Components of HIT…a start

UPDATE: The final output of this project, HIT Ontology, can be found in this blog post: http://singularityblog.wordpress.com/2009/07/20/health-it-ontology/

Health information technology (HIT) is a broad and extremely complex field, and I want to visualize it. I’m going to need your help to do it. But first it needs defining…

HIT could simply be defined as any information technology utilized within the healthcare industry vertical, but that would be too inclusive, because that means a MySQL database is considered HIT because it is sometimes used in a hospital. Brailer & Thompson, former ONC Secretary and former HHS Secretary respectively, define it as “the application of information processing involving both computer hardware and software that deals with the storage, retrieval, sharing, and use of health care information, data, and knowledge for communication and decision making” (Thompson & Braile, 2004). The line between HIT and health informatics is fuzzy and we’ll ignore it for now.

With this definition, I tried to create a hierarchical list of the types of health IT software. I want the list to be comprehensive in breadth and don’t care quite as much about depth (3 or 4 levels should be sufficient). There are dozens of ways to structure this list and probably hundreds of items I missed. This is a work in progress, so please leave a comment and let me know what you would change/add/remove. I’ll keep updating it until everyone feels good about it. After that comes the visualization…

HIT Categorization Hierarchy – Take 5

  • Clinical
    • EMR/EHR
      • Ambulatory
      • Specialty
      • Anti-Retroviral Treatment (ART) Focused (common in areas with high HIV/AIDS & TB prevalence)
    • eRx (CPOE)
    • Clinical Decision Support
    • Digital Imaging & Archiving Systems (e.g. PACS)
    • Medical Devices & Equipment
    • Clinical Document Management
    • “Personalized Medicine”
  • Hospital/Clinic Management
    • Physician Office Management Information System (POMIS)
    • Hospital Management Information System (HMIS)
    • Accounting
    • Patient Billing
    • Claims Processing
    • Human Resource Management
    • OR Scheduling
    • Appointment Scheduling
    • Lab/Pharmacy Management
  • Public Health & Biosurveillance
    • Public Health Reporting
    • Diesease Surveillance Networks (e.g. CDC Biomonitoring and Environmental Public Health Tracking Network)
    • Vital Registry (Birth, Death, & Marraige Records)
  • Consumer-Oriented Technologies
    • Personal Health Devices (e.g. WAN-enabled weight scale, phone-enabled glucose monitor, etc.)
    • Personal Health Applications (i.e. exercise & weight tracking)
    • Patient Portals
    • Personal Health Records (PHR)
    • Health-centered Social Networks (Patients Like Me, 23andme, etc.)
  • Medical References
    • Drug references (for docs and patients)
    • Medical references (like WebMD, also for docs and patients)
  • Research
    • Genomics
    • Medical data warehousing
    • Clinical Trial Recruitment, Management, etc.
  • Regional & Systems Level Health Information Systems
    • Vitals Registration
    • Health Information Exchange (HIE)
    • National Health Information Network (NHIN)

A special thanks to the Twitterers that have already helped me on this: @chadosgood, @oneofthefreds, @ChristineKraft, @ePatientDave, @MedC2, and my good friend Jake. And a shout out to Sam Adam’s HIT Primer on his blog, IT (R)EVOLUTION, that helped get me started.

A few other helpful sources:

7 responses to “Components of HIT…a start

  1. Ranking/rating/review system for patients to instantly rate/review care received no matter where/what in medical setting….

    @SusannahFox, @jayparkinson and I (@staticnrg) had a twittersation about this yesterday. Jay tweeted a link and said: “yep. next minor revision of hh will have this built in: http://bit.ly/R4ZzR their dashboards are awesome.”

    Love the idea/concept. My theory is that patients tend only to rate doctors/medical personnel/medical facilities only when disgruntled as things stand now. With an easy response/survey system like Jay linked, patients can give valuable feedback instantly which benefits all concerned. It does not have to be a negative system.

  2. The components of HIT are evolving all the time but to begin with you must understand where the application is being used. So if you were to be focusing on personal health records the first thing you could do is to review most all PHR vendor software to how each vendor tackles content. Then after you develop a list of data points and functions see if you could get the attention of physicians to guide the content. One thing is for sure even for the Personal Health Record the content and functionality will expand endlessly.

  3. You might also want to include Claims Processing software – the system that automatically submits reimbursement claims for medical practices and deals with all the bureaucracy surrounding them.

  4. Nicolae, Good suggestion on claims processing. I think I’ll wrap that in with the section on billing software.

    Alfred, regarding endlessly expanding functionality, that’s a great point. This will probably never be a final list. But I’m hoping that the general categories, just a few layers deep (so avoiding actual functionality and technical implementation), will not change much at least for a couple of years.

    Thanks for your comments!

  5. Pingback: Health IT Ontology « singularity

  6. Pingback: aaron c beals » Blog Archive » feedback on health IT ontology

  7. Although it could fall under patient billing I believe what I am about to mention is different. With the growing amount of the physician bill that is paid by the patient there is an emergence of tools that estimate the amount a patient will owe at the point of care instead of being forced to wait until the claim adjudicates. There is a description of this in the following article:

    http://www.claimcare.net/medical-billing-news/bid/9721/ClaimCare-s-Patient-Collection-Tool-Maximizes-Patient-Collections

    I am not trying to be self serving with the link above, but this type of software is growing in importance and is rarely considered when people talk about patient collections.

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