Health Informatics Assignment Week 13 to 15

Week 13 Questions

1. Briefly explain the differences among an HCO’s operational, planning, communications, and documentary requirements for information. Give two examples in each category. Choose one of these categories, and discuss similarities and differences in the environments of a tertiary-care medical center, a community-based ambulatory-care clinic, and a specialty-care physician’s office. Describe the implied differences in these units’ information requirements.
2. Describe three situations in which the separation of clinical and administrative information could lead to inadequate patient care, loss of revenue, or inappropriate administrative decisions. Identify and discuss the challenges and limitations of two methods for improving data integration.
   

   Answer:

   By consolidating administrative and economic capabilities and combining scientific services. Such IDNs have been challenged to coordinate patient care and manage business operations throughout an extensive community of network and nearby sources. As a end result, HCISs were advanced to percentage statistics and coordinate sports no longer best inside, however among a couple of hospitals, ambulatory care websites, physicians’ exercise businesses, and other affiliated agencies.

   In hospitals, scientific and administrative employees have historically had awesome areas of duty and done many of their capabilities one after the other. Consequently, it is not sudden that administrative and clinical facts had been often managed separately administrative records in commercial enterprise offices and clinical records in medical records departments. When computers have been used in any respect, the medical institution’s data processing turned into often achieved on separate computer systems with separate databases, thus minimizing conflicts approximately priorities in offerings and investment.

   The lack of integration of information from various sources creates a host of issues. If clinical and administrative facts are saved on separate systems, then data wanted through each have to either be entered immediately into both structures or be copied from one device to the opposite. Similarly, to the cost of redundant facts access and records protection incurred via this method, the consistency of records tends to be terrible because information may be up to date in one area and no longer inside the other, or records can be copied incorrectly. Inside the hospital putting, many of those troubles had been addressed through the improvement of automated interfaces to transfer demographic information, orders, effects, and charges between scientific structures and billing structures. Regardless of an interface engine coping with data among disparate systems, but an organization still ought to clear up the thorny issues of synchronization of information and comparison of similar records types.

3. Describe three situations in which lack of integration of information systems with clinicians’ workflow can lead to inadequate patient care, reduced physician productivity, or poor patient satisfaction with an HCO’s services. Identify and discuss the challenges and limitations of two methods for improving process integration.
4. Describe the trade-off between functionality and integration. Discuss three strategies currently used by HCOs to minimize this tradeoff.
5. Assume that you are the chief information officer of a multi-facility HCO. You havejust been charged with planning a new HCIS to support a large tertiary care medical center, two smaller community hospitals, a nursing home, and a 40-physician group practice. Each organization currently operates its own set of integrated and standalone technologies and applications. What technical and organizational factors must you consider? What are the three largest challenges you will face over the next 24 months?
   

   Answer:

   The domain of my focus would be upon administrative safeguards, physical and technical safeguards. HIPAA security precautions are quite explicitly mentioned, as the methods by which HCOs enforce the disclosure rules. They highly suggest a sequence of administrative processes, physical controls and scientific specifications and information security processes, but not really the specific technologies or methodologies. HIPAA further gives consumers substantial new privileges to be notified on how or by whom their medical information would be used, as well as to investigate their medical information, or even to ratify it. Stiff criminal penalties which include fines and possible imprisonment are linked to lack of compliance or knowledge of the misappropriation of hospital-identifiable data. In the upcoming 24 months, the challenging prospects would be effectively monitoring the security management process in the various location systems. The responsibility related to security would be enhanced by security awareness and appropriate training. The procedures that would enhance the security. Proper periodic contingency and evaluation plans shall effectively be monitored. The physical safeguarding shall be precisely administered with proper control to the facilitated access. The device and media controls shall be encouraged. The technical issues would be related to the integrity and controlling to limited accessibility. This is quite essential to provide a safe treatment procedures by limiting every kind of threat so that the patients and the healthcare providers could specifically complete their procedures.

6. How do you think the implementation of HCISs will affect the quality of relationships between patients and providers? Discuss at least three potential positive and three potential negative effects. What steps would you take to maximize the positive value of these systems?

Week 14 Questions

Questions for Discussion

1. Telehealth has evolved from systems designed primarily to support consultations between clinicians to systems that provide direct patient care. This has required changes in hardware, user interfaces, software, and processes. Discuss some of the changes that must be made when a system designed for use by health care professionals is modified to be used directly by patients.
2. Some people involved in CHI advocate that any publicly accessible health information be credentialed (reviewed and certified as accurate) by a professional body. Other people argue that credentialing is antithetical to the consumerist perspective. Assume and defend one of these perspectives.
3. Using CHI and telehealth systems, patients can now have interaction with a large number of health care providers, organizations and resources. As a result, coordination of care becomes increasingly difficult. Two solutions have been proposed. One is to develop better ways to transfer patient-related information among existing EHRs. The other is to give the give the patient control of the health record, either by giving them a smart card or placing the records on a central web site controlled by the patient. Assume and defend one of these perspectives.

Week 15 Questions

1. What are the current and potential effects of a) the genomics revolution; and b) 9/11 on public health informatics?
2. How can the successful model of immunization registries be used in other domains of public health (be specific about those domains)? How might it fail in others? Why?
3. Fourteen percent of the US GDP is spent on medical care (including public health). How could public health informatics help use those monies more efficiently? Or lower the figure absolutely?
   

   Answer:

   Public fitness informatics can be considered as the application of biomedical informatics to populations. Public fitness packages work to enhance care, prevent disease, and prevent headaches of disorder. An investment in continual disease prevention and control applications saves lives, improves quality of existence and saves healthcare bucks. In a experience, it's miles the closing evolution of biomedical informatics, which has historically centered on applications related to character patients. Public fitness informatics highlights the potential of the fitness informatics disciplines as a collection to integrate records from the molecular to the population stage. Public health informatics and the development of fitness information infrastructures are intently related. Public fitness informatics deals with public fitness programs, while health statistics infrastructures are populace-degree programs in the main focused on hospital therapy. While the statistics from these regions overlaps, the orientation of both is the network rather than the person. The informatics challenges inherent in both public health informatics and the development of health statistics infrastructures are giant. They include the assignment of big numbers of different varieties of corporations which includes authorities in any respect tiers. Eventually, communications demanding situations are mainly tough due to the massive quantity of areas of information represented, together with those that cross beyond the fitness care area. To address those conversation issues, the interlocutor function is especially essential. Effective statistics systems in those domain names can assist to assure powerful prevention, fantastic care, and minimization of scientific mistakes. Further to the consequent decreases in both morbidity and mortality, these systems also have the capacity to save loads of billions of dollars in each direct and oblique prices. The law calls for companies to use licensed EHRs, take part in scientific data change, and report exceptional metrics. To be eligible for the incentives, providers and organizations must show that they're the usage of EHRs in meaningful methods, as laid out in an evolving definition of significant use.

   A great deal of studies has proven that within the care of person sufferers, health it is able to:

   • Optimize work tactics, as an example, do away with attempting to find charts and multiple access of information.
   • Facilitate gold standard choices, for instance, thru using evidence-based totally order sets, take a look at lists, predefined dose ranges, drug interplay assessments, remarks on nice metrics, and training via linkage to information resources.
   • Reduce errors via scientific selection aid, dose variety assessments, reminders, and indicators.
   • Facilitate the integration and summarization of records from a couple of sources, lessen redundancy of test ordering,18 and further reduce mistakes in prescribing.
4. Compare and contrast the database desiderata for clinical versus public health information systems. Explain it from non-technical and technical perspectives.
5. Make the case for and against investing billions in an NHII.
6. What organizational options would you consider if you were beginning the development of a local health information infrastructure? What are the pros and cons of each? How would you proceed with making a decision about which one to use?
   

   Answer:

   The organizational and collaborative issues involved in developing immunization registries are daunting due to the large quantity and wide sort of companions. Both public and personal sector providers and different companies are in all likelihood contributors. For the companies, specifically within the personal sector, immunization is just one among many issues. Collaboration is any other critical approach in selling NHII. To allow the large adjustments had to transform the health care machine from its modern-day paper-primarily based operation to the extensive utilization of digital fitness statistics systems, the guide of a completely massive range of agencies and individuals with notably various agendas is needed. Amassing and focusing this help requires great cooperative efforts and precise mechanisms for insuring that everyone’s problems and concerns are expressed, liked, and integrated into the continued efforts.  Some of personal collaboration efforts had been hooked up consisting of the e-fitness Initiative and the national Alliance for fitness facts generation (NAHIT). Within the public quarter, NHII has emerge as a focal point of pastime at DHHS. As part of this attempt, the primary ever countrywide stakeholders assembly for NHII was convened in mid-2003 to expand a consensus countrywide time table for shifting ahead. Those a couple of efforts are having the collective impact of both catalyzing and selling organizational commitment to NHII. As an example, among the key stakeholders are now forming high-degree committees to especially address NHII issues. For some of these businesses, this represents the primary formal reputation that this transformational technique is underway and could have a primary effect on their sports. It's miles crucial to consist of all stakeholders on this procedure. Similarly, to the traditional agencies together with companies, payers, hospitals, fitness plans, fitness IT vendors, and health informatics experts, representatives of companies which include customers (e.g., AARP) and the pharmaceutical enterprise need to be added into the manner. Focusing NHII efforts on one network at a time additionally maintains the implementation problem more reasonable in its scope. It's miles a lot greater feasible to permit health information interchange among some dozen hospitals and some hundred or maybe some thousand carriers than to recall the sort of venture for a large area or the complete United States of America. In addition, different demographic and organizational variations as well as the presence of precise extraordinarily specialized medical care establishments make each network’s health care device specific. A nearby approach to HII improvement lets in some of these complicated and varied elements to be taken into consideration and addressed, and respects the reality of the yank political landscape, which gives high precedence to neighborhood controls. Complicating those organizational, cultural, and information structures problems, bioterrorism preparedness has an ambiguous governance shape. Many groups and businesses have valid and overlapping authority and duty, so there's often no unmarried clean path to remedy conflicting troubles. Despite the fact that, it took several years of chronic and hard efforts to triumph over the technical, organizational, and felony issues worried. With quicker and less expensive hardware and noticeably advanced software tools, it has end up financially and technically feasible to create records structures on the way to provide the records approximately individuals and populations essential for optimized selection-making in hospital therapy and public fitness.

7. If public health informatics (PHI) involves the application of information technology in any manner that improves or promotes human health, does this necessarily involve a human “user” that interacts with the PHI application? For example, could the information technology underlying anti-lock braking systems be considered a public health informatics application?