of these ancillary systems, integrating them into an overall solution. Through this electronic interface, CIS can communicate providers' orders to these systems and deliver status reports and order results generated by them back to the providers.
The following figure illustrates how CIS works with other medical applications.
CIS not only automates and streamlines many of the processes used by healthcare providers, but provides an extremely useful and usable electronic patient chart. The electronic patient record has all the flexibility of the traditional patient chart and all the advantages of electronic information flow. The care provider can update, browse, and share the information on the chart, and use it for outcome analysis, as well as integrate the information into the electronic systems for billing, filling prescription, lab tests, referrals, etc. While patient data tends to come from a variety of autonomous and dissimilar clinical applications, the healthcare provider using CIS works with just one interface.
