INDUSTRIAL ENGINEERING APPLICATIONS IN HEALTH CARE SYSTEMS:APPLICATION OF INFORMATION SYSTEMS / DECISION SUPPORT TOOLS

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APPLICATION OF INFORMATION SYSTEMS / DECISION SUPPORT TOOLS

Many projects conducted by industrial engineers in health care deal with the use of information systems to improve quality and performance. There is a need to take a team approach in information system-related projects. A project team is needed that has individuals from management engineering and information services as well as the user department. The role of an industrial engineer on this team is to first interview the client department to determine the user requirements. The requirements are then used in the request for proposal (RFP) process to obtain proposals from vendors of infor- mation systems. Subsequently, the evaluation of proposals is also done on the basis of meeting these requirements as well as other factors. Industrial engineers are also used in the implementation phase to redesign the manual processes in the client department because these processes usually require major changes after the implementation of an information system. Kachhal and Koch (1989) report on the development of user requirements for a management information system for an operating room and the evaluation of the systems available in the market in meeting these requirements.

Decision support systems (DSS) have become a standard component of hospital information systems. They allow managers to look at financial data on a product line basis. A product line is a collection of one or more diagnostic related groups (DRGs). DSS are able to integrate various sources of data and give managers the capability for ad hoc reporting, building models to project revenues and costs, analyzing various reimbursement scenarios, and the like. The Journal of the Society for Health Systems (1991) published an issue with focus on decision support systems that presents a good overview of DSS in health care.

The other type of DSS used in health care are the clinical decision support systems (CDSS), which use a set of clinical findings such as signs, symptoms, laboratory data, and past history to assist the care provider by producing a ranked list of possible diagnoses. Some CDSS act as alerting systems by triggering an alert when an abnormal condition is recognized. Another set of these systems act as critiquing systems by responding to an order for a medical intervention by a care provider. Several systems that detect drug allergies and drug interactions fall into this category. Another use of CDSS is in consulting systems that react to a request for assistance from a physician or a nurse to provide suggestions about diagnoses or concerning what steps to take next. The application of CDSS in implementing clinical practice guidelines has been a popular use of these systems. Doller (1999) provides a current status of the use of these systems as medical expert systems in health care industry. The author predicts that the major use of CDSS in future will be in implementing clinical guidelines and allowing nonphysicians to handle routine care while directing the attention of true medical experts to cases that are not routine.

While some industrial engineers may be involved in the development of home-grown DSS or CDSS, the role of other industrial engineers is still in the evaluation and cost–benefit analysis of the standard systems available in the market.

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