Health Information Systems and Clinical Data Management

Diraya System Objectives and Elements

Diraya Objectives: Integrated into a single Health History (HC); manage appointment schedules, and monitor treatments (ttos).

Diraya Elements: Unique health history, unifying access to services, structured information, accessibility to services, benefits, and information.

User Database (BDU) Functions

BDU: Administrative data, medical service, health service, and management of the health card.

BDU Functions: Identify citizens, know the insurance status of persons, and facilitate the free choice of doctor.

Minimum Data Set (MDS) and CMBDA Rules

MDS: A set of unprocessed basic data, collected in the shortest possible time, with the greatest range of applications; a centralized information system.

MDS Requirements: One person responsible for each center; define the variables of the database; determine the feedback with specific periods and information structures.

CMBDA Rules: The requirement for implementation in all hospitals; CIE (International Classification of Diseases); safety and confidentiality; evaluation by the central services of SAS; and technical data.

Clinical Classification and Case Mix

Case Mix: A catalog of diagnoses of diseases and health problems specific to a healthcare system.

GRD Dependent Variable: Hospital stay.

Relevant GRD Variables: Primary Diagnosis (DP), comorbidity, procedures, and age over 70.

Severity and Patient Indices

AS-SCORE Limitations: The classification of patients based on the criterion that is classified; the classification of patients at each level of severity has to be done manually.

PSI Variables: Primary Diagnosis (DP) stage, presence of other factors that alter the clinical course in the hospital, the degree of response to treatment (tto), residual lesions, complications, nursing unit, and surgical procedures.

RVG Variables:

• Dependent variable: Time for patient care.
• Independent variables: The ability to perform personal hygiene, ability to ambulate, feeding, and control of fluid balance (liquids equilibrium).

AVG Variables: Age, major problems, secondary problems, Primary Diagnosis (DP), Secondary Diagnosis (DS), new patient status, reason for consultation, referral status, and use of psychotherapy.

Developmental Stages of Disease

1. Complexity minima and lack of complications.
2. Affectation of an organ or system.
3. Affectation of multiple organ systems.
4. Death.

Database Table Relationships

Advantages of Table Relationships: Increases the speed of work, saves disk space, facilitates the updating of data, and enables referential integrity.

Types of Relationships:

• One-to-One: A single record in the main table relates to a single row in the related table.
• One-to-Many: A single record of the primary table (tp) is related to several records of the related table (tr).
• Many-to-Many: Several primary table (tp) records relate to several records of the related table (tr).

Ways to Create a Relationship: Directly, or indirectly through the search wizard.

Relationship Options: Require integrity, analyze cascading updates, and cascading deletes.

Export Options: Allows you to export data, the definition only, or both data and the definition.