Abstract
This chapter discusses the critical role of anesthesia information management systems (AIMS) in clinical tracking and operating room information management. It begins by reviewing the history and implementation of such systems and examines their current abilities and utilities. The current known benefits of AIMS, as documented by peer-reviewed literature, are examined. Possible additional benefits, both future and current, and the potential role of AIMS in future healthcare information management are discussed. Though AIMS vary greatly between individual systems and will continue to evolve over time, this chapter aims to highlight fundamental system features. The goal of this chapter is to broaden understanding of AIMS and their clinical utility, as they have an essential part of modern operative care.
TopHistorical Background Of Aims
The first ten years of experience with AIMS (1975 – 1985) were characterized by early proprietary systems. (Chase et al., 1983; Rosen & Rosenzweig, 1985; Zollinger et al., 1977) No framework existed for the interfacing of clinical devices or interchange of clinical information. Most early computer user interfaces (UI) were text-based and non-intuitive. (Ash & Ulrich, 1986)
In the mid-1970’s, a prototype electronic anesthesia record was developed at the Departments of Surgery und Anesthesiology, University Hospitals, Case Western Reserve University, in Cleveland, OH. (Zollinger et al., 1977) It was one of the first systems to successfully obtain, display, and store real-time data from patient monitors during surgery. In addition, it allowed entering time stamps for intra-operative events (intubation, incision, etc). This simplistic system initiated the era of AIMS and the electronic anesthesia record.
Another early system, called the Computer-Assisted Patient Evaluation (CAPE) system, was designed in the early 1980s at the University of Vermont College of Medicine. It provided a method to record patient indicators, based on the preoperative assessment, to track medical devices (monitors, ventilators, etc), and to document the administration of fluids and medications. (Chase et al., 1983) Unlike the earlier Case Western prototype, it did not have the capability of recording real-time vital signs, i.e. data from patient monitors. The benefits described by the developers included convenience of record keeping and time-savings for internal audits. The CAPE system was noted to enable physicians to research identification of high-risk surgical patients and translate those results into a preoperative screening method.
Early recognition that AIMS would be important did not mean that enabling technology yet existed to support rapid development. In the early 1980’s, there were difficulties absorbing data from multiple proprietary and independent anesthesia devices, in interfacing with the system in a rapid and intuitive fashion, and in transferring data to other clinical environments.
Key Terms in this Chapter
Anesthesia Information Management Systems (AIMS): An electronic system of tracking clinical patient data throughout an operation for uses in patient care and medical administration.
Operating Room Management: The process of organizing, staffing, funding and coordinating the functions of a surgical center.
Quality Assurance (QA): A process by which clinical care is assessed for adequacy and improved through the refinement of clinical systems.
Clinical Decision Support Systems (CDSS): Software designed to assist the healthcare practitioner in making appropriate choices for patient care.
Clinical Information Systems (CIS): A database of patient information that can be used for patient care, medical administration, and billing.
Standard Operating Procedure (SOP): The expected or most common method in which a given function is performed.
User Interface (UI): A representation of data which conveys information between a computer and its user.
Graphical User Interface (GUI): A picture-based representation of data which conveys information between a computer and its user.