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  1. Perioperative information management systems (PIMS) are software systems that manage the documentation, workflow, and charge capture of the operating room (OR) environment. PIMS are composed of two main components: anesthesia information management systems (AIMS) and operating room management information systems (ORMIS).

  2. AIMS have been shown to improve processes of care. However, implementing these systems is expensive and takes a tremendous effort from both clinicians and information technology staff. Only recently has there been an increase in adoption rates, influenced by the Affordable Care Act and the Health Information Technology for Economic and Clinical Health (HITECH) Act passed by US Congress.

  3. Point-of-care software and hardware are available in many different forms. There has been a growth in AIMS software for mobile devices. There are advantages and disadvantages to each software and hardware architecture. Ultimately, the institutional and practice leaders need to decide on the best fit for its users.

  4. Functional components of AIMS include automated device interfaces, user-entered documentation, decision support capabilities, charge capture, and reporting capabilities.

  5. Functional components of ORMIS include clinical documentation, process reporting, OR scheduling, resource management, and patient tracking.

  6. AIMS and ORMIS need to be configurable systems to account for changes in practice patterns, new regulatory requirements, and updates in medical technology.

  7. AIMS need to integrate with hospital-wide electronic health records (EHRs). The anesthetic record needs to be available for viewing as part of the medical record, and anesthesiologists need to view enterprise patient information in the perioperative environment while using the AIMS.

  8. Institutions need to have disaster preparedness strategies, including data redundancy plans, to account for failure at each level of software and hardware architecture.

  9. AIMS vendors will continue to add new features and functionality to their systems. Exciting opportunities lie in the standardization of content and ability to aggregate and analyze large amounts of clinical data.


The use of information technology (IT) has irrevocably altered clinical practice. Health care providers interact with, and depend on, electronic medical information every day. From humble beginnings as extensions of billing and registration systems, clinical information systems are now designed to allow management of clinical workflow and, in best cases, improve the quality of care delivered to patients. There is ample evidence that anesthesia information management systems (AIMS) can improve documentation accuracy, clinical compliance, process-of-care measures, and even operational efficiency. However, there are still detractors who feel these systems hamper the clinician’s ability to focus on the patient. And, in fact, poorly designed and implemented systems can contribute to medical errors and poor quality of care. Although the adoption of AIMS has been slower than expected, the number of successful implementations has dramatically risen over the last few years, and many medium and large practices now have electronic anesthesia records in their practices. More than just documenting care, AIMS adopters are using the immense amount of data generated to better understand perioperative medicine and develop practices that improve ...

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