This document provides an overview of electronic health record systems (EHRs). It discusses how EHRs are used by various healthcare professionals and departments to longitudinally collect and share patient health information. Key features of EHRs discussed include providing access to patient data, clinical decision support, supporting efficient healthcare processes, and enabling remote access to patient records. Several examples of early EHR systems developed by the VA, DoD, and IHS in the 1970s are provided. The role of government agencies and standards organizations in facilitating EHR adoption is also summarized.
Whether the designation is electronic
medical records (EMR) or electronic
health records (EHR), there is widespread
consensus that the costs and difficulties
associated with system adoption are surpassed
by the benefits to be gained by all stakeholders. In
addition to providing more efficient and cost-effective
care delivery workflows, EHRs offer opportunities
to standardize care delivery processes, reduce
medical errors, and speed reimbursements.
Whether the designation is electronic
medical records (EMR) or electronic
health records (EHR), there is widespread
consensus that the costs and difficulties
associated with system adoption are surpassed
by the benefits to be gained by all stakeholders. In
addition to providing more efficient and cost-effective
care delivery workflows, EHRs offer opportunities
to standardize care delivery processes, reduce
medical errors, and speed reimbursements.
Cyber Risk in Healthcare Industry- Are you Protected? Mark Merrill
WE BUILD CORE HANDS-ON ON INFORMATION SECURITY SKILLS FOR ALL LEVELS AND DEPARTMENTS- It has already been two years since hackers shifted their main focus from BFSI sector to healthcare industry aggressively targeting hospitals all over the world, while U.S. is experiencing the most severe threat. How we can help you with HIPPA security and privacy concerns. DO YOU NEED TO INVEST IN INFORMATION SECURITY TRAINING, CONSULTING AND ADVISORY?
mHealth Israel_Ellen Janos_Healthcare Partner_Mintz Levin_ US Regulatory Envi...Levi Shapiro
Presentation from the 2014 mHealth Israel conference in Tel Aviv by Ellen Janos, Healthcare Partner at the law firm of Mintz Levin: "US Regulatory Environment and Investment Trends". To see all the presentations, go to http://www.mhealthisrael.com/agenda
FTC Spring Privacy Series: Consumer Generated and Controlled Health DataBrian Ahier
Increasingly, consumers are taking a more active role in managing and generating their own health data. For example, consumers are researching their health conditions and diagnosing themselves online. Consumers are also uploading their information into personal health records and apps that allow them to manage and analyze their data, and utilizing connected health and fitness devices that regularly collect information about them and transmit this information to other entities.
The movement of health data outside the traditional medical provider context has many potential benefits; however, it also raises potential privacy concerns. The seminar will address questions such as:
What types of websites, products, and services are consumers using to generate and control their health data, and how are consumers using them?
Who are the companies behind these websites, products, and services, what are their business models, and what does the current marketplace look like?
How can consumers benefit from these companies’ websites, products, and services?
What actions are these companies taking to protect consumers’ privacy and security?
What do consumers expect from these companies regarding privacy and security protections?
Do consumers differentiate between these companies and those that offer traditional medical products and services that are covered by HIPAA?
What restrictions, if any, do advertising networks and others impose on tracking of health data?
MANAGING THE INFORMATION SECURITY ISSUES OF ELECTRONIC MEDICAL RECORDSijsptm
All healthcare providers should have enough knowledge and sufficient information to understand the potential risk, which can lead to a breach in the Jordanian health information system (Hakeem program). This study aims to emphasise the importance of sharing sensitive health information among healthcare providers, create laws and regulations to keep the electronic medical records secure, and increase the
awareness about health information security among healthcare providers. The study conducted seven interviews with medical staff and an information technology technician. The study results showed that sharing sensitive information in a secure environment, creating laws and regulations, and increasing the
awareness about health information security render the electronic medical records of patients more secure and safe
Health Care Data Sets and their purpose
UHDDS, UACDS, MDS, OASIS, DEEDS and EMDS.
Explain the standardization data collection efforts.
Explain the five type of standards that need to be in place to implement the Nationwide Health Information Network (NHIN).
Standard Development Organizations
Evolving and Emerging Health Information Standards
Transforming the Kenya Health Information System (KHIS) to an Early Warning a...Stephen Olubulyera
Transforming the Kenya Health Information System (KHIS) to an Early Warning and Real-Time Electronic Disease Notification System: Optimization for Epidemiology, Disease Surveillance and Response in Kenya.
To develop a concept on transforming the Kenya Health Management Information System (KHIS) to an electronic disease early warning and real-time notification system through optimization of disease surveillance indicators: automatic and real-time notifications integrated into an informative standardised tool. The concepts will enhance and develop part of the list of diseases mandatorily reported within the stipulated period in disease occurrence depending on the case definition of the diseases, virulence and the degree of spread of new emerging diseases that have not been defined e.g. a new infectious disease.
Year after year, technology has played a role in changing the way that health care is delivered. Now in 2014, as technology continues to advance, consumers are demanding more convenient and cost effective care through increased use of mHealth and Telehealth. The mHealth + Telehealth World 2014 is must attend event for health care executives interested in learning how to most efficiently utilize Telehealth programs and mHealth practices to improve patient outcomes by promoting interoperability, sustainability, provider interest, and consumer engagement. Hear case studies, understand the ROI, and discuss ways to address critical issues – including licensing and security issues – of digital health practices.
http://www.worldcongress.com/events/HL14028/
Electronic health record (EHR) is a computerized patient-centric history of an individual’s health
care record that includes data from the multiple sources of care that the patient has used.
Cyber Risk in Healthcare Industry- Are you Protected? Mark Merrill
WE BUILD CORE HANDS-ON ON INFORMATION SECURITY SKILLS FOR ALL LEVELS AND DEPARTMENTS- It has already been two years since hackers shifted their main focus from BFSI sector to healthcare industry aggressively targeting hospitals all over the world, while U.S. is experiencing the most severe threat. How we can help you with HIPPA security and privacy concerns. DO YOU NEED TO INVEST IN INFORMATION SECURITY TRAINING, CONSULTING AND ADVISORY?
mHealth Israel_Ellen Janos_Healthcare Partner_Mintz Levin_ US Regulatory Envi...Levi Shapiro
Presentation from the 2014 mHealth Israel conference in Tel Aviv by Ellen Janos, Healthcare Partner at the law firm of Mintz Levin: "US Regulatory Environment and Investment Trends". To see all the presentations, go to http://www.mhealthisrael.com/agenda
FTC Spring Privacy Series: Consumer Generated and Controlled Health DataBrian Ahier
Increasingly, consumers are taking a more active role in managing and generating their own health data. For example, consumers are researching their health conditions and diagnosing themselves online. Consumers are also uploading their information into personal health records and apps that allow them to manage and analyze their data, and utilizing connected health and fitness devices that regularly collect information about them and transmit this information to other entities.
The movement of health data outside the traditional medical provider context has many potential benefits; however, it also raises potential privacy concerns. The seminar will address questions such as:
What types of websites, products, and services are consumers using to generate and control their health data, and how are consumers using them?
Who are the companies behind these websites, products, and services, what are their business models, and what does the current marketplace look like?
How can consumers benefit from these companies’ websites, products, and services?
What actions are these companies taking to protect consumers’ privacy and security?
What do consumers expect from these companies regarding privacy and security protections?
Do consumers differentiate between these companies and those that offer traditional medical products and services that are covered by HIPAA?
What restrictions, if any, do advertising networks and others impose on tracking of health data?
MANAGING THE INFORMATION SECURITY ISSUES OF ELECTRONIC MEDICAL RECORDSijsptm
All healthcare providers should have enough knowledge and sufficient information to understand the potential risk, which can lead to a breach in the Jordanian health information system (Hakeem program). This study aims to emphasise the importance of sharing sensitive health information among healthcare providers, create laws and regulations to keep the electronic medical records secure, and increase the
awareness about health information security among healthcare providers. The study conducted seven interviews with medical staff and an information technology technician. The study results showed that sharing sensitive information in a secure environment, creating laws and regulations, and increasing the
awareness about health information security render the electronic medical records of patients more secure and safe
Health Care Data Sets and their purpose
UHDDS, UACDS, MDS, OASIS, DEEDS and EMDS.
Explain the standardization data collection efforts.
Explain the five type of standards that need to be in place to implement the Nationwide Health Information Network (NHIN).
Standard Development Organizations
Evolving and Emerging Health Information Standards
Transforming the Kenya Health Information System (KHIS) to an Early Warning a...Stephen Olubulyera
Transforming the Kenya Health Information System (KHIS) to an Early Warning and Real-Time Electronic Disease Notification System: Optimization for Epidemiology, Disease Surveillance and Response in Kenya.
To develop a concept on transforming the Kenya Health Management Information System (KHIS) to an electronic disease early warning and real-time notification system through optimization of disease surveillance indicators: automatic and real-time notifications integrated into an informative standardised tool. The concepts will enhance and develop part of the list of diseases mandatorily reported within the stipulated period in disease occurrence depending on the case definition of the diseases, virulence and the degree of spread of new emerging diseases that have not been defined e.g. a new infectious disease.
Year after year, technology has played a role in changing the way that health care is delivered. Now in 2014, as technology continues to advance, consumers are demanding more convenient and cost effective care through increased use of mHealth and Telehealth. The mHealth + Telehealth World 2014 is must attend event for health care executives interested in learning how to most efficiently utilize Telehealth programs and mHealth practices to improve patient outcomes by promoting interoperability, sustainability, provider interest, and consumer engagement. Hear case studies, understand the ROI, and discuss ways to address critical issues – including licensing and security issues – of digital health practices.
http://www.worldcongress.com/events/HL14028/
Electronic health record (EHR) is a computerized patient-centric history of an individual’s health
care record that includes data from the multiple sources of care that the patient has used.
Electronic Health Records: purpose of electronic health records, popular electronic health record system, advantages of electronic records, challenges of electronic health records, the key players involved.
Pg2 Beginning in 1991, the IOM (which stands for the Institute o.docxrandymartin91030
Pg2 Beginning in 1991, the IOM (which stands for the Institute of Medicine of the National Academies) sponsored studies and created reports that led the way toward the concepts we have in place today for electronic health records. Originally, the IOM called them computer-based patient records.1 During their evolution, the EHR have had many other names, including electronic medical records, computerized medical records, longitudinal patient records, and electronic charts. All of these names referred to essentially the same thing, which in 2003, the IOM renamed as the electronic health records, or EHR.
Note: EHR
The acronym EHR is commonly used as shorthand for Electronic Health Records, and will be used in the remainder of this book.
Institute of Medicine (IOM)
The IOM report2 put forth a set of eight core functions that an EHR should be capable of performing:
Health information and data
This function provides a defined data set that includes such items as medical and nursing diagnoses, a medication list, allergies, demographics, clinical narratives, and laboratory test results. Further, it provides improved access to information needed by care providers when they need it.
Result management
Computerized results can be accessed more easily (than paper reports) by the provider at the time and place they are needed.
· Reduced lag time allows for quicker recognition and treatment of medical problems.
· The automated display of previous test results makes it possible to reduce redundant and additional testing.
· Having electronic results can allow for better interpretation and for easier detection of abnormalities, thereby ensuring appropriate follow-up.
· Access to electronic consults and patient consents can establish critical links and improve care coordination among multiple providers, as well as between provider and patient
Order management
Computerized provider order entry (CPOE) systems can improve workflow processes by eliminating lost orders and ambiguities caused by illegible handwriting, generating related orders automatically, monitoring for duplicate orders, and reducing the time required to fill orders.
· CPOE systems for medications reduce the number of errors in medication dose and frequency, drug allergies, and drug–drug interactions.
· The use of CPOE, in conjunction with an EHR, also improves clinician productivity.
Decision Support
Computerized decision support systems include prevention, prescribing of drugs, diagnosis and management, and detection of adverse events and disease outbreaks.
· Computer reminders and prompts improve preventive practices in areas such as vaccinations, breast cancer screening, colorectal screening, and cardiovascular risk reduction.
Electronic communication and connectivity
Electronic communication among care partners can enhance patient safety and quality of care, especially for patients who have multiple providers in multiple settings that must coordinate care plans.
· Electronic co.
Please research Meaningful Use. Prepare a brief report on its origin.pdfsolimankellymattwe60
Please research Meaningful Use. Prepare a brief report on its origin, its purpose, how it is
conducted, etc. Please make sure you understand and explain the three different stages.
Solution
Meaningful Use(MU)
Purpose: The concept of meaningful use rested on the \'5 pillars\' of health outcomes policy
priorities, namely:
->Improving quality, safety, efficiency, and reducing health disparities
->Engage patients and families in their health
->Improve care coordination
->Improve population and public health
->Ensure adequate privacy and security protection for personal health information
Origin:
The American Reinvestment & Recovery Act (ARRA) was enacted on February 17, 2009.
ARRA includes many measures to modernize our nation\'s infrastructure,
one of which is the \"Health Information Technology for Economic and
Clinical Health (HITECH) Act\". The HITECH Act supports the concept of
electronic health records - meaningful use [EHR-MU], an effort led by
Centers for Medicare & Medicaid Services (CMS ) and the Office of the
National Coordinator for Health IT (ONC). HITECH proposes the meaningful
use of interoperable electronic health records throughout the United States
health care delivery system as a critical national goal. Meaningful Use is
defined by the use of certified EHR technology in a meaningful manner
(for example electronic prescribing); ensuring that the certified EHR
technology is connected in a manner that provides for the electronic
exchange of health information to improve the quality of care; and that
in using certified EHR technology the provider must submit to the Secretary
of Health & Human Services (HHS) information on quality of care and other measures.
How its conducted:
As in order to encourage widespread EHR adoption, promote innovation and to avoid
imposing excessive burden on healthcare providers, meaningful use was showcased
as a phased approach, which is divided into three stages which span 2011
(data capture and sharing), 2013 (advanced clinical processes) and 2015
(improved outcomes). The incentive payments range from $44,000 over 5 years
for the Medicare providers and $63,750 over 6 years for Medicaid providers
(starting in 2011). Participation in the CMS EHR incentive program is totally
voluntary, however if EPs or EHs fail to join in by 2015, there will be negative
adjustments to their Medicare/Medicaid fees starting at 1% reduction and escalating
to 3% reduction by 2017 and beyond.
The CDC currently offers several types of technical assistance to state and
local health departments related to Meaningful Use, including:
->Meaningful Use Public Health Technical Assistance Team - To request assistance
from this team, email meaningfuluse@cdc.gov with “Request for Technical Assistance”
in the Subject line.The CDC National Program of Cancer Registries provides support
and tools for cancer registries. For more info visit its official website
->The CDC Immunization Information Systems Support Branch (IISSB) provides technic.
Digital health is about electronically connecting up the points of healthcare so that health information can be shared securely.
This is the first step to understanding how digital health can help deliver safer, better and quality healthcare.
“My Health Record” is the new name of the digital health record system.
Cis evaluation final_presentation, nur 3563 sol1SBU
An overview of a Computer Information System (CIS) and considerations that need to be taken with implementing an Electronic Health Record (EHR) in a healthcare setting.
Chapter 6 Health Information ExchangeRobert Hoyt MDWilliam .docxrobertad6
Chapter 6: Health Information Exchange
Robert Hoyt MD
William Hersh MD
After viewing the presentation, viewers should be able to:
Identify the need for and benefits of health information exchange (HIE) and interoperability
List healthcare data that should be shared
Enumerate HIE challenges and barriers
Describe several organizations known as Health Information Organizations (HIOs)
Summarize the newest HIE models
Learning Objectives
Health Information Exchange (HIE) is the “electronic movement of health-related information among organizations according to nationally recognized standards”
Health Information Organization (HIO) is “an organization that oversees and governs the exchange of health-related information among organizations according to nationally recognized standards”
Important Definitions
Regional Health Information Organization (RHIO) is “a health information organization that brings together health care stakeholders within a defined geographic area and governs health information exchange among them for the purpose of improving health and care in that community.”
Interoperability is defined as “the ability of two or more systems or components to exchange information and to use the information that has been exchanged”. This implies that the data is computable and that standards exist that permit interoperability
Important Definitions
Foundational: refers to the technology or platform used to exchange information
Syntactic: means messages have a structure and syntax that is understandable. Uses XML and HL7 standards
Semantic: terminology and coding must be the same for the sending and receiving organizations
Interoperability Levels
Exchange (sharing) of health information is vital for healthcare reform at the local, state and national level
The next two slides will demonstrate the types of healthcare data that should be shared
If electronic health records don’t share data, then we have moved from paper siloes of information to electronic siloes; not the goal of anyone
HIE is part of the Meaningful Use program, discussed in the module on electronic health records
Introduction
Clinical results: Lab, pathology, medication , allergies, immunizations and microbiology data
Images: Actual images and radiology reports
Documents: Office notes, discharge notes and emergency room notes
Clinical summaries: Continuity of Care Documents (CCDs); XML-based documents that standardize and summarize care
Financial information: Claims data and eligibility checks
Medication data: Electronic prescriptions, formulary status, and prescription history
Healthcare Data Potentially Shared
Performance data: Quality measures like blood pressure or diabetes control, cholesterol levels, etc.
Case management: Management of the underserved and emergency room utilization
Public health data: Infectious diseases outbreak data, immunization records
Referral management: Management of re.
Chapter 17 Implementing and Upgrading an Information System Soluti.docxcravennichole326
Chapter 17 Implementing and Upgrading an Information System
Solution
Christine D. Meyer
No matter whether the electronic health record (EHR) is new or an upgrade, the ultimate goal in implementations is to provide the highest level of care at the lowest cost with the least risk.
Objectives
At the completion of this chapter the reader will be prepared to:
1.Discuss the regulatory and nonregulatory reasons for implementing or upgrading an electronic information system
2.Compare the advantages and disadvantages of the “best of breed” and integrated system approaches in selecting healthcare information system architecture
3.Explain each step in developing an implementation plan for a healthcare information system
4.Develop strategies for the successful management of each step in the implementation of a healthcare information system
5.Analyze the benefits of an electronic information system with an integrated clinical decision support system
6.Explain the implications of unintended consequences or e-iatrogenesis as it relates to implementing an electronic health record (EHR)
Key Terms
Best of breed, 277
Big bang, 284
Phased go-live, 284
Scope creep, 276
Tall Man lettering, 276
Workarounds, 279
Abstract
The decision to implement a new electronic health record (EHR) or to upgrade a current system is based on several factors, including providing safe and up-to-date patient care, meeting federal mandates and Meaningful Use requirements, and leveraging advanced levels of clinical decision support. Implementing EHRs entails multilayered decisions at each stage of the implementation. Major decisions include evaluating vendor and system selection, determining go-live options, redesigning workflow, and developing procedures and policies. The timeline and scope of the project is primarily dictated by expenses, staff, resources, and the drop-dead date for go-live. Success depends on variables such as a well-thought-out and detailed project plan with regular review and updating of the critical milestones, unwavering support from the organization's leadership, input from users during the design and build phases, mitigation of identified risk factors, and control of scope creep. The implementation of an EHR is never finished. Medication orders, nonmedication orders, and documentation screens or fields will continuously need to be added, modified, or inactivated; patches will be installed and tweaks to workflows and functionality will be ongoing.
Introduction
This chapter focuses on the implementation of healthcare information systems. Of course, many different types of applications are used within a healthcare information system. The general principles for implementing these many different applications are the same; however, for the purposes of discussion this chapter will focus mainly on the implementation of an electronic health record (EHR) to demonstrate these general principles. In 2004 President George W. Bush promoted the i ...
Instructions for Submissions thorugh G- Classroom.pptxJheel Barad
This presentation provides a briefing on how to upload submissions and documents in Google Classroom. It was prepared as part of an orientation for new Sainik School in-service teacher trainees. As a training officer, my goal is to ensure that you are comfortable and proficient with this essential tool for managing assignments and fostering student engagement.
Synthetic Fiber Construction in lab .pptxPavel ( NSTU)
Synthetic fiber production is a fascinating and complex field that blends chemistry, engineering, and environmental science. By understanding these aspects, students can gain a comprehensive view of synthetic fiber production, its impact on society and the environment, and the potential for future innovations. Synthetic fibers play a crucial role in modern society, impacting various aspects of daily life, industry, and the environment. ynthetic fibers are integral to modern life, offering a range of benefits from cost-effectiveness and versatility to innovative applications and performance characteristics. While they pose environmental challenges, ongoing research and development aim to create more sustainable and eco-friendly alternatives. Understanding the importance of synthetic fibers helps in appreciating their role in the economy, industry, and daily life, while also emphasizing the need for sustainable practices and innovation.
A Strategic Approach: GenAI in EducationPeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
Model Attribute Check Company Auto PropertyCeline George
In Odoo, the multi-company feature allows you to manage multiple companies within a single Odoo database instance. Each company can have its own configurations while still sharing common resources such as products, customers, and suppliers.
Francesca Gottschalk - How can education support child empowerment.pptxEduSkills OECD
Francesca Gottschalk from the OECD’s Centre for Educational Research and Innovation presents at the Ask an Expert Webinar: How can education support child empowerment?
June 3, 2024 Anti-Semitism Letter Sent to MIT President Kornbluth and MIT Cor...Levi Shapiro
Letter from the Congress of the United States regarding Anti-Semitism sent June 3rd to MIT President Sally Kornbluth, MIT Corp Chair, Mark Gorenberg
Dear Dr. Kornbluth and Mr. Gorenberg,
The US House of Representatives is deeply concerned by ongoing and pervasive acts of antisemitic
harassment and intimidation at the Massachusetts Institute of Technology (MIT). Failing to act decisively to ensure a safe learning environment for all students would be a grave dereliction of your responsibilities as President of MIT and Chair of the MIT Corporation.
This Congress will not stand idly by and allow an environment hostile to Jewish students to persist. The House believes that your institution is in violation of Title VI of the Civil Rights Act, and the inability or
unwillingness to rectify this violation through action requires accountability.
Postsecondary education is a unique opportunity for students to learn and have their ideas and beliefs challenged. However, universities receiving hundreds of millions of federal funds annually have denied
students that opportunity and have been hijacked to become venues for the promotion of terrorism, antisemitic harassment and intimidation, unlawful encampments, and in some cases, assaults and riots.
The House of Representatives will not countenance the use of federal funds to indoctrinate students into hateful, antisemitic, anti-American supporters of terrorism. Investigations into campus antisemitism by the Committee on Education and the Workforce and the Committee on Ways and Means have been expanded into a Congress-wide probe across all relevant jurisdictions to address this national crisis. The undersigned Committees will conduct oversight into the use of federal funds at MIT and its learning environment under authorities granted to each Committee.
• The Committee on Education and the Workforce has been investigating your institution since December 7, 2023. The Committee has broad jurisdiction over postsecondary education, including its compliance with Title VI of the Civil Rights Act, campus safety concerns over disruptions to the learning environment, and the awarding of federal student aid under the Higher Education Act.
• The Committee on Oversight and Accountability is investigating the sources of funding and other support flowing to groups espousing pro-Hamas propaganda and engaged in antisemitic harassment and intimidation of students. The Committee on Oversight and Accountability is the principal oversight committee of the US House of Representatives and has broad authority to investigate “any matter” at “any time” under House Rule X.
• The Committee on Ways and Means has been investigating several universities since November 15, 2023, when the Committee held a hearing entitled From Ivory Towers to Dark Corners: Investigating the Nexus Between Antisemitism, Tax-Exempt Universities, and Terror Financing. The Committee followed the hearing with letters to those institutions on January 10, 202
Palestine last event orientationfvgnh .pptxRaedMohamed3
An EFL lesson about the current events in Palestine. It is intended to be for intermediate students who wish to increase their listening skills through a short lesson in power point.
The French Revolution, which began in 1789, was a period of radical social and political upheaval in France. It marked the decline of absolute monarchies, the rise of secular and democratic republics, and the eventual rise of Napoleon Bonaparte. This revolutionary period is crucial in understanding the transition from feudalism to modernity in Europe.
For more information, visit-www.vavaclasses.com
3.
Is often used interchangeably with
computerized patient record clinical
information system, electronic medical –
record, and many others. Yet the choice of
the words in the term EHR – S reflects the
boarder focus on the health of the consumer
or patient and indicates that the EHR – S may
be used by all participants in the process of
achieving health, including all disiplins of
clinical, family caregivers and the patient.
4.
Longitudinal collection of electronic health
information for and about persons, where health
information is defined as information pertaining
to the health of an individual or healthcare
provided to an individual.
Immediate electronic access to person and
population – level information by authorized, and
only authorized, users.
Provision of knowledge and decision support that
enhances the quality, safety, and efficiency of
patient care.
Support of efficient process for healthcare
delivery.
5.
Different departments exert different
influence towards the common goal of an
EHR for most Americans. Other agencies
provide leadership by offering monetary
incentives; finding research, development and
demonstration projects; and shaping
regulations and policy.
6.
The Veterans Health Administration in the
Department of Veterans Affairs (VA) and the
National Institutes of Health (NIH) in the
Development of Health and Human Services
(HHS) are two examples of the initiation of
system in the 1970’s that were activity used
by clinicians.
7.
The Veterans Health Information System and Technology Architecture (VISTA)
support day – to – day clinical and administrative operations at local VA healthcare
facilities. All electronic records are password protected to guarantee patients
privacy other features include the following:
A checking system that alerts clinicians if an order they are entering could cause a
problem.
A notification system that immediately alerts clinicians to clinically significant
events.
A visual posting system that alerts healthcare providers to issues specifically
related to the patient on the opening of the patients electronic chart, including
crisis notes, adverse reactions, and advance directives.
A template system that allows the healthcare provider to automatically create
reports.
A clinical reminder systems that electronically alerts clinicians when certain
actions, such as examinations, patien education, and laboratory test, need to be
performed.
Remote data viewing to allow clinicians to see the patient medical history at all the
VA facilities where the patient was seen.
8.
Within DoD, providers have had a
computerized physician order entry capability
that enables them to order lab test and
radiology examinations and issue
prescriptions electronically for over 10 years.
9.
The IHS has long been pioneer in using
computer technology to capture clinical and
public health data. RPMS was developed in
1970 and many facilities have access to
decades of personal health information and
epidemiologic data local populations.
10.
The government is also pursuing the
development of a public – private national
health information network to facilitate EHR –
S deployment.
11.
The executive order of April 2004, mentioned
earlier in the chapter, created the ONCHIT to
coordinate HIT efforts in the federal sector and to
collaborate with the private sectors in driving HIT
adoption across the healthcare system.
The National Committee on Vital and Health
Statistics in 2000 and 2001, the National
Committee on Vital and Health Statistic (NCVHS)
which advises the secretary of HHS on health
information policy, held a series of national
hearings to develop a consensus vision of the
national Health Information Infrastructure
(NHCII).
12.
13.
Inform Clinical Practice: Informing clinical
practice
Is fundamental to improving care and making
healthcare delivery more efficient. Three
strategic for realizing goal are:
Incentivize EHR adoption
Reduce risk of EHR investment
Promote EHR diffusion in rural and under
segued areas
14. Interconnect Clinicians: will allow information
to be portable and to more with consumer.
The three strategies for realizing this goal
are:
Foster regional collaboration
Develop national health information systems.
Coordinate federal health information
systems.
15. Personalize care: consumer – centric
information helps individuals manage their
own wellness and assist with their personal
healthcare decisions. The three strategies for
realizing this goal are:
Encourage use of personal health records
Enhance informed consumer choice
Promote use of telehealth systems
16. Improve Population Health: Requires the collection
of timely, accurate, and detailed clinical
information to allow for the evaluation of
healthcare delivery and the reporting of critical
findings to public health officials, clinical trials
other research and feedback to clinicians:
Unify public health surveillance architecture
Streamline quality and health status monitoring
Accelerate research and dissemination of
evidence
17.
In addition AHRQ funded demonstration
grants to establish and implement
interoperable health information systems and
data effectiveness of healthcare for patients
and populations on a specific state or
regional level.
18.
Several large pilot programs were authorized
in the 2003 Medicare Modernization Act
(MMA) the 3 – year is intended to promote
continuity of care, help stabilize medical
conditions and reduce adverse health
outcomes, such as adverse drug interactions.
19.
Among these private sector organizations are
those formed specifically to address issues of
connectivity, HIT, and standards
development.
20.
Is addressing the barriers to development of
an interconnected health information
infrastructure. It brings together several
dozen of the leading healthcare provider and
prayer organizations, HIT vendors and
representatives of federal and state agencies.
21.
Is an independent, nonprofit affiliated
organizations established to foster improvement
in the quality safety, and efficiency of healthcare
through information and IT. Shares its mission
and providers funding for its initiatives.
Is Connecting Communities for better, a nearly
$4miillion program that provides seed funding
and technical support to multi stakeholder
collaborative within communities that are using
electronic health information exchange and other
HIT tools to drive improvements in healthcare
quality, safety and efficiency.
22.
As an independent adviser to the nation with
the goal of improving health, the 10M has
championed the advantages of use of IT to
improve healthcare since its 1991
foundational work: the report created a
framework for identifying core functions of
an EHR – S, along with the primary and
secondary uses of these systems.
23.
The goal of this group is to support Goal 1,
strategy 2, “Reduce risk of EHR investment” of
the strategic framework. Twelve
commissioners serve on the certification
group, with two ex – officio representing the
federal government.
24. Is known for its large body of work in the
production of technical specifications for the transfer
of healthcare data. This transport mechanism known
as messaging, is widely used domestically and
internationally.
The HL7 EHR –s functional model contains a list
of functions in three categories: direct care,
supportive, and information infrastructure.
Direct care functions are familiar to clinicians.
Supportive functions involves secondary use of the
data captured via the direct care functions.
Information infrastructure section is the “backend” of
the systems.
Functional Model is the Creation of a Profile.
26.
In this section we discuss five fundamental
guidelines that can help increase the
dependability of healthcare systems.
27.
The infrastructure level, features that are
transparent to software applications should
be implemented to detect faults are detected
and to recover from failures before they
become catastrophic. To handle exceptions in
the execution of specific software
applications, application – specific feature
should be implemented security feature to
detect, disable and recover from malicious
attacks, while preserving system stability and
security, should be implemented.
28.
Fundamental Principle of System architecture
is that an enterprise system architecture
should be developed from the bottom up so
that no critical component is dependent on a
component less trustworthy than itself. At the
bottom of the architecture are the physical
and logical networks that support the
enterprise and provide the “pipes“ that carry
data from system to system.
29.
The system planning process should
anticipate business success and the
consequential need for larger networks more
system, new applications, and additional
integration. Such models can provide valuable
input into planning for scalability and future
integration.
30.
Managing and keeping complex network and
integrated system available and responsive
requires meticulous overseers – individuals
who know that failures will occur and accept
that failures are most likely to occur when
they are least expected.
31.
Imagine that small start – up company called
Cute Chutes has announced the availability of
a new parachute unit that promises to
revolutionize the sport of sky diving.
32.
This system provides an informal assessment
of how well healthcare provider organizations
follow the guidelines discussed above.
33.
Healthcare Organizations build – or perhaps
“compose” their systems from the top down rather
than from the bottom – up. The healthcare
professionals select the user interfaces they like, and
the IT team negotiates terms with the vendors who
offer the systems that generate those interfaces these
systems are familiarly known as “departmental”
system because they generally are used only in one
department, such as registration laboratory, or
pharmacy.
The healthcare Portability and Accountability Act
(HIPAA) security regulation prescribes administrative.
Physical and technical safeguards for protecting the
confidentially and integrity of health information and
the availability of critical systems services.
34.
Security management, including security analysis and risk
management.
Assigned security responsibility.
Information access management, including the isolation of
clearinghouse functions from clinical function.
Security awareness and training.
Security incident procedures, including response and
reporting.
Contingency planning, including data back up planning
disaster recovery planning, and planning for emergency
mode operation.
Evaluation.
Business associate contracts that lock in the obligations of
business partners in protecting health information to
which they may have access.
35.
Access control, including unique user
identification and an emergency access
procedure.
Audit control.
Data integrity protection.
Person or entity authentication.
Transmission security.
37.
Medical technology and prescription drugs,
as well as clinical treatment protocols, are
required to undergo extensive validation
before they can be used in clinical practice.
38.
These organization have hired IT manager
who appreciate the important role of IT in a
healthcare environment and who recognize
the need for dependable systems that can
anticipate and recover from failures.
40.
Nursing care
Patient or client demographics
Service Elements
The NMDS was develop by building on the
foundation establish by the United State
uniform hospital discharge.
42.
The NMDS identifies essential, common and
core data elements to be collected for all
patients/client receiving nursing care.
Is a standard approach that facilitates that
abstraction of these minimum, common,
essential care data elements to describe
nursing practice.
The NMDS was conceptualized through a
small group work at the nursing information
system (NISS) conference help in 1977 at the
University of Illinois College of Nursing.
44.
Unique facility or service agency number
Unique health record number or
patient/client
Unique number of principle registered nurse
provider
Episode admission or encounter date
Discharge or termination date
Disposition of patient/client
Expected payer for most of this bill
45.
The NMDS influenced the work of the professional
nurses association. In 1991, the Americans Nurses
Association (ANA) recognized the NMDS as the
minimum data elements to be included in any data
set or patient record.
The NMDS servers as a key component of the
standards developed by the Nursing Information and
Data Set Evaluation Center (NIDSEC).
NIDSEC develops and disseminates standards
related to nomenclature, clinical associations, clinical
data repositories, and system characteristics/
decision support/contextual variable pertaining to
data sets in information system that supports the
documentation of nursing practice (NMDS).
46.
47.
The Early NMDS work in the United States
spurred the development of NMDS in
numerous other countries. A perusal of these
data set reveals a definite consensus on the
importance of the nursing care elements
across all countries which identified NMDS’s.
48.
Several countries across most continents
beyond North America are exploring
development of NMDS systems.
It is clear that there is major work being
accomplished across the globe to ensure that
nursing essential data will be more
comprehensively available in the future.
NMDSs relationship to International Nursing
Minimum Data Set (I – NMDS).
49.
The i – NMDS includes the core,
internationally relevant, essential, minimum
data elements to be collected in the course
for providing nursing care.
These data can provide information to
describe compare and examine nursing
practice around the globe.
i-NMDS is intended to build on the efforts
already underway in individual countries.
50.
The i-NMDS Research Center is lead by a
steering committee of international
representative of countries with existing and
emerging NMDS as well as professional
cosponsor ship and areas of informatics
expertise.
51.
Describing the human phenomena
Improving the performance of healthcare
system
Enhancing the capacity of nursing
Addressing the nursing shortage
Testing credence based practiced
improvements
Empowering the public internationally
52.
The i-NMDS elements are organized into
three categories, subjects of care, and
nursing elements.
53.
The power of NMDS to describe nursing
practice from international perspective is
daunting.
55.
In 2001, the American Nurses Association
(ANA) published the code of Ethics for nurses
with Interpretive statements, a complete
prevision and interpretive statements that
guide all nurses in practice, be it in the
domain of direct patient care, education,
administration, or research.
Nursing informatics is the nursing specialty
that endeavors to make the collection, and
knowledge easier for the practitioner,
regardless of the domain and setting.
56.
Informatics is a science that combines a
domain science, computer science,
information science, and cognitive science.
Healthcare informatics may be defined as
the integration of healthcare information.
Healthcare informatics address the study
of management of healthcare information.
Nursing informatics reflects this duality as
well, moving in and out of integration and
separation as situations and needs demand.
57.
In 1985, Kathryn Hannah proposed a
definition that nursing informatics in the use
of informatics technologies in relation to any
nursing function and action of nurses.
Nursing sciences, computer science and
information, and knowledge to manage and
communicate data, information, and
knowledge in nursing practice.
58.
In early 1992, the ANA established nursing
informatics as a destine specialty in nursing
with a distinct body of knowledge.
The scope of nursing informatics practice
includes activities such as developing and
evaluating applications, tools, processes, and
strategies that assist registered nurses in
managing data to support decision – making.
59.
Models are representation of some aspect of
the real world. Models show particular
perspectives of a selected aspect and any
illustrate relationships. Models evolve as
knowledge about the selected aspect changes
and are dependent on the “world view” of
these developing the model.
60.
Data, information and knowledge are defined
as current met structures or overarching
concepts for nursing informatics with specific
definitions in the scope and standards of
Nursing Informatics Practice. Data are
“discrete entities that are described
objectively without interpretation” and would
include some value assigned to a variable.
62.
Registered nurses are consumable twenty
first century knowledge workers.
Knowledge work of course, depends on
access to data, information and knowledge.
63.
This desired change in skills involves the
evolution from novice level to advanced
beginner to competent to proficient to finally
an expert level.
64.
Healthcare environment is characterized by
significant emphasis on establishing the EHR
in all settings.
The concept of EHR emerged, initially, as a
computer – based patient record or CPR and
was given significant impetus ba a 1991
report from the institute of medicine that
advocate the adoption of the CPR as the
primary source of client healthcare data and
information.
65.
This is best accomplished by using standard
communication formats and terminologies
and recognized convention for describing the
concepts being presented. Concept
representation involves the set of terms and
relationship that describe the phenomena,
processes, and practices of a discipline, such
as nursing.
66.
Has evolved from alphabetical listing in the
mid – 1980’s to a conceptual system that
guides the classification of nursing diagnoses
in a taxonomy and includes definitions and
defining characteristics.
Includes 167 recognized diagnoses that
every different from the pathology and
mortality focus of the ICD – 9 CM terms used
for medicine and third party payment claims.
67.
The fourth edition of NIC contains 514
nursing interventions that describe the
treatments nurses perform updated linkages
with NANDA diagnoses and core interventions
identified for 44 specialty practice areas.
There terms differ from the surgically biased
CPT – 4 code set terms used by medicine and
third party programs.
68.
To provide standardization of expected
patient, caregiver, family and community
outcomes for measuring the effect of nursing
interventions.
Clinical Care Classification (CCC) Formerly
Home Health Care Classification (HHCC)
CCC system is a research – based
nomenclature designed to standardize the
terminologies for documenting nursing care
in all clinical care settings.
69.
Was released in November 2004, originally
developed for use un home practice, the
Ohama system is now used in all clinical
settings.
70.
Is a core clinical terminology containing over
357,000 healthcare concepts with unique
meanings and formal logic – based
definitions organized into multiple
hierarchies.
71.
The PNDS provides a universal language for
peri – operative nursing and education and a
framework to standardize documents.
72.
Provide a mechanism for coding integrative
health interventions by clinician by state
location for administrative billing and
insurance claims.
73.
Includes terms and codes for patient
problems, therapeutic goals, and patient care
orders. This data set was developed by Dr.
Judith Ozbolt from research data from nine
acute care hospitals throughout the United
State.
74.
Originated as a database of standardized
laboratory term for result reporting for
chemistry, hematology, serology,
microbiology, and toxicology.
Includes about 32,000 terms including a
clinical portion with codes for observations at
key stages of the nursing process, including
assessments, goals and outcomes.
75.
Is a combinational terminologies for nursing
practice developed by the international
nursing community under sponsorship of the
International council of Nurses (ICN).
76.
Includes terms to describe the context and
environment of nursing practice, and includes
terms for nursing delivery unit/service,
patient/client population, care delivery
method, personnel characteristics and
financial resources.
77.
Provide information resources and value –
added membership benefits that support
those individuals interested in healthcare and
nursing informatics.