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Informatics for librarians: the core of the onion


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Informatics for librarians: the core of the onion

  1. 1. INFORMATICS FORLIBRARIANS:THE CORE OF THE ONIONJacqueline Leskovec, MLIS, MA, RNOutreach, Planning & Evaluation CoordinatorNational Network of Libraries of MedicineGreater Midwest RegionJune 2012
  2. 2. ObjectivesParticipants will:•Be able to define health informatics•Understand the role of legislation in health care reform•Understand the relationship between health informaticsand HIT•Be able to list at least 5 HIT tools•Explore ideas on the roles of librarians within the realm ofHIT
  3. 3. Health Informatics• Health informatics or medical informatics is the application of information technology to the healthcare profession with the aim of creating tools and procedures that can help doctors, nurses, and other healthcare personnel diagnose and treat patients more accurately and efficiently.
  4. 4. William Hersh
  5. 5. “It isnt just about computer scienceanymore…”
  6. 6. Health Information Technology• Health information technology (health IT or HIT) makes it possible for health care providers to better manage patient care through secure use and sharing of health information. Health IT includes the use of electronic health records (EHRs) instead of paper medical records to maintain peoples health information. The Office of the National Coordinator for Health Information Technology:
  7. 7. The Medical Record
  8. 8. Disciplines & Departments
  9. 9. Health Information Management• 1898: AML• 1907: MLA____________• 1928: ARLNA• 1938: AAMRL• 1970: AMRA• 1991: AHIMA Grace Whiting Myers
  10. 10. Informatics Pyramid Dalrymple 2011
  11. 11. Health InformaticsLibrarians!
  12. 12. June 29, 1956 February 13,2009
  13. 13. The HITECH VISION Courtesy: Office of the National Coordinator for Health Information Technology
  14. 14. Health Informatics Applications• Electronic Medical Records• ePrescribing• Personal Health Records• Remote Monitoring• Secure Messaging• Telehealth
  15. 15. EMR? EHR? HIE?• EMR: Electronic Medical Record • Electronic record of health-related information on an individual • Within one health care organization• EHR: Electronic Health Record • Electronic record of health-related information on an individual • Across more than one health care organization• HIE: Health Information Exchange • Electronic movement of health-related information among organizations • Involves networks • Local, state, and national HIE initiatives
  16. 16. Health information exchange is a teamsport.
  17. 17. Who uses the EMR?
  18. 18. The Most Important User
  19. 19. Medical Model Vs. Patient-Centered Model
  20. 20. Being a Meaningful User• By adopting electronic health records in a meaningful way, clinicians can: • Know more about their patients. • Make better decisions. • Save money. • Be eligible for CMS incentive payments.
  21. 21. (Intended) Results of MU:• Improved clinical health outcomes• Improved population health outcomes• Increased efficiency in the health care system• Empowered individuals• Learning health care system
  22. 22. Stage 1: Meaningful Use• Focus on electronically capturing health information in a coded format, using that information to track key clinical conditions, communicating that information for care coordination purposes, and initiating the reporting of clinical quality measures and public health inform
  23. 23. MU Stage 1 – Key Components• Computerized Provider Order Entry (CPOE)• Clinical Decision Support (CDS)• Electronic Prescribing (E-prescribing)• Structured documentation of quality measures• Up-to-date Problem Lists and Diagnoses• Provide patients with health information electronically• Information exchange• Report clinical quality measures to CMS Glossary of Selected Terms Related to Health IT
  24. 24. Stage 2: Meaningful Use• Expand upon the Stage 1 criteria in the areas of disease management, clinical decision support, medication management support for patient access to their health information, transitions in care, quality measurement and research, and bi-directional communication with public health agencies.
  25. 25. Stage 3: Meaningful Use• Focus on achieving improvements in quality, safety and efficiency, focusing on decision support for national high priority conditions, patient access to self management tools, access to comprehensive patient data, and improving population health outcomes.
  26. 26. Physicians’ Readiness For Ten Stage 1 Core Objectives, By Intention To Apply, 2011. Hsiao C et al. Health Aff doi:10.1377/hlthaff.2011.1315©2012 by Project HOPE - The People-to-People Health Foundation, Inc.
  27. 27. The Human Factor: HCI• Multi disciplinary• Usability job titles• Methods define the expertise
  28. 28. Roles for Librarians• Patients who can access their own health information are likely to have questions they couldn’t articulate previously• Patients will be much more effective if they are taught to use these tools• Public libraries as well as medical libraries are appropriate venues for classes and support Maxine l. Rockoff, PhD Department of Biomedical Informatics Columbia University December 2010
  29. 29. IFH’s Tutorial Modules• Sign in• Review Health Summary• Review lab results• Renew a prescription• Schedule an appointment• Send a message to your doctor• Get health information from MedlinePlus
  30. 30. All Your Health Info, All in OnePlace• Veterans, active duty Servicemembers, their dependents and caregivers • Account upgrades with IPA
  31. 31. MLA/NLM Joint Task Force: PHR• PHR user support is a new role for medical librarians.• Medical librarians need to be proactive in their communities to educate consumers about PHRs.• Given the dynamic nature of this market, medical librarians should make a concerted effort to stay abreast of trends in this area. J Med Libr Assoc. 2010 July; 98(3): 243–249. PMCID: PMC2900995
  32. 32. Standards• Continuity of Care Document (CCD)• ASTM Continuity of Care Record (CCR)• Clinical Document Architecture (CDA)• Digital Imaging and Communications in Medicine (DICOM)• Good Electronic Health Record (GEHR)• Health Level Seven (HL-7)
  33. 33. Hospitals as Information Environments• “…altogether the most complex human organization ever devised.” • Peter Drucker, 1993 American Hospital Association
  34. 34. Why FPs don’t use EMRs… I don’t type………….8.3% AAFP 2003
  35. 35. HIT and Educational Content• Training and education opportunities everywhere • Physicians and Nurses • Nursing • Other staff • Patient/Family Education
  36. 36. Infobutton
  37. 37. • ICD-9-CM• SNOMED CT®• CORE Problem List Subset codes• RXCUI• NDC
  38. 38. Patient Education• Trusted source of information – Your doctor – Your hospital• Develop online patient education libraries – Well developed content – Easy to find what you need
  39. 39. Training. Free. Yes, FREE.• Practice workflow and Information and Information Management Redesign Specialist• Clinician/Practitioner Consultant• Implementation Support Specialist• Technical/Software Support Staff• Implementation Manager• Trainer Time (and money!) is running out!
  40. 40. Trainer• Workers in this role design and deliver training programs, using adult learning principles, to employees in clinical and public health settings.• The previous background of workers in this role includes experience as a health professional, health information management specialist, or medical librarian. Experience as a trainer in the classroom is also desired.
  41. 41.
  42. 42. EMR Optimization• “We are running out of time, let’s just get it up and running and fix the problems later.”
  43. 43. 1 The right to view and/or obtain a copy of your health information2 The right to accurate and complete health information3 The right to request changes to your health information4 The right to know who receives your health information and how it is used5 The right to request limitations on the uses and releases of your healthinformation6 The right to expect your health information is private and secure7 The right to be informed about privacy and security breaches of your healthinformation8 The right to file a complaint or report a violation regarding your healthinformation
  44. 44. Safety and Error Prevention• Information system configuration/use• Process design• Communication• Labeling• Education
  45. 45. Research - Clinical Guidelines
  46. 46. Doing what we do best…•What are you doing??
  47. 47. • Librarians have a unique perspective and understanding of the application of medical information resources to meet clinical user needs. Karen M. Albert Medical Reference Services Quarterly Vol. 26, Iss. 3, 2007
  48. 48. Questions/comments?•• SlideShare: leskovec• 1.800.DEV-ROKSThis project has been funded in whole or in part with Federal funds from the National Library of Medicine, National Institutes ofHealth, Department of Health and Human Services, under Contract No. HHS-N-276-2011-00005-C with the University of Illinois at Chicago.