Data Rules in Healthcare: Cerner vs. Epis Software

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Table of Contents

Introduction
Control files
FILE file
References

Introduction

Every database that is created should have control files and data rules which should be followed for successful implementation. Cerner Software is a health care management system that was developed by Cerner Corporation. Cerner Corporation was developed in 1979 and is headquartered in Kansas City, Missouri. The company has all their modules in one platform, called Cerner Millennium 2007 (Rick, 2006). The modules range from administration, financial, and clinical. The company also designs individual systems which include laboratory systems, and records management. On the other hand, Epic is another healthcare information technology firm and is based in Madison, Wisconsin. They offer many products used in eth hospital. Some of the products offered by this company include e-health and handhelds, products used for decision making, products used for clinical purposes, and also those used for connectivity within a hospital.

Control files

These are the database files that are used for the startup and update of a database. It is a small binary file that is required for the database to function correctly (Poissant et al, 2005). Some of the information that is contained in a control file is the date and time that the database was created, the timestamp of the data created, the locations of the files that are used for redo, the log history, and the ranges for the data used for offline.

FILE file

Given the datasets that are found in the system, all the control files, security files and log files are protected from intruders and people not authorized to access them by the operating system DAC mechanisms. The control files specify the formats of the various variables in the database. In the Cerner management system, for example, the control files and security files are authorized to the medical staff with full authentication of the system. Looking at the Epic information management system, this file is used to maintain a secure system so that the unauthorized staff are kept at bay.

Epic health information system

The database that is maintained by the two companies also has some differences. While Epic databases are longitudinal, that of Cerner is more confined. The case of Epic is because they have quite some applications they have developed that will use the database. The applications that have been developed access the central database using either wireless connectivity or through wired network. The data for this information system range from ambulatory, inpatient, and payer environments. The database is the foundation of its big repository of applications.

Data rules

The data rules in this information system require that the date format that is used in the handheld devices correspond to the system that is in the system. When the medical staff collects information from the patients, some fields in the handheld devices do not correspond to the fields in the system. An example is that the LMP date in the handheld device does not have time value. It is therefore upon the IT staff to configure these disparate datasets so that there is compatibility (Margaret, 2006).

Another data rule is that all the medical record system IDS should have 10 digits. This helps in getting the correct identification of the patients in the hospital. If the ID gets non-digit characters, it will be rejected by the system. This is one of the precautions that have been put aside to make sure that correct authentication is followed in the system.

Cerner information system

Cerner, in their expansion efforts, developed Open Clinical Foundation (OCF), which is a relational database that is to cover the whole hospital. The database was centered on the patient data in the hospital. The various departments were able to get access to the database (Macnee, & McCabe, 2008). A dentist, for example, would post the patient data to the database so that they can be accessed from the other department who are dealing with the patient. The finance department would for example clear the patient based on the information from the database. The database also supports data extraction so that research and the hospital are integrated.

In this system, one of the data rules is that the staff should have IDs in two phases. The two IDs should have strong passwords. The passwords consist of numerals and alphanumeric characters. Failure of this will fail to create the user of the system. The first authentication stage is for the user to gain access to the system and the second is that of getting access to specific data in the system.

The other data rule is that all patients should have a universal patient ID which is used to identify the patients in the system. The universal ID, like the personal ID, should have characters and numerals in their identification.

Vulnerabilities

Some vulnerabilities are seen in both of the systems. In Epic management system, for example, the system allows the user to scan the bar-code or key in the identification of the patient. If someone keys in the wrong ID as long as they conform to the system, it will be wrong in the system. Vulnerability is the fact that both systems should address. In the screen shot below, the Epic system has less control features to address security.

References

Macnee, C.l., & McCabe, S. (2008). Understanding nursing research: using research in evidence-based practice. New York: Lippincott Williams & Wilkins.

Margaret, M. (2006). “Case Study: Factors in Defining the Nurse Informatics Specialist Role,” Journal of the Health Information Systems Society, Spring. Vol. 20, Issue 2, p 30.

Poissant, L., Pereira, J., Tamblyn, T., & Kawasumi, Y. (2005). “The impact of electronic health records on time efficiency of physicians and nurses: A systematic review.” Journal of American Medical Informatics Association.

Rick, K. (2006). “Technology – How Healthcare IT Can Address the patient data security,” Journal of the Health Information Management. Spring. Vol. 20, Issue 2, p. 21.

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