Information Technology System

Electronic health record Primary application

Ensuring effectice patient monitoring and treatment

Electronic health record function

Real-time documentation of patient data, accessible by professionals across departments

Electronic health record impact

Reduce the risk of medical errors and allow for timely and informed decision making

Physiologic monitoring systems Functions

-measures and records temperatures, heart rate, respiration, alertness, and activity

- assess aspects of human performance and either respond with a corrective action, or alert a human being to do so

Basic parts of Physiologic monitoring systems

1. Sensors

2. Signal conditioners

3. Files

4. Computer processor

5. Evaluation or controlling components

Sensors function

Captures data

Signal conditioners function

Converts data to make it suitable for further processing

Files function

Data to be analyzed

Computer processor function

Analyzes data and directs reports

Evaluation or controlling components

Regulates equipment or alerts nurses

Hemodynamic monitors

Machines used under human machine interface

Hemodynamic monitors 3 functions

1. Measures Hemodynamic parameters closely and examines cardiovascular function

2. Evaluates cardiac output and volume status (thermodilution)

3. Continuously assess respiratory gases (capnography) and stores waveforms

Arrhythmia monitors what is it?

Performs computerized monitoring and analysis of cardiac rhythms

4 uses for arrhythmia monitors

1. Detection

2. Surveillance

3. Diagnostic

4. Interpretative

Holter monitor (Ambulatory ECG) what is it?

Small, wearable device that records the heart's rhythm usually for 1 to 2 days and sports irregular heartbeats

Patch recorder/monitor

Good for 2 weeks of nonstop monitoring. It has everything contained in one unit a patch that sticks to your chest

Symptom event monitor/recorder

Sticks sensors on skin and turn the device on when you have symptoms

Implantable loop recorder

Records the heartbeat continuously for up to three years

Commercial devices

Smartwatches, dedicated heart rate monitors, fitness trackers with heart rate monitoring capabilities

holter advantage

Continuous recording, records as events, all ecg leads

Holter disadvantage

Short monitoring period, patient needs to keep symptom diary

Event recorder advantage

Longer monitoring period, correlation of rhythm and sx

Event recorder disadvantage

Does not detect asx episodes, requires patient participation

Patch monitor advantage

Continuous recording, wireless

Patch monitor disadvantage

Patient needs to keep symptom diary

Implantable loop recorder advantage

Continuous long term monitoring

Implantable loop recorder disadvantage

Expensive, invasice

Commercial devices advantage

Commercially available, fun, widespread

Commercial devices disadvantage

Limited data on ability to detect various arrhythmias

3 categories of physiologic monitoring systems

1. Bedside monitoring

2. Wearable devices

3. Telemonitoring systems

Bedside monitoring system example

Vitals machine thingy majiggy

Wearable devices example

Apple Watch

Telemonitoring system exam

Patient at home calls the medical service center, and they report to the doctor/nurse

Critical care information system (CCIS) what is it?

Designed to collect, store, organize, retrieve and manipulate all data related to the critically ill patient

3 advantages of CCIS

1. Facilitates clinical documentation (flow sheets)

2. Provides decision support (alerts/reminders)

3. Enables interdisciplinary plans of care

Examples of CCIS

1. Patient management system

2. Vital signs monitoring machines

3. Medication management systems

4. Laboratory information systems

5. Radiology information systems

Patient management system. What is it?

Monitors services given to patient, length of stay, mortality and readmission rates

Vital signs monitoring what is it

Automatically acquires vital signs and other physiologic data and incorporates it into the clinical database

Medication management system

Facilitates medication administration process incorporating the use of bar code technology

Laboratory information system what is it

Reports on blood, body fluid, and tissue samples, provides clinicians with reference ranges for tests

Radiology information system what is it?

Schedules, provides results, and stores information which is related to diagnostic radiology procedures, including images via picture archiving and communications systems

Advantages of CCIS

1. Clinical documentation

2. Decision support

3. Interdisciplinary plans of care

Clinical documentation (further explained)

- generation of flow sheets from data collected

- interdisciplinary entry of data to CCIS

- Automatic calculation of physiologic indices

Decision support (further explained)

- provides alerts or reminders to guide care in accordance with evidence-based guidelines

Interdisciplinary plans of care (further explained)

Orchestrates all numerous and simultaneous processes

Telemedicine in critical care, what does it do?

- allows healthcare providers to virtually monitor patients, consult with specialists, and collaborate

- telehealth tools such as tele-ICUs allow remote monitoring of patients and transmission of vital signs

Ambulatory care settings System design

Specialized healthcare information systems designed to support outpatient services

ACIS advantages

1. Real time access to records

2. Improved workflow

3. Reduced errors

4. Automated and integrated backend processes

ACIS issues

1. Increased accountability

2. Need for continuous support

3. Privacy and confidentiality of info

4. Accessibility and security of data and info

5. Integration and support to other system

EHRs in outpatient facilities, what are they used for?

They are used to document and track patient information, improving the accuracy and efficiency of care delivery

Patient portals do what?

- they allow patients to access health records, schedule appointments and communicate with providers

- streamlines administrative tasks for nurses and encourage patient participation in health management

Telemedicine

- offers remote care, reduces the need for in-person visits

- beneficial for patients in rural areas or those with mobility issues

Community Health Settings Goal

Effective and timely assessment that involves monitoring and tracking the health status of populations

Health information Exchange systems do what? (HIEs)

- allow health care providers to securely share patient data across different organizations

- improves continuity of care, reduce duplication and promote comprehensive health management

Mobile health (mHealth) Applications

What do they do and what are they for?

- Chronic condition management and health promotion

- patients can track vital signs, medication adherence and health behaviors

- Nurses use these platforms for remote monitoring, sending reminders, and following up on patient progress

Geographic Information Systems (GIS) used for what?

- used to improve accessibility and delivery of healthcare services

- enables mapping of health outcomes and tracking of disease outbreaks within geographic services

- used to identify communities with high rates of chronic or infectious diseases

Philippine integrated disease surveillance and response (PIDSR)

- comprehensive system that is established by the department of health in the Philippines to monitor, detect, and respond to various diseases and events promptly.

Patient Safety CDSS (clinical decision support system) what it do?

- provides real-time, evidence based recommendations and alerts

- essential in high-risk environments like ICU

- reduces cognitive load on nurses, helping them make quicker, more informed decisions

Automated medication dispensing system what it do?

- automates processes of storing, preparing and dispensing medications, reducing medication errors and risk of human error

Barcode medication administration what it do? (BCMA)

A critical tool that ensures correct medication delivery by scanning patient's wristband and medications's barcode

Workflow management solutions

- helps orchestrate numerous simultaneous processes, especially in critical care.

Emergency preparedness and response, what does it use

- use of informatics on the mitigation and control of emergencies

- public health informatics (PHI), in a community setting

- emergency medicine informatics, in a hospital setting

Mitigation and control of emergencies

- information outreach for potential victims

- tracking patients / workers/ resources (RFID)

- Biosurveillance- Early recognition and monitoring of risk factors that cause disease

Automated tracking systems

- track patients, victims, medical equipment, monitoring medication administration, and update patient records in real time

What does RFID stand for?

Radiofrequency identification tracking

WEB-GIS (Geographical information Systems)

- critical for tracking resources, identifying hotspots and ensuring resources are distributed where needed

What is telehealth?

- the use of digital information and communication technologies, such as computers and mobile devices, to access health care services remotely and manage health care

Telehealth definition

Comprehensive term encompassing a wide range of digital healthcare services, including telemedicine

Telemedicine

Specific subset of telehealth focused on providing clinical services to patients online when they are at a different location

T/F Teleheatlh and telemedicine are the same

Nah bruh false

Telehealth services

- virtual consultations with healthcare providers

- non clinical services like patient education, training for healthcare professionals, and healthcare- related communication conducted online

Telehealth services

- excludes non clinical services

- clinical services delivered online, typically involving virtual visits with healthcare providers

Technology used in telehealth

- videoconferencing, email, text messaging, streaming media

Telemedicine Technology

- videoconferencing, email, text, communication, and online patient portals for clinical consultations

Telehealth benefits

- improved access to health care services

- access to specialized care

- remote monitoring of chronic conditions

- improved healthcare delivery

Telehealth challenges

- technical barriers and infrastructure issues

- lack of digital literacy and training

- economic barriers

Telehealth legal and ethical concerns

- patient privacy

- data security

- standard of care

Balance technology use in nursing

- prioritize patient connection

- utilize technology effectively

- set boundaries with technology

- ensure patient privacy

- be prepared to troubleshoot technical issues