Health Informatics Assignment Week 1 to 2

Week 0 (warm up) Assignment

1. True or False:

AMIA was started in 1967?

2. True or False:

The earliest use of computers in health informatics was in dental projects during late 50s in the US

3. True or False:

There were over 40 members at the first HMSS convention in the 1960s.

4. True or False:

The use of clinical guidelines and standardized protocols of care increased significantly during the 1970s

5. Which of the following is a challenge of health informatics?

1. Modern statistics and datasets used to compare symptoms, diagnoses, and treatments
2. Information is easily available in a digital format for healthcare professionals, the patient and possibly by family members as well (with proper authentication and credentials)
3. Protection and security of data and information is not only dependent on the systems and devices, but also on the professional’s actions.
4. Electronic systems decrease the time required for scheduling, storing data, and sending information

6. Which of the following is an HIM principle of health informatics?

1. Contribute to the selection and utilization of appropriate information technologies to meet business requirements.
2. Contribute to ongoing evaluation of the functionality of systems so that they can evolve to support best practice in clinical care.
3. Demonstrate knowledge of analysis, design, development and implementation of health information systems and applications
4. Demonstrate an understanding of architectural relationships between key health information technology components.

Week 1 Assignment

Questions for Discussion

1. How do you interpret the phrase “logical behaviour”? Do computers behave logically? Do people behave logically? Explain your answers.
2. What do you think it means to say that a computer program is “effective”? Make a list of a dozen computer applications with which you are familiar. List the applications in decreasing order of effectiveness, as you have explained this concept. Then, for each application, indicate your estimate of how well human beings perform the same tasks (this will require that you determine what it means for a human being to be effective). Do you discern any pattern? If so, how do you interpret it?
3. Discuss three society-wide factors that will determine the extent to which computers are assimilated into medical practice.
4. Reread the future vision presented in Section 1.1. Describe the characteristics of an integrated environment for managing medical information. Discuss two ways in which such a system could change medical practice.
5. Do you believe that improving the technical quality of health care entails the risk of dehumanization? If so, is it worth the risk? Explain your reasoning
   

   Answer:

   The incorporation of computing technology in healthcare environments will interfere with the ability of relationships between clinicians and patients and thus marginalize the treatment relationship. Computer systems can influence the communication among clinicians and their patients exactly the exact reverse. The bio-psycho-social patient-centered approach concentrates on conventional or complementary conventional therapy methodologies, valuing a holistic assessment of patients such as their feelings, ideas, values and needs.

   However, the bio-medical evidence-based approach to medicine, the dominant paradigm in scientific experience and medical care, gives priority to strongest information to guide decisions. As such, the individuality of clinicians as individuals is ignored, and then, the approach focuses on positivist and economic perspectives. This method is a big explanation why health services are dehumanized.

Week 2 Assignment

1. You check your pulse and discover that your heart rate is 100 beats per minute. Is this rate normal or abnormal? What additional information would you use in making this judgment? How does the context in which data are collected influence the interpretation of those data?

2. Given the imprecision of many medical terms, why do you think that serious instances of miscommunication among health care professionals are not more common? Why is greater standardization of terminology necessary if computers rather than humans are to manipulate patient data?

3. Based on the discussion of coding schemes for representing medical information, discuss three challenges you foresee in attempting to construct a standardized medical terminology to be used in hospitals, physicians’ offices, and research institutions throughout the United States.

4. How would medical practice change if nonphysicians were to collect all medical data?

5. Consider what you know about the typical daily schedule of a busy clinician. What are the advantages of wireless devices, connected to the Internet, as tools for such clinicians? Can you think of disadvantages as well? Be sure to consider the safety and protection of information as well as workflow and clinical needs.
   

   Answer:

   Doctors are the key players in the data collection and analysis process. They speak to a person to collect concise descriptive details on the chief issue, past conditions, family and social knowledge, and analysis of the program. They observe the patient, gather and document relevant data throughout or at the end of the visit. The storytelling descriptions are governed and then translated by typesetters that work with word processors to generate printable overviews for integration in health records. Such narrative data had been usually handwritten by physicians and then put in the medical record of the patient. The computerized copies of such documents could also be seamlessly implemented into electronic medical records and clinical research databases, enabling physicians to obtain significant medical data even when there is no paper documentation. Electronically stored transcripts of dictated information often include not only patient history and physical assessments, as well as other statistical information such as highly specialized counselling reports, medical interventions, tissue pathology examinations, and overviews of hospital stay when a patient is released. Improvements in disease prevention by accessing real time information, medical data science and set topped with the advancement of electronic devices and internet interconnection. Reduction in costs and the Internet of things would boost medical data collection, patient monitoring and reduce unnecessary visits by medical workers in real time.

   Disadvantages of such systems are-

   It can significantly boost private information. As we have said before, technologies are being hacked.

   Unapproved centralization connects. There is a possibility that deceitful interlopers can have access to traditional centralized and also some cruel motivations are realized.

   Legislation governing global health care coverage.

6. To decide whether a patient has a significant urinary tract infection, physicians commonly use a calculation of the number of bacterial organisms in a millilitre of the patient’s urine. Physicians generally assume that a patient has a urinary tract infection if there are at least 10,000 bacteria per millilitre. Although laboratories can provide such quantification with reasonable accuracy, it is obviously unrealistic for the physician explicitly to count large numbers of bacteria by examining a millilitre of urine under the microscope. As a result, one recent article offers the following guideline to physicians: “When interpreting . . . microscopy of . . . stained centrifuged urine, a threshold of one organism per field yields a 95 percent sensitivity and five organisms per field a 95 percent specificity for bacteriuria [bacteria in the urine] at a level of at least 10,000 organisms per ml.” (Senior Medical Review, 1987, p. 4)

1. Describe an experiment that would have allowed the researchers to determine the sensitivity and specificity of the microscopy.
2. How would you expect specificity to change as the number of bacteria per microscopic field increases from one to five.
3. How would you expect sensitivity to change as the number of bacteria per microscopic field increases from one to five.
4. Why does it take more organisms per microscopic field to obtain a specificity of 95 percent than it does to achieve a sensitivity of 95 percent.

Answer:

1. A feature is much more regularly shown in one illness or disease classification. The relation is not full, then it is in some. There are very few infection organisms other than infections, for example, that escalate the number of white blood cells in a person. For example, it is definitely true that leukemia could even keep raising the number of white blood cells, and so can the use of medication prednisone, and most patients without infectious diseases will still have normal white blood cell counts. Thus, an increased white count doesn't really mean that a patient has an illness but it appears to cause or support the notion that there is an illness. The test which determined specificity and sensitivity: Pap smear (cell smear swabbed from the cervix at the opening of the cervix). The uterus, treated with Papanicolaou dye, and then studied under a microscope, is rarely seen with highly irregular cells (called Class IV findings) unless the woman has cervical or uterine cancer.
2. Sensitivity is the degree to which correct substantive factors are not ignored (so there are few false negatives).
   

   The formulae that describes the problem properly:

   PV (+) = (sensitivity) (prevalence)/(Sensitivity)(prevalence) + (1-sensitivity) (1-prevalance)

   Similar formula is used to define PV− in terms of sensitivity, specificity, and prevalence. Both formulas are derivable from the simple theory of probability. The specificity was at least 95 per cent when viewing more than 5 organisms per field of oil immersion.

3. Specificity is to what degree real negatives are marked even so (only some false positives). It shall be noted that if the prevalence of this disease is low, positive tests with high sensitivity and specificity may still lead to low post-test disease probability (PV+). This is this connection that practices tend to misunderstand and it is often considered as counterintuitive. It must be (noted by replacement of the formula) that perhaps the test response and spread of cancer may be overlooked. Only if a test is to detect the pathogenesis (i.e. when it is 100% specific, which requires 100% PV+).
4. A high-specificity test would accurately find out just about anyone who might not have the illness and won't produce several false-positive tests. Extreme susceptibility influences the ability to properly classify people who do have the infection typically comes at the expense of decreased precision (indicating more false-positives).