Module 6: Information Technology and Community Health

the use of information and communication technologies (ICT) for health (WHO); an emerging field in the intersection of medical informatics, public health and business, referring to health services and information delivered or enhanced through the Internet and related technologies.

E-Health

Communicating with a patient through a teleconference, electronic mail (e-mail), short messaging services (SMS) is a purpose of e-health

True

Recording, retrieving and mining data in an electronic medical record (EMR) is a purpose of e-health

True

Providing patient teachings with aid of electronic tools such as radio, television, computers, smartphones, and tablet is a purpose of e-health

True

Delivery of health information for health professionals and health consumers, through the internet and telecommunications is a purpose of e-health

True

Using the power of IT and e-commerce to improve public health services (Ex: education and training of health workers) is a purpose of e-health

True

The use of e-commerce and e-business practices in health systems management is a purpose of e-health

True

As part of a records management plan for electronic records, you will need to determine where and how your records will be stored.

Storage

allows immediate access to records to anyone on the system's network. Properly designed storage will provide access to appropriate users only. It maintains the greatest functionality but requires more expensive network storage.

Online Storage

Examples of online storage include:

Storage Area Networks (SAN)

Files that cannot be accessed immediately are said to be stored offline. The longer records need to be maintained the more important preservation methods, back-up procedures, storage conditions, handling procedures, and security become.

Offline Storage

Examples of offline storage include:

-Removable magnetic or optical media (tape, DVD). For integrity purposes, read-only media is preferred.

-Flash media (solid state media has no moving parts)

-External hard drives (with moving parts)

the act of getting something back, or of accessing stored data and files in a computer

Retrieval

the transfer of data (a digital bitstream or a digitized analog signal) over a point-topoint or point-to-multipoint communication channel.

Data Transmission

There are two methods used to transmit data between digital devices:

serial transmission and parallel transmission

It sends data bits one after another over a single channel

Serial Data Transmission

It sends multiple data bits at the same time over multiple channels.

Parallel Data Transmission

Is faster than standard data transmission over regular phone lines, and cable modem transmission is faster than DSL

Digital Subscriber Line (DSL)

a worldwide computer network that connects hundreds of thousands of smaller networks.

Internet

a device used to connect a computer or router to a telephone line which provides the digital subscriber line service for connection to the Internet

DSL Broadband / DSL Modem

simply facts or figures — bits of information, but not information itself.

Data

When data are processed, interpreted, organized, structured or presented so as to make them meaningful or useful

Information

_____ in healthcare allows health systems to create holistic views of patients, personalize treatments, advance treatment methods, improve communication between doctors and patients, and enhance health outcomes.

Data collection

Disadvantages of Paper-based records:

1. Continuity and interoperability of care stops in the unlikely event that a record gets misplaced

2. Illegible hand writing poses misinterpretation of data

3. Patient privacy is compromised

4. Data are difficult to aggregate

5. Actual time for patient care gets limited

Advantages of ICT Data:

1. Data are readily mapped, enabling more targeted interventions and feedback

2. Data can be easily retrieved and recovered

3. Redundancy of data is minimized

4. Data for clinical research becomes more available

5. Resources are use efficiently

This ensures that documentation reflects the event as it happened. All values should be correct and valid.

Accuracy

Readily available reports or statistics when needed by decision makers

Accesibility

Data inputted should be complete. Done by making sure that all required fields in the patient's record are properly filled up

Comprehensive

Having no discrepancies in the data record makes it consistent. Can be done by error detection and alerts program by the computer.

Consistency/Reliability

All data must up-to-date and timely. This is exemplified when the community nurse records data at the point-of-care or when it happened.

Currency

Data should be properly labeled and clearly defined.

Definition

Health sector also utilized ICT to improved their services, for example:

Electronic Filed Health Service Information System

Online Electronic Injury Surveillance System

Philippine Health Atlas

Unified Health Management Information System

Factors Affecting eHealth in the Country:

1. Limited Health Budget

2. The Emergence of Free and Open Source Software

3. Decentralized Government

4. Target Users and Unfamiliar with the Technology

5. Surplus of "Digital Native" Registered Nurses

The main focus of eHealth in the community is:

health promotion and health maintenance of individuals, families, and groups within the community

comprehensive patient records that are stored and accessed from a computer or server

Electronic Medical Records (EMRs) or Electronic Health records (EHRs)

to provide better health services to geographically isolated and disadvantaged areas; to support Millennium Development Goal

Telemedicine

use of electronic tools to aid in teaching which can be done synchronously or asynchronously; can be done with simple instructional videos and interactive simulations

eLearning

with eLearning community nurse can elicit community interest by showing ______ on measures to control a particular disease

instructional videos

Areas of Community Health Systems:

1. Healthcare Programs 2. Agencies 3. Settings

The Following are some of the typically used systems in the community health systems:

1. Categorical systems

2. Screening Programs

3. Client registration systems

4. Management Information System (MIS) 5. Statistical reporting systems

6. Public Health Information Network

7. National Electronic Disease Surveillance System

8. Special purpose systems

9. School Health Systems

10. Home Health Information Systems

They are designed to support data processing and tracking specific programs such as cancer program, MCH immunization, or Family planning; Collect longitudinal data for specific disease that can be use for national databases for tracking incidence and prevalence of disease conditions

Categorical Program Systems

They are use to detect individuals afflicted with specific disease or predisposing health condition; The results of the screening test are tracked so that data analysis can be used to measure the effectiveness of the screening program

Screening Programs

They are designed to identify state/local residents/clients eligible for CHN services in clinics and home; They consist of an online communication network, with terminals located in each of the local/district offices that are linked to a central computer facility used to collect, store, and process all data.

Client Registration System

They focus on the management of statistical and operational needs of the agency ad professionals; provides framework on collecting and reporting statistical as well as financial data needed for the management of personal/client and programs

Management Information Systems

these are community health computer applications that have been developed to collect and process statistical information primarily for state/local health departments such as epidemiologic data and immunization data

Statistical Reporting System

enable consistent exchange of response (during emergencies/disaster), health, and disease tracking data between public health partners through defined data and vocabulary standards

Public Health Information Network

5 key components of Public Health Information Network:

a) Detection and Monitoring

b) Analysis

c) Information Resources and Knowledge Management

d) Alerting and Communication

e) Response

promote the use of data and information system standards to advance the development of efficient and integrated surveillance systems at the national and local level

National Electronic Disease Surveillance System (NEDSS)

NEDSS is designed to:

a. Detect outbreaks rapidly and monitor the health of the nation

b. Facilitate the electronic transfer of appropriate information from clinical health departments

c. Reduce provider burden in the provision of information

d. Enhance he timeliness and quality of information

Developed to collect statistical data for administering a specific program, regardless of what type of agency offers the program; Collect and summarize management data on services in clinics, schools, and homes

Special Purpose Systems

Improved data collection and monitor and evaluate health of school age students; Could be individual school base or district base allowing for collecting data about education district

School Health Systems

Designed to support home healthcare, hospice, and private duty programs and hospital based programs; Designed to collect and process data in order to prepare the documents required by third party payer for the payment of home healthcare services

Home Health Information Systems

They monitor trends of disease through EMR/EHR allowing for targeted interventions for health promotion, disease prevention, curative services or rehabilitation; They make sure all data are accurate, complete, consistent, correct, and current

Data and Records Manager

work closely with the community and implementing eHealth with them and not for them; inform and guide the community in selecting and applying appropriate ICT tools

Change Agent

provide health education to the individuals, families, groups and community through ICT tools (teleconference, SMS, e-mail and virtual); participate in making eLearning videos on specific disease

Educator

In the event that a patient needs to be referred to a remote medical specialist; Nurse present the patient's case to a remote medical specialist; Noting salient points for case assessment, evaluation treatment

Telepresenter

Must safeguard clients records ensuring that security, confidentiality and privacy of all patient information are being upheld; Nurse must also guarantee that all eHealth interventions are performed in a safe ethical manner, making sure that personnel involved in eHealth are competent and have received eHealth training/certification

Client Advocate

responsible for identifying possible points for research and developing a framework, based on data aggregated by the system

Researcher