Health Informatics Assignment Week 13 to 15

Week 13 Questions

1. Briefly explain the differences among an HCO’s operational, planning, communications, and documentary requirements for information. Give two examples in each category. Choose one of these categories, and discuss similarities and differences in the environments of a tertiary-care medical center, a community-based ambulatory-care clinic, and a specialty-care physician’s office. Describe the implied differences in these units’ information requirements.
2. Describe three situations in which the separation of clinical and administrative information could lead to inadequate patient care, loss of revenue, or inappropriate administrative decisions. Identify and discuss the challenges and limitations of two methods for improving data integration.
3. Describe three situations in which lack of integration of information systems with clinicians’ workflow can lead to inadequate patient care, reduced physician productivity, or poor patient satisfaction with an HCO’s services. Identify and discuss the challenges and limitations of two methods for improving process integration.
   

   Answer:

   The lack of integration of information from various sources creates a host of issues. If clinical and administrative facts are saved on separate systems, then data wanted through each have to either be entered immediately into both structures or be copied from one device to the opposite. Similarly, to the cost of redundant facts access and records protection incurred via this method, the consistency of records tends to be terrible because information may be up to date in one area and no longer inside the other, or records can be copied incorrectly. Inside the hospital putting, many of those troubles had been addressed through the improvement of automated interfaces to transfer demographic information, orders, effects, and charges between scientific structures and billing structures. Regardless of an interface engine coping with data among disparate systems, but an organization still ought to clear up the thorny issues of synchronization of information and comparison of similar records types.

   The information integration could be improved by:

   • Identifying and working upon the already existing while developing of desired operational concepts regarding processes in relation to the pre-existing reliability.
   • Recognizing the stakeholder co-operations involved
   • Recognizing and modification of particular efficient connections and interventions
   • Opportunity in developing the agreements to the agencies associated so that upgradations could be introduced whilst sharing the data and collaborating upon the activities in-practice.
4. Describe the trade-off between functionality and integration. Discuss three strategies currently used by HCOs to minimize this tradeoff.
5. Assume that you are the chief information officer of a multi-facility HCO. You havejust been charged with planning a new HCIS to support a large tertiary care medical center, two smaller community hospitals, a nursing home, and a 40-physician group practice. Each organization currently operates its own set of integrated and standalone technologies and applications. What technical and organizational factors must you consider? What are the three largest challenges you will face over the next 24 months?
6. How do you think the implementation of HCISs will affect the quality of relationships between patients and providers? Discuss at least three potential positive and three potential negative effects. What steps would you take to maximize the positive value of these systems?
   

   Answer:

   Despite the importance of incorporated facts systems, implementation of HCISs has proved to be a frightening project, regularly requiring a multiyear capital investment of tens of thousands and thousands of dollars and forcing essential modifications in the sorts and ways that fitness specialists carry out their jobs. To gain the ability advantages, fitness groups should plan cautiously and invest wisely. The grand venture for an HCO is to layout and put in force an HCIS that is satisfactorily flexible and adaptable to meet the converting desires of the organization.

   The potential benefits of introduction of this system includes The HCIS provides the knowledge health practitioners need to perform their work safely and effectively. HCISs promote collaboration, incorporate information and organize action among numerous professionals in health. They also help organize and store data, and assistance specific record-keeping and reporting functions. However, the negative impacts include threat to the confidentiality that is to be maintained by the care organization. The possibility of the data to be hacked by the network hackers has aggressively been increased. It takes training and lot of time investment in learning the technique.

   Introduction of more positive changes would help in quite effectively improving the system. Given the unexpectedly changing surroundings and the multiyear attempt concerned, human beings must be cautious to keep away from enforcing a system that is out of date functionally or technologically earlier than it becomes operational. Success in imposing an HCIS includes consistent and brave coping with of numerous technical, organizational, and political demanding situations. A proper governance shape with representation from all important materials affords the essential discussion board for route putting, prioritization, and resource allocation throughout an HCO. Leadership by means of reputable clinical friends has proved a vital achievement element for CIS planning, implementation, and recognition.  For IDNs even within the great of situations, the cultural and organizational challenges of linking diverse users and care-delivery settings will tax their capability to exchange their information systems environments quickly enough. These troubles will boom in acuity as operational budgets preserve to cut back today’s IDNs are spending enormous quantities of their capital budgets on records-systems investments. If protection and confidentiality issues may be resolved, the emergence of a networked society will profoundly trade our considering the nature of healthcare delivery. Dispensed healthcare abilities will allow the implementation of collaborative fashions that would include digital residence calls and routine far off monitoring through telemedical linkages. The technological sense of everyday activities is also evolving as seems to be the healthcare climate. The digital technology has indeed dramatically altered one’s strategies to workplace access to knowledge and implementation stages. At the very same moment, more medical information than it has ever been is available to motivated healthcare consumers willing to engage throughout self-help and unorthodox frameworks. Such influences alter the interrelationship between doctors, care staff, patients, and outside forces. The evolving treatment approach, combined with increasing business opportunities, is placing additional emphasis on wellness and preventive and lifetime treatment.

Week 14 Questions

Questions for Discussion

1. Telehealth has evolved from systems designed primarily to support consultations between clinicians to systems that provide direct patient care. This has required changes in hardware, user interfaces, software, and processes. Discuss some of the changes that must be made when a system designed for use by health care professionals is modified to be used directly by patients.
2. Some people involved in CHI advocate that any publicly accessible health information be credentialed (reviewed and certified as accurate) by a professional body. Other people argue that credentialing is antithetical to the consumerist perspective. Assume and defend one of these perspectives.
3. Using CHI and telehealth systems, patients can now have interaction with a large number of health care providers, organizations and resources. As a result, coordination of care becomes increasingly difficult. Two solutions have been proposed. One is to develop better ways to transfer patient-related information among existing EHRs. The other is to give the give the patient control of the health record, either by giving them a smart card or placing the records on a central web site controlled by the patient. Assume and defend one of these perspectives.

Week 15 Questions

1. What are the current and potential effects of a) the genomics revolution; and b) 9/11 on public health informatics?
   

   Answer:

   The Genomic Revolution is termed as technological innovations within the mid 1970's brought about techniques of separating particular regions of DNA from complicated genomes and determining their chemical structure. Genomic remedy has the ability to make genetic analysis of ailment a extra efficient and value-effective technique, by using decreasing genetic checking out to a single evaluation, which then informs individuals for the duration of life. Among 1988 and 2010 the human genome sequencing projects, associated research and industry interest without delay and in a roundabout way generated a monetary impact of $796 billion, personal income exceeding $244 billion, and 3.8 million activity-years of employment. As an alternative, genomics and associated technologies must be used to slim the prevailing unethical inequities in international fitness. A file lately released via the arena fitness employer makes a specialty of this inequity. It factors out, for example, that about 80% of investments in genomics in 2000 had been made within the America, and 80% of the DNA patents in genomics inside the length 1980 to 1993 had been held through US agencies. Of the 1233 new pills marketed among 1975 and 1999, best thirteen had been permitted in particular for tropical illnesses. The continuing genomics revolution, highlighted via the sequencing of the human genome, guarantees to exchange how diseases are recognized, averted, and handled. It has exquisite ability to improve fitness globally. No matter the flush of excitement approximately its capacity, tablets and interventions derived from genomics are likely to be pricey, and of particular interest is how those advances will affect the fitness of human beings residing inside the developing countries. The truth is that most of the advances in genomics had been made, and in component are owned, by means of the developed world, and this has given upward thrust to the priority that a genomics divide might be created on the way to in addition widen the fairness gap in fitness among rich and terrible international locations. To make certain that advantages are shared by growing international locations, interest should be paid to complicated moral, felony, social, and monetary problems, as well as to public training and engagement. As a substitute, genomics and related technologies ought to be used to slender the present unethical inequities in worldwide fitness. Early analysis of a disease increased the chances of a success remedy, and genomics can hit upon a sickness lengthy earlier than signs and symptoms gift themselves. Many diseases, together with cancers, are due to changes in our genes. Genomics can pick out those alterations and search for them using an ever-developing wide variety of genetic assessments, many available online. The study of genetics has end up large fact technological know-how. One of the capacity advantages from the sphere of genetic studies is to use genomic data to similarly our information of not unusual complex illnesses. An essential first step made towards this intention become via the identification of thousands of single nucleotide polymorphisms displaying strong affiliation with loads of different traits and diseases. As insight into commonplace genetic variation has multiplied particularly and the era to become aware of more uncommon variant has end up available. Those improvements have been used to gain a higher understanding of sickness etiology and therefore has cause tendencies in personalized medication and P4 healthcare.

   Over the last quarter of 20th century, emergence and rapid evolution of microprocessor technology enabled tendencies in information and conversation technologies (ICTs) that heralded an information age, which widened and transformed economic and social sports everywhere in the world. Governments of numerous nations in particular evolved countries harnessed the power of ICTs to provoke "e-fitness" tasks in their respective jurisdictions. Simultaneously, there has been an evolution of health/ medical informatics science that is described as the integrative field that arises from the synergistic software of computational, informational, cognitive, organizational, and other sciences whose number one awareness is the acquisition, garage, and use of information within the health/biomedical area. In conjunction with the inadequacies of fitness care shipping systems, extreme weaknesses in public health infrastructure had been uncovered through international locations all around the global who witnessed devastating manmade and natural disasters like 9/11 terrorist assault in U.S.A., Asian Tsunami, and many others. This has caused the big investments in public health infrastructure based on software of informatics to public fitness by using evolved countries over the last decade. Consequently, there's an emergence of a new and awesome distinctiveness vicinity of public health informatics inside the broader area of health informatics, defined by means of a specific set of ideas and demanding situations. Public health informatics described because the systematic utility of data and pc technology and era to public health exercise, studies, and mastering" is truly informatics implemented to public fitness exercise intelligently and focused on preventive and promotive health. The scope of public fitness informatics includes the conceptualization, design, improvement, deployment, refinement, preservation, and assessment of conversation, surveillance, and facts structures applicable to public fitness. It requires the software of expertise from several disciplines, specially records science, pc technological know-how, management, organizational principle, psychology, communications, political technology, and law. The capacity function of informatics in lowering health disparities in underserved populations has been identified through a number of reviews from all over the international.

2. How can the successful model of immunization registries be used in other domains of public health (be specific about those domains)? How might it fail in others? Why?
3. Fourteen percent of the US GDP is spent on medical care (including public health). How could public health informatics help use those monies more efficiently? Or lower the figure absolutely?
4. Compare and contrast the database desiderata for clinical versus public health information systems. Explain it from non-technical and technical perspectives.
   

   Answer:

   Biomedical informatics includes a huge variety of disciplines that span statistics from the molecular to the population stage. A medical records gadget (CIS) is a data gadget designed specifically to be used inside the important care environment, including in an intensive Care Unit (ICU). It draws records from all these systems into an electronic affected person record, which clinicians can see at the patient's bedside. Populace-stage informatics has its personal special troubles, problems, and concerns. Creating records systems on the populace stage has constantly been very difficult because of the large number of information factors and people that must be covered, as well as the want to deal with records and records problems that have an effect on health within the mixture (e.g., environmental determinants of health). With faster and cheaper hardware and radically improved software program tools, it has come to be financially and technically feasible to create statistics systems so that it will provide the information about people and populations important for optimized selection-making in medical care and public health. In addition to speaking frequently to this organization approximately the desires, plans, and development of the registry, a useful tool to enlist their participation is a technical answer that minimizes their time and expense for registry statistics access, even as maximizing the gain in terms of stepped forward information approximately their sufferers. Whilst the technical implementation of statistics trade is non-trivial, it pales in comparison to the demanding situations of organizing the underlying prison agreements and policy modifications that ought to precede it. Fitness records structures can combination affected person data, examine it and discover traits in populations. The era also works in opposite. Scientific selection assist systems can use large information to help diagnose character patients and treat them.

5. Make the case for and against investing billions in an NHII.
6. What organizational options would you consider if you were beginning the development of a local health information infrastructure? What are the pros and cons of each? How would you proceed with making a decision about which one to use?
7. If public health informatics (PHI) involves the application of information technology in any manner that improves or promotes human health, does this necessarily involve a human “user” that interacts with the PHI application? For example, could the information technology underlying anti-lock braking systems be considered a public health informatics application?
   

   Answer:

   Massive information machine projects involving more than one partners which includes immunization registries frequently require multiple committees to ensure that each one events have a voice within the improvement process. Specially, all choices that materially have an effect on a stakeholder ought to be made in a setting that consists of their representation. Legislative and regulatory issues should be considered in an informatics context because they impact the probability of achievement of tasks. With appreciate to immunization registries, the particular issues of confidentiality, facts submission, and liability are important. The particular policies with admire to confidentiality need to be described to permit get entry to folks who need it while denying get admission to others. Regulatory or legislative efforts on this area ought to additionally operate in the context of the federal HIPAA that units countrywide minimum privacy requirements for personal health records.