The document discusses the history and development of electronic health record systems (EHRs) in the United States. It describes how the US president called for widespread EHR adoption in 2004. It outlines the key components of EHRs and notes their benefits like improved patient care. It also discusses the roles of various government agencies and private organizations in initiatives to promote EHR adoption and interoperability through standards, funding, and public-private partnerships.
With the advent of technology and implementation of many electronic health records across the globe, take a step back and analyze what are the issues and challenges EHR implementation is facing right now.
Slide presentation for our MS Health Informatics 201 class under Dr. Iris Isip-Tan.
With the advent of technology and implementation of many electronic health records across the globe, take a step back and analyze what are the issues and challenges EHR implementation is facing right now.
Slide presentation for our MS Health Informatics 201 class under Dr. Iris Isip-Tan.
Electronic Medical Records (EMR) in the PhilippinesDennis Seymour
https://seriousmd.com/ - Software for EHRs or Electronic Health Records is still relatively new in the Philippines. This is changing, however. Authorities like Frost & Sullivan predict sustained growth in the EHR market for the region.
In spite of that, EHR vendors and creators will have to contend with obstacles. The country still has relatively poor ICT (information and communications technology) infrastructure. Cultural resistance to new technologies and processes will also play a part. New concerns with novel technologies, privacy issues, for instance, are factors as well.
Despite that, knowledge is growing of EHRs' benefits. These benefits are slowly but steadily fueling interest in EMRs within the Philippines, and more options are appearing over time.
Where to get primary health informationthomas654564
Medooc is a search engine for researching medical information.It has been built by medical professionals to help others in the community to research and share credible health information.Doctors, Physcials and medical professionals participate in Medooc.com on day to day basis to help each other.
For more information you can visit:-http://www.medooc.com/
Where to get primary health informationthomas654564
Medooc is a search engine for researching medical information.It has been built by medical
professionals to help others in the community to research and share credible health information.
Doctors, Physcials and medical professionals participate in Medooc.com on day to day basis to help
each other.
For more information you can visit:-http://www.medooc.com/
Security framework for cloud based Electronic Health Record (EHR) system IJECEIAES
Health records are an integral aspect of any Hospital Management System. With newer innovations in technology, there has been a shift in the way of recording health information. Medical records which used to be managed using various paper charts have now become easier to organize and maintain, thereby increasing the efficiency of medical staff. The Electronic Health Records (EHR) System is becoming a high-tech medical management technology developed for the economic or emerging economic countries like India. In a national health system, the EHR integrates the Electronic Medical Records (EMR) in all collaborating hospitals through different networks. EHR gives healthcare professionals a way to share and manage patient data quickly and effectively. Due to the mass storage of confidential patient data, healthcare organizations are considered as one of the most targeted sectors by intruders. This paper proposes a security framework for EHR system, which takes into consideration the integrity, availability, and confidentiality of health records. The threats posed to the EHR system are modeled by STRIDE modeling tool, and the amount of risk is calculated using DREAD. The paper also suggests the security mechanism and countermeasures based on security standards, which can be utilized in an EHR environment. The paper shows that the utilization of the proposed methods effectively addresses security concerns such as breach of sensitive medical information.
An electronic health record (EHR) is a collection of patient’s electronically-stored health information in a digital and systematic format. EHR system can store data accurately.
Survey of open source health information systemshiij
Due to the Health Information Technology for Economic and Clinical Health Act (HITECH), the US
medical industry has been given a directive to transition to electronic health records. Electronic Health
Records will enhance efficiency and quality of patient care. In this paper, open-source health information
systems are surveyed.These systems include electronic medical records, electronic health records and
personal health record systems. Their functionality, implementation technologies used, and security
features are discussed.
This is about an Electronic Medical Record System for General Practitioners, especially for those who are from developing countries like Sri Lanka. Details are there in www.lakmedi.com
Electronic Medical Records (EMR) in the PhilippinesDennis Seymour
https://seriousmd.com/ - Software for EHRs or Electronic Health Records is still relatively new in the Philippines. This is changing, however. Authorities like Frost & Sullivan predict sustained growth in the EHR market for the region.
In spite of that, EHR vendors and creators will have to contend with obstacles. The country still has relatively poor ICT (information and communications technology) infrastructure. Cultural resistance to new technologies and processes will also play a part. New concerns with novel technologies, privacy issues, for instance, are factors as well.
Despite that, knowledge is growing of EHRs' benefits. These benefits are slowly but steadily fueling interest in EMRs within the Philippines, and more options are appearing over time.
Where to get primary health informationthomas654564
Medooc is a search engine for researching medical information.It has been built by medical professionals to help others in the community to research and share credible health information.Doctors, Physcials and medical professionals participate in Medooc.com on day to day basis to help each other.
For more information you can visit:-http://www.medooc.com/
Where to get primary health informationthomas654564
Medooc is a search engine for researching medical information.It has been built by medical
professionals to help others in the community to research and share credible health information.
Doctors, Physcials and medical professionals participate in Medooc.com on day to day basis to help
each other.
For more information you can visit:-http://www.medooc.com/
Security framework for cloud based Electronic Health Record (EHR) system IJECEIAES
Health records are an integral aspect of any Hospital Management System. With newer innovations in technology, there has been a shift in the way of recording health information. Medical records which used to be managed using various paper charts have now become easier to organize and maintain, thereby increasing the efficiency of medical staff. The Electronic Health Records (EHR) System is becoming a high-tech medical management technology developed for the economic or emerging economic countries like India. In a national health system, the EHR integrates the Electronic Medical Records (EMR) in all collaborating hospitals through different networks. EHR gives healthcare professionals a way to share and manage patient data quickly and effectively. Due to the mass storage of confidential patient data, healthcare organizations are considered as one of the most targeted sectors by intruders. This paper proposes a security framework for EHR system, which takes into consideration the integrity, availability, and confidentiality of health records. The threats posed to the EHR system are modeled by STRIDE modeling tool, and the amount of risk is calculated using DREAD. The paper also suggests the security mechanism and countermeasures based on security standards, which can be utilized in an EHR environment. The paper shows that the utilization of the proposed methods effectively addresses security concerns such as breach of sensitive medical information.
An electronic health record (EHR) is a collection of patient’s electronically-stored health information in a digital and systematic format. EHR system can store data accurately.
Survey of open source health information systemshiij
Due to the Health Information Technology for Economic and Clinical Health Act (HITECH), the US
medical industry has been given a directive to transition to electronic health records. Electronic Health
Records will enhance efficiency and quality of patient care. In this paper, open-source health information
systems are surveyed.These systems include electronic medical records, electronic health records and
personal health record systems. Their functionality, implementation technologies used, and security
features are discussed.
This is about an Electronic Medical Record System for General Practitioners, especially for those who are from developing countries like Sri Lanka. Details are there in www.lakmedi.com
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.
SURVEY OF OPEN SOURCE HEALTH INFORMATION SYSTEMS hiij
Due to the Health Information Technology for Economic and Clinical Health Act (HITECH), the US
medical industry has been given a directive to transition to electronic health records. Electronic Health
Records will enhance efficiency and quality of patient care. In this paper, open-source health information
systems are surveyed.These systems include electronic medical records, electronic health records and
personal health record systems. Their functionality, implementation technologies used, and security
features are discussed.
Running Head THE HEALTH INFORMATION EXCHANGE (HIE) IN U.S 1.docxtodd521
Running Head: THE HEALTH INFORMATION EXCHANGE (HIE) IN U.S 1
THE HEALTH INFORMATION EXCHANGE (HIE) IN U.S 9
The Health Information Exchange (HIE) in U.S
Yehyun Park
Purdue University
01/02/2019
The impetus of Health Information Exchange in U.S
Health Information Exchange (HIE) is an information system that promotes a secure sharing of critical information as well the inclusive access critical medical information about a patient electronically (Abdelhak et al, 2014). One merit of the use of such electronic systems in the U.S is that they occur in different verities. The HIE also offer different types of services. Evidently, a recent development has enabled the HIE systems to promote the Marketplace and regional institutional services concerning the health sector. The merit of HIE applications included the improvement of speed, Quality, safety and reduced relative prices of charge per patient for care. This is made possible by the quick sharing of critical information among the doctors, pharmacists, nurses among all the relevant health personnel. The HGIE systems are such that, they are technically enabled to provide quick response to information demand with the relevant urgency and thus aids in the making of vital patient’s data and medical progress devoid of medical errors, readmissions, and duplicate testing. The resulting system has a generally improved diagnosis.
HIE enables three line of services in general: directed exchange, Query-based Exchange a consumer-mediated exchange services. Direct Exchange is the sending or receiving data electronically in the aid of coordination by caregivers. Whenever heath care provider wants to consult with other providers about a planned care, they employ the Query-based exchange while consumer-mediated Exchange enables patients to manage through control of the use of their personal information (Abdelhak et al, 2014). The availability of the three forms of health information Exchange makes the strong point of HIE since their integration in use is guided by some predetermined policies, technology, principles, and policies provision which have already been piloted before. The three forms are completely available throughout. With the Consumer-mediated Exchange system, the patient can be able to monitor the use of his personal medical information by their care provider. The patients can make a participation in their care enhancing through providing alternative providers with their heath condition, describe their heath information give the health missing or incorrect information, track and manage their own health.
Describe basic HIE organizational structures, architectures, and services
The commonly known architecture types of HIE includes the centralized hybrid and the federated models of HIE. The centralized HIE model is enabled with one Clinical Data Repository (CDR). The CDR is managed by HIE authority that is under the governance of the representatives from the relevant hospitals (Abdelhak .
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.
64 journal of law, medicine & ethicsDreams and Nightmare.docxevonnehoggarth79783
64 journal of law, medicine & ethics
Dreams and
Nightmares:
Practical and
Ethical Issues
for Patients and
Physicians Using
Personal Health
Records
Matthew Wynia and Kyle Dunn
Introduction and Definitions
The term “Electronic Health Records” (EHR) means
something different to each of the stakeholders in
health care, but it always seems to carry a degree of
emotional baggage. Increasingly, EHRs are advert-
ized as a nearly unmitigated good that will transform
medical care, improve safety and efficiency, allow
better patient engagement, and open the door to an
era of cheap, effective, timely, and patient-centered
care.1 Indeed, for some EHR proponents the ben-
efits of adopting them are so obvious that adoption
has become an end in itself.2 But for others — and
especially for a number of skeptical practitioners and
patients — EHR is a code word that portends the cor-
porate transformation of health care delivery, the loss
of patient privacy, the demand that patients bear more
responsibility in health care, and the unreflective take-
over of the health care system by people who do not
understand medical care or how health care relation-
ships unfold.3
For our purposes, we will consider EHRs impar-
tially, as a set of tools that can be used for a variety of
purposes. We define EHRs broadly as any electronic
means of storing and transferring health-related
information. We exclude from this definition the use
of the telephone and fax, arguably precursors to the
electronic means of data exchange now available. Like
face-to-face and paper-based interactions, the tele-
phone and fax are generally limited to two people.
Breaches of phone line security, while possible and
perhaps even frequent, are unlikely to affect thou-
sands of people at once.
In this paper, we examine the development of a new
set of EHR tools, Personal Health Records (PHRs).
PHRs may be variously defined (Table I) and have sev-
eral potential functional and payment models (Table
II), but the general aim of all PHRs is to increase
patients’ access to and sense of ownership over their
health care information. According to the Markle
Foundation, the advent of PHRs “represents a transi-
tion from a patient record that is physician-centered
to one that is patient-centered, prospective, interac-
Matthew Wynia, M.D., M.P.H., is the Director of the In-
stitute for Ethics at the American Medical Association and a
Clinical Assistant Professor at the University of Chicago. He
received his M.D. from the Oregon Health and Science Univer-
sity in Portland, Oregon and his M.P.H. from Harvard Uni-
versity School of Public Health in Boston, MA. Kyle Dunn,
M.H.S., was a Research Assistant at the Institute for Ethics
at the American Medical Association and is now a Ph.D. can-
didate in the Department of Health Policy and Management
at the Johns Hopkins Bloomberg School of Public Health. He
received a B.S. in Molecular, Cellular and Developmental Bi-
ology .
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
2.
In April 2004, the United States president called for action to put EHRs in place for most
American in 10 years. Today, these systems can manage healthcare data and information in a
way that is patient- centered and information in a way that is improved information and for the
better patients care.
The term EHR-S is often used interchangeably with computerized patients record, clinical
information systems, electronic medical record, and etc. and this term was eventually used
internationally. EHR’s also can be made up of one or more applications. The 10M’s 1991
definition of computer based patient record systems is currently the basic for domestic and
international definitions of an EHR-S.
The sets of component that form the mechanism by which patients records are
created, used, stored and retrieved. A patient record system is usually located within a
healthcare provider setting. It Includes people, data, rules and procedures, processing and
storage devices and communication and support facilities (Dick, Steen and Derimer,1991).
EHR-S includes the following;
1. Longitudinal collection of electronic health information for and about persons, where health
information is defined as information pertaining to the health of an i9ndividual or health
provided to an individual.
2. Immediate electronic access to a person and population level information by authorized, and
only authorized users.
3. Provision of knowledge and decision support that enhance the quality safety, and efficiency
of patient care: and
4. Support of efficient process for healthcare delivery.
3.
FEDERALO INITIATIVES
An agencies providing direct healthcare offer evidence that the use of HER-Ss across a multifacility
enterprise is a realistic goal with measurable, repeatable positive outcomes.
GOERNMENT AS PROVIDER AND EARLY ADOPTER
1. The veterans health administration in the Department of Veterance Affairs
2. The National Institute of Health (NIH) in the department of Health and Human Services (HHS) are
the two examples of the initiation of systems in the 1970’s that were actively used by clinicians.
The Department of Defense (DOD) and the Indian Health Services (HIS) in the department of HHS both
acquired the VA’s original clinical information systems years ago customizing it to meet their clinical
and business needs (Kolodner, 1997).
DEPATMENT OF VETERARS AFFAIRS
The Veterans Health Information Systems and Technology Architecture (VISTA) supports day-to-day
clinical and administrative operations at local VA health facilities.
DEPARTMENT OD DEFENSE
Within DOD, provides have a computerized physician order entry capability that enables them to
order lab test and radiology examinations and issue prescriptions electronically for over 10 yrs.
INDIAN HEALTH SERVICE
The HIS has long been a pioneer in using computer technology to capture clinical and public health
data. Many of its components are imported from the VA’s CPRS and adapted to fit the business needs
of the HIS clinical environments of care.
NURSING INFORMATICS
4.
GOVERNMENT AS LEADER
Federal activities are focused on the development
and adoption of terminologies and standards,
grants for demonstrations of data exchange, and
other pilot projects. The government is also
pursuing the development of a public-private
national health information network to facilitate
HER-S deployment.
OFFICE OF THE NATIONAL COORDINATOR FOR
HEALTH INFORMATION TECHNOLOGY
The national health information network is the
technical infrastructure enabling national
interoperability. Regional health information
organizations are now being proposed at the
community, regional or state level, as mentioned
in the discussion of the Agency for Healthcare
Research and Quality (AHRQ).
THE NATIONAL COMMITTEE ON VITAL AND
HEALTH STATISTICS
NCVHS (2002) presented the concept of an
infrastructure that emphasizes health-oriented
interaction and information sharing among
individuals and institutions, rather than simply the
physical technical, and data defined the NHII as
including the values, practices relationships, laws
standards, systems, applications and technologies
that support all facts of individual health,
healthcare, and population health.
5.
Three dimensions of the National Health
Information Infrastructure and examples of
their content.
HEALTHCARE PROVIDER DIMENSION
-provider note
-clinical orders
-practice guidelines
-decision- support programs
PERSONAL HEALTH DIMENTION
-non-shared personal information
-self-care
-audit logs
-personal library
POPULATION HEALTH DIMENSION
-infrastructure data
-planning and policy document
-surveilance systems
-health disparities data
SOURCE; National Committee on Vital and
Health Statistics
6.
CENTERS FOR MEDICARE AND MEDICAL SERVICES
Within HHS, the CMS has initiates several pilot projects to
promote health IT. In May 2004, CMS awarded as $ 100,000
grant to the American Academy of Family Physicians (AAFP) for a
pilot project to improved comprehensive, standardized HER
software to small and medium sized ambulatory care practices.
Although the use of health IT is not mandatory, CMS views CCIF
as a significant opportunity to demonstrate
innovative, integrative information infrastructures and
communication technologies.
PUBLICT-PRIVATE PARTNERSHIPS
Are those formed specifically to address issues of
connectivity, HIT, and standards of organizations.
CONNECTIVITY FOR HEALTH
A large private collaborative with federal participants supported
by the Marlke and Robet Wood Johnson Foundations, connecting
for Health is addressing the barriers to development of an
interconnected health information infrastructure.
7.
CENTERS FOR MEDICARE AND MEDICAL
SERVICES
Within HHS, the CMS has initiates several pilot
projects to promote health IT. In May
2004, CMS awarded as $ 100,000 grant to the
American Academy of Family Physicians (AAFP)
for a pilot project to improved
comprehensive, standardized HER software to
small and medium sized ambulatory care
practices. Although the use of health IT is not
mandatory, CMS views CCIF as a significant
opportunity to demonstrate
innovative, integrative information
infrastructures and communication
technologies.
PUBLICT-PRIVATE PARTNERSHIPS
Are those formed specifically to address issues
of connectivity, HIT, and standards of
organizations.
CONNECTIVITY FOR HEALTH
A large private collaborative with federal
participants supported by the Marlke and
Robet Wood Johnson Foundations, connecting
for Health is addressing the barriers to
development of an interconnected health
information infrastructure.
EHEALTH INITIATIVE
Is an independent, nonprofit affiliated organizations
established to faster improvement in the quality,
safety and efficient of health care through
information and IT. Its membership brings together
hospitals and other providers, practicing clinicians,
community organizations, payers, employers,
community-based organizations, HIT suppliers
manufacturers, and academic organizations.
INSTIUTE OF MEDICINE
The 10M has championed the advantage of use of IT
to improved healthcare since its 1991 foundational
work. The 10M continues to illuminate the
importance for the use of IT in healthcare.
CERTIFICATION COMMISSION FOR THE HEALTH
INFORMATION TECHNOLOGY
The goal of this group is to support goal1, strategy2,
“Reduce risk of HER investments,” of the strategic
framework shown in representing the federal
government.
HEALTH LEVEL SEVEN
An non-for-profit volunteer standards organizations,
Health Level Seven (HL7) is known for its large body
of work in the production of technical specification
for the transfer of healthcare data.
This time of great change brings grand opportunities
for nursing informatics and the entire nursing
profession.
8.
DEPENDABLE SYSTEM FOR QUALITY CARE
Dexie B. Barker
The transformation of the healthcare industry is
undergoing manually intensive, crisis-driver model
of care delivery to a more efficient, consumercentric, science-based model that proactively
focuses on health management.
DEPENDABILITY
Are thus ethical obligations drive requirements for
system reliability, availability, confidentiality , data
integrity, responsiveness, and safety attributes
collectively.
Dependability is also a measure of the extent to
which a system can justifiably be relied to delver
the services expected from it.
DEPENDABILITY SIX ATTRIBUTES
System reliability
Service Availability
Confidentiality
Data integrity
Responsiveness
Safety
Safety
WHEM THINGS GO WRONG?
Even we would like to be able to assume that
computers, networks and software are as
dependable as our toaster and telephones,
unfortunately that is not the case, and stories that
have appeared in trade journals have documents
this fact.
The bottom line is that systems, networks, and
software applications are highly complex and the
only safe assumption is that failures will occurs.
GUIDELINES FOR DEPENDABLE SYSTEMS
A more practical approach to attaining
dependability is to build tolerant systems- systems
that anticipate problems, that detect faults,
software glitches, and intrusions, and that take
action so that services can continue and data are
protected from corruption, destruction and
unauthorized disclosure.
GUIDELINE 1: ARCHITECT FOR DEPENDABILITY
At the bottom of the architecture are the physical
and logical networks that support the enterprise
and provide the “pipes” that carry data from
systems to system. The simplest design and
integration strategy will be the easiest to
understand to maintain, and to recover in the case
o a failure or disaster.
9.
GUIDELINE 2: ANTICIOATE FAILURES
In anticipation of failures at the infrastructure
level, features that are transparent to software
applications should be implemented to defects
faults, to fail over the redundant components
when faults are detected. And to recover from
failures before they become worst.
GUIDELINE 3: ANTICIPATE SUCCESS
The systems planning process should
anticipate business, success and the
consequential need for larger networks, more
systems, applications, and additional
integration.
GUIDELINE 4: HIRE METICULOUS MANAGERS
These managers use middle ware to manage
the work load access the network. They take
emergency and disaster planning seriously.
GUIDELINE 5: DON’T BE ADVENTUROUS
The products brochure urges the consumers
to be adventurous and states that the
company guarantees satisfaction or the
purchaser’s money will be cheerfully refunded.
ASSESSING THE HEALTHCARE INDUSTRY
For adherence to the first guideline
“architect for dependability” the clinical
care provider community gets a barely
passion grade of “D”. Healthcare
organizations build or perhaps ”compose”
– their systems from the top down rather
than from the bottom up.
THE HEALTH INSURANCE PORTABILITY AND
ACCOUNTABILITY ACT (HIPAA)
The following eight required administrative
safeguards represent important
operational practices that clearly will
contribute to system dependability.
Security management, including security
analysis and risk management.
Assigned security responsibility.
Information access management, including
the isolation of clearing house functions
from other clinical functions.
10.
Security awareness and training.
Security incident
procedures, including response
and reporting
Contingency planning including
data backup planning, disaster
recovery planning, and planning
for emergencies mode
operations.
Evaluation
Business associate contracts that
lock in the obligations of
business partners in protecting
health information to which they
may have access.
Five specified physical
safeguards also contribute
to systems dependability by
requiring that
facilities, workstations, devi
ces and media be
protected.
Access control, including
unique user identification
and on emergency access
procedure
Audit controls
Data integrity protection
Person or entity
authentication
Transmission security.
11.
ANTICIPATING FAILURES
For adherence to the second guideline
“expect failure” the clinical care provider
community gets another grade of “D”.
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.
ANTICIPATION SUCCESS
Healthcare organizations definitely expect
their software applications computer
systems, and network to work.
IT MANAGEMENT
Organizations have hired IT managers who
appreciate the important role of IT in a
healthcare environment and who
recognized the need for dependable
systems that can anticipate and recover
from failures.
ADVENTUROUS TECHNOOGIES IN
HEALTHCARE
On the one hand, healthcare givers
typically are not early adopters. But on the
other hand, they seem to cast fate to the
wind for technologies that catch their
collective fancy.
NATIONAL NURSING MINIMUM DATA SETS
The early NMDS work in the United States
spurred development of NMDS on
numerous other countries.
EMGRENT NMDSS
Most continents beyond North America are
developing of NMDS systems. In
summary, it is clear that there is major
work being accomplished across the globe
to ensure the nursing essential data will be
more comprehensively available in the
future.
12.
CALL FOR STANDARDIZED CONTEXTUAL
DATA
Ample studies have demonstrated the
significance of nurse staffing,
patient/staff ratios, professional
autonomy and control, organizational
characteristics, unit internal
environment, work delivery patterns,
work group characteristics, external
environment, staff work satisfaction
education of staff, multidisciplinary
coordination/collaboration, and
educational level on the quality and
outcomes of patient care.
The development within the United Sates
of the NMMDS addresses this void.
13.
The 18 NMMDS elements are organized into three categories:
ENVIRONMENT
Unit / cost center identification
Organizational decision making power
Type
Environmental complexity
Patient/ client population
Patient/ Client accessibly
Volume
Method of care delivery
Accreditation
Clinical decision making complexity
NURSING CARE
Management demographic profile
Staffing
Staff demographic profile
Staff satisfaction
FINANCIAL RESOURCES
Payer type
Reimbursement
Budget
Expense
14.
NURSING MINIMUM DATA SETS SYSTEMS
Connie White Delaney
The NMDS historical Summary
It is a standardized approach that facilitates the abstraction of these
minimum, common, essential core data elements to describe nursing
practice (Werly and Lang,1988) from both paper and electronic records.
Eight benefits of NMDS
Access to comparable, minimum nursing care and resources data on
local, regional, national and international levels.
Enhanced documentation of nursing care provided
Identification of trends a related to patient or client problems and
nursing care provided.
Impetus to improved costing of nursing services
Improved data for quality assurance evaluation
Impetus to further development and requirement of NISs
Comparative research on nursing outcomes, intensity of nursing
care3, and referral for further nursing services.
Contributions toward advancing nursing as a research-based discipline.
15.
STANDARDS AND RESEARCH ERATWENTY-FIRST CENTURY
Although the full benefits of the NMDS are
still being, the NMDS work has influenced
a number of advances.
The NMDs serves as a key component of
the standards developed by the Nursing
Information & Data Set Evaluation Center
(NIDSEC). The tools and methods to
facilitate comparability of nursing data
continue to evolve, including the
international for nursing practice.
NMDSs relationships to International
Nursing Minimum Data (i-NMDS)
EVOLUTION OF CONCEPT
Te i-NMDS includes the core,
internationally relevant, essential minimum
for providing nursing care (Clark and
Delaney, 2000)
These data can provide information to
describe, compare, and examine nursing
practice around the globe.
COSPONSORSHIP
I-NMDS research center is lead by a
steering committee of international
representatives of countries with existing
and emerging NMDS as well as
professional co sponsorship and areas of
informatics expertise.
PORPOSES
Contribution of nursing care and nurses is
essential to healthcare globally
The i-NMDS as a key data sets will
support.
-Describing the human
phenomena, nursing interventions, care
outcomes and resources consumption
related to nursing services
16.
-Improving the performance of healthcare
systems and the nurses working within
these systems worldwide.
-Enhancing the capacity of nursing and
midwifery services
-Addressing the nursing
shortage, inadequate working conditions
poor distribution and inappropriate
utilization of nursing personnel and the
challenges as well as opportunities of
global technological innovations.
DATA ELEMENTS
The elements of i-NMDS are organized
into three categories setting subjects of
care and nursing elements (Delaney et
al, 2003).
Setting variable include country
characteristics as well as descriptors of the
location of the care, whether the setting is
acute ambulatory, home and so on.
Measures includes care personnel
characteristics including numbers, fulltime
equivalents, education, gender and so on.
ISSUES
Normalization of data collection time
periods is a difficult issue.
FUTURE DIRECTIONS
To describe the power of NMDS in nursing
practice from international perspective is
daunting, (Delaney, 1996, et al.)
The human phenomena serve by nursing
the interventions given and the outcomes
realized are essential to improving
outcomes assuring patient safety, and
providing wise stewardship of ll resources,
from human to financial.
CASE SCENARIO
The National Service in collaboration with
the world health organization wishes to
establish bench makers for case.
17.
You are ask to file a report
addressing the following:
What is the relationship
between and among the
number, education, certifica
tion and experience of
healthcare workers and the
vacancy rate?
What is the relationship
between and among the
number, education
certification, and
experience of health
workers and turnovers
rates?
What is the relationship
between and among the
number, education
certification, and
experience of healthcare
workers and the following
outcomes:
Nosocomial infections
Discharge effectiveness
Patient/ Family satisfaction
with care received
Length of stay appropriate
to diagnosis
Morbidity/ Morality
Nurse satisfaction
18.
THEORIES, MODELS AND
FRAMEWORKS
Carol BicFord
Kathleen M. Hunter
Based on the recognition of
patterns and variances, builds
on previous experiences and
knowledge and involves the
use of analogies. Recognition
of such learning principles
proves in valuables for those
exploring or already engage in
nursing informatics practices
because the nurse in this
specially roles is always
learning and always teaching.
FOUNDATIONAL DOCUMENTS
GUIDE NURSING INFORMATICS
Nursing working in the
informatics specialty are
professionally bound to follow
these provisions.
Terms such as decisionmaking comprehension
information, knowledge share
goals, disclosure , outcomes,
privacy, evaluation.
Confidentiality, protocols and
factual documentation abound
throughout the explanatory
language of the interpretative
statements.
19.
IT IS A SCIENCE THAT COMBINES A DOMAIN
SCIENCE, COMPUTER SCIENCE, INFORMATION
SCIENCE AND COGNITIVE SCIENCE.
NURSING INFORMATICS
According to Kathryn Hanna who proposed a
definition that NI is the use of information
technologies in relation to any nursing
functions and actions of nurses
(Hanna, 1985)