WGU C427 Technology Applications in Healthcare

Healthcare Management Information System
(HMIS)

Healthcare Management Information System
(HMIS)

One of the six building blocks essential for health system strengthening. Is a data collection system specifically designed to support planning, management, and decision making in health facilities and organizations.

Protected Health Information (PHI)

The HIPAA Privacy Rule provides federal
protections for personal health information held by covered entities and gives patients an array of rights with respect to that information. At the same time, the Privacy Rule is balanced so that it permits the disclosure of personal health information needed for patient care and other
important purposes.

Health Information Portability and Protection Act
(HIPAA)

Enacted on August 21, 1996, by the U.S. Congress to accelerate the development of data standards to improve the privacy, confidentiality, integrity, and security aspects of personal health information and to simplify the movement of individual patients' protected health information (PHI) between healthcare professionals and other
covered entities that require the information,
such as insurance companies

Health Level 7 (HL7)

Accredited by ANSI, is a system development organization whose aim is to promote interoperability for the interchange
of healthcare data. "Level Seven" refers to the
highest level of the International Organization for Standardization (ISO) communications model for open-systems interconnection (OSI)—the application level.12 Built on existing production protocols, predominantly those of ASTM Standard 1238. It operates as a nonprofit
volunteer-, vendor-, and provider-supported
organization to encourage information scientists and various experts in the healthcare field to endeavor toward the development of standards for the management, processing, integration, and
exchange of electronic healthcare information.

American National Standards Institute (ANSI)

Oversees the creation, promulgation and use of thousands of norms and guidelines
that directly impact businesses in nearly every sector: from acoustical devices to construction equipment, from dairy and livestock production to energy distribution, and many more. Also actively engaged in accreditation - assessing the competence of organizations determining conformance to standards.

Health Information Exchange (HIE)

allows doctors, nurses, pharmacists, other health care providers and patients to appropriately access and securely share a patient's vital medical information electronically—improving the speed, quality, safety and cost of patient care

Digital Imaging and Communications in Medicine
(DICOM)

The standard for the communication and management of medical imaging information
and related data.

World Wide Web Consortium (W3C)

international community that develops open
standards to ensure the long-term growth of the Web.

Health Information Technology for Economic and Clinical Health (HITECH)

part of the American Recovery and Reinvestment Act of 2009 (ARRA). Created to
motivate the implementation of electronic health records (EHR) and supporting technology in the United States. Clinical Decision Support Systems (CDSS) `Computer tools

Computerized Physician Order Entry (CPOE)

A computer application that allows a physician's orders for diagnostic and treatment services (such as medications, laboratory, and other tests) to be entered electronically instead of being recorded on order sheets or prescription pads.
The computer compares the order against
standards for dosing, checks for allergies or
interactions with other medications, and warns the physician about potential problems.

Laboratory Information Systems (LIS)

software system that records, manages, and
stores data for clinical laboratories. Traditionally been most adept at sending
laboratory test orders to lab instruments,
tracking those orders, and then recording the
results, typically to a searchable database

Logical Observation Identifiers Names and Codes (LOINC)

a classification system used for identifying
laboratory results and clinical observations

Systematized Nomenclature of Medicine
(SNOMED)

a coding scheme meant to integrate the data
accumulated from multi-provider care processes by mapping with ICD, LOINC, and various other data classification standards

Medical Information Bus (MIB)

represents an application of networking and
information technology for healthcare. The
purpose of MIB is to define a standard means of connectivity between critical care bedside
medical devices and hospital host computers. The devices include patient monitors, infusion pumps, ventilators, pulse oximeters and other devices used in operating rooms, intensive care units and
emergency rooms.

Healthcare Common Procedure Coding System
(HCPCS)

set of health care procedure codes based on the American Medical Association's Current
Procedural Terminology (CPT)

Office of the National Coordinator for Health
Information Technology

at the forefront of the administration's health IT efforts and is a resource to the entire health system to support the adoption of health information technology and the promotion of nationwide health information exchange to improve health care. Organizationally located within the Office of the Secretary for the U.S. Department of Health and Human Services (HHS).
The principal federal entity charged with
coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health
information.

PACS

Medical imaging technology which
provides economical storage and convenient
access to images from multiple modalities
(source machine types).

Which of the following has proven to be the MOST effective means of communication?

Face to face.

What is the best strategy to gain support from physicians for implementation of a new
electronic health records system?

Allow physicians to actively participate in the process.

What is the MOST important area of expertise in information technology that a practice
manager should possess?

The ability to identify the current and future needs.

Which of the following would NOT typically be included in an analysis of an information
system's most common problems?

Voltage requirements.

According to computer crime studies, who is responsible for more than 80% of all
network security incidents?

Disgruntled employees.

What should a healthcare provider complete to allow an outside entity to have access to
protected information under its control?

A business associate agreement.

Which of the following is NOT considered in determining physician evaluation and
management (E&M) coding?

The need for an interpreter.

Which of the following is essential for keeping electronic patient information secure and
confidential?

Compliance with the Federal Security Rule.

Which of the following is NOT a crucial step in ensuring quality of data?

Strategic planning.

According to the Health and Human Services guidelines on the Health Insurance Portability
and Accountability Act, which of the following would NOT be relevant to medical record
procedures?

Maximum allowable charge to copy records for an attorney's office.

What is data scrubbing?

The act of detecting and removing incorrect data without review.

As used in U.S. federal government initiatives, electronic health record (EHR) is:

specific focus of health information technology (HIT)

Which of the following purposes is virtually impossible without an EHR:

knowledge management

Health information exchange is:

organization that formally enables exchange health data
product that enables data integration and connectivity
seamless exchange of health data

In the U.S., unifying public health surveillance is a strategy relating to the government's
goal of:

Improving population health

The term electronic "health" record is preferred over other terms in order to add which of the following to the traditional concept of the medical record:

promotion of health and wellness

In comparison to other industries, slower adoption of information technology in health
care may be attributed in part to:

contextual and textual nature of data

A health information exchange could address some reimbursement issues through

providing access to health plan information

The primary benefit of personal health records for clinicians is:

coordination of care

In hospitals today, the EHR is largely a:

set of components

PHI is:

Protected Health Information

What is the penalty for an eligible healthcare provider not meeting meaningful use
requirements?

Reduced Medicare reimbursements

What is the general term for the use of mobile phones and other wireless
technology in medical care?

mHealth (mobile health)

Telepathology is:

Medical diagnosis facilitated by the digital transmission of pathological data

What is the term for the transmission of healthcare-related patient data among
facilities and government agencies?

Health information exchange (HIE)

Most of the world is using the International Statistical Classification of Diseases
and Related Health Problems, 10th edition (ICD-10). What does the U.S. currently
use?

ICD-10

The National Broadband Plan is designed to bring high-speed Internet to all
Americans. The FCC estimates that health care costs could be reduced over the
next 15-20 years. How much money did the FCC estimate will be saved?

$700 billion

All health care providers must have a unique 10-digit identification number to
identify themselves in all HIPAA transactions. What is this 10-digit identification
number called?

National provider identifier (NPI)

How is health information accessed?

Isolated legacy systems are being replaced by more efficient and interconnected business-oriented systems like supply chain management (SCM), customer relationship management (CRM), and enterprise resource planning (ERP).

How are systems used in Healthcare IT?

A number of new systems are being implemented by outside vendors to curate patients' health information on an opt-in basis. Patient-centered management system components, including EHRs, CPOEs, and CDSSs, are designed to work together to improve patient care.

What are the standards for exchanging healthcare information?

As the exchange of information continues to increase at a rapid pace, organizations have been formed to help standardize the healthcare management information systems that carry this data across a network of systems.

How are Healthcare IT systems integrated?

Progress toward integration is occurring as organizations adopt standards and frameworks for data exchange. These standards are meant to improve interoperability among the diverse systems. One solution to this complex challenge is leveraging the Internet to bring together fragmented HMIS.

How does e-health technology globalize medicine?

Advancements in technology are offering patients the flexibility to receive care wherever they are located. The barriers of time and distance have disappeared with the emergence of telemedicine.

HMIS components

Data/information/knowledge component.
Hardware/software/network component.
process/task/system component.
Integration/interoperability component.
User/administration/management component.

Data and Information Processing

Data input
Data management
Data output

What components comprise the foundation of Healthcare IT?

Utilization
HMIS components
Data and Information Processing

Who is accessing health information?

Health information seekers "Access has been found to be greatest among those with higher education and incomes. Moreover,
this access is least significant among African Americans and Latinos, who both continue to trail whites and Asian Americans.15This phenomenon contributes to the digital divide, or exclusion, and stands to affect education and health quality, equity, accessibility, affordability, and availability."

why Explore HMIS

Healthcare managers must be able to implement successful HMIS initiatives and provide pathways for better communication, both verbally and electronically, to achieve the vision of a healthcare organization.

what is Health Informatics?

Health Management Information Systems (HMIS) are one of the six building blocks essential for health system strengthening. HMIS is a data collection system specifically designed to support planning, management, and decision making in health facilities and organizations.

Information systems executives are chiefly responsible for

Directing the vision for future health management information systems (HMIS). Must be an expert in technology, business, and healthcare delivery.

Information systems executives Vision

Allows a healthcare organization to better achieve its missions, goals and objectives through an HMIS.

Information systems executives Strategy

Possessing strategies for growth, diversification, turnaround, and competing priorities will help minimize challenges to an organization's IT vision and mission.

Information systems executives Training

must educate their staff about the importance of active engagement
with information technology

High-level strategic planning is necessary to

break down an organization's mission so that it can drive actions toward the defined goals.

planning, organizing, directing, and
controlling(PODC) model

For high-level organizational goals. A robust tool healthcare managers can use to realize their greater organizational visions.

PODC method

provides a framework to identify and define specific actions aimed at meeting the organizational goals and aligning an HMIS
strategy. The healthcare organization's business strategies are guided by higher-level planning. Additionally, a health management strategic
information system plan (HMSISP) is intended to clearly define concrete and measurable objectives.

75% of poor data quality is likely caused by

human data-entry errors.
It is a healthcare manager's responsibility to ensure that employees understand the system and
are provided with the manager's support to expedite problem mitigation and support a culture of
mindfulness over production, with a shared goal of correct data entry.

Health management strategic information system plan (HMSISP)

can help healthcare
managers identify and deploy an aligned approach to justify implementation of an
information system that mutually supports the organization's objectives of improving patient
care.

Change continuums

three basic continuums: technology, processes, and people.

health management information systems (HMIS)
implementation requires

collecting accurate, reliable, and timely data.

The components of data stewardship

quality, management, security, and
business intelligence (BI)—are domains essential in HMIS design.

Data stewardship

Having high-quality data is not just about the accuracy of each patient record. It also involves controlling access to the data, managing data updates, and validating the data.

Obtaining accurate data is not enough; proper data stewardship is
essential to ensuring that the right information is delivered to the right person at the
right time.

Steps HMIS implementation

(1) assessing the available resources, (2) assessing data and data inventory, (3) profiling data and determining the valid values for each attribute, (4) reviewing processes, and (5) reviewing personnel responsibilities.

Data stewardship has four major components,

Quality. This component is concerned with providing current, accurate, and consistent information whenever and wherever the data are accessed
Management. This is the physical aspect of handling or managing data from the point the data are collected to the point the data are used and archived. This component not only includes the hardware and software technology, but also the processes, as well as both the people and the machine involved in managing the data.
Security. This component has to do with controlling access to the data to ensure that not only are data available and retrievable to those who are supposed to access the data but the release of data is also securely guarded from those who are not supposed to have access to the data.
Business Intelligence. This component has to do with utilizing the data to yield better, more complete, and more usable information. This is what some have called "putting the information back into information technology."

Computer-based Decision Support Systems (CDSS)

Medical information processing systems that are designed to aid clinicians in making complex and/or less-than-complex clinical-based decisions
Use CDSS to query general and specific questions about the conditions of their patients, infer and/or forecast resulting outcomes, & arrive at the computed alternatives and/or choice outcomes for the decision makers

Patient-Centric Management Systems Challenges

Confusion due to complexity
Cost of implementation
Lack of standardization
Reliability, privacy, confidentiality, and security of housed patient data
Lack of motivation in creating interoperability
Uncertainties about the direct benefits

Patient-Centric Management Systems Benefits

Allow direct sourcing and capturing of patient data -
Direct patient care
Continuing patient care
Follow-up treatment protocols
Medical education (for nurses and resident physicians)
Research
Improve legal compliance
Cut costs
Improve patient safety
Decision support capabilities

Enterprise software systems offer a number of benefits to a healthcare organization, including

Flexibility: Enterprise software systems can expand an individual HMIS as other organizations participate in data-sharing.
Networking: By allowing enterprise-wide views of an organization, enterprise software systems enable interorganizational collaborations.
Interoperability: Enterprise software can connect standalone legacy systems.

The benefits of a Web service-based integrated healthcare information systems WSIHIS solution include the following:

Remote access: By layering a web service on top of a legacy HMIS system, other WSIHIS are able to access legacy systems over the network.
System independence: By using Microsoft .NET framework, as an example coupled with the use of the C# programming language, WSIHIS can operate on a variety of system platforms including Linux and Windows, among others.

Telecare

The use of information and communication technologies to transfer medical information for the delivery of clinical services to patients in their place of domicile.

Telemedicine

The use of information and communication technologies to transfer medical information for the delivery of clinical and educational services

Telehealth

The use of information and communication technologies to transfer healthcare information for the delivery of clinical, administrative and educational services

e-Health

A commitment for networked, global thinking, to improve health care locally, regionally, and worldwide by using information and communication technology

4 different theoretical e-Health models from which antecedents are drawn

Technology Acceptance Model (TAM)
Perceived usefulness
Perceived ease-of-use
Theory of Planned Behavior
Attitudes toward behavior
Subjective norms
Perceived behavioral control
Diffusion of Innovation Theory
Relative advantage
Compatibility
Complexity
Trialability
Observability
Society, Social norms, Behaviors, Structures, and
Systems
Technology-Organization- Environment Model
Technological facet
Organizational facet
Environmental facet