Introduction

The National Library of Medicine awarded the Robert C. Byrd Health Sciences Center (RCB HSC) a two-year planning grant to develop an Integrated Advanced Information Management Systems (IAIMS) Program beginning April 1, 1998. IAIMS are institution-wide information systems that link and relate institutional databases and information files for patient care, administration, education, and research with library systems. Emphasis is placed on facilitating effective access to information.

The RCB HSC IAIMS planning process involves resources from three separate legal entities: WVUH, UHA, and HSC. Despite this complexity, there is a consensus that an integrated system that provides required information resources when and where they are needed will become a cornerstone to fulfilling our common purpose of serving the health care needs of West Virginia.

Specific Aims of the IAIMS Program

The specific goals for the IAIMS program are to:

• Identify the critical data and information needs, including library resources, necessary for patient care, education, research, and administrative enterprises of the RCB HSC.

• Develop policy and planning activities to provide seamless access to data and information in a way that allows students, faculty, and staff to integrate these resources effectively in their work.

• Develop a policy and a process to align the management of data and information with strategic planning processes of the RCB HSC organizations.

• Establish a policy and a collaborative process for the organization and integration of information management units to achieve effective utilization and strategic management of data and information resources.

• Develop the key functional objectives and strategies for an IAIMS implementation program that can begin by the end of the planning project, the major elements of which can be achieved within five years after implementation begins.

Four IAIMS focus area groups have been established to assess information needs among researchers, educators, administrative systems users, and clinicians at the RCB Health Sciences Center. The needs of these groups will be addressed as the integrated information system is planned and implemented. Each focus area team has summarized their findings and offered worthwhile recommendations in the form of individual reports. This document introduces and summarizes points from the four focus area reports, as well as issues arising from IAIMS meetings and interviews. Copies of the focus area reports are attached, as is a roster of the members of each team.

Key Recommendations

The recommendations offered here have received widespread support from IAIMS planning participants. These recommendations represent the common themes found in the four focus area reports.

• Centralized information technology entity

IAIMS participants recommend the creation of a centrally coordinated information technology unit. Presently, access to information and support is fragmented; data gathering is described as proceeding through a frustrating maze of different computer systems, geographic locations, and legal entities. A centrally coordinated information technology unit, which incorporates information systems from the schools of the Health Sciences Center, the Health Sciences Library, the hospitals, and the clinics, is therefore proposed. The integrated information system should feature a secure sign-on process that would provide access to all approved accounts across the Health Sciences enterprise. The result of this unified system would be the desired one-stop information access for users.

IAIMS advisors also recommend centralized Help Desk support. Both clinical and academic systems support should be accessible via one telephone number. A short menu could route the caller to the appropriate resource (clinical or academic). Unified Help Desk support would require the managers of Clinical and Academic Help Desks to meet regularly to ensure all users’ needs are met.

While the separate legal entities, which comprise the Health Sciences enterprise, may not be ready to support a single, centralized information technology unit, greater communication, coordination, and cooperation between the groups could be fostered. The success of the IAIMS program will hinge upon collaboration.

• Communication

The communication issues raised thus far in the IAIMS planning process involve both internal and external communication. Internally, IAIMS planning participants acknowledge a need to know who is undertaking specific technology-related initiatives within Health Sciences. They fear unnecessary duplication of purchase, training, and development initiatives due to a lack of communication. At a more elementary level, there is a desire for an enterprise-wide directory (web-based and printed). WVUH employees are excluded from existing directories. In addition, while most Health Sciences faculty, staff, and students have e-mail accounts, not all have embraced this form of communication. A user profile, which documents the preferred method of contact (phone, fax, or e-mail), would ensure that efforts to communicate with others would be more efficient.

Furthermore, within the HS enterprise, common e-mail and electronic calendar software would enhance our ability to communicate with one another. E-mail or Intranet bulletin boards for communication with resident and student teams would improve both teaching and patient care.

Externally, communication with referring physicians could be enhanced. The development of print and web-based directories of referring providers that include office and private phone numbers, fax number, and e-mail address information, as well as preference for mode of communication could strengthen external communication. Similarly, web browser lists of home health agencies and pharmacies would be beneficial. These resources could be linked to the proposed web page for the HS enterprise.

Recent changes designed to make it easier for outside physicians to transfer patients to WVUH and the POC for care may have eased some of the communication difficulties identified by IAIMS advisors.

There has also been a call for developing better health information for patients and their families. Health information for patients and families could be delivered in several formats, including web-based, pamphlets, video, and telephone.

• Data repository

Both the Clinical and Research Focus Area teams have advocated for the development of a clinical data repository. A CDR would be valuable tool for clinicians, as well as those engaged in health services research and evidence-based medicine research. The CDR would eliminate the need for costly, time-consuming chart abstraction when conducting health outcomes research. Also, it could contribute to improved patient care by generating automatic health prevention protocol reminders.

Medsite, a web-based patient information retrieval system, currently provides access to various transcribed patient reports. Electronic patient information can be viewed from anywhere within the HSC network. Medsite provides the foundation needed to develop a CDR.

IAIMS participants recommend that the development of a CDR become a priority for the HS enterprise. Its development should be a collaborative effort involving physicians, other health care practitioners, researchers, and administrators from each of the organizations that comprise the Health Sciences enterprise.

• Single point of information access

The need to develop a single information access point using web-based technology for the Health Sciences enterprise (HSC, UHA, and WVUH) has been a theme that has appeared throughout IAIMS planning activities. IAIMS participants suggest that a redesigned web presence should be a priority for the IAIMS program. It should be designed with users’ functional needs in mind. The RCB-HSC web presence should direct health care providers, grant seekers, educators, researchers, students, administrators, and the public to essential information across the Health Sciences enterprise. It would include a user-friendly search engine and hot news topics. Other recommended features include toolkits for users, (e.g., educators, researchers, clinicians, and administrators), links to extramural funding agencies, library resources and policies, and on-line regulations of the IRB, Animal Care and Use Committee, and Biohazards Committee.

Summary

A center-wide planning effort is needed to improve information access for patient care, research, education, and the administrative programs of the HS enterprise. Some, possibly many, of the ideas championed by the IAIMS program are underway or at least being considered by individual organizations. What appears to be lacking is widespread coordination of these efforts. The IAIMS program represents an opportunity to achieve greater cooperation, coordination, and communication regarding information technology.