The organization, delivery, and financing of health care services in the United States is complex, comprising an interdependence of the private and governmental sectors of the economy. This pluralistic health care economy, with its pragmatic mix of public and private organizations, has produced a wide range of databases that help to monitor the health of the nation.
Health care spending has risen rapidly in the United States, claiming a larger and larger share of national resources. In 1965, $41.1 billion was spent for health care, constituting 5.7 percent of the gross domestic product (GDP). In 1998, health care expenditures totaled $1.1 trillion, an average of $4,094 per person and 13.5 percent of the GDP. Almost 11.5 million civilians—8.8 percent of employed civilians—were employed in the health services industry in 1998.
The growth of the health care industry in the United States has been accompanied by significant achievements in public health, including advances in prevention and, since 1950, significant declines in death rates for cardiovascular diseases, diseases of the heart, and stroke. There has been great success in monitoring these and other morbidity and mortality trends through the growth and development of our health information systems.
There is general agreement that data are needed to monitor the health of the nation; to plan and develop better health services; to deliver those services in an effective, efficient, and equitable manner; to measure their effectiveness, to make decisions on resource allocation; and to conduct research. Data also are needed to facilitate effective policymaking, planning, management, and evaluation. The federal government needs a variety of data to support its role in improving health and medical care delivery systems throughout the nation. State and local government agencies also play key roles in disease prevention, delivery of health services, and health planning and evaluation, all of which require timely and reliable health statistics. Private organizations of health professionals, health-service providers, health insurance, and many others have important interests in the collection and use of health data.
The statistical and information needs of the American pluralistic health care economy have grown enormously in the years since the enactment of the Medicare and Medicaid programs in 1965. The rapid growth of public and private health insurance, the expansion of the health care industry, and the concomitant public health, medical, and technological advances to meet the needs of a growing population have contributed to the growth of health information systems. Trends that require close monitoring include the aging of the population, the emergence of the chronic illnesses as the leading causes of morbidity and mortality, and the growing health care needs of subpopulation groups, including minorities, the uninsured, immigrants, and persons with disabilities and low incomes.
HEALTH SURVEYS AND ORGANIZATIONS
Health surveys go back to the Hagerstown morbidity studies conducted by the U.S. Public Health Service in the early 1920s. However, sample surveys did not become dominant until the rise of probability sampling in the 1930s. The U.S. Public Health Service conducted the first National Health Survey in 1935–1936, funded by the Works Projects Administration (WPA). In 1953 the National Opinion Research Center began a series of surveys, separated by five-year intervals, on consumers' use of medical care, the degree of health insurance protection, and expenditures for care.
In October 1953 a subcommittee of the U.S. National Committee on Vital and Health Statistics recommended that a national health survey be established on a permanent basis. The National Health Survey Act of 1956 called for a continuing survey and special studies on the nation's health. It also provided for studying methods and survey techniques for obtaining this statistical information and for disseminating the results of these surveys and studies. The National Health Survey, later renamed the National Health Interview Survey (NHIS), began in 1957. In 1960 the National Center for Health Statistics (NCHS) was created by combining the National Health Survey and the National Office of Vital Statistics. Responsibility for vital statistics had been transferred to the U.S. Public Health Service from the Bureau of the Census.
The NCHS is the federal government's principal health statistics agency. The NCHS congressional mandate addresses the full spectrum of health concerns from birth to death, including overall health status; environmental, social, and other health hazards; the onset and diagnosis of illness and disability; health resources; and the use, cost, and financing of health care. The NCHS also has the mandated responsibility for assisting state and local health agencies in meeting their costs of data collection.
Many other federal agencies have responsibilities for health-data collection. For example, within the U.S. Department of Health and Human Services (USDHHS), thirteen agencies have such responsibilities, including the National Institutes of Health (NIH), the Centers for Disease Control and Prevention (CDC), the Substance Abuse and Mental Health Services Administration (SAMHSA), the Office of the Assistant Secretary for Planning and Evaluation (OASPE), the Agency for Health Care Policy and Research (AHCPR), the Health Care Financing Administration (HCFA), and the Health Resources Services Administration (HRSA). In addition, other federal agencies have health statistic operations in support of their programs, including the Bureau of the Census, the Bureau of Labor Statistics, and the Departments of Agriculture, Defense, Commerce, Transportation, and Veterans Affairs.
The production of health statistics is clearly a multiorganizational responsibility. No one agency or organization can produce all of the health statistics needed to monitor the health of the nation. Following is a summary of the major types of health statistics, who produces them, and how they contribute to monitoring the health of the nation.
Birth, death, and fetal-death statistics are kept through the National Vital Statistics System of the NCHS. This program, together with the Bureau of the Census decennial census, immigration, and emigration data, provide information on the dynamics and growth of the population. This information is used in making population projections, in fertility analysis, in planning for health services, for projecting school needs, and for other purposes. It is essential in the teaching and application of demography, epidemiology, sociology, medicine, and public health.
The historical roots of the vital statistics registration system go back to the earliest American settlements, when colonies such as Massachusetts and Virginia, following the English custom, required that records be kept of christenings, weddings, and burials. Lemuel Shattuck was the leading proponent of registration. He demonstrated that the health of the residents of the city of Boston was deteriorating, as measured by mortality levels. The Report of the Sanitary Commission of Massachusetts, authored by Shattuck, recommended the creation of a state board of health based on complete registration and vital statistics. However, it was not until 1933 that all states had similar registration programs.
Vital statistics are provided through state-operated registration systems. Standard forms for the collection of data and model procedures for the uniform registration of events are developed and recommended for use through cooperative activities of the states and the NCHS. The NCHS shares the costs incurred by the states in providing vital statistics for national use. Additional programs related to the National Vital Statistics System include the Linked Birth and Infant Death Data Set, the National Maternal and Infant Health Survey, the National Mortality Followback Survey, and the National Death Index. The introduction of the National Death Index (NDI), a computerized index of death record information beginning with 1979 deaths, has made enormous contributions to more efficient epidemiologic and health studies. Researchers can go to one source, the NCHS, to obtain mortality information on their study participants. Prior to the establishment of the NDI, each state had to be contacted separately for such information.
The vital statistics program is generally regarded as a successful program, providing full counts of births and deaths at the local, state, and federal geographic levels. Except for the important issue of timeliness, the reports emanating from the vital statistics program have done an excellent job of meeting the demands of users. The availability of data electronically has helped to improve the timeliness of vital-statistics data, thereby enhancing the usefulness of the data.
PUBLIC HEALTH SURVEILLANCE
Public health surveillance is defined as the "ongoing systematic collection, analysis, and interpretation of data on specific health events affecting a population, closely integrated with the timely dissemination of these data to those responsible for prevention and control" (Thacker et al. 1996, p.633). A feature of surveillance is the ability to identify individuals and groups of individuals for further action on prevention and treatment. The CDC and other federal agencies are involved in the collection of surveillance data, including, but not limited to, the following:
- The CDC operates the National Notifiable Disease Surveillance System. Physicians, laboratory personnel, and other health care providers are required by state law to report weekly all cases of health conditions, mainly infectious in origin, that are specified as being notifiable. The Council of State and Territorial Epidemiologists determines which notifiable conditions should be reported from state health departments to the CDC.
- The National Institute of Occupational Safety and Health has maintained the National Traumatic Occupational Fatalities Surveillance System, a sentinel health event verification system for occupational risk. It is based on information taken from death certificates.
- The Food and Drug Administration conducts post-marketing surveillance of adverse reactions to drugs.
- The National Cancer Institute conducts the Surveillance, Epidemiology, and End-Results (SEER) Program that includes eleven population-based registries in the United States. It provides data on all residents diagnosed with cancer during the year, as well as follow-up information on all previously diagnosed patients.
- The CDC conducts the Behavioral Risk Factor Surveillance System (BRFSS), a telephone survey conducted in each of the fifty states that provides data on health behaviors. Questions can be added to the survey by individual states.
- The CDC has developed the Pregnancy Assessment Monitoring System (PRAMS) to collect information on maternal behaviors that occur before, during, and shortly after pregnancy.
- The Consumer Product Safety Commission conducts surveillance on product-related injuries.
Surveillance data vary in their quality, are often incomplete and unrepresentative, and they may vary in sensitivity and specificity. Although the current programs provide essential data to monitor the incidence of communicable diseases and some chronic diseases, the system also relies on voluntary physician reporting, which has been demonstrated to be variable and inconsistent. States differ in their authority to require physician reporting. Development of greater standardization in reporting from state to state and obtaining improved physician cooperation are both areas that need further exploration.
Population-based registries and national sample surveys have also been used for surveillance purposes. Registries are established to identify cases through several sources (schools, hospitals, laboratories). Registries require extensive confirmation of cases, which leads to longer lag times between a health event and the reporting of the event. NCI's SEER program covers about 10 percent of the U.S. population and provides data that are used to monitor long-term trends of cancer incidence and mortality. Currently, approximately thirty states have population-based registries, but they may be limited by both under-registration and selection bias.
HEALTH STATUS, HEALTH CARE UTILIZATION, AND COSTS
Statistics abound on health status and the use of medical care services at the federal, state, and local levels. The National Health Interview Survey (NHIS) and the National Health and Nutrition Examination Survey (NHANES) are the major national surveys for assessment of health status in the United States. Both are sponsored by the NCHS. The NHIS is a primary source of information on the health of the civilian, noninstitutionalized population of the United States. Conducted continuously since 1957, it provides national data on the annual incidence of acute illness and accidental injuries, the prevalence of chronic conditions and impairments, the extent of disability, the utilization of health care services, and other health-related topics. To provide data on special topic areas in addition to the basic NHIS data, extensive supplements have been conducted annually. Topics of coverage in the supplements vary from year to year. For example, in 1995 the supplements included questions on the following topics: immunization, disability, followback of persons with disabilities interviewed in the prior year, family resources (access to care, health care coverage, income, and assets), year 2000 objectives, tobacco use, nutrition, clinical preventive services, physical activity and fitness, and AIDS (acquired immunodeficiency syndrome) knowledge and attitudes. The NHIS sample design includes about 40,000 households interviewed, resulting in a sample of about 102,000 individuals, with oversampling of black and Hispanic persons.
The National Health and Nutrition Examination Survey (NHANES) was established in 1971 to collect the kind of health data best obtained by direct physical examinations and physiological and biochemical measurements. The NHANES is the cornerstone of the National Monitoring and Related Research Program, providing data needed for nutrition monitoring, food fortification policy, establishing dietary guidelines, and assessing government programs and initiatives such as the Healthy People 2000 objectives of the USDHHS. In the past, researchers sometimes had to wait as long as ten years after data collection before gaining access to data based on the entire six-year sample. The NHANES is now a continuing, annual survey, linked to the NHIS, and data are being collected from a representative sample of the U.S. population every year.
The NHIS and the NHANES are only two of the many national federal surveys that collect data on heath status, medical care utilization, and insurance coverage. Other important surveys that collect similar data, as well as data on medical care expenditures, include the following:
- The National Immunization Survey (NIS) is a continuing nationwide telephone sample survey that gathers data on children 19 to 35 months of age. In 1997, data were obtained for 32,742 children to provide estimates of vaccine-specific coverage for areas considered to be high risk for under-vaccination.
- The Medical Expenditure Panel Survey (MEPS) conducted by the Agency for Healthcare Research and Quality (AHRQ) is a study of approximately 9,000 households. MEPS is a subsample of NHIS participants, providing health status and other data to enhance analytical capacity. Use of NHIS data, in concert with the data collected in the MEPS, provides the capacity for longitudinal analysis. Each sample panel is interviewed a total of five times over thirty months to yield annual use and expenditure data for two calendar years. The MEPS household component reflects an oversampling of households with Hispanics and blacks. MEPS also has an institutional component.
- The National Household Survey on Drug Abuse (NHSDA), conducted by SAMSHA, focuses on the incidence, prevalence, consequences, and patterns of substance use and abuse. In 1997 the NHSDA was expanded from 18,000 respondents to about 25,000 respondents to generate estimates for the nation and for two states (California and Arizona). In 1999 the NHSDA was further expanded to 70,000 respondents to generate estimates for all fifty states.
- The Survey of Mental Health Organizations, conducted by SAMSHA, is a biennial inventory of mental health organizations and general hospital mental health services.
- The Medicare Current Beneficiary Survey (MCBS), conducted by the Health Care Financing Administration (HCFA), is an ongoing rotating panel survey of approximately 12,000 aged and disabled Medicare beneficiaries, consisting of four overlapping panels of Medicare beneficiaries surveyed each year. Each panel contains a national representative panel of beneficiaries who are interviewed twelve times to collect three complete years of utilization data. The survey provides comprehensive data on health and functional status, use of medical services, covered and noncovered health care expenditures, and health insurance for Medicare beneficiaries.
- The National Health Care Survey (NHCS) is a family of NCHS provider-based surveys that measure the utilization of health services. Included are hospitals (National Hospital Discharge Survey), physicians (National Ambulatory Medical Care Survey), emergency and outpatient departments (National Hospital Ambulatory Medical Care Survey), ambulatory care centers (National Survey of Ambulatory Surgery), nursing homes (National Nursing Home Survey), and health agencies providing home health care services and hospice care (National Home and Hospice Care Survey).
- The National Survey of Family Growth (NSFG) is a periodic survey of women 15 to 44 years of age. The purpose of the survey is to provide national data on factors affecting birth and pregnancy rates, adoption, and maternal and infant health. In 1995, for the first time, the sample was obtained from households that had been interviewed in the NHIS. A total of 10,847 women were interviewed, and Hispanic and black women were oversampled. Cycle six of the NSFG will include a sample of men for the first time.
- The Healthcare Cost and Utilization Project (HCUP), conducted by the AHRQ, consists of the State Inpatient Databases (SID) and the Nationwide Inpatient Sample (NIS). The SID contains all hospitals and all discharges from twenty-two participating states. The AHCPR receives the data from each statewide data organization, processes the data into a uniform format, and then returns the uniform SID files to the statewide data organization. The NIS database contains a sample of hospitals selected from SID. The NIS can be used to produce national estimates, regional estimates, and state estimates for participating states.
- The Current Population Survey (CPS) is a monthly sample survey of about 50,000 households conducted by the U.S. Bureau of the Census for the Bureau of Labor Statistics. The CPS is the primary source of information on labor force characteristics of the U.S. population. Monthly estimates from the CPS include employment, unemployment, earnings, hours of work, and other indicators. The annual March supplement produces national and state estimates on health insurance coverage, including private health insurance, Medicare, Medicaid, CHAMPUS, and military health care.
PRIVATE SECTOR DATA COLLECTION SYSTEMS
In addition to the federal health statistics surveys and the programs briefly discussed above, the fifty states and the private sector maintain data systems and conduct many surveys of hospitals, health professionals, and health care organizations. The private health sector includes organizations of health-service providers, health professionals, health-insurance payers, consumers, industry, and private philanthropy. The following private organizations maintain health-data systems relating to their specific areas of interest: The Alan Guttmacher Institute conducts an annual survey of abortion providers; the American Association of Colleges of Osteopathic Medicine compiles data on various aspects of osteopathic medical education; the American Association of Colleges of Pharmacy compiles data on student enrollment and types of degrees conferred; the American Association of Colleges of Podiatric Medicine compiles data on schools and enrollment; the American Dental Association conducts annual surveys of predoctoral dental educational institutions, including information on student characteristics, financial management, and curricula; the Association of American Medical Colleges collects information on student enrollment in medical schools; the Association of Schools and Colleges of Optometry compiles data on the various aspects of optometric education; the Association of Schools of Public Health compiles data on the twenty-eight schools of public health in the United States; and the National League for Nursing conducts an annual survey of schools of nursing.
The American Hospital Association conducts an annual survey of all hospitals and compiles information on characteristics of the facilities and services provided, admissions, and expenses and revenues. The American Medical Association maintains a physician masterfile on almost every physician in the United States. Inter Study compiles data on health maintenance organizations. Many national and state data collection activities are conducted by these private organizations, but their scope and quality varies.
HEALTHY PEOPLE 2000
A relatively recent and important development in monitoring the health of the nation has been the identification of broad goals and detailed objectives, described in Healthy People 2000: National Health Promotion and Disease Prevention Objectives, published by the U.S. Department of Health and Human Services in 1991, and in subsequent reports. The targets contained in Healthy People 2000 were developed between 1987 and 1990 through an extensive consultative and hearings process conducted and managed by the U.S. Public Health Service in partnership with the Institute of Medicine of the National Academy of Sciences. To provide guidance to the effort, a national consortium was formed that included the principal health officials in the fifty states and representatives of more than three hundred professional and voluntary national membership organizations.
Three broad goals were identified for the program: (1) increase the span of healthy life for Americans, (2) reduce health disparities among Americans, and (3) achieve access to preventive services for Americans. To foster accomplishment of these goals, Healthy People 2000 also set forth three hundred measurable objectives to be accomplished by the year 2000 in twenty-two priority areas of health promotion, health protection, and clinical preventive services. In addition, objectives were established for improving surveillance and data systems at national, state, and local levels to target interventions to areas of greatest need. The range of topics covered by the objectives is extensive, and includes the following: (1) personal behavior and risk factors such as physical fitness and activity, nutrition, tobacco, and alcohol and other drugs; (2) psychosocial factors such as mental health and violent and abusive behavior; (3) the physical environment, including unintentional injuries, occupational safety and health, environmental health, and food and safety; (4) infectious diseases, including HIV (human immunodeficiency virus) infection and sexually transmitted diseases; (5) reproductive and infant health, including family planning and maternal and infant health; (6) chronic diseases such as heart disease and stroke, cancer, diabetes, oral health problems, and chronic disabling conditions; and (7) services and protection, including educational and community-based programs, as well clinical preventive services.
Based on 319 unduplicated objectives, 15 percent of the objectives reached or surpassed the year 2000 targets by the end of 1999. At this point, progress toward the targets had been made for another 44 percent of the objectives, 18 percent showed movement away from the target, 6 percent showed mixed results, and 3 percent showed no change from the baseline. The remaining objectives had no data with which to evaluate progress.
The national objectives in Healthy People 2000 have provided motivation for the continued development of public health assessment and monitoring of the nation's health efforts at the national, state, and local levels. This effort has led to the development of Healthy People 2010, the nation's prevention agenda for the first decade of the twenty-first century. It contains two broad goals— to increase the years and quality of healthy life and to eliminate health disparities among Americans, especially minorities. The two goals are supported by 467 objectives, grouped into 28 focus areas with specific numerical targets. Data for the baselines and to monitor progress in reaching these targets come from the National Vital Statistics Program, the National Health Interview Study, the National Health and Nutrition Examination Survey, and the Behavioral Risk Factor Surveillance System, and others data systems.
A variety of health data and information systems are now available in the United States to monitor the health of the nation. This information base must continue to be available to allow the monitoring of trends and the detection of changes or aberrations in the economic, social, or health characteristics of the nation. The appropriate federal role is to produce national data useful for these purposes, as well as to provide norms to which state and local data can be compared. The data must be of high quality, produced in a timely manner, and relevant to issues of the day.
As the nation moves closer to the objective of a national, systematic approach to meeting the information needs for monitoring the health of the nation, an effort must also be made to coordinate data-collection activities, both within the federal establishment and between the government and the private sector. This will avoid unnecessary and costly duplication and encourage comparability of information collected by different systems. These health information systems are essential to meet the multiple needs of many programs and organizations in the twenty-first century.
Dorothy P. Rice
(see also: Biostatistics; Certification of Causes of Deaths; Community Health Report Cards; Epidemiology; Field Survey; Healthy People 2010; Information Technology; Mortality Rates; National Center for Health Statistics; National Death Index; National Health Surveys; Notifiable Diseases; Registries; Reporting, Mandatory; Sampling; SEER Program; Statistics for Public Health; Surveillance; Surveys )
Andersen, R., and Anderson, O. W. (1967). A Decade of Health Services: Social Survey Trends in Use and Expenditures. Chicago: The University of Chicago Press.
Cohen, S. B.; DiGaetano, R.; and Goksel, H. (1999). "Estimation Procedures in the 1996 Medical Expenditure Panel Survey Household Component." MEPS Methodology Report No. 5. AHCPR Pub. No. 99–0027. Rockville, MD: Agency for Health Care Policy and Research.
Committee to Evaluate the National Center for Health Statistics (1973). "Health Statistics Today and Tomorrow: A Report of the Committee to Evaluate the National Center for Health Statistics." Vital and Health Statistics, Series 4, No. 15. DHEW Publication No. (HRA) 74–1452.
Duncan, J. W., and Shelton, W. C. (1978). Revolution in United States Government Statistics. Washington, DC: Office of Federal Statistical Policy and Standards, U.S. Department of Commerce. U.S. Government Printing Office.
Martin, M. E., and Straf, M. L., eds. (1992). Principles and Practices for a Federal Statistical Agency. Washington, DC: National Academy Press.
McGinnis, J. M., and Lee, P. H. (1995). "Healthy People 2000 at Mid Decade." Journal of the American Medical Association 273:1123–1129.
Morbidity and Mortality Weekly Report (August 6, 1999). "Achievements in Public Health, 1990–1999." Atlanta, GA: Centers for Disease Control and Prevention.
National Center for Health Statistics (1998). "Current Estimates from the National Health Interview Survey, 1995." Vital and Health Statistics 10. Pub. No. 98–1527. Hyattsville, MD: Author.
—— (1999). Health United States, 1999, With Health and Aging Chartbook. USDHHS Pub. No. (PHS) 99–1232. Hyattsville, MD:Author.
—— (1999). Healthy People 2000 Review, 1998–99. USDHHS Pub. No. (PHS) 99–1526. Hyattsville, MD: Author.
Office of Management and Budget (1998). Statistical Programs of the United States Government: Fiscal Year 1999. Washington, DC: Executive Office of the President.
Rice, D. P. (1981). "Health Statistics: Past and Present." The New England Journal of Medicine 305(4):219–220.
Stoto, M. A. (1992). "Public Health Assessment in the 1990's." Annual Review of Public Health 13:59–78.
Thacker, S. B.; Stroup, D. F.; Parrish, R. G.; and Anderson, H. A. (1996). "Surveillance in Environmental Public Health: Issues, Systems, and Sources." American Journal of Public Health 86(5):633–638.
U.S. Department of Health and Human Services (1991). Healthy People 2000: National Health Promotion and Disease Prevention Objectives. Washington, DC: Public Health Objectives.
Information systems refers to technology designed to handle the data that institutions receive, process, generate, save, backup, disseminate, and use to make decisions. Designs for such systems vary according to the missions, goals, objectives, and global market conditions of the institutions investing in the technology.
DATA, INFORMATION, AND KNOWLEDGE
Information should not be confused with the related concepts of data and knowledge. Data are simply characteristics or descriptions of relevant objects or events that influence business decisions. Common examples include inventory, sales, receipts, and payments of transactional activities frequently stored and retrieved in databases.
Information is an extension of data by adding organization in ways that add value and relevance to the data. Institutional users are then able derive interpretation that leads to conclusions and implications. When data become more valuable than simple retrieval, information has been produced.
Knowledge exists when users understand how existing information can be applied in higher-order tasks such as explaining phenomena, predicting happenings, or projecting trends. These abilities allow users to become experts rather than simply perform operations.
THE SYSTEMS CONCEPT
A system consists of elements that have either been designed into particular configurations or evolved into configurations over time. For example, a computer system for one user may be just one element, a computer, and related peripheral elements, devices. A system for multiple users may have many computers and peripheral devices. The main point of such a system, however, is that the elements allow users to use the system in some concerted manner to achieve personal or institutional missions, goals, and objectives.
THE INFORMATION SYSTEM
An information system is a melding of the concept of information with a system of technology to best facilitate organizational needs. An information system requires designers and users capable of systems thinking to keep the system dynamic within an environment of constantly changing variables over time.
CLASSIFICATION OF INFORMATION SYSTEMS
The need for information systems creates various classifications. The areas of need reflected in these classifications are organizational levels, functional areas, support areas, and the information system architecture.
Organizational Level Classification
Many organizations are so complex that their technological systems are organized in a hierarchical structure representative of their organizational charts. For example, information systems may be classified by departments, divisions, and/or work units. A major point, however, is that organizational information systems must be interconnected.
Functional Area Classification
An information system can be classified by the major functions of the organization that cross organizational structure. Typical functional information systems are developed for accounting, finance, manufacturing, marketing, and human resource management.
Support Area Classification
Information systems all have a support role in facilitating the meeting of institutional missions, goals, and objectives. Examples of support classification information systems are transaction processing systems, management information systems, knowledge management systems, office automation systems, decision support systems, group support systems, and intelligent support systems.
Transaction processing system:
A transaction processing system (TPS) performs the routine functions of an organization, such as payroll, customer orders, billing, and expenses. A TPS provides support to the monitoring, collection, storage, processing, and dissemination need for these routine business processes.
Management information system:
A management information system (MIS) supports activities to make sure that business strategies are being efficiently employed. Those support activities include planning, monitoring,
and control. Specific technology activities might include providing periodic reports on operational efficiency, effectiveness, and productivity.
Data and reports from MISs are used in making decisions, such as projecting inventory and sales levels. Typical information from a MIS includes statistical summaries, exception reports, periodic as well as on-demand reports, comparative analysis, projections, early detection, routine reports, and communications. Human relations issues, such as projecting employee retirement liability, are important to long-term employment policy.
Knowledge management system:
Knowledge management is a collaborative organizational system wherein knowledge is shared and dispensed. Functions of a knowledge management system (KMS) include support for assisting organizations to identify, select, organize, disseminate, and transfer information that represents expertise. For example, some individuals know so much about their organizations that continuing to operate without them, as in the case of employees accepting employment elsewhere, dying, or experiencing diminished capacity, is difficult. Knowledge management as a technological information system allows organizations to pull together the collective knowledge of its employees. That collective knowledge is then available to all of the institution's employees for decision making.
Examples of KMS mechanisms include electronic bulletin boards for posting information needs, threaded discussion groups for sharing on a particular topic over electronic mail (e-mail), knowledge tracking, and creating space on an organization's Web site for information about the organization and for descriptions of the projects of its employees.
Office automation systems:
One of the earliest information systems to emerge was the office automation system (OAS). Functions of the office such as document processing, imaging, photocopying, data transfer, data storage, and communications have been forged into single software systems.
The effects of OAS have had a tremendous impact on who does the work. In much of the business environment, positions such being a secretary to an individual or being in a pool of clerical office workers have changed. Most employees in organizations do much of their own clerical work on their own desktops. Employees who were formerly isolated in offices and pools now have a much richer array of job duties and responsibilities.
Decision support depends on how structured a particular problem that needs solving is. For example, some problems are unstructured in that similar problems have not occurred before and no ready routine exists for problem solving. Other problems have occurred routinely and a decision process exists for the problem.
Decision support systems (DSS) contain decision-modeling routines, such as what-if analysis, whereby users can try particular decisions in simulations before actual implementation. Problems needing decisions can be developed into scenarios where users enter what they know about the problem, enter possible decision designs, make choices among the designs, implement decisions, and observe effects. Once the effects are within the level of tolerance set by management, the decision is made.
Group support systems:
Group support systems (GSS), sometimes called groupware, are interactive computer-based systems that allow groups of people throughout an institution to work on the same projects. The software contains routines for generation of ideas, resolution of conflicts, and freedom of expression.
A major problem encountered in group work is the development of negative behaviors, such as destructive miscommunication. Another problem is groupthink, a condition in which group work emerges as unimaginative and the members resist taking responsibility for the work. GSS contain functions that make information instantaneous and build consensus to make sure that members remain excited about the project. GSS also provide for early and continuous voting.
Intelligent support systems:
Intelligent support systems (ISS), sometimes referred to as expert systems, are one of the more advanced forms of information systems. The premise of such systems is that they can apply reasoning—sometimes called artificial intelligence—to a particular area of problems and generate advice, recommendations, and solutions.
Problem areas for which ISS has been applied include early detection of conditions, patterns to identify fraud in accounting, voice recognition, computer security and password encryption, health diagnosis and prognosis, and disaster planning.
SYSTEM ARCHITECTURE CLASSIFICATION
Information architecture is the conceptualization of the information requirements of a core business of an organization as well as the ways in which those requirements are met. Information architecture can be centralized, such as for communications architecture, data architecture, and business architecture. Other strategic, managerial, and operational architectures may be decentralized.
System architecture is the specific technologies—such as computers, networks, databases, and communication devices—that anchor the information system. For example, an insurance company or an inventory company may have a system architecture that anchors the remainder of the institution's information system.
A frequent way of classifying information systems by system architecture is by focusing on the device structure where the actual computing or calculating happens. For example, the anchor technology may be a mainframe computer, strategically located stand-alone computers, or a distributed or networked system of desktop computers.
A mainframe computer contains the computing power of the system. Computer terminals that have no computing power contend for access to the mainframe computer for computing that is then sent back to the respective computer terminal. Information systems using a mainframe are referred to as distributed because computing results must be distributed to users at various locations. Mainframe architecture is frequently used where the applications place heavy mathematical demands on the computer's brain, the central processing unit (CPU).
Stand-Alone Desktop Computers
Desktop computers, also known as personal computers, have the CPU in the unit on the users' workspace. The desktop stand-alone may come with devices on board such as compact disks, digital video devices, and digital video recorders, in addition to input and output devices such as keyboards, storage devices, monitors, and printers. Since a stand-alone with such devices represents multiple elements, it is also an information system.
Networked Desktop Computers
Desktop computers can be wired together in various ways to produce a network, sometimes called a local area network. In a network, devices and information can be shared by desktop users. A main desktop computer, called a server, maintains traffic over the writing schemes to make sure that documents, e-mail, and other communications arrive at the designated destination computer intact. A system of servers can be used for added capacity or for distinct purposes, such as e-mail and printing.
The information systems described here are all technological mechanisms tailored to meet both enterprise-wide and specific-need missions, goals, and objectives.
see also Information Processing; Software
Jones, Gareth, and George, Jennifer (2004). Essentials of contemporary management. New York: McGraw-Hill/Irwin.
Stair, Ralph M., and Reynolds, George W. (2003). Principles of information systems (6th ed.). Boston: Thomson/Course Technology.
Stair, Ralph M., and Reynolds, George W. (2006). Fundamentals of information systems (3rd ed.). Boston: Thomson/Course Technology.
Douglas C. Smith
Before we can understand information systems, we should ask what is information? What is a system? Information can be regarded as that which is happening in our brains: the questions we continuously ask—what, where, when, who—and the answers we get. A second approach is to consider information as something that our minds and hands produce, something we give to others. Information is something tangible that we construct from a state of consciousness. What you are reading here is information. It is a product of the thinking that made it possible. That thinking is also information—it is the process that made the product possible. Information includes what we write about in letters, the subjects we study in school, the things we read in newspapers, or watch on TV or film, and the numbers we find printed on our pay checks. Information is a material product: something that we can acquire, keep, and give to others.
We are all systems. The body we carry around is a system. There are many components, or subsystems, of our bodies—the nervous system, the digestive system, the circulatory system, and others. Almost all things around us are systems: pens and pencils are systems allowing us to write and express ourselves and give ideas and feelings to others. Media entertainment units such as televisions, and computers that help us do many things—all of these are systems. An organization of people, what they do and produce, is a system. The public transportation we use to get to work or school is a system. A system is an environment that includes humans, tools, and ways of doing things for a goal and purpose.
We ourselves are information systems because we use the native capacity of our minds and hands to interact with energy and matter around us, including the air we breathe and the ground on which we stand. We have the capacity to be continuously aware or conscious of what is happening to and around us. This is true from the very moment we are born to the time we die.
We cannot live without information or the ability to process and respond to it. But, we are limited as to what our bodies and minds can see, hear, touch, smell, and, in general, do. So we invent and create tools—technology—that add to our ability and capacity to do things.
The wheel, the carriage, the automobile, and then the airplane are all human-designed technologies—systems—that enable us to move from one place to another, faster and longer, overcoming the physical limits of our bodies. Information technology (IT) is created to extend our biological ability to think, learn, remember, anticipate, and resolve many of the physical and mental tasks we face each day.
Human beings invented paper, chalk, and pens and pencils to help us record and present our thoughts and experiences. Later, in the 1450s, Johannes Gutenberg's invention of the printing press made the sharing of written ideas with multiple people more efficient and affordable. The early Chinese invented the abacus, a kind of primitive accounting and adding machine to help facilitate arithmetic computations. Present-day computers are extensions of this early information technology.
There are many kinds of information technologies, including radars, telephones, FAX machines, computers, and satellites, to list a few. These technologies contribute to many forms of information systems such as systems for information retrieval and systems that help us solve problems or make decisions. Some systems help us avoid or reduce paper work. There are information systems that help manage organizations and there are specialized kinds of information systems such as artificial intelligence (AI) and expert systems . Basically, information systems are categorized by the specific work they do and the software that enables them to function as they do. Software consists of instructions that tell the computer what to do, how to do it, and when.
Information Retrieval Systems
An information retrieval system (IRS) is an environment of people, technologies, and procedures (software) that help find data, information, and knowledge resources that can be located in a particular library or, for that matter, anywhere they exist. Information about available resources is acquired, stored, searched, and retrieved when it is needed. An IRS can help users in general ways, such as obtaining data on a subject of general interest, or in more specific ways, such as retrieving information to help them find a good job. Information retrieval software allows a user to formulate and ask a question, then it searches a database to create an appropriate response. A database is a collection of data on a specific subject organized in such a way that a person can locate and acquire chunks of information for specific purposes. Retrieving information is a skill that requires training and experience. Librarians in general, and reference or special librarians in particular, are the professionals who serve this function.
Decision Support Systems
Information systems are particularly important in adding to our capability to solve problems and make decisions. With the amount of information being generated each day in almost every aspect of our lives, solving problems and making decisions can be complicated. Decision support systems (DSS) are information systems with a specific function to help people with the problem-solving and decision-making process. As with all modern information systems, a DSS consists of a collection of people, procedures, software, and databases with a purpose. The computer is the primary technology in such systems; other information technologies may include electronic displays (e.g. a TV monitor) and teletransmission capabilities (telephone links). DSS systems help identify the factors that are creating the problem, provide ways through which approaches can be established to resolve the problems, and help in the selection of choices that are available to resolve the problem.
Quite often in solving problems it is wise to benefit from those who know much about a subject—experts in a particular subject area or field. We refer to these information systems as expert systems (ES). An expert system is a specific kind of information system in which computer software serves the same function expected of an expert. The computer, programmed to mimic the thought processes of experts, provides the decision-maker with suggestions as to the best choice of action for a particular problem situation. The hope is that we can design computers (and generally information systems) that extend our ability to think, learn, and act as an expert.
Artificial intelligence (AI) is a familiar expression of this idea. It is exciting to see if a machine can beat a human in playing chess, or vice versa. During the last years of the twentieth century, information processing technologists began using computer-generated images and sounds, rather than real objects, to explore the relationships between human beings and computer-generated environments known as virtual reality (VR) . Virtual reality is part of an area in AI where the objective is to explore how the computer can extend the limits of how we see the world and our place in it. Expanding our understanding of reality can enable us to analyze and design ever better information systems.
Lastly, robots exemplify another perspective on information systems. Robots are machines that are designed to do what humans can do. An important application of this technology has been to create robots to perform certain functions that are dangerous for human beings, or to do tasks that can be more effectively performed by machine than by people. Although it may not have the physical appearance of a human being, a robot may be thought of as a machine acting as a person while being controlled by a computer.
Management Information Systems
Information systems can be found in our homes, our schools, our workplaces, and our places of recreation and relaxation. Information systems are part of all sorts of organizations including schools, the local YMCA, worldwide fast food companies, and the governments and military operations of countries around the globe. Within these organizations, resources, both human and technological, require management. A management information system (MIS) is an environment that consists of people, technology (i.e., computers), and procedures that help an organization plan, operate, and control the access and use of resources, both human and material. Resources managed by such systems can include the labor force (executives, line workers, sales people), computer centers, photo and research labs, mailrooms, libraries, and other subsystems of a larger organization. Management information systems help an organization achieve its objectives through the processing and sharing of data and information important to the organization at all levels.
Last, but certainly not least, we should include the Internet as an important part of an information system. Since 1950, developments in computer and teletransmission technology (telephone, radio, and FAX, for example) have changed the ways we can communicate with each other. The Internet began as a tool for scientists to discuss their research work over long distances (ARPANET). As this technology evolved and access expanded to business, industry, education, and personal users, the Internet and the World Wide Web (WWW) were born. They have changed the way we work, learn, and stay in touch with others. Now we can find, through the Internet, a friend or relative that we have not seen or communicated with in years; we can send and receive letters electronically and instantly (without a stamp); we can purchase almost anything without physically traveling to a store; and we can quickly locate products and services via the Internet that may not be available in our own geographic neighborhoods. We can even build businesses and create networks of coworkers and customers without the need for office space and daily commuting.
Computer-based information systems have changed the way we gather, process, and share information. They have enhanced our ability to identify and solve problems and to perform tasks that are beyond our physical ability. Information system technology will continue to provide new horizons to us.
see also Artificial Intelligence; Database Management Software; E-commerce; Expert Systems; Internet; Intranet; SQL; Virtual Reality.
Anderson, David. Managing Information Systems. Dover, NJ: Prentice Hall, Inc., 2000.
Beniger, James R. The Control Revolution. Cambridge, MA: Harvard University Press, 1986.
Debons, Anthony, Esther Horne, and Scott Cronenweth. Information Science: An Integrated View. Boston: G. K. Hall & Co., 1988.
Flynn, Roger R. An Introduction to Information Science. New York: Marcel Dekker, 1987.
Kobler, Ron, ed. The Illustrated Book of Terms and Technologies. Lincoln, NE: Sundhills Publishing, 1998.
Miller, James Grier. Living Systems. New York: McGraw-Hill, 1978.
Newell, Allen, and Herbert A. Simon. Human Problem Solving. Dover, NJ: Prentice Hall, Inc., 1972.
Stair, Ralph M., and George W. Reynolds. Principles of Information Systems, 5th ed. Cambridge, MA: Course Technology, 2001.
Stuart, Rory. The Design of Virtual Environments. New York: McGraw-Hill, 1996.
The term could have a very much wider meaning than that suggested, considering the range of meaning of the words information and system. It could, for instance, be broadened to include all computer-based systems, or further broadened to include many non-computer-based systems. Thus, within the domain of computer-based systems, the more specific term organizational information system is sometimes used.
Information systems include data processing applications, office automation applications, and many expert system applications. When their primary purpose is to supply information to management, they are commonly called management information systems.
The following are among the more important characteristics of information systems, and make their design and construction particularly difficult.
(a) Their environment is complex, not fully definable, and not easily modeled.
(b) They have a complex interface with their environment, comprising multiple inputs and outputs.
(c) The functional relationships between inputs and outputs are structurally, if not algorithmically, complex.
(d) They usually include large and complex databases (or, in future, knowledge bases).
(e) Their “host” organizations are usually highly dependent on their continuing availability over very long periods, often with great urgency attending their initial provision or subsequent modification.
See also information systems.