Integration of ORMS and AIMS

The safe, efficient, and coordinated passage of a patient through the surgical and anesthesia experience begins long before the patient arrives at the hospital on the day of surgery. The process actually begins at the time a patient's health concern is recognized and a medical professional concurs that surgery is needed. From that moment forward, hundreds of data elements will be collected by multiple health-care providers and placed into a variety of systems—electronic or paper, integrated or not. Within this complex matrix of information systems, some of these data will be redundant, some will be contradictory, some will overlap, some will pass from system to system, and some will reside only within a single database. Healthcare providers engaged in the process of safe care will sort through and try to collate and organize these data to generate a profile of the patient that will subsequently inform the process of care and evaluate the outcomes of multiple interventions. Ultimately, these data (which could be located in a variety of disparate systems) may be the key to creating new knowledge and evidence for practice innovation for anesthesiolo-gists, surgeons, and nurses. The goal of this chapter is to stimulate thinking on the topic of data interchange and interoperable systems for the purposes of safe and efficient anesthesia care. Although the process is thought of as a simple linear one, the data collection is far from linear and may include data exchange in both direc-tions as well as from multiple sites (Fig. 18.1).