unit 1 informatics in the health care system (potter) – Flashcards

is a broad academic field encompassing artificial intelligence, cognitive science, computer science, information science, and social science.

refers to informatics related to health care and describes a distinct specialty in the discipline of medicine. It deals with the resources, devices, and methods required for the acquisition, storage, retrieval, and use of information in health and biomedicine. In addition to computers, informatics tools in health care include clinical guidelines, formal medical terminologies, and information and communication systems.

a specialty area of informatics that addresses the use of health information systems to support nursing practice. The American Nurses Association (ANA, 2008) states that the specialty of nursing informatics integrates nursing computer and information science for the management and communication of data, information, knowledge, and wisdom.

data

capture, storage, retrieval, organization, processing, and analysis of patient health data. Information summaries can be used to make a diagnosis, plan for care, provide nursing or medical decision support, enhance documentation, and identify care trends and costs.

Computers, tablets, or pocket devices used at the bedside for documentation are examples of

the foundation of information, knowledge, and wisdom. In informatics, the structural and functional relationships between these four concepts are often represented in a hierarchical relationship, progressing from data (shallow, rule-based knowledge) to wisdom (the appropriate use of knowledge).

Facts, observations, measurements; can be used as a basis for reasoning, discussion, or calculation. Until organized and processed, data are meaningless.

Organized and processed data; can be communicated, are meaningful and useful to the recipient.

Organized and processed information; can be applied to problem-solving and decision-making. Transformation of patient data to clinical information becomes nursing knowledge.

Addresses use of knowledge & experience to manage & solve problems; is appropriate application of knowledge. At this level, a nurse uses critical thinking to interpret & evaluate nursing knowledge

computer science and information science

data storage, date capture, data retrieval

Bedside or mobile computers Tablets and hand-held devices Cell phones and pocket devices Electronic digital patient monitoring systems Device interface systems linking devices with a facility's electronic medical record and internal digital links and resources

Health care staff working with computers and mobile IT must develop skills in the use of certain technologies. IT training and support must be accessible for health care staff to take full advantage of the benefits to patient care offered by information technology. Health care providers using IT as part of patient care need to work within facility policy and HIPAA guidelines. The rapid advancement of IT means that the technology in use today may be entirely different in the future.

Hand-held technology assists in the transformation of assessment data, interventions, and outcome documentation into evidence-based decision making in nursing (Hardwick, Pulido, and Adelson, 2007). The most obvious advantage of mobile technology is prevention of medication errors. As the final providers in the administration process, nurses are in a position to prevent a medication error. Mobile technology provides nursing students and nurses with instant access to safe dose, compatibility, and pharmacokinetic information that is essential for safe medication administration (Yoost, 2011). Among hand-held technology users, there is a significant improvement in research awareness and valuing, quality of care, job satisfaction, and reduction in barriers to research use (Doran, Straus, Haynes, et al., 2009).

health care robotics, digital imaging, and telehealth systems.

Information technology has advanced the use of sophisticated robots in the health care setting. Robots in the operating room assist to make procedures less invasive. Robots in pharmacies support safer medication selection.

Digital imaging in health care supports efficient distribution of visual information. Information systems have moved from strict alphanumeric data to multimedia information that can include graphics and sound. X-rays and other imaging results are now available in a digital format, making image sharing and interpretation more efficient.

is the use of the Internet to link medical experts with other clinicians, allowing remote consultations with clear video images and high-fidelity links. Patients may have telehealth hardware in their homes to provide in-home monitoring and direct reporting to their health care providers. Telehealth nursing is the nurse transmitting electronic data, images, or audio from a patient's bedside or home to other health providers for the purpose of providing care and improving outcomes. The use of telemonitoring offers the opportunity to reduce the cost of health care while improving outcomes and patient satisfaction.

tablets and hand-held devices bedside computers telehealth systems electronic health record

prevention of medical errors improvements in research valuing improvements in patient care outcomes

telehealth technology

robotics technology

digital imaging technology

mobile device technology

Patient safety Record management Research access Networking

patient safety

reduction of errors and improved patient safety in clinical settings.

When technology such as a bar-code medication administration system is used as part of the process of medication administration, fewer errors are made. After signing into the system or scanning his or her identification badge, the nurse electronically scans the bar codes of the patient ID, the medication administration record (MAR), and the drug to ensure that the right patient is getting the right drug and the right dose at the right time. An alert signals a potential error, and it is the nurse's responsibility to verify all information before administration.

Computerized decision support systems (DSSs) utilized alongside or embedded within electronic medical records include safe practice alerts and reminders that quality of care. Some DSSs assist in determining a correct diagnosis and choosing an appropriate medication.

Computerized provider order entry (CPOE) allows orders to be directly communicated to the appropriate department: diet orders to dietary, medication orders to the pharmacy, laboratory orders to the laboratory. CPOE systems ensure legible orders and have the potential to reduce ordering and transcribing errors and delays in care.

CPOE as one of the safe practices for better health care. Disadvantages of CPOE include workflow issues, provider resistance to new technology, and overdependence on technology (AHRQ, 2012).

When used with a CPOE system, the CDSS: suggests dosages, frequencies, and routes of administration for drugs; cross-checks for drug allergies and drug-drug interactions; and may suggest laboratory tests, depending on the drugs ordered (AHRQ, 2012).

ignificant innovations in the ease of access and storage of medical records. Specific benefits include: Remote access by multiple providers Implementation of computerized or electronic medical records makes patient records readily available through remote access to multiple providers at the same time. This availability of patient information supports efficient delivery of effective care. Compilation of data in one location As EHRs become fully implemented, they include provider order entries, progress notes for all disciplines, computerized medication profiles, access to diagnostic test results on a timely basis, DSSs, and online clinical reminders and alerts. Search ability of aggregate data As care records are aggregated in a data storage system, the patient data can be searched for cases, trends, and outcomes that can be analyzed to determine the best evidence for practice. Improved individual patient health management The ability to quickly review a patient's longitudinal data at the point of care supports the improved management of each patient. For example, being able to see blood pressure documented over time enables the nurse to assess the effect of an ordered medication. Ability to create task lists Customized task lists for specific health care staff groups can be generated by the EHR based on the order information in the database. For example, a nursing task list can be generated for a single patient or group of patients and organized by the type of tasks required, or when the tasks are due (e.g., wound dressing changes every morning and evening). Task lists generated by the EHR help ensure that patient care and medication administration tasks are completed at the appropriate times.

Computer applications are available for quantitative and qualitative research designs. Data management programs can analyze data to identify trends and patterns, allowing meaningful organization of information. Comparisons of nursing care data at the nurse-patient level can initiate comparisons across patient populations, and findings can support evidence-based nursing, evidence-based staffing, and specific billing for nursing services (Welton and Sermeus, 2010).

is the process of developing and using an interaction format with professional colleagues and agencies.

The Internet is a shared global computer network that enables health care team members to connect with resources and libraries, which may contain information to assist in effective clinical decision-making and improved patient outcomes.

E-mail has become a common means of communication. A listserv is a computer program that automatically sends messages to multiple e-mail addresses on a mailing list. Listservs can be used in health care to connect groups of patients with common problems, or to send updated information to large groups.

Social media allows participating individuals to communicate easily via the internet to share information and resources. Social media enables a potentially massive community of participants to collaborate, providing a mechanism for tapping into collective power in ways previously unachievable. When participating and interacting on social media, nurses must always follow confidentiality policies and HIPAA guidelines to protect patient privacy. Examples of social media include Facebook, Twitter, and LinkedIn.

A blog is a regularly updated website or web page that is typically managed by an individual or small group. Blogs often contain regular entries of commentary, descriptions of events, or other material such as graphics or videos. Most blogs are interactive, allowing visitors to leave comments and message each other. Many blogs focus on health care issues.

Admission systems that capture demographic patient data and bed availability Improved functionality and applications of the electronic health record Computerized provider order entry Bar-code medication administration E-prescribing and telehealth Personal health records Radiofrequency identification (RFID) of health care objects for tracking, inventory management, and validation of use with correct patient I'M CONFUSED

remote access by multiple providers compilation of data in one location searchability of aggregate data

computer programs can analyze data to identify trends, allowing meaningful organization of info for research comparisons of nursing care data can be easily used to support evidence-based nursing digital health care data is an accessible source of info easily utilized in reasearch

ensures legible orders reduces the potential for delays in care reduces the risk of transcription errors

Creation and retention of patient documentation Ownership of software Ownership and integrity of health care data Preservation of patient privacy and confidentiality Prevention of computer fraud and misuse

Access to electronic records requires a user to have system access and verification codes as a measure of security and protection of patients' privacy. The codes leave an electronic trail that can be used to trace any user who illegally accesses a patient's health care data.

The Health Insurance Portability and Accountability Act (HIPAA) standards for how security and confidentiality of health care information must be maintained. The act also outlines legal penalties for any health care staff who breach security of health care data.

The Computer Ethics Institute (CEI) in l985. CEI was founded to serve as a forum and resource for identifying, assessing, and responding to ethical issues related to information technology. CEI also promotes the recognition of ethics in the development and use of computer technologies.

Thou shalt not use a computer to harm other people. Thou shalt not interfere with other people's computer work. Thou shalt not snoop around other people's computer files. Thou shalt not use a computer to steal. Thou shalt not use a computer to bear false witness. Thou shalt not copy or use proprietary software for which you have not paid. Thou shalt not use other people's computer resources without authorization or proper compensation. Thou shalt not appropriate other people's intellectual output. Thou shalt think about the social consequences of the program you are writing or the system you are designing. Thou shalt always use a computer in ways that ensure consideration and respect for your fellow humans.

"to ensure that people worldwide can confidently, and with full understanding of known risks, realize the potential of the Internet in managing their own health and the health of those in their care."

candor, honesty, quality, informed consent, privacy, and professionalism in online health care, responsible partnering, and accountability (Rippen and Risk, 2000).

legal penalties formal reprimand immediate dismissal

thou shalt not snoop around other people's computer files

prevention of computer fraud and misuse ownership and integrity of health care data preservation of patient privacy and confidentiality

Technology is transforming the delivery of health care, from bedside care practices to broad-scale policy changes. Informatics in the health care system facilitates quality clinical decision-making and supports the improvement of health care outcomes and efficiency. It is important that all members of the health care team, including nurses, understand the benefits of informatics in patient care and embrace technological advances as valuable complements to compassionate face-to-face care.

in some situations, point-of-care data collection decreases the time spent on documentation point-of-care technology reduces the potential for errors electronic point-of-care data collection allows immediate patient info access by other health care team members.

data

social science, computer science, info science

enables staff to optimize patient outcomes through appropriate use of IT tools

facility policy regulated and defines the acceptable use of IT within a facility health care staff today must develop skills in the use of certain technologies

nurses having audio and visual contact with a patient in the home clinicians and specialists conducting consultations remotely via an internet connection

patient safety, research access, networking

use of technology to interact within individuals and resources

includes safe practice alerts assists in determining correct diagnoses assists in selecting an appropriate medication

ensure that people can use internet resources confidently to manage health

HIPPA outlines legal penalties for nurses who breach security of health care data nurses are legally and professionally responsible for understanding HIPPA HIPPA sets standards for how confidentiality of health care info must be maintained

the system tracks and records the users electronic trail within the record. security staff can review the trail