Discussion: Cherry Health System Scenario Discussion Paper

Discussion: Cherry Health System Scenario Discussion Paper ORDER NOW FOR CUSTOMIZED AND ORIGINAL ESSAY PAPERS ON Discussion: Cherry Health System Scenario Discussion Paper Cherry Health System Scenario [WLOs: 2, 4] [CLOs: 1, 2, 3] Prior to beginning work on this discussion forum, Read Chapters 1, 2, 3, 4, and 6 of Health Informatics: An Interprofessional Approach and analyze the Hierarchy of Informatics Diagram in Chapter 35 of your text (Figure 35.6). Ashford HIM 301 WeeK 1 CH35 Cherry Health System Scenario Discussion Paper Read the article What Informatics Is and Isn’t (Links to an external site.) . You will be responding to the following discussion question based on your Ashford University major of study (e.g., Health Information Management, Nursing, Health Administration, Health and Human Services, or Public Health). Read the following scenario: Cherry Health System (CHS) consists of a general hospital, a women’s hospital, 20 doctor practices comprised of doctors who work for CHS, and an ambulatory surgery center. The leadership of this facility has decided they would like to take the existing paper-based consumer education pamphlets on tobacco education and deploy them to the ambulatory population of CHS who visit the doctor offices and surgery center. They would like to use the informatics tools, principles, and content available through gov (Links to an external site.) as a basis for this education. In order to identify patients who can benefit from this informatics solution, they asked administrators in the physician offices and the surgery center to print a report of patients who currently use tobacco from the CHS electronic health record (EHR). As a professional in your field of study, you have been asked to provide input into the design of this informatics solution. Ashford HIM 301 WeeK 1 CH35 Cherry Health System Scenario Discussion Paper Based on the above scenario: Provide a rationale as to where in the Hierarchy of Informatics (Chapter 35, page Figure 35.6, page 608) the CHS tobacco informatics solution would be categorized. Based on your major of study and the patient education informatics tools available from Health finder.gov (Links to an external site.) , discuss three informatics functions that your design for the tobacco education solution would include. Identify at least two program evaluation methods (found in Chapter 4 of the course textbook) that you would recommend to CHS leadership to evaluate the effectiveness of the tobacco education informatics solution. Initial Post: Your initial post should be a minimum of 350 words. Utilize a minimum of three unique credible, or scholarly sources (excluding the textbook or other course provided resources) cited in APA format, as outlined in the Ashford Writing Center’s Citing Within Your Paper (Links to an external site.) resource. Keep in mind that scholarly sources include peer reviewed articles and non-commercial websites. Review the Library’s Scholarly, Peer-Reviewed, and Other Credible Sources (Links to an external site.) tip sheet for more information about sources. Multiple pages from the same scholarly website will be counted as one scholarly source. him_301_chap_1_3.pdf what_informatics_isnt.pdf 1 An Introduction to Health Informatics Ramona Nelson and Nancy Staggers The ultimate goal of health informatics is to empower populations, communities, families, and individuals with the opportunity to improve the quality and increase the quantity of their days by maximizing the use of technology in healthcare. OBJECTIVES At the completion of this chapter, the reader will be prepared to: 1. Define healthcare informatics. 2. Discuss the significance of health informatics within healthcare delivery. 3. Provide an overview of health informatics-related topics. KEY TERMS health informaticians, 2 health informatics, 2 ABSTRACT This chapter provides the reader with an introduction to health informatics as both a discipline and a profession. It begins by introducing the reader to the significance of health informatics. Health informatics is then defined, and example applications are listed. The next section of the chapter provides an overview of the topics inherent in the discipline and profession of health informatics. These topics are organized around the nine units in the book. INTRODUCTION Almost 20 years after the Institute of Medicine (IOM) report To Err Is Human1 was released, John T. James published a seminal article on the same topic in The Journal of Patient Safety. Using a carefully designed methodology, he analyzed data published from 2008 to 2011 to estimate the number of preventable adverse events occurring in American hospitals. James found that each year, an estimated 440,000 hospitalized Americans experience a preventable adverse event that contributed to their death. In addition, serious harm is estimated to be 10- to 20-fold more common than lethal harm.2 These findings were reinforced in 2016 when Martin Makary and Michael Daniel published a study in The BMJ entitled “Medical Error—The Third Leading Cause of Death in the US.”2a The numbers are astounding, but the personal consequences are even greater for the people and the families who suffer such “preventable events.” Dr. James, whose distinguished professional career was in healthcare, maintains a website that provides some insight into his strong interest in patient safety.3 The website is dedicated as follows: This site is dedicated to my 19-year-old son, John Alexander James, who died as a result of uninformed, careless, and unethical care by cardiologists at a hospital in central Texas in the late summer of 2002. In 2016, 3 years after publication of the James article, this same journal published another research study in which the question is asked Can electronic health records prevent harm to patients?4 Key points from this research include the following: • The investigators analyzed Medicare Patient Safety Monitoring System (MPSMS) patient medical record data for 1351 hospitals from the years 2012 and 2013. They found 347,281 exposures to adverse events. Of these exposures, 7820 adverse events actually took place, resulting in a 2.25% occurrence rate. • Of the patients, 13% (5876) received care that was captured by an electronic health record (EHR). • The analysis of these data demonstrated that cardiovascular, surgery, and pneumonia patients whose complete treatment was captured in an EHR were between 17% and 30% less likely to experience in-hospital adverse events.5 The studies2,2a,4 taken together suggest that if EHRs were in use in American hospitals, somewhere between 74,800 and 132,000 preventable fatal hospital-based events each year might never occur. 1 05/13/2020 – RS0000000000000000000003545171 (Penny VelasquezAshford HIM 301 WeeK 1 CH35 Cherry Health System Scenario Discussion Paper ) – Health Informatics 2 UNIT 1 Foundational Information in Health Informatics Going forward, if health informaticians and knowledgeable healthcare providers are fully involved in the design, selection, and implementation of health information systems, these numbers are just the beginning of what would be possible in terms of improved healthcare. Improved patient safety is just one of the many reasons why the study of health informatics is imperative for all healthcare professionals. Throughout this book, other vital reasons will become obvious. Competent, compassionate healthcare depends on healthcare providers who understand and can maximize their use of health information technology (IT) and informatics knowledge in providing care to patients. This book provides the foundation required to develop that competence. DEFINITION OF HEALTH INFORMATICS Today health informatics is an exciting and well-established field. It is recognized as both a discipline and a profession. As a discipline, it is a field of study in the same sense that medicine, sociology, and pharmacy are fields of study. Core disciplines, including informatics, along with terminal competencies or learning outcomes, provide the framework for developing curricula within the healthcare professions. Learning outcomes include the skills, knowledge, and professional aptitudes expected of all graduates within the profession. In 2003 the IOM identified five core competences that should be achieved by all healthcare professionals: • Delivering patient-centered care • Working as part of interdisciplinary teams • Practicing evidence-based medicine • Focusing on quality improvement • Using informatics6 Other professional groups and accrediting agencies are now including an informatics-related requirement. For example, the American Association of Colleges of Nursing (AACN) developed a group of documents titled the Essentials Series.7–9 The Essentials outline the necessary curriculum content and expected competencies of graduates from baccalaureate, master’s, and doctor of nursing practice programs. Each of these documents includes a technology or informatics requirement and cites the IOM report as the rationale for this requirement. Health informatics is also a profession within the healthcare arena. Thousands of informaticians practice the specialty in varied roles that include, for example: • Installing and evaluating new technologies such as EHRs • Developing mHealth (mobile health applications) for patients • Analyzing users’ interactions with health IT to create applications that mirror the way clinicians think and do work • Leading telehealth initiatives in a region or nationally • Developing and implementing national policies for health IT and informatics • Building terminologies to support interoperability • Doing research on the effect of health IT on patients, providers, or organizations Although the existence of health informatics as both a discipline and as a profession is well accepted, it is interesting to note there is currently no consensus or generally accepted name and standard definition for this profession. Current titles for members of this profession include health informatics specialist, informaticist, or informatician (sometimes spelled informaticien). Table 1.1 lists several accepted definitions and the source of those definitions. The history, reasons, and issues presented by this lack of consensus are discussed in detail in Chapter 35. In this book, health informatics is defined as an interdisciplinary professional specialty and scientific discipline that integrates the health sciences, computer science, and information science, as well as a number of other analytic sciences, with the goal of managing and communicating data, information, knowledge, and wisdom in the provision of healthcare for individuals, families, groups, and communities. Ashford HIM 301 WeeK 1 CH35 Cherry Health System Scenario Discussion Paper A review of this definition as well as the definitions in Table 1.1 demonstrates three common themes within each of these definitions. That is, health informatics is: • An interdisciplinary professional specialty • Tied to the use of IT in healthcare • Focused on assisting healthcare providers with tasks related to collecting data, processing information, and applying that information to processes such as problem solving, knowledge development, and decision making Health IT touches nearly every aspect of healthcare today, even less obvious ones such as providing emotional support to patients. A few examples include: • Tele-intensive care units (ICUs). Patients in ICUs in more remote geographical areas are monitored by experienced ICU nurses and physicians using telehealth technology. TABLE 1.1 Informatics Common Definitions of Health Source Definition AHIMA Health informatics is the scientific discipline concerned with the cognitive, informationprocessing, and communication tasks of healthcare practice, education, and research, including the information science and technology to support these tasks.28 HIMSS Health informatics is the interdisciplinary study of the design, development, adoption, and application of IT-based innovations in healthcare services delivery, management, and planning as defined by the U.S. National Library of Medicine.29 AMIA Biomedical informatics is the interdisciplinary field that studies and pursues the effective uses of biomedical data, information, and knowledge for scientific inquiry, problem solving and decision making, motivated by efforts to improve human health.30 US NLM Health informatics is “the interdisciplinary study of the design, development, adoption, and application of IT-based innovations in healthcare services delivery, management, and planning.”31 05/13/2020 – RS0000000000000000000003545171 (Penny Velasquez) – Health Informatics CHAPTER 1 An Introduction to Health Informatics • Robotics. DaVinci is a widely used surgical robot guided by a surgeon. It is used to translate hand movements during minimally invasive surgery, using tiny instruments inserted into small incisions. • Behavioral health at-a-distance. The U.S. Army has a telehealth network that spans 50 countries. Behavioral health telehealth makes up 55% of their services, followed by cardiology and dermatology.10 • Sensors. Sensors in long-term care settings can help monitor residents’ health status, detect emergency situations, and contact health providers.11 In the future, clinicians may monitor patients with wearable sensors, such as clothing, after discharge.12 • Healthcare for islanders. People living on four islands off the coast of Maine have no available healthcare providers. A 72-foot boat beams health services via live video conferencing with a nurse. TOPICS AND AREAS OF STUDY IN INFORMATICS This book is divided into nine units outlining the key topics and areas of study within health informatics. This section of the chapter is built around these nine units. Each subsection presented here focuses on one of the nine units, and begins by describing the theme of the unit. This is followed by an example taken from professional reports, research studies, or a news story. As you read each subsection, you are encouraged to think about how informaticians using information technology could improve the quality of healthcare and the satisfaction of both providers and patients, while decreasing costs. Unit 1: Fundamental Information in Health Informatics The content of the first five chapters of the book can be applied to each of the remaining chapters. These chapters introduce the reader to terms, definitions, concepts, theories, and models that are used throughout the book, thereby providing the mental infrastructure for understanding the discipline of health informatics. Ashford HIM 301 WeeK 1 CH35 Cherry Health System Scenario Discussion Paper Why Informatics Is Needed in Healthcare: An Example The weblog GeriPal is an online community of interdisciplinary providers interested in geriatrics or palliative care. In August 2013, they published an article titled “Transfers from the hospital to nursing home: an F-grade for quality.”13 The article reviews a study published in Journal of the American Geriatrics Society.14 GeriPal describes the finding from this research as follows: “A rather stunning study in the Journal of the American Geriatrics Society suggests the quality of communication between the hospital and the nursing home is horrendous.”13 Patients arrived at skilled nursing facilities (SNF) with missing or inaccurate information on their health status, their medication orders, and their functional abilities. The research found that care was routinely delayed and nursing hours were wasted trying to obtain the required information. Poor-quality discharge communication was identified as the 3 major barrier to safe and effective transitions. Interestingly, nurses from the SNFs in the study identified a specific list of information and components that they need to facilitate a safe, high-quality transition. Nevertheless, the lack of an interoperable healthcare system providing clear, concise patient data/ information between institutions makes the situation described in their study a common occurrence in SNFs across the country. Healthcare providers and informaticians who have a mental infrastructure and understand what is possible are the first requirement for building such an interoperable system. Unit 2: Information Systems and Applications for the Delivery of Healthcare The Health Information Management Systems Society (HIMSS) provides a searchable website for applications used in healthcare. As of this writing, HIMSS listed 30 categories of applications ranging from Ambulatory to Web/Internet Solutions. Under each of these categories are subcategories: for example, under Operating Room, one can find PeriOperative Systems, Post-Operative Systems, Pre-Operative Systems, and Scheduling. The point is that an enormous number of applications are used in healthcare and more are being developed every day. As healthcare providers discover and explore different applications used in healthcare, three questions can be used to provide an overview of each application. • What is the purpose of this application? Each healthcare application will have a specific purpose or list of purposes: for example, a scheduling system helps schedule staff or patients within a particular clinical unit. • What functions can this application perform? Function is how an application achieves its purpose: For example, can the scheduling system assign staff to work shifts of any length or does it function with predetermined shifts only? • How is this application internally and externally structured? Internal structure determines how efficiently and effectively the application actually functions; for example, a poorly designed user interface can increase the number of user errors. External structure determines how the application fits into the environment, especially how the application interfaces with other applications. The six chapters in this unit explore the common applications used across the healthcare settings. Healthcare Applications Improving Healthcare: An Example A study conducted in 2008 entitled The Balancing Act: Patient Care Time Versus Cost explored how nursing time is distributed in a clinical setting.15 This research correlated the time spent on various activities with the nurses’ wages, thereby measuring the cost of nursing care. The authors reported that $757,000 of nursing wages was spent on tasks such as hunting for equipment. Nursing Times, in 2009, published an article based on an online survey of over 1000 nurses16 entitled “Nurses Waste ‘an Hour a Shift’ Finding Equipment.” Ashford HIM 301 WeeK 1 CH35 Cherry Health System Scenario Discussion Paper A 2011 study from the Robert Wood Johnson Foundation estimated that only 20% to 30% of a nurse’s time is actually spent at the 05/13/2020 – RS0000000000000000000003545171 (Penny Velasquez) – Health Informatics 4 UNIT 1 Foundational Information in Health Informatics FIG 1.2 RoboCourier® Autonomous Mobile Robot in a healthcare setting with the people and information systems that direct the robot. (Used with permission of Swisslog.) Unit 3: Participatory Healthcare Informatics (Healthcare on the Internet) ® FIG 1.1 RoboCourier Autonomous Mobile Robot. (Used with permission of Swisslog.) bedside, and as much as 70% of their time can be spent on documentation, finding supplies, and carrying out other duties, such as tracking down equipment.17 One informatics-based solution to this well-documented waste of nursing time is the use of an autonomous mobile robot (AMR) with tracking software, RFID (radio-frequency identification), and barcode technology to manage supplies needed on a clinical unit. One example of such a robot is RoboCourier®, developed by Swisslog (Fig. 1.1). Automated robots such as RoboCourier® can safely and securely transport laboratory specimens, medications, clinical supplies, and other materials throughout the healthcare setting, thereby allowing healthcare professionals to focus on patient care instead of searching for the materials they need to provide that care.18 As you consider this technology, think about how the robot would be programed to automatically interface with elevators and doors so the robot can move independently throughout the facility on programmed paths with no human interference. Also consider how the robot would know what supplies to deliver where. To gain the maximum benefit of AMRs, they need to be interfaced with other information systems in the hospital, thus diminishing the human effort needed to maintain needed supplies on a clinical unit. For example, could the pharmacy system be interfaced with the AMR so that new medication orders could be quickly delivered to the clinical unit? Fig. 1.2 demonstrates an AMR in relation to the people and information systems that direct the AMR as well as other institutional systems that might be interfaced with the AMR. Since the beginning of healthcare, providers have been proactive in meeting the needs of patients. Historically, patients and their families have looked to healthcare providers both to assess/diagnosis their health problems and to tell them what was needed. Today patients are no longer exclusively dependent on providers to determine what is wrong and what options they might consider in dealing with their health problem. Patients, whether well or facing problems, are assuming an increasingly proactive role in maintaining or obtaining a higher level of health. Ashford HIM 301 WeeK 1 CH35 Cherry Health System Scenario Discussion Paper These proactive patients are often referred to as ePatients. ePatients are equipped, empowered, engaged, and electronically connected. They are informed about their health and have gained much of that knowledge via the internet. Knowledge is power, and as more patients are becoming ePatients, the traditional relationship between the patient and the provider is shifting from a parent– child-type relationship toward more collegial ones. Now providers and patients have access to much of the same information. However, both patients and providers are overwhelmed by the amount of quality information they can access. In addition, they differ greatly by the scope of the information that each group needs to access. Providers must focus on a much larger scope of data/information. First, they need to be aware of the growing literature base across their specialty and also the information available to patients. Second, they must be aware of trends and changes across the broad area of healthcare delivery: for example, providers need to be aware of the role that social media plays in healthcare delivery. Patients and their families can limit research to their own health issues rather than all disorders within a specific specialty. When working together in social media groups, individuals can become experts in every sense of the word about their own expression of their specific health problems. 05/13/2020 – RS0000000000000000000003545171 (Penny Velasquez) – Health Informatics CHAPTER 1 An Introduction to Health Informatics However, when confronted with this massive amount of information, providers have one significant advantage not available to most patients. Their experience and education makes it much easier to assess the quality of the information and incorporate new findings into their current knowledge. Patients, on the contrary, mus … Get a 10 % discount on an order above $ 100 Use the following coupon code : NURSING10

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