Health Informatics Assignment Week 16 to 18

Week 16 Questions

Questions for Discussion

1. What is the utility of a linear model of patient care as the basis for a decision-supportsystem? What are two primary limitations? Discuss two challenges that a nonlinear model poses for representing and supporting the care process in an information system?
2. Compare and contrast “segregated” versus “integrated” models of interdisciplinarypatient care. What are the advantages and disadvantages of each model as a mode of care delivery? As the basis for developing information systems to plan, document, and support patient care?
3. Imagine a patient-care information system that assists in planning the care of eachpatient independently of all the other patients in a service center or patient-care unit. What are three advantages to the developer in choosing such an information architecture? What would be the likely result in the real world of practice? Does it make a difference whether the practice setting is hospital, ambulatory care, or home care? What would be the simplest information architecture that would be sufficiently complex to handle real-world demands? Explain.
   

   Answer:

   Statistics architecture is a greater hard field to define than many others. Unlike content material method, that's achieved through content material strategists, or interplay layout, that's accomplished by way of designers, statistics architect could be very now and again an activity name. It's miles, but, a valuable and vital field which crosses a couple of roles. In different words, information structure is the introduction of a structure for the internet site, utility, or different task, that allows us to apprehend in which we are as customers, and where the records we want is on the subject of our position. Records architecture results inside the advent of site maps, hierarchies, categorizations, navigation, and metadata. Facts structure makes the complicated clear. It allows commercial enterprise makers to investigate and examine what data is vital to the success in their product and be able to address the needs of the person by means of offering them access to most effective vital data. Sure, it might certainly make a difference whilst brought to clinic settings. For creating an efficient information system, it is necessary that first the person should group and likewise label the content. After this, it might be necessary that the navigation shall directed in a clear manner and the specific site should be created upon the site. After all this the third step comprises of conducting various user tests. The user testing would help to come to know about the progress of the system and also if the system could be operated by each one of the assigned users.

4. Zielstorff et al. (1993) proposed that data routinely recorded during the process ofpatient care could be abstracted, aggregated, and analyzed for management reports, policy decisions, and knowledge development. What are three advantages of using patient care data in this way? What are three significant limitations?
5. A number of patient-care information systems designed in the 1970s are still in use.How do the practice models, payer models, and quality focus of today differ from those of the past? What differences do these changes require in information systems? What are two advantages and two disadvantages of “retrofitting” these changes on older systems versus designing new systems “from scratch”?
6. What are three advantages and three disadvantages of free text (including oral narrative entered by dictation) versus structured data for recording observations, assessments, goals, and plans? What is the impact of using free text on the ability to retrieve and aggregate data? Should developmental efforts focus on interpreting natural language or on creating data standards? Explain your position.
   

   Answer:

   Contemporary computing device, pc, or handheld structures use keyboard, mouse, or pen-based totally entry of based facts, with free textual content stored to a minimal. These systems additionally provide for retrieval of reports and beyond data. Some systems provide decision assist or indicators to remind clinicians about wanted care, including immunizations or screening examinations, and to keep away from contraindicated orders for medicinal drugs or pointless laboratory analyses. Relying on community capabilities, systems may also facilitate communications most of the specialists and settings involved inside the patient’s care. Even though this mode of information access has the benefits of ease and familiarity to clinicians, loose textual content inside the document inhibits seek, retrieval, and evaluation of data. Earlier than dictated notes can turn out to be as beneficial as established information, the entry structures will should come to be able to apprehend the meanings of phrases and their context and to shop the facts in databases. Despite the fact that this stage of clever processing of herbal language stays within the destiny, structures to help ambulatory care have without a doubt made remarkable strides. Disadvantages might encompass the idea that the students must know the relevant terms used in such strategic assessments otherwise it may lead to miscommunication and the person shall misinterpret the supplemented information. Another disadvantage might highlight that the staff shall be quite efficient to involve observing in link to record the effective speaking skills. Affected person-care statistics structures in use these days constitute a vast range inside the evolution of the sphere. Versions of some of the earliest structures are nevertheless in use. Those structures were commonly designed to speed documentation and to boom legibility and availability of the facts of patients presently receiving care. Maximum lack the capacity to aggregate statistics across patients, to query the records about subsets of sufferers, or to use records collected for scientific functions to meet informational needs of directors or researchers. Those shortcomings seem evident these days, but they have been no longer apparent while the very concept of the use of computers to save and speak affected person facts required a leap of the imagination. All sites had broadscale pc-primarily based results reporting and order entry for medications and other therapeutics. It is noteworthy that even in such sites that are broadly recognized for his or her superior clinical records systems, clinicians’ progress notes aren't absolutely computer-based totally.

7. What are four major purposes of patient care information systems? What criteriashould be used to evaluate them? What methods of evaluation could be used to assess the system with respect to these criteria?

Week 17 Questions

1. Describe how the integration of information from multiple bedside monitors, the pharmacy, and the clinical laboratory can help to improve the sensitivity and specificity of the alarm systems used in the ICU.
   

   Answer:

   Alarms from bedside monitors at the moment are among “smarter” buys and lift fewer false alarms. In beyond, analog alarm systems used only excessive–low threshold limits and had been at risk of sign artifacts. Now, computer-based bedside monitors frequently can distinguish between artifacts and real alarm situations through the use of the information derived from one signal to verify that from each different and may with a bit of luck alert physicians and nurses to actual alarms. For instance, coronary heart artifacts may be recognized from both the ECG or the arterial blood stress. If each alert means unstable tachycardia (fast coronary heart charge), the tool sounds an alarm. If the 2 signals do not match, the screen can notify the fitness-care professional approximately the ability instrumentation or scientific hassle. The system isn't no longer like that completed through a human verifying feasible troubles through the use of redundant facts from easier bedside display alarms. From time to time low saturation alarms were neither positioned nor replied to via any caregiver in big component due to everyday fake alarms related to such devices. However, this advancements in bedside video display units, but, fake alarms are nevertheless very commonplace. Some latest affected person-tracking gadgets, which includes protected pulse oximeters and direct strain measuring systems, have built in noise-rejection algorithms to decorate the high-quality of the records offered. Sudden coronary heart stoppage or extreme dysrhythmias are the maximum frequent causes of surprising loss of life. Therefore, heart-charge and rhythm monitors should feature constantly and should sound alarms within 15 to twenty seconds after detecting a problem. Different physiological parameters aren't as labile and may be monitored much less regularly. For the maximum part, clinical measurements are made intermittently, and even continuously measured parameters are displayed at intervals.

2. What factors must you consider when deciding when and how often a physiological, biochemical, or observational variable should be measured and stored in a computer’s database?
3. You have been asked to design part of an electronic exercise bicycle. Sensors in thehand grips of the bicycle will be used to pick up transmitted electrical signals reflecting the rider’s heart activity. Your system then will display the rider’s heart ratenumerically in a liquid crystal display (LCD).
   1. Describe the steps your system must take in converting the heart’s electrical signals(essentially a single ECG lead) into the heart rate displayed on the LCD.
   2. Describe how computerized data acquisition can be more efficient and accurate than manual methods of data acquisition.

Week 18 Questions

1. Describe the various factors that a planner must consider when estimating the stor-age requirements for image data in an all-digital radiology department. What are the major factors that reduce the volume of data that are maintained in on-line storage?
2. Refer to Table 18.1. How many bytes are needed to store a digitized chest X-ray image? How many bytes are needed to store a 15-image CT study? If you have a com-munication line that transmits 56,000 bits per second, how long will it take to trans-mit each of these images to the display workstations within the hospital? What are the implications of your answer for widespread transmission of image data?
3. What are the economic and technologic factors that determine how quickly hospitals and clinics can adopt alldigital radiology departments?
   

   Answer:

   There are various factors which consists of ill person waiting times, workloads, numbers of exposures acquired in step with process, first-rate of snap shots, radiation dose, yields of tactics, and prevalence of complications are measured and adjusted. Technological advances in digital imaging have also enabled the photos produced to be put up-processed, manipulated and additionally transmitted swiftly all over the global to be regarded simultaneously with the transmitting center. There are frequently quick innovation cycles of radiological device and it is important that there are expert radiologists who're capable of help the producers with technological trends and scientific implementation. For virtual imaging, these factors determine the sort and stage of gadget and the facilities and team of workers to be had, since the capital acquisition cost of virtual imaging gadget is generally more expensive than that of movie-based systems. But, low quit ultrasound system, CT, MRI and nuclear medicinal drug may also enjoy a price advantage due to the lack of image utilization in most practices with those abilities. The distribution of imaging obligation has given upward push to the need of many departments to address troubles of photograph acquisition, garage, transmission, and interpretation. As those modalities have regularly grow to be largely digital in layout, the improvement of digital structures to aid these obligations has been needed. Many Radiology departments have become rather dispensed corporations, with acquisition of web sites in extensive care unit regions, normal patient flooring, emergency departments, vascular offerings, screening facilities, ambulatory clinics, and in affiliated community-based exercise settings. Interpretation of pictures can be in those places whilst dedicated onsite radiologists are demanded, however increasingly, due to high-velocity network availability, interpretation can be executed at critical sites, or consistent with extraordinary methods of company, considering the fact of that picture acquisition and interpretation can be efficiently decoupled. Unbiased imaging facilities in a network face some of the equal problems and possibilities, although to a lesser degree. Image management and implementation of PACS were originally conceived as having major benefits for the radiology departments in spite of decreases in film-library space and staff resources as well as spontaneity of information acquisition. Direct processing of high-quality digital photographs took a bit longer for other methodologies, especially plain film radiography and mammography, that's still in process. Secondary digitization isn't really cost-effective besides browsing from film. As a response, some areas of the radiology departments (like the sections of CT, MRI, ultrasound, and nuclear medicine, where pictures are primarily digital) were more comfortable with PACS than other areas, producing mini-PACS programs. It has always been acknowledged that much of PACS compensation accumulates from providing clinicians with image results in a prompt manner that facilitates patient diagnosis, the capacity to perform remote consultations, and the efficiency of teleradiology facilities. Expenses for network maintenance and image processing, storage, and analysis may be borne by the overall medical system, instead of contributing solely to departments of radiology.

4. What are the ways in which radiology reports of examination interpretations can be generated, and what are the advantages and disadvantages of each approach, in terms of ease and efficiency of report creation, timeliness of availability of report to clini-cians, usefulness for retrieval of cases for research and education?