Health Care Informatics

Throughout these last five weeks of this health care informatics class, I have learned so much useful and important information and material related to technology in healthcare such that of what meaningful use is and how using technology meaningfully is crucial today in healthcare, interoperability, health care and government data bases, create a blog utilizing visuals and videos, and different ways to present while keeping employees and the audience engaged such as movenote, SnagIt, and picktochart. All of these enlightening technologies and information have given me the knowledge to feel more confident when utilizing and discussing health care informatics with other healthcare professionals. These are important tools to use because they each improve staff knowledge, staff satisfaction, patient satisfaction, as well as safety and quality of patient care being delivered. Reflecting on all that I have learned the past few weeks, I will discuss with you, in my opinion, the most important aspects of what I have learned.

Click Here to learn more about health care informatics

Meaningful Use

 

In my own opinion, the most important term that I learned was “Meaningful Use”. This term describes the guidelines and regulations which must be met during the use of electronic health records. Some of the regulations are bettering care coordination, security of patient records, and allowing patients access to their records. “Meaningful use” is important to both patients, providers, nurses, and families. Meaningful use consents the electronic health record to deliver information and data about ones’ healthcare in real time and is much more useful to patients and their families. This is important to providers because it is the difference between being reimbursed or not reimbursed. Meaningful use is important for leaders to understand because it improves the quality of patient care as well as reimburses the physicians and hospitals. A crucial part of the meaningful use of the electronic health record is being able to share patient data and reports to supplementary healthcare providers of the patient rapidly. Since the HITECH act, there has been an increase in use of interoperability. Interoperability is the ability to which devices and technological systems can share information and interpret that data (HIMSS, 2016). Having interoperability allows for improved patient-family awareness, allowing all patients, family members, and other health care providers to have access to information leading to vital decision making decisions in regards to the health of the patient (HIMSS, 2016).  It is crucial that we are using technology to its fullest potential to reap the benefits. The leader must understand this in order to use and educate other staff members on the importance of using technology meaningfully.

Click Here to read more on meaningful use

Databases

Health care, education in the health care world, and nursing research are solely based on the utilization of technology and databases. Today, there are numerous data bases that occur in order to help teach and permit staff members and students to have a strong and evidence based literature review. There is an extensive history of evidence which supports the connection between the care directed to the patients and the patients’ outcome. The use of health IT and databases for research and evidence has demonstrated to be cost effective, high quality, and safest patient care (Dykes & Collins, 2013). The National Database of Nursing Quality Indicators (NDNQI) is the solitary national nursing database that offers quarterly and annual reporting of structure, process, and outcome indicators to gauge nursing care at the unit level. Nursing-sensitive quality measures can be followed and associated to local, regional and national standards for hospitals applying a nursing database called National Database of Nursing Quality Indicators (NDNQI). Operating databases is an exceptional way to ensure the patients are in receipt of the best care and healthcare staff members are educated and researching best practices. It is essential for leadership to encourage the use of databases from their nurses in order to provide them with the tools for education and learn best practices to ensure our patients are receiving the highest quality of care.

NDNQI Information

 



Technology Challenges

Each week I was assigned a technology challenge to complete. I thoroughly enjoyed these challenges and assignments because they were engaging and useful tools to help present while engaging staff members. Most of them allowed “Voice over”, therefore the presenter did not necessarily need to be present when the project was being viewed.
The first technology challenge was using SnagIt presentation using a nursing sensitive quality outcome dashboard. My SnagIt was based around my HCAHPS dashboard and what we can do as a team to improve and what we are doing as a team really well. This presentation allowed for voice over as well as “cursor movement” to help engage the staff members. I definitely could see myself using this, now and in the future, as a way to explain and present information to my staff members.
The second technology challenge was to use Picktochart. We had to create an infographic representation of quality improvement strategies using technology. We then had to utilize SnagIt in order to present the graphic and audio. I found this exceptionally easy and a great way to address any issue in a fun and educational way. I would see myself using this technological tool as a leader as well.
Week three we were taught to use Prezi in order to present an article that each student was assigned. My article was that of “Text Data Mining”. I had to create a Prezi presentation of the clinical implications and nursing interventions of text data mining. This article was not only interesting, but so was the technology we used to create the presentation. Prezi allowed for a presentation similar to power point which allowed “voice over”. This was another technology I would definitely use in the future.

Last week, week 4 the students were asked to create a Powtoon about data sets and information management. Powtoon was much more difficult to use. It was fun to watch once it was completed, but the creating and placing of each icon was time consuming. The information in which we had to place into the Powtoon was helpful and useful. Data sets and information management are crucial terms and important for healthcare informatics, leaders, and staff nurses. I would use this technology if I had a short, boring presentation that I could “spice up” with some animated graphics.
The technology challenges were always interesting. I enjoyed learning from them because not only did we learn new technologies, but we learned new information about healthcare informatics in the process.

Individual Assignment

For the individual assignment, we were asked to interview three key leaders in our healthcare informatics team where we work. I found this assignment to be very helpful because I was able to learn much more about health care informatics at my workplace. I was also able to introduce myself to many key leaders and have conversations with them about their jobs and daily functions. I think in this assignment, I learned the most that I have in a class.
I interviewed a multitude of nurses, doctors, and key informatics leaders at Unity Hospital throughout this class. I found three key leaders to be crucial to the informatics team at Unity. They each described their job to me and the job of John Glynn, the Chief Information Officer, who could not find time for me to interview him. The three leaders I interviewed were Karan Sharma, the manager of clinical informatics; Maureen Doyle, Maureen is currently the associate director of nursing clinical practice; and lastly Dr. Matos, Dr. Matos is the Chief Medical Information Officer. John Glynn’s role as the Chief Information Officer. He stated that Johns job as the CIO is to manage and direct all information technology in the hospital. He must understand how each technology is integrated within the hospital. He thoroughly understands and can apply all technologies to the overall system and is able to show and describe what each technology has to offer the hospital, physicians, nurses, and all other staff members. Johns role is to implement and optimization clinical informatics systems for the purpose of enhancing the quality of patient care and clinical efficiency of the organization. He works closely with the function groups of IT, internal departments, and clinicians to achieve involvement and support of the projects. He must keep up to date on the developments if clinical informatics. He also leads the effort to design and standardize the process related to the EHR to improve quality, safety, and efficiency of patient care. John must provide, plan, and implement training programs for the clinical informatics staff so they may also develop a solid understanding of informatics and the systems.

Dr. Matos then described to me his job as the Chief Medical Information Officer. He provides clinical direction to the to the clinical informatics team to help problem solve, design solutions, and validate the building of the system to meet providers’ requirements. He champions the use of technology to all care team members. He must maintain empathy and understanding of the providers needs to gain support of IT initiatives.
Upon meeting with these three key leaders, I also gained an understanding for the job role of the Privacy Officer at Unity Hospital. The privacy officers main job role is to monitor the electronic health record for compliance with state and federal privacy laws. He or she must demonstrate a high level of integrity, maturity, and responsibility due to the confidential nature of the information handled. They are responsible for monitoring and running privacy reports including same name reports. They must determine if access was appropriate and investigate protected health information as a result of patient complaints. They must keep all privacy monitoring to strict confidence and provide reports when requested by a manager. They must maintain knowledge of HIPPA privacy laws and educate awareness within the health system. They have the ability to educate others on these law, and therefore should.

 
Throughout this individual assignment, I learned all about our electronic health record as well as four technologies as to which I researched. Throughout this individual project and assignment, I have gained an incredible amount of knowledge. Not only did this assignment permit me to introduce myself and meet the informatics team such as the CMIO which I do not see very often at all. It gave me an all new insight to the IT and informatics side of nursing. Learning informatics is one thing but seeing it play out in the real world is a completely different experience. I have a whole new respect for each and every individual in the informatics department. Their job is much more important and detailed than I could have ever imagined.

It is very important and crucial for the nurse leader to understand and be a part of the area of health informatics. I believe this because leaders should comprehend how to use technology to its fullest potential in order to deliver highest quality care to patients as well as educate staff members on how to do so. Technology allows for improved care and safety of the patients; leaders want this as well as an improved cost to the hospital which will be attained. It is important for leaders to understand how to utilize databases offered to them and be able to educate others on how to use them since they are of great knowledge to the health care world. Health informatics has so many different aspects in which I feel are important to leaders and nurses.

Reflection

 

Reflecting back on the last five weeks, I have a new respect and understanding for the informatics health care team. Their roles entail much more than I could have ever expected. The past five weeks have been challenging, but in a very positive and educational manor. I appreciate everything that I have learned and will utilize this new education from here on out in my leadership role. The terminologies, technologies, and projects have given me the tools to be a better leader and educate other staff members on the importance of using technology for improved quality of care for our patients. I am thankful for the opportunity to be educated on the topic, and look forward to sharing my new knowledge with others.

Work Flow Management

Work Flow Management

 

Workflow management is how documents, information, and tasks are passed from one participant to another for an action to occur based on a set of procedural rules. It is the process and procedures in which tasks are completed. Work flow affects the processes such as a job is posted which then leads to the process of an employee being hired. Though there are numerous processes and communications in between, which if not completed appropriately may lead to inefficiency and inconsistency. The question management and leaders must ask is, are we operating as effectively and efficiently as possible? If no, that is when workflow management comes into action.

Unity’s Information Management

For the most part, Unity Hospital manages its information via technology and the EMR. Communication between the doctors, physician assistance, nurses, staff members, and patients can all occur via the electronic health record. There are some areas in the hospital which are still paper charting like the Family Birth Place, which does make communication between providers there more difficult. In all honesty, I believe that Unity does an excellent job for the most part with information management. With all things in life, there is always room for improvement.

                                                   Information Management Issue

An information management issue at Unity Hospital that I have recognized is that of the discharge instructions. Discharge instructions are completed by the physician’s assistant or resident once the patient has been seen by the attending or surgeon. Discharge instructions are completed by the PA or resident and then printed by the nurse and reviewed verbally with the patient.  The nurse as well as the patient have many other items on their mind at the time of discharge. The nurse is thinking about the patient who is not doing well down the hall, trying to answer the questions of family members, pass late medications, their next admission coming, as well as making sure this patient is discharged.

The patient is then handed a paper copy of the instructions. The paper copy has the ability to be lost in between the time it is handed to the patient, the patient packs his/her belongings, the patient leaves the room, enters his/her house, and then is relaxing. The patient may or may not recall specific instructions if they lose the paper copy such as important numbers to call, signs and symptoms to look for, their new medication list, as well as follow up appointments. These are the patients that typically are re-admitted through the ED within 30 days.

Is there a better way for the patient to be discharged? Can we electronically send the patient discharge instructions? Can we electronically send appointment reminders? Can we have the pharmacy call the patient when the medication they have been prescribed electronically is ready for pick up?

 

The Nurse as a Central Player

The nurse can be a cause of the issue, but also a solution to the workflow concern.

The concern: The nurse is busy with many legit concerns for his/her unit such as the dying patient down the hall, the patient who is non-compliant and refusing his/her insulin, the family members who keep calling to ask how their sick mother is, the doctor who needs to talk to you about the plan for room 7, all on top of the discharge the nurse just wants done so there is one less thing to do. But the nurse really doesn’t feel that way, the nurse wants the patient to understand the instructions, take their medications appropriately, and follow up with the Primary care physician as well as the attending or surgeon. The discharge instructions are often rushed and in terms that the patient may or may not understand. Chances are those papers will be dirty, thrown away, or misplaced by the time the patient is home and has the time to comprehend them.

The Solution: Sending a copy of the discharge instruction via email to the patient, helping the patient set up patient portal prior to discharge and having the discharge instructions linked to the portal, setting up phone call reminders to the patient about follow up appointments. Calling the pharmacy to send a reminder phone call when it is time to pick up their new medications.

Technology can be added or enhanced to add to the flow of discharge and allow the patient and nurse to feel more at ease during this difficult, time consuming process.

 

There are many links and articles that support the use of electronic discharge instructions as well as discharge follow ups. Below are a few of the articles and websites found:

Electronic Discharge Instructions on Post-Discharge Hospital Utilization

E-mail Follow Up Reminders

Improving Patient Understanding

Discharge Summary: Handwritten vs. Electronic Documentation

 

Nursing Leadership and Incorporating Technology

 

 

The Importance of Technology in Healthcare

The use of technology within the healthcare setting is growing at an increasingly fast pace. There is currently technology all around us within the hospital setting from the way we barcode scan patient medications, EMRs and documentation, Electronic prescriptions, the online bed board, communication between physicians, patients, and the nursing staff, and so much more. The use of technology within health care is a key dynamic of the health care reform.  Technologies in hospitals, doctors offices, and out patient clinics, etc. are being utilized to improve the care of the patient, the safety of the patient and staff, patient and staff satisfaction as well as decreasing cost across the board of healthcare. The need for the nursing leader to understand the technology in order to implement and explain the use of technology to other staff member is crucial. There are many organizations such as the American Nursing Association, The American Organization of Nurse Executives' Guiding Principles, and the TIGER which help to support nursing leadership in understanding and helping to educate other staff members.

 

The ANA and Technology

The American Nurses Association has developed guidelines to use technology to enhance patient outcomes. Another guideline created is the Technology Informatics Guiding Education Reform or TIGER. This recommends having competencies for all levels of nursing by integrating education of informatics to the nursing curriculum in order to integrate healthcare information technology. Hospital executives and leaders are persuaded to guarantee  practicing nurses are given informatics education which correspond with the three main TIGER informatics competencies: computer basics, information literacy and information management.  Guiding principles for the use of technology by all nursing staff include:

1. A model which defines the vision, roles, and responsibilities of the nurses using technology

2. The steps for integrating the multitude of technologies within the scope of nursing practice

3. A model which allows communication and collaboration amongst the CNO, CIO, and technology partners.

 

Nursing Leadership and Technology

Nursing leadership organizations have posted much on how to educate and implement nursing informatics among fellow staff members and nurses throughout the clinical setting. It is of utmost importance that nursing leadership is prepared to educate nursing staff members on the positives in adopting new technology as it helps to improve patient care and the cost of the healthcare system.

Among many of the nurse leaders responsibilities in order to facilitate the use of technology in the healthcare setting are:

1. To partner with colleges in nursing to develop the required skills and competencies that are needed for use of the technology

2. Explaining the policies and procedures that come along with adopting the new technologies to all staff members such as HIPPA violations.

3. Educate focusing on leadership, communication, business operations, technical skills, etc.

4. Join informatics leadership programs to further education.

5. Create an environment which relies on reward and recognition and career path development through technology and informatics.

6. Develop a champion leader who has the skills to integrate informatics and collaborate on goals and implementing the technology throughout the health system.

 

 

 

To learn more about the nurse leaders role in engaging staff in the use of technology click HERE or HERE

More on the TIGER project can be viewed HERE

 

 

Human-Technology Interface in Nursing

What is it?

 

 

Technology in todays world is improving everyday. With that said it is important for healthcare providers and nurses to take advantage of the technology to bring better quality of care to our patients. Human-Technology Interface also known as Human Computer Interface (HCI) is the communication between a human and a computer system. When this is used in the healthcare setting, quality, safety, and patient satisfaction all increase. The aim of this is to allow for patients and family members to be actively engaged in the plan of care for the patient. This allows them to be knowledgeable and educated in important health care decisions. This also allows for nurses to spend more time at the bedside with the patient because they are not worried about what task they must complete next, it is all outlines for them. Technology has made communication between staff members, physicians, and all members of healthcare uncomplicated.

 



 

Implementing Technology in Healthcare

 

Applying technology in the healthcare setting has been a work in progress. Technology in healthcare was designed to remove errors and adverse events, reduce the amount of times an error occurs, detect the error before injury results, and diminish the effect of the errors following an event to prevent injury. There are many technologies that have been implemented into healthcare. A few include bed alarms, IV pumps with occlusion signals, patient call bells, code alarm, cardiac alarms, etc. All of these were initiated to decrease harm and risk of harm to the patient. Patient care technology offers improved nurse productivity, increased nurse and patient satisfaction, improved safety and quality of care.

 

Electronic Health Records

 

A major technological advancement that has recently occurred is the Electronic Health Record. There are a multitude of ways that humans can interact with this technology. Flash back to 2009 when the HITECH Act of 2009 was established. This act was created because many physicians were not using the Electronic Health Record (EHR) to its fullest potential.  This act was created to enforce providers to use the EHRs and use them meaningfully. If providers are currently not utilizing EHRs to their fullest potential, penalties instead of reimbursement occurs.  

The EHR provides significant improvements in care. They allow for a free exchange of information throughout the world to other providers or the patient. The ideal goals of the EHR is to design a comprehensive national electronic health care framework which leas to a decrease in duplicating tests, improving the cost effectiveness of care, and save a patient history. The interoperability of the EHR allows for a multidisciplinary approach to the patients care.

 

 

Patient Engagement

 

In todays day in age, patients and their family members are very tech savvy. They are using iPhone, tablets, laptops, etc. to research diagnosis, disease processes, and treatment options. Much of what is found online can be incredible due to the patients history or current status. The EHR has allowed for patient and family engagement thanks to this technology and the EHR. Giving patient access to their records and charts allows them to view their medications, appointments, past appointments, and vital signs. This helps to educate the patient and the family on their health and disease. Not only is it accessible, available and a great educational tool, but it is helping to reduce health care costs.

 

 

Nursing Aspect

 

Through the EHR, nurses are able to help create tools in order educate and allow for patient engagement. Nurses are the frontline of care for the patient and need to be involved in selection and education process of the multiple technologies being introduced into todays healthcare. It is the nurse leaders role to utilize the technology to its fullest potential and help educate other nurses to use it fully. Technology today improves nurse, physician, and staff productivity, increases patient satisfaction, and decreases cost of health care. Technology is a wonderful aspect of the world we live in, we need to take advantage of it to better the care of our patients.

 

Exemplar Scenario

 

Patient named K. Smith comes into the ED and was given a bolus for dehydration after passing out in the heat. K. Smith then gets admitted to the floor where she is on a continuous IV solution rate of 200cc/hr. Her nurse has had a very busy shift and sent a patient to the ICU and received two neurosurgical patients and now K. Smith. K. Smith puts her call bell and her nurse enters the room to find K. Smith very short of breath, assesses the patient and is found to have crackles throughout all lungs. The nurse pulls up the patients chart, reviews current vital signs  which are HR of 115, BP of 188/96 O2 sat of 84%. The nurse then checks the patients previous history while staying in the room with K. Smith. K. Smith has a history of CHF. The nurse quickly turns off the fluids and using her portable phone contacts the covering P.A. The P.A. orders Lasix electronically which is reviewed, barcoded, and administered and then comes to assess the patient.

 

There is technology incorporated throughout this scenario. First off, the patient using her call bell when she feels something is wrong, allowing the nurse to enter the room. Secondly, having an accessible computer in the patients room to access her vitals, past medical history, and current chart. Thirdly, having a portable phone to communicate with the provider, and lastly, the electric EMR which allowed the provider to quickly place the medication order so it can be barcoded and administered.

 

The nurse can now show the patient how to enter her own electronic health record and see why she felt so short of breath. Educating the patient on CHF and how to decrease the risk of CHF flares. 



 

 

Human-Technology Interfaces seen in Healthcare

 

- Temperature sensing catheters

- Oxygen and air regulators

-Code carts

-IV pumps

-Barcoding medication administration

-Patient transfer devices

-Telemetry

-Pulse Oximetry

-Cardiac monitors

- Morphine or Dilaudid PCA's.

 

 

 

To read more on human-technology interface in healthcare visit these two informative articles by  clicking here or here 













The Language of Healthcare: SNOMED CT

  THE GLOBAL LANGUAGE OF HEALTHCARE

Nursing informatics has drastically changed the way nurses, providers, and all healthcare staff work. The advancing technology allows for consumer and provider to obtain information which has completely changed the publics view on healthcare. Patients are able to view health details online and be responsible for their health. Utilizing evidence and standardizing nursing language within IT systems allows collaboration between providers and nurses. Making use of the nursing language and informatics is necessary to make the work of nurses noticed, and express evidence about the benefits of nurses in the care of patients, groups, and populations.

 

To Read More On the Nursing Language of Healthcare Click Here

 

 

Overview of SNOMED CT

SNOMED CT is known as one of the most inclusive, specific, and definite health terminology throughout the globe. It is distributed around the world by the International Health Terminology Standards Development Organization (IHTSDO). The way it was made incorporates the different needs worldwide. SNOMED CT allows for patients and healthcare professionals to benefit from a multitude of clinical items which leads to higher quality, consistency, and safety.

WHAT IS SNOMED CT?

- The easiest multilingual healthcare terminology worldwide.

- Includes comprehensive and scientifically evident clinical content

- Allows for consistent content in the electronic health record

-Mapped internationally

-Currently used in over 50 countries

The use of the electronic health record betters communication between providers and professionals.

SNOMED CT represents clinical thoughts, each concept has an identifier. Concepts are then organized. SNOMED CT relationships connect to other concepts whose meaning is relative.

The Purpose Of SNOMED CT

SNOMED CT is only a small part of the problem solving  for creating an effective electronic health record. The terminology alone will not do much for a health system, but incorporating and implanting it within an application makes for desired outcomes. The purpose is to code meanings used in health information. To create this success and best outcomes, utilizing the software application in which it is embedded, as well as the objectives, and high qualified, and inspired individuals are all key. SNOMED CT can support clinical information. It allows for careful retrieval of information considering settings, terminology, record structure, as well as communication.

 

WHY SNOMED? WHY IS THIS IMPORTANT TO HEALTHCARE?

SNOMED CT was created to benefit the patients, clinicians, and populations supported by evidence. Electronic health records improves communication between healthcare providers as well as improving the access to information. If used "meaningfully", it removes language barriers, shares adequate information with other physicians providing care for the patient, allows for easy access to identify patients whom need follow ups. SNOMED CT can run a detailed analysis of clinical records to search for outliers, reduces duplications and errors which is cost saving, enables links between records and protocols or guidelines. SNOMED CT improves cost effectiveness and quality of care delivered to patients.

ISSUES WITH SNOMED CT

Though SNOMED CT is of highest quality and produces a multitude of benefits, there are some issues and flaws. Some flaws are producing links correctly and keeping them up to date. Another flaw is searching for data in a comprehensive application. Why not just utilize a limits list? There are always flaws within a system which continue to be worked out continuously

 

VISIT THE PRIMARY WEBSITE OF SNOWMED CT TO LEARN MORE

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To Read More On SNOMED CT Click Here or Here To View Articles.