Health Informatics: An Interprofessional Approach

✍ Scribed by Ramona Nelson; Nancy Staggers

• Publisher: Mosby
• Year: 2017
• Tongue: English
• Leaves: 691
• Category: Library

✦ Synopsis

Awarded second place in the 2017 AJN Book of the Year Awards in the Information Technology category. See how information technology intersects with health care! Health Informatics: An Interprofessional Approach, 2nd Edition prepares you for success in today's technology-filled healthcare practice. Concise coverage includes information systems and applications such as electronic health records, clinical decision support, telehealth, ePatients, and social media tools, as well as system implementation. New to this edition are topics including data science and analytics, mHealth, principles of project management, and contract negotiations. Written by expert informatics educators Ramona Nelson and Nancy Staggers, this edition enhances the book that won a 2013 American Journal of Nursing Book of the Year award!

Experts from a wide range of health disciplines cover the latest on the interprofessional aspects of informatics - a key Quality and Safety Education for Nurses (QSEN) initiative and a growing specialty area in nursing.
Case studies encourage higher-level thinking about how concepts apply to real-world nursing practice.
Discussion questions challenge you to think critically and to visualize the future of health informatics.
Objectives, key terms and an abstract at the beginning of each chapter provide an overview of what you will learn.
Conclusion and Future Directions section at the end of each chapter describes how informatics will continue to evolve as healthcare moves to an interprofessional foundation.
NEW! Updated chapters reflect the current and evolving practice of health informatics, using real-life healthcare examples to show how informatics applies to a wide range of topics and issues.
NEW mHealth chapter discusses the use of mobile technology, a new method of health delivery - especially for urban or under-served populations - and describes the changing levels of responsibility for both patients and providers.
NEW Data Science and Analytics in Healthcare chapter shows how Big Data - as well as analytics using data mining and knowledge discovery techniques - applies to healthcare.
NEW Project Management Principles chapter discusses proven project management tools and techniques for coordinating all types of health informatics-related projects.
NEW Contract Negotiations chapter describes strategic methods and tips for negotiating a contract with a healthcare IT vendor.
NEW Legal Issues chapter explains how federal regulations and accreditation processes may impact the practice of health informatics.
NEW HITECH Act chapter explains the regulations relating to health informatics in the Health Information Technology for Education and Clinical Health Act as well as the Meaningful Use and Medicare Access & CHIP Reauthorization Act of 2015.

✦ Table of Contents

Front Cover
Inside Front Cover
Health Informatics: An Interprofessional Approach
Copyright
Dedication
About the Authors
Contributors
Reviewers and Ancillary Writers
Acknowledgments
Preface
Uses of the Book
Vendors, Applications, Foundations and Institutions
Organization of the Book
Teaching and Learning Package
For the Instructor
For the Student
Contents
Chapter 1: An Introduction to Health Informatics
Introduction
Definition of health informatics
Topics and areas of study in informatics
Unit 1: Fundamental Information in Health Informatics
Why Informatics Is Needed in Healthcare: An Example
Unit 2: Information Systems and Applications for the Delivery of Healthcare
Healthcare Applications Improving Healthcare: An Example
Unit 3: Participatory Healthcare Informatics (Healthcare on the Internet)
Unit 4: Managing the Life Cycle of a Health Information System
Using the Systems Life Cycle: An Example
Unit 5: User Experience, Standards, Safety, and Analytics in Health Informatics
Using Big Data: A Real-Life Example
Unit 6: Governance Structures, Legal, and Regulatory Issues in Health Informatics
Health Policy in Operation: An Example
Unit 7: Education and Health Informatics
Unit 8: International Health Informatics Efforts
Unit 9: Historical Implications and Future Directions in Health Informatics
Conclusion and future directions
References
Discussion Questions
Case Study
Case Study Questions
Chapter 2: Theoretical Foundations of Health Informatics
Introduction
Foundational Literacies for Health Informatics
Definition of Basic Literacy
Definition of Computer Literacy/Fluency
Definition of Information Literacy
Definition of Digital Literacy
Definition of Health Literacy
Understanding theories and models
Theories and Models Underlying Health Informatics
Systems Theory
Characteristics of Systems
Systems and the Change Process
Complex Adaptive Systems
Characteristics of a CAS
Cynefin Framework for Managing Uncertainly in CAS
Simple Domain
Complicated Domain
Complex Domain
Chaotic Domain
Disorder Domain
Information Theory
Shannon-Weaver Information-Communication Model
Blum Model
Graves Model
Nelson Model
Learning Theory
Cognitive and Constructionist Learning Theories
Adult Learning Theories
Learning Styles
Change Theory
Planned Change
Diffusion of Innovation
Using Change Theory
The Systems Life Cycle Model
Staggers and Nelson Systems Life Cycle Model
Additional informatics-related models
Conclusion and future directions
References
Discussion questions
Case study
Discussion Questions
Chapter 3: Evidence-Based Practice, Practice-Based Evidence, and Health Informatics
Introduction
Evidence-based practice
Evidence-based practice models
Stevens star model of knowledge transformation
Point 1: Discovery Research
Point 2: Evidence Summary
Resources and Examples
Point 3: Translation to Guidelines
Resources and Examples
Point 4: Practice Integration
Resources and Examples
Point 5: Evaluation
Resources and Examples
Informatics and evidence-based practice
Relationship of EBP and PBE
EHRs and PBE Knowledge Discovery
Knowledge Building Using Health Information Technology
Practice-based evidence
Practice-Based Evidence Features and Challenges
Steps in a PBE Study
Create a Multisite, Multidisciplinary Project Clinical Team
Control for Differences in Patient Severity of Illness
Controls for Patient Factors
Controls for Treatment and Process Factors
Controls for Outcome Factors
Implement Intensive Data Collection and Check Reliability
Create a Study Database
Successively Test Hypotheses
Validate and Implement Findings
Limitations and Strengths of Practice-Based Evidence Studies
Informatics and practice-based evidence
Conclusion and future directions
References
Discussion questions
EBP case study
Discussion Questions
PBE Case study
Pressure Ulcer Case Study
Negative Association With Likelihood of Developing a Pressure Ulcer (Less Likely)
Patient Factors
Treatment Factors
Nutrition
Medications
Facility Staffing Patterns
Positive Association With Likelihood of Developing a Pressure Ulcer (More Likely)
Patient Factors
Treatment Factors
Discussion Questions
Chapter 4: Models, Theories, and Research for Program Evaluation
Introduction
Purposes of evaluation
Formative Versus Summative Evaluation
Generalizability and Scope
Program Continuance Versus Growth
Theories and frameworks
Social Science Theories
Social Cognitive Theories
Diffusion of Innovations Theory
Cognitive Engineering Theories
Information Theory
Information Foraging Theory
Information Technology Theories
Information System Success
Unified Theory of Acceptance and Use of Technology
Program Implementation Models
PRECEDE-PROCEED Model
Promoting Action on Research Implementation in Health Services
Reach Effectiveness Adoption Implementation Maintenance
Consolidated Framework for Implementation Research
Sociotechnical Model for Informatics Interventions
Quality Improvement
Program Theory Models
Six Steps
Logic Models
Methods, tools, and techniques
Quantitative Versus Qualitative Questions
Qualitative Methods
Structured and Semi-Structured Interviews
Observation and Protocol Analysis
Ethnography and Participant Observation
Quantitative Methods
Research Designs
Time Series Analysis
Regression Discontinuity Design
Multiple Baseline With Single Subject Design
Instruments
User-Satisfaction Instruments
Social Network Analysis
Cost-Effectiveness Analysis
Conclusion and future directions
References
Discussion questions
Case study
Discussion Questions
Chapter 5: Technical Infrastructure to Support Healthcare
Introduction
Electronic health record component model
Clinical Data Repository
Central Versus Distributed Storage
Encounter-Based Versus Longitudinal-Based Storage
Master Person Index
Clinical Applications
Review and Reporting
Data Collection
Patient Management
Clinician Productivity
Data Dictionary
Knowledge Base
Clinical Decision Support System
System integration and interoperability
Interface Engine
Interoperability Standards
Networking systems
Regional Health Information Organization, Health Information Exchanges, and Health Information Organizations
eHealth Exchange
Other infrastructure models
Application Service Provider
Cloud Computing
Current challenges
Conclusion and future directions
Mobile Apps
Service-Oriented Architecture
Open Source Software
SMART
References
Discussion questions
Case study
Discussion Questions
Chapter 6: Electronic Health Records and Applications for Managing Patient Care
Introduction
Early Terms and Definitions
Electronic Medical Record Versus Electronic Health Record
Electronic health record components, functions, and attributes
Sociotechnical perspectives
Electronic Health Record Adoption
Federal EHR Requirements
Electronic Medical Record Adoption Model
Health Practitioner Role in Electronic Health Record Adoption and Meaningful Use
Electronic health record applications used in the clinical setting
Computerized Provider Order Entry
Electronic Medication Administration Record
Bar Code Medication Administration
Clinical Documentation
Specialty Applications
Clinical Decision Support
Ancillary Systems
Electronic health record benefits
Cost
Access
Quality, Safety, and Efficiency of Care Delivery
Stakeholder perspectives
Consumers
Nurses
Healthcare Providers
Healthcare Organizations
Insurance Payers
State and National Governments
Key issues
Cost
Ownership
Data Integrity
Privacy and Confidentiality
Standards
Organizational Culture
User Experience
Patient Access to the Electronic Health Record
Patient-Generated Health Data
Conclusion and future directions
References
Discussion questions
Case study
Discussion Questions
Chapter 7: Administrative Applications Supporting Healthcare Delivery
Introduction
Vendor Resource Guides
Major Types of Applications
Financial Systems
Evolution of Healthcare Financial Information System
General Ledger
Payroll Application
Patient Accounting Application
Claims Processing and Management System
Claims Denial Management Application
Contract Management Application
Fixed Asset Management Application
Financial Reporting
Challenges with Financial Information Systems
Analyzing Accountable Care Organizations and Pay for Performance
Financial Information Systems Integration
Efficiency Tools
Practice Management Systems
Patient Outreach System
Online Billing and Payment Tool
Hospital–Healthcare Provider Connection
A Matter of Perspective
Supply Chain Management
Healthcare Supply Chain and Informatics
Integrated Applications in Supply Chain Management
Supply Cost Capture
Human Resources Information Systems
Human Resources Information Systems as a Competitive Advantage
Human Resources Information Systems Vendors
Human Resources Subsystems
Personnel Administration
Managing Human Resources Strategically and Operationally
Staffing and Scheduling
Training and Development
Compensation, Benefits, and Pension Administration-Payroll Interface
Performance Evaluation
Underrepresented Subsystems
Business Intelligence Systems
Conclusion and Future Directions
References
Discussion questions
Case Study
Michael H. Kennedy, Kim Crickmore,a and Lynne Milesa
Discussion Questions
Chapter 8: Telehealth and Applications for Delivering Care at a Distance
Introduction
Examples of Successful Telehealth Programs
Telehealth Historic Milestones
Leading Telehealth Organizations
American Nurses Association
United States Federal Government Agencies
American Telemedicine Association
International Council of Nurses
Telehealth technologies
Synchronous or Real-Time´´ Technologies Video Conferencing Patient Monitoring Technologies Asynchronous orStore-and-Forward´´ Technology
Technical Standards in Telehealth
Telehealth and Health Information Technology
Telehealth clinical practice considerations for healthcare professionals
Equal To or Better Than In-Person Care?
Telehealth Clinical Competency
Confidentiality, Privacy, and Informed Patients
Scope of Clinical Practice
Types of Clinical Telehealth Applications
Telehealth operational and organizational success factors and barriers
B.E.L.T. Framework
Operationalizing Telehealth
Telehealth Acceptance and Training
Telehealth Implementation
Preimplementation Phase
Implementation Phase
Postimplementation Phase
Telehealth challenges: licensure and regulatory issues for healthcare professionals
Licensure
Credentialing and Privileging
Reimbursement
Malpractice and Liability
Telehealth and direct patient health services
Patient-to-Provider Telehealth-Delivered Care
Delivering Direct Care Using Health Monitoring Tools and Biometric Sensors
Remote Telehealth Home Visits and Monitoring Devices
Sensor Technology
Telehealth Technology and Healthcare Consumers
eHealth Literacy: Critical Element for Telehealth Adoption
Conclusion and future directions
Telehealth Industry Growth
Telehealth to uHealth
Improve Healthcare Provider Shortages and Access to Care
References
Discussion questions
Case Study
Discussion Questions
Chapter 9: Home Health and Related Community-Based Systems
Introduction
Evolution and milestones
Practice models
Home Health
Palliative Care and Hospice
Community-Based Public Health
Nurse-Managed Health Centers
Other Practice Sites
Similarities Among Practice Models
Standardized datasets
Outcome and Assessment Information Set
Hospice Item Set
Patient-Experience Surveys
Supporting home health with electronic health records and health information technology
Billing Solutions
Point-of-Care Solutions
Clinical Decision Support Systems
Standardized terminologies
Omaha system
Description
Problem Classification Scheme
Intervention Scheme
Problem Rating Scale for Outcomes
Clinical Example from Practice
Interpretation of the Clinical Example
Examples of Electronic Health Record Screen Images
Conclusion and future directions
References
Discussion questions
Case Study
Discussion Questions
Chapter 10: Clinical Decision Support Systems in Healthcare
Introduction
Definition of Clinical Decision Support
History
De Dombal Computer-Aided Diagnosis of Acute Abdominal Pain
Computer Reminders at Regenstrief Institute
Clinical Decision Support Examples from the HELP System
Clinical decision support types and examples
Medication Dosing Support
Order Facilitators
Point-of-Care Alerts and Reminders
Relevant Information Display
Expert Systems
Workflow Support
Clinical decision support impact
Evidence of Effectiveness
Examples of Clinical Decision Support Impact Studies
Financial Impact of Clinical Decision Support
Clinical Decision Support Adoption
Challenges and Barriers to Clinical Decision Support Adoption
Clinical decision support best practices
Recent progress toward disseminating clinical decision support on a national level
Value-Based Payment Models
Meaningful Use Incentives for Electronic Health Record and Clinical Decision Support Adoption
Statewide Health Information Exchanges
Clinical Decision Support Standards
National Clinical Decision Support and Knowledge Management Initiatives
Open Source, Freely Available Resources
Research challenges
Conclusion and future directions
References
Discussion questions
Case study
Discussion Questions
Chapter 11: Public Health Informatics
Introduction
Public health: A population perspective
Social and Political Challenges That Affect Public Health Informatics
Sociological Context of Public Health
The value of informatics for the domain of public health
Surveillance
Immunization Information Systems
Health Information Exchange
Public Health Reporting
Conclusions and future public health informatics strategies
Transforming Practice With New Strategies
Advancing the Technical Infrastructure
References
Discussion questions
Case study
Discussion Questions
Chapter 12: The Engaged ePatient
Historical background and drivers of the epatient evolution
ePatient as a Pioneering Concept
Our Connected World
Policy and Legislative Influences
Characteristics of Digital Healthcare Consumers
Convergence of epatients, clinicians, patient-centered models of care, and informatics
Participatory Patient-Centered Healthcare
The New Role of Clinicians and Informaticians in ePatient Care
Health Informatics and ePatients
Transparency and Access to Data
Health 3.0 emerges
Virtual Patient Communities and Research Networks
Conclusion and future directions
21st Century Health and Healthcare
References
Discussion questions
Case study
Discussion Questions
Chapter 13: Social Media Tools for Practice and Education
What is social media?
Social media tools
Social Networking
Blogging and Wikis
Microblogging (Twitter)
Social Bookmarking
Video and Image Sharing Content
Social media statistics
Benefits of social media
Challenges of social media
Privacy and Confidentiality
Inappropriate Behaviors
Security
Regulatory Issues
Market Pressure
Social media in education
Policy
Guidelines for Writing Policies
Resources for Policy Development
Conclusion and future directions
References
Discussion questions
Case study
Social Media in Education and Healthcare
Discussion Questions
Chapter 14: Personal Health Records
Definitions of the personal health record
The development of the electronic personal health record
Blue Button for Patient Access to Electronic Health Records
Principles of an ideal personal health record
Proposed Benefits of an Ideal Personal Health Record
Types of Personal Health Records
Examples of existing personal health records
Current evidence of benefits of personal health records
Experience of Care
Quality of Care
Cost/Utilization
Current use of personal health records
Barriers to personal health record adoption
Awareness
Usability
Privacy Concerns
The Digital Divide
Provider Engagement
Interoperability
Summary of Adoption
The future of personal health records
References
Discussion questions
Case study
Discussion Questions
Chapter 15: mHealth: The Intersection of Mobile Technology and Health
Introduction
What Is Mobile Health?
Mobile Health Tools, Applications, and Examples of Uses
Client Education and Behavior Change
Sensors and Point-of-Care Diagnostics
Registries and Vital Events Tracking
Data Collection and Reporting
Electronic Health Records
Electronic Decision Support
Communication (Provider-Provider, Patient-Provider)
Provider Work Planning and Scheduling
Provider Training and Education
Human Resource Management
Supply Chain Management
Financial Transactions and Incentives
Driving forces of mobile health
Technology
Access
Range and Capabilities
Consumer/Patient Engagement and Empowerment
Global Health and Connected Healthcare
Research, Policy, and Business
Research
Policy
Business: Economic Potential and Cost Savings
Mobile health benefits and challenges
Mobile Health Evolution and Evidence
Benefits
Challenges
Patient Misinterpretation of Data
Data Privacy Risks
Legal Risks: Safety, Regulation, and Oversight of Data
Leading mHealth Organizations, Key Resources, and Information Repositories
Future directions of mobile health and conclusions
References
Discussion questions
Case study
Discussion Questions
Chapter 16: Strategic Planning and Selecting an Information System
Introduction
Strategic vision and alignment
Systems life cycle
Analysis and Requirements Definition
Project Planning
Develop or Purchase
Developing, Obtaining, and Evaluating Requests for Information and Requests for Proposals
Evaluating Vendors
Selecting the System
Preparing for Contract Negotiations
Establishing a Working Relationship with the Vendor
Conclusion and future directions
References
Discussion questions
Case study
Key Considerations for System Selection
Findings from Inventory of Current Systems and Functionality
Findings from Inventory of Paper Documents and Forms
Findings from Staff Interviews and Observations
SWOT Analysis
Chapter 17: Project Management Principles for Health Informatics
Introduction
The need for project management in healthcare organizations
Project, program, and portfolio management
Project Management
Project Process Groups
Key Knowledge Components
Benefits of Improved Project Performance
Program Management
Portfolio Management
Benefits of Portfolio Management
Portfolio Governance
Roles and responsibilities: project, program, and portfolio managers
Project Manager
Program Manager
Portfolio Manager
Project management tools
Gantt Charts
Project and portfolio management software selection
Conclusions and future directions
References
Discussion questions
Case study
Discussion Questions
Chapter 18: Contract Negotiations and Software Licensing
Introduction
Overview of licensing agreements
Intellectual Property Concepts Relevant to Software
Why Are Contracts Used for Software Licensing?
The Concept of Licensing Versus Sale
On-Premises´´ Licensing Versus Licensing Through theCloud´´
The Vendor's Contract: Healthcare Organizations, Beware!
The Mechanics and Process of Contract Negotiation for a Software License
Before the Agreement Is Signed: Due Diligence
Use the Request for Proposal Process
The ``Entire Agreement´´ Clause: Know What This Means!
Major steps or stages in the performance of a license agreement
Specific components of the licensing agreement
Definitions of Terms
Time Schedule
Scope of the License
Who Are the Users?
Rights
Restrictions and License Metrics
Scope of Use
Number of Copies
Environments and Instances
Derivative Works
Software and Software as a Service Escrows
Specifications
Software Warranties
Service Level Agreements
Uptime
Performance
Response Time and Resolution Time
Problem Severity
Remedies
Acceptance of the Software
Remedies for Rejection
Maintenance and Support
Maintenance Fees
Other Services
System Implementation or Installation Support
Outsourcing to Data Centers for Hosting and Software Management Services
Revenue Recognition and Payments
Payments
Overview of Termination
Termination for Breach
Is the Breach Curable?
Transition and Transition Period
Exclusive Remedy Clauses
Limitations and Exclusions of Liability
Limitation of Liability
Exclusion of Liability
Reciprocity and Exceptions
Insurance
Dispute Resolution
Special Clauses
Confidentiality
Intellectual Property Infringement
Indemnification by the Healthcare Organization and Disclaimers by the Vendor of Responsibility
Restrictive Covenants and Feedback Clauses
Governing Law and Forum Clauses
Right to Assign the Agreement and License
Use of the Healthcare Organization's Name, Marks, and Logos
Data Usage and Data Ownership
Conclusions and future directions
References
Discussion questions
Case study
Discussion Questions
Chapter 19: Implementing and Upgrading an Information System
Introduction
Reasons to implement or upgrade a healthcare information system
Changing Government Regulations
The American Recovery and Reinvestment Act
The Transition from ICD-9-CM to ICD-10-CM Codes and from HIPAA Version 4010 to HIPAA Version 5010
Best Practices: Incorporating Evidence-Based Content and Clinical Decision Support Systems
Patient Safety and Improved Quality of Care
New implementation versus an upgrade
Sufficient Resources
Risk Factors
Scope Creep
Best of Breed Versus an Integrated Health System
Opportunities for Improvement
Implementation and the systems life cycle
Phases of the Systems Life Cycle
Project Planning
Defining Success
Executive Management Support
Engage Stakeholders
Redesigned Workflows
Building or Tailoring the Product
Testing
Preparing for go-live
Big Bang or Incremental Go-Lives
Detailed Go-Live Plan
Education and Training
Trainers
Training Methodology
Length of Class and Class Schedule
Go-live
Post-live maintenance
Conclusion and future directions
References
Discussion questions
Case study
Discussion Questions
Case Study Follow-Up
Discussion Questions
Chapter 20: Downtime and Disaster Recovery for Health Information Systems
Introduction
Downtime risk assessment
Downtime And Response Planning
Clinical Impact and Planning: Acute Care Focus
Redundant Systems
Downtime policies and procedures
Information technology impact and planning
Disaster planning
Disaster Recovery
Business Continuity
Communication
Responsibilities
Conclusion and future directions
References
Discussion Questions
Case Study
Discussion Questions
Chapter 21: Improving the User Experience for Health Information Technology
Introduction to improving the user experience
The Current User Experience With Health Information Technology Products
Definitions of terms and their relationships
User Experience
Human Factors
Ergonomics
Human-Computer Interaction
Usability
The goals of usability
User-centered design
Design Thinking
Potential Benefits of Improving the User Experience
Increased Individual Effectiveness
Increased User Productivity and Efficiency
Decreased User Errors and Increased Safety
Improved Cognitive Support
Increased Organizational Efficiencies
Decreased Maintenance Costs
Decreased Customer and Individual Training and Support Costs
Decreased Development Time and Costs
Human-computer interaction frameworks for health informatics
Human Factors and Human–Computer Interaction Frameworks
The Health Human–Computer Interaction Framework
Essential Components for Improving the User Experience
Selecting methods to improve the user experience
Discount Usability Methods
Heuristic Evaluation
Examples of a Heuristic Evaluation Project
Traditional Usability Methods
Think-Aloud Protocol
Task Analysis
Example of a Task Analysis
Contextual Inquiry or Focused Ethnographies
Example of a Focused Ethnography or Contextual Inquiry
Formal user testing
Usability Questionnaires
Selecting a type of usability test
Determining User Needs and Requirements
Example of a Requirements Determination Usability Study
Formative Tests
Examples of Formative Tests
Validation Test
Example of a Validation Test
Comparison Test
Examples of a Comparison Study
Identifying Usability Issues With Fielded Health IT Products
Steps for Conducting User Experience Tests
Conclusion and future directions
References
Discussion questions
Case study
Discussion Questions
Chapter 22: Informatics-Related Standards and Standards-Setting Organizations
Introduction
Standardized healthcare terminologies relevant to patient care
Healthcare data standardization
Definitions
Evaluation of the Quality of Terminology
Multidisciplinary Terminologies
Logical Observation Identifiers Names and Codes
Systematized Nomenclature of Medicine-Clinical Terms
Classifications Used for Reimbursement
RxNorm
World Health Organization Family of International Classifications
Nursing Terminologies
Clinical Care Classification
International Classification for Nursing Practice
NANDA International Nursing Diagnoses
Nursing Interventions Classification
Nursing Outcomes Classification
Omaha System
Perioperative Nursing Data Set
Data exchange efforts
HL7 Standards
Terminology Harmonization
Application of standardized terminologies
Designing User Interfaces Using Terminologies
Supporting Data Retrieval and Exchange
Monitoring the Quality of Care
Discovering Knowledge Through Research
Conclusion and future directions
References
Discussion questions
Case study
Discussion Questions
Chapter 23: Data Science and Analytics in Healthcare
Introduction
Data science in healthcare
Characteristics of big data
Data science for clinical and translational research
Benefits of data science
Approaches to analyses
Exploratory Data Analysis
Predictive Analytics
Prescriptive Analytics
Knowledge discovery and data mining
Retrieving a Dataset for Analysis
Preprocessing Clinical Data
Preprocessing Text Data
Preprocessing Coded (Structured) Data
Sampling and Partitioning
Data Mining
Statistical Approaches
Machine Learning
Evaluating Data Mining Models
Model Deployment
Organizational Considerations for Data Science
Data Science Personnel
Recommended Skills for a Data Science/Health Analytics Professional
Tools and Platforms
Data Standardization
Data Governance
Conclusions and future directions
References
Discussion questions
Case study
Chapter 24: Patient Safety and Quality Initiatives in Health Informatics
Introduction
Definitions
Quality of Care
Patient Safety
National initiatives driving adoption and use of health it
National efforts related to quality data standards
Evaluating quality and patient safety
Conceptual Framework for Patient Safety and Quality
Medication Safety
Chronic Illness Screening and Management
Nursing Sensitive Quality Outcomes: Patient Falls and Pressure Ulcers
Success factors and lessons learned
Conclusion and future directions
References
Discussion questions
Case study
Discussion Questions
Chapter 25: Legal Issues, Federal Regulations, and Accreditation
Introduction
Legal system
Federalism and the Constitution
Federal Healthcare Regulatory Framework
Laws
Regulations and Rule Making
Guidance and Advisory Opinions
Enforcement
Administrative Enforcement
Court System
Fraud and abuse and billing issues related to electronic health record use
Stark Law
Federal Anti-Kickback Statute
Safe Harbors
Health and Human Services Donation Safe Harbor
False Claims Act
Wire/Mail Fraud
Fraud and Abuse and the Electronic Health Record
State Law
Accreditation
The Joint Commission Health Information Management Standards
Sentinel Event Alerts
The intersection of new technology and regulation
Medical Devices
mHealth Wearable Devices and Telehealth
Privacy and Ownership of Data Collected by mHealth and Wearable Devices
Liability Issues
Social Media and Informatics
Conclusion and future directions
References
Discussion questions
Case study
Discussion Questions
Chapter 26: Privacy and Security
Introduction
Definitions and concepts
Legal and historical context
Fair Information Practice Principles
Code of Ethics for Health Informatics Professionals
International Medical Informatics Association
Principles, laws, and regulations guiding practice
National Privacy and Security Framework for Health Information Laws and Regulations
International Laws
U.S. Federal Law
The History of HIPAA
HITECH Act
HIPAA Omnibus Final Rule of 2013
ONC Tool for Integrating Privacy and Security into Health Practices
Federal-State Collaboration
HIPAA and Secondary Uses of Electronic Health Data
Public Health Monitoring or Surveillance and HIEs
De-identification of Data
The importance of information security
The Public Trust
Legal Requirements and Fines
Increasing Security Threats to Healthcare Data
Current security vulnerabilities
External Events
Internal Vulnerabilities
Medical Devices
Current security challenges
Managing security risks with security controls
Administrative
Conducting Risk Assessments or Risk Analysis
Technical
Physical
Resources
Conclusions and future directions
References
Discussion questions
Case study
Discussion Questions
Chapter 27: The Health Information Technology for Education and Clinical Health Act, Meaningful Use, and Medicare Access ...
Introduction
Federal initiatives to drive health information technology
Executive Order 13335
The American Recovery and Reinvestment Act of 2009
Office of the National Coordinator for Health Information Technology
Health Information Technology Policy Committee
Health IT Standards Committee
Office of the National Coordinator for Health Information Technology Standards and Interoperability Framework
Regional Extension Centers
Financial Incentives
Eligible Entities and Eligible Professionals
Medicare and Medicaid Payments
Meaningful Use
Medicare Access and Children's Health Insurance Program Reauthorization Act of 2015
Conclusion and future directions
References
Discussion questions
Case study
Discussion Questions
Chapter 28: Health Policy and Health Informatics
Introduction
Developing and implementing health information technology policy
Role of the Federal Government
Office of the National Coordinator for Health Information Technology
Driving forces for creating health information technology policy
Patient Safety
Institute of Medicine Report on Health Information Technology and Patient Safety
Unintended Consequences of Health Information Technology Implementation
Quality Initiatives
National Quality Strategy
Leadership competencies for developing and implementing health information technology policies
Ensuring That Health Practitioners Are Positioned on Key Committees and Boards
Responding to Requests for Comments
Developing Position Statements
Leading policy activities through organizational work and leadership
Strategies
Discipline-specific policies: nursing
Use of Health Information Technology to Advance the Future of Nursing
The Future of Nursing Report Recommendations
Implications for Time and Place of Care
Expand Opportunities for Nurses to Lead and Diffuse Collaborative Efforts
Prepare and Enable Nurses to Lead Change to Advance Health
Center to Champion Nursing in America
Advancing Education Transformation
Fostering Interprofessional Collaboration
Healthcare Information and Management Systems Society Nursing Informatics Position Statement
Assessing Progress on the Institute of Medicine Report The Future of Nursing
Conclusion and future directions
References
Discussion Questions
Case Study
Discussion Questions
Chapter 29: Health Information Technology Governance
Introduction
Health information technology governance: need and core components
Key insights
Respect Current Decision-Making Structures
Shift in Organizational Mindset
The Continual Increase in Demand for Health Information Technology
Governance Does Not Depend on Specific Technology Choices
Coordination and Collaboration with Diverse Stakeholders
Recommendations
Conduct a Health Information Technology Capability Maturity Assessment
Investigate Peer Informatics Governance Models
Design, Implement, and Iteratively Enhance Informatics Governance
Conclusion and future directions
References
Discussion Questions
Case study
Discussion Questions
Chapter 30: Informatics in the Curriculum for Healthcare Professionals
Introduction and background
Overview of Informatics and Health Information Technology
Education Reform Initiatives
Accreditation, Certification, and Credentialing
Challenges of Technology-Enhanced Education
Faculty Expertise
Health IT Tools
Teaching and learning in an evolving healthcare and technology environment
The Role of Informatics in the Curriculum
The History of Informatics Competency Development
The Science of Informatics and Curriculum Design
Framework for informatics curriculum
The Learning Health System
Pedagogy
Teaching Tools and Learning Strategies
It takes a village: roles and competencies
Health IT Workforce Roles
Community College Training Overview
University-Based Education Overview
Educating the Generalist
Educating Healthcare Specialists at the Graduate Level
Educating the Health Informatics Specialist
Educating the Health Informatics Researcher and Innovator
Continuing Professional Development
Conclusion and future directions
References
Discussion Questions
Case Study
Discussion Questions
Chapter 31: Distance Education: Applications, Techniques, and Issues
Introduction
Historical development
Terminology
Course delivery systems: course management systems
Portals
Ellucian
Jenzabar
Proprietary Course Management Systems and Learning Management Systems
Blackboard
Desire2Learn
SharePoint Learning Management System
Open Source
Moodle
Sakai
Cloud Based
Partnerships
Selection Criteria and Role of the Selection Committee
The Future of Course Management Systems
Instructional design for distance education and learning
Learners and How They Learn
Goals and Objectives (Outcomes)
Instructional and Learner Activities
Evaluation
Student (learner) support services
Library
Tutoring Services
Online Textbook Distributors
Help Desk
Administrative Services, Academic Support, and Community Building
Issues
Legal
Digital Millennium Copyright Act of 1998
Technology, Education, and Copyright Harmonization Act
Higher Education Opportunity Act
Intellectual Property
Family Educational Rights and Privacy Act
Disability Issues
Quality
Readiness
Institution
Students (Learners)
Conclusion and future directions
References
Discussion Questions
Case Study
Discussion Questions
Chapter 32: Informatics Tools for Educating Healthcare Professionals*
Introduction
Comprehensive education information system
Computerized teaching tools
Hardware
Interactive Whiteboards
eReaders and Digital Books
Smartphones
Tablets
Laptops and Desktop Computers
Clickers
Educational Software
Learning and Content Management Systems
Mind Maps
Digital Portfolios
Web-Based Student Testing
Student Journaling Software
Gaming
Virtual Worlds
Impact on the teaching and learning process
Teaching From a Global Perspective
Impact on the faculty role
Using Best Practices for Technology-Enhanced Course
Scenario
Impact of Technology Enhanced Courses on Faculty Evaluation
Conclusion and future directions
References
Discussion Questions
Case study
Discussion Questions
Chapter 33: Simulation in Healthcare Education
Introduction
Types of Simulations
Fidelity
Benefits of Simulation
Challenges and Opportunities
Cost
Technology
Faculty Development
Organizations
Faculty or Administrative Buy-In
The simulation process
Learning Theories Applied to Simulation
International Nursing Association for Clinical Simulation and Learning Standards of Best Practice: Simulation
Glossary46
Professional Integrity of the Participants
Participant Objectives and Outcomes
Facilitation
The Debriefing Process
Participant Evaluation
Simulation-Enhanced Interprofessional Education
Simulation Design
Application of simulation
General Application of Simulation to Education
Application of Simulation for Evaluation
Application of Simulation to Interprofessional Education
Example
Conclusion and future directions
References
Discussion questions
Case study
Discussion Questions
Chapter 34: International Efforts, Issues, and Innovations
Introduction
Key initiatives in world regions
eHealth Initiatives in Europe
The European Federation for Medical Informatics
eHealth Initiatives in the Asia-Pacific Economic Cooperation Region
Asia Pacific Association for Medical Informatics
eHealth Initiatives in the Pan American Health Organization Region
International Medical Informatics Association for Latin America and the Caribbean
eHealth Initiatives in Africa
Health Informatics in Africa
International organizations with ehealth involvement
eHealth and Health Informatics at the World Health Organization
The eHealth Resolution
Global Observatory for eHealth
World Health Organization Family of International Classifications
International Medical Informatics Association
IMIA-NI
International standards efforts
International Organization for Standardization
International Council of Nurses
International Classification for Nursing Practice
The ICN Telenursing Network
Connecting Nurses
Health Level Seven
International Health Terminology Standards Development Organisation
Global challenges to ehealth
Global Interoperability
Human Resources for eHealth
eHealth Infrastructure
Legal and Regulatory Framework for eHealth
Conclusion and future directions
References
Discussion questions
Case study
Discussion Questions
Chapter 35: The Evolution of Health Informatics
Introduction
The roots of informatics within the computer and information sciences
Computer Science
Information Science
Health Informatics
Establishing the specialty of health informatics
Books
Journals
Professional Organizations
Educational Programs
Accreditation for Health Informatics Education Programs
Certification
Recognition by the U.S. Bureau of Labor Statistics
Recognition of the specialty
Naming the specialty—naming the discipline
Conclusion and future directions
References
Discussion questions
Case study
Discussion Questions
Chapter 36: Future Directions and Future Research in Health Informatics
Introduction
Futures research (futurology)
Defining Futures Research (Futurology)
Future Directions and Scope of Change
The Challenge of Anticipating Future Directions
Approaches for Predicting
Trend Analysis and Extrapolation
Content Analysis
Scenarios
Backcasting
Application of Futures Research
The future of health informatics
Person-Centered Health and Informatics
Care Anywhere
Personal Data Integration
Technical Trends
The Internet of Things
Cybersecurity Threats and Mitigation
Clinical informatics
Beyond EHRs 1.0
Improving the user experience for health information technology
Analytics (big data) and data visualization
Predictive analytics
Data visualization
Nanotechnology
History of Nanotechnology
Nanofabrication and Nanomedicine
Nanofabrication
Nanomedicine
Cautions About Nanotechnology
Nanoinformatics
Issues in Regulation and Ethics
Conclusion and future directions
References
Discussion questions
Case study
Discussion Questions
Glossary
Index
Inside Back Cover