OPERATING ROOM INFORMATION SYSTEMS
It is hard to imagine that ORs, the largest and most complex areas
of the hospital, which are also the site of the greatest revenue (as well as costs),
are not more fully developed in information technology. The OR has been
referred to as being data rich but information poor. Hospitals in general have been
thought to be 10 to 20 years behind industry in developing information management.
However, information systems are critical for the OR director to effectively run
this area. A well-designed system can provide many benefits, including OR scheduling,
automated records, materials management, preoperative data, laboratory tracking,
medication tracking, cost data, patient tracking, and quality improvement/quality
assessment (QI/QA).[68]
[69]
[70]
[71]
[72]
[73]
Most hospitals now only use the basics of
such
systems to manage scheduling, generate statistical reports, and create equipment
lists.
These information systems are complex and expensive. The need
for information systems to integrate large volumes of information from many different
sources has been a challenge for companies. It has been estimated that a single
OR case creates over 1 million data bits in 3 hours.[74]
However, manual transcription of this information is also problematic. Legibility,
medical errors, regulatory compliance, and legal concerns make manual record keeping
less than ideal. Manual entry also requires significant time; it has been estimated
that 30% to 40% of an anesthesia provider's time in the OR is spent functioning as
a scribe for information.[74]
Hospitals have been slow to adopt information systems in the OR
for a variety of reasons. These systems are expensive, with costs averaging 1 to
2 million dollars for a medium-sized hospital. Integration of the new system into
the OR requires a lot of work and the continual support of a systems manager. Vendor
credibility in delivering all the advertised benefits of the system has also been
of concern. Hospitals frequently want to see a return-on-investment analysis to
justify the expense of these systems. These systems may provide value by improving
charge data and managing equipment and personnel better. A detailed information
management system is invaluable to the OR director. Data on OR resources allow improved
QI/QA assessment. Clear, accurate information allows the OR manager to focus on
areas of improvement and create behavior changes in the system. Information systems
should not be considered a luxury but rather a necessity for the OR director to monitor
the OR process and make the necessary changes to remain efficient and competitive.
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