D220 Competency 5

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What is one of the main legal issues related to informatics in healthcare?

Protecting patient privacy and confidentiality

What is a potential legal issue related to the use of informatics in healthcare?

Potential for medical malpractice

From an ethical standpoint, what is a concern about algorithms or decision-making tools used in healthcare?

Potential for bias

What is one of the ethical concerns related to the use of informatics in healthcare?

Potential for bias in algorithms

What do healthcare professionals have a legal obligation to protect in the context of informatics in healthcare?

Patient privacy and confidentiality

What is a concern about the role of healthcare professionals in the context of informatics in healthcare?

Becoming obsolete due to technology

What is a potential consequence of failing to ensure that information used for patient care decisions is accurate and up-to-date?

Serious harm to patients and potential legal action

Why is it important to carefully consider the legal and ethical implications of informatics in the healthcare environment?

To protect patient privacy and ensure fairness in care

What is one of the concerns related to the use of informatics in healthcare from an ethical standpoint?

Potential for discrimination and bias

What is a major concern about electronic health records (EHR) with regards to patient data?

Ensuring accuracy and security of patient data

Which federal law protects medical information?

HIPAA (1996)

Which law expanded the use of electronic health records (EHRs) and incentivized their adoption?

MIPPA (2008)

Which law provided financial incentives for EHR implementation?

HITECH (2009)

Which law included provisions related to healthcare reform and EHRs?

ACA (2010)

Which law changes the way Medicare pays healthcare providers and includes provisions related to the use of EHRs?

MACRA (2015)

Which act has provisions related to medical records interoperability, precision medicine, and mental health?

21st Century Cures Act (2016)

Which law requires reporting of certain patient safety events to the FDA?

Patient Safety Act (2005)

What is the primary purpose of the Health Information Technology for Economic and Clinical Health Act (HITECH)?

To fund the implementation of electronic health records (EHRs) and health information exchange (HIE) systems

What was the main goal of the Affordable Care Act (ACA) in relation to healthcare technology?

To implement electronic health records (EHRs) and health information exchange (HIE) systems

Which federal law emphasized the safety and security of healthcare information systems and medical devices?

Food and Drug Administration Safety and Innovation Act (FDASIA)

What was the focus of the 21st Century Cures Act in relation to healthcare technology?

Focus on promoting the use of technology and innovation in healthcare delivery

Which law provided funding for the implementation of electronic health records (EHRs) and health information exchange (HIE) systems?

American Recovery and Reinvestment Act (ARRA)

What was the primary purpose of the Patient Safety and Quality Improvement Act (PSQIA) in relation to healthcare technology?

Encouragement of reporting and analysis of healthcare errors and adverse events

Which act encouraged healthcare providers to adopt electronic health records (EHRs) and promote interoperability of healthcare information systems?

Medicare Access and CHIP Reauthorization Act of 2015 (MACRA)

What was the focus of the Food and Drug Administration Safety and Innovation Act (FDASIA) in relation to healthcare technology?

Emphasis on the safety and security of healthcare information systems and medical devices

What did the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) aim to encourage in relation to healthcare technology?

Adoption of electronic health records (EHRs) by healthcare providers

"What was the main goal of the American Recovery and Reinvestment Act in relation to healthcare technology?

Funding for the implementation of electronic health records (EHRs) and health information exchange (HIE) systems

Which stage of Meaningful Use focuses on healthcare outcomes through decision support and patient engagement?

Stage 3

According to the Four Component Model in nursing informatics, what does 'Knowledge' involve?

Applying information

What is a violation of transparency and accountability in nursing practice?

Not reporting medical errors due to paperwork

Which organization's Code of Ethics includes principles related to protecting patient privacy and maintaining competence?

American Health Information Management Association (AHIMA)

What is the main goal of the Four Component Model in nursing informatics?

To provide a comprehensive framework for understanding technology in nursing practice

What does the American Health Information Management Association (AHIMA) Code of Ethics aim to foster?

Professional practice standards

What is an important aspect of Stage 1 in Meaningful Use?

Data capture and sharing

In the context of the Four Component Model, what does 'Wisdom' involve?

Integrating knowledge and experience

What is a key focus area of Stage 2 in Meaningful Use?

Advanced clinical processes

What does the Four Component Model aim to provide?

A comprehensive framework for understanding technology in nursing practice

What is the primary focus of Severson's Four Principles of Information Ethics?

Safeguarding personal information from unauthorized access

Which term refers to the individual's right to keep personal information confidential and control access to it?

Privacy

What is the practice of protecting information and systems from unauthorized access or damage?

Information security

Which measure involves identifying weaknesses in information security and prioritizing remediation efforts?

Vulnerability assessments

What does Severson's Four Principles of Information Ethics consider as the protection of personal information and control of access to it?

Privacy

Which term refers to obtaining permission before collecting, using, or disclosing personal information?

Information consent

What does confidentiality entail as an ethical and legal obligation?

Protecting sensitive information

What does organization protection aim to prevent in the context of patient data?

Data breaches

What is the primary goal of Meaningful Use (MU) in healthcare?

To encourage healthcare providers to adopt and effectively use electronic health records (EHRs) to improve patient care and safety

What is the main purpose of the Magnet Program by the American Nurses Credentialing Center (ANCC)?

To recognize healthcare organizations that provide excellent nursing care

What is the role of Healthcare Facilities Accreditation Program (HFAP) in the accreditation process?

Focusing on accrediting rural and community hospitals

What does the Accreditation Commission for Healthcare (ACHC) provide accreditation services for?

Various healthcare organizations

What is the primary function of the American Nurses Credentialing Center (ANCC)?

Offering credentialing programs for nurses

What is the main emphasis of the Joint Commission (TJC) in its accreditation process?

Accrediting and certifying healthcare organizations

What does the Meaningful Use (MU) focus on in relation to electronic health records (EHRs)?

Improving patient care through the use of EHRs and other health information technology

What is the significance of Healthcare Facilities Accreditation Program (HFAP) in the healthcare industry?

Focusing on accreditation of rural and community hospitals to improve their quality of care

What is the primary objective of the Accreditation Commission for Healthcare (ACHC)?

Providing accreditation services to various healthcare organizations

Which of the following is NOT considered a threat to information security?

Interoperability

What is the primary goal of social engineering in the context of information security?

To gain unauthorized access to sensitive information

Which type of software is specifically designed to exploit devices or networks?

Ransomware

What do insider threats in the context of information security refer to?

Risk of harm caused by employees or contractors

Which type of attack is usually carried out by sophisticated threat actors such as nation-states or organized crime groups?

Advanced persistent threats (APTs)

What do physical threats in information security include?

Theft, vandalism, and natural disasters

Which term refers to targeted attacks on an organization's network designed to gain access to sensitive information over an extended period of time?

Advanced persistent threats (APTs)

What does the term 'phishing' refer to in the context of information security?

Sending fraudulent emails or messages with the intent of stealing sensitive information

What does malware specifically aim to do in the context of information security?

Cause harm or exploit devices or networks

What is the risk associated with insider threats in information security?

Employees or contractors causing harm to the organization's information security

What is the primary focus of logical security in healthcare information systems?

To safeguard digital assets through encryption and access controls

What is the primary purpose of physical security measures in healthcare facilities?

To protect the infrastructure and equipment

What is the main advantage of biometric identification over traditional methods in healthcare systems?

It reduces the risk of fraudulent access

Which type of threats do healthcare information systems face from external sources?

Unauthorized users gaining entry through guessing passwords

What is the primary objective of protecting patient data in healthcare systems?

To safeguard patient privacy and maintain competence

What is the main purpose of biometric identification in healthcare information systems?

To reduce the risk of unauthorized access to patient data

Which security measure is used to protect digital assets in healthcare information systems?

Firewalls

What do overprivileged users with legitimate access pose a risk to in healthcare information systems?

Patient privacy and data integrity

What is the primary function of the physical security measures used in healthcare facilities?

To protect physical infrastructure and equipment

Why is biometric identification preferred over traditional methods in healthcare systems?

It reduces the risk of fraudulent access

What is the primary focus of IoT devices?

Network connectivity and data exchange

What is a key concern related to IoT devices?

Privacy and security

Which factor is crucial in protecting patient data in Nursing Informatics?

Vulnerability assessment

What are examples of malicious programs?

Trojan horses, logic bombs, rootkits

How can one avoid malicious software?

Regularly updating operating system and software

What is the primary focus area of Cybercrime?

Illegal activities using computers and networks

What is the primary purpose of encrypting emails?

To protect the confidentiality and privacy of the message content

Why is PHI (Personal Health Information) more valuable on the black market than credit card information?

PHI contains sensitive information such as medical history and treatments

What is the main focus of wearable technology in healthcare systems?

To track and monitor various health-related metrics

Which task is involved in good system security management?

Developing a plan for incident response

What does access control involve in system security management?

Implementing measures to control physical access to system resources

What is the primary purpose of Public Key Infrastructure (PKI) in healthcare systems?

To establish and maintain a trusted environment for the exchange of digital information

Which component of PKI is freely available to anyone who wants to send messages to a particular recipient?

Public key

What is the main function of a firewall in healthcare systems?

To act as a barrier between the internal network and external networks

Which type of firewall can be both hardware or software-based?

Proxy firewall

What does PKI use to encrypt and decrypt data in healthcare systems?

Public and private keys

What is the main concern about algorithms or decision-making tools used in healthcare from an ethical standpoint?

Patient privacy violations

What do insider threats in information security refer to?

Risks posed by individuals within an organization who have legitimate access to sensitive information

What is the risk associated with overprivileged users with legitimate access in healthcare information systems?

'Overprivileged users' with legitimate access pose a risk to unauthorized access or damage to sensitive information

What was the focus of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) in relation to healthcare technology?

Encouraging the adoption of electronic health records (EHRs) and health information exchange (HIE) systems

What does Severson's Four Principles of Information Ethics consider as the protection of personal information and control of access to it?

'Confidentiality' as a key principle

What is the primary focus of a stateful inspection firewall?

Monitoring active connections and providing better security than packet filter

What does an application-level gateway firewall primarily operate at?

Application layer

What does a circuit-level gateway firewall primarily do?

Operates at the session layer, sets up virtual circuits, provides basic security

What are the key features of a next-generation firewall (NGFW)?

Combines features of stateful inspection, application-level gateway, and intrusion prevention system

What is a ransomware attack?

Malicious software that blocks access to computer system or files, demands payment for decryption key

What is the primary goal of an effective information security plan?

Requires participation of executives, managers, IT professionals, employees, third-party service providers, culture of security awareness

What does confidentiality ensure in the context of information security?

Sensitive information is not disclosed to unauthorized personnel

What does integrity ensure in the context of information security?

Ensures data is accurate, complete, and trustworthy

Study Notes

  • Health informatics in healthcare requires a balance between technology and human interaction/decision-making.

  • Legal and ethical implications of health informatics are complex and multifaceted.

  • Understanding laws and policies related to health informatics is crucial for healthcare professionals and organizations.

  • HIPAA, ACA, and HITECH Act are examples of laws that aim to protect patient health information.

  • Healthcare professionals and organizations have a duty to maintain patient information confidentiality and integrity in line with laws and policies.

  • Failure to comply with these laws can lead to severe legal consequences.

  • Policies refer to guidelines established by an organization to govern its operations, legislation are laws created by a governing body to regulate health informatics, and regulations enforce compliance with laws and policies.

  • HIPAA (1996) is a federal law protecting medical information, MIPPA (2008) expanded the use of electronic health records (EHRs) and incentivized their adoption, ARRA (2009) provided funding for health IT initiatives, HITECH (2009) provided financial incentives for EHR implementation, and ACA (2010) included provisions related to healthcare reform and EHRs.

  • MACRA (2015) is a law that changes the way Medicare pays healthcare providers and includes provisions related to the use of EHRs.

  • 21st Century Cures Act (2016) has provisions related to medical records interoperability, precision medicine, and mental health.

  • FDA Safety and Innovation Act (2012) expands the ability of the Food and Drug Administration to regulate medical devices, including software as a medical device.

  • Patient Safety Act (2005) is a law that requires reporting of certain patient safety events to the FDA.

  • Policies in healthcare organizations include requirements for employee training, password change frequencies, and other data security measures.

  • Laws and policies impacting health information technology from 1996 to present include HIPAA, MIPPA, ARRA, HITECH, ACA, and MACRA.

  • HIPAA has impacted healthcare by requiring policies to keep information secure, MIPPA has incentivized EHR adoption, ARRA has provided funding for health IT initiatives, HITECH has provided financial incentives for EHR implementation, ACA has included provisions related to healthcare reform and EHRs, and MACRA has changed the way Medicare pays healthcare providers and included provisions related to EHRs.

  • Nurses must handle patient data ethically, considering privacy, security, confidentiality, informed consent, and professional conduct.

  • Ethical dilemma: example of a situation where balancing patient interests and confidentiality was challenging. The specifics of the situation were not provided.

  • Severson's Four Principles of Information Ethics:

    • Privacy: protection of personal information and control of access to it.
    • Accuracy: reliability and integrity of information.
    • Property: ownership and ethical use of intellectual property.
    • Accessibility: availability of information to all individuals.
  • Privacy: individual's right to keep personal information confidential, controlling access and keeping it secure.

  • Confidentiality: ethical and legal obligation to protect sensitive information.

  • Information-and-data privacy: safeguarding personal information from unauthorized access, use, disclosure, modification, or destruction.

  • Information security: practice of protecting information and systems from unauthorized access or damage.

  • Information consent: obtaining permission before collecting, using, or disclosing personal information.

  • Organization protection: measures to prevent downtime, breaches in confidentiality, loss of consumer confidence, cybercrime, liability, and lost productivity.

    • Comprehensive cybersecurity policy: outlining data security approach and guidelines.
    • Employee training: educating employees on cybersecurity best practices.
    • Security controls: implementing firewalls, intrusion detection systems, and antivirus software.
    • Vulnerability assessments: identifying weaknesses and prioritizing remediation efforts.
    • Disaster recovery plan: procedures for responding to cybersecurity incidents.
  • IoT devices are physical objects with sensors, software, and network connectivity, allowing data exchange over the internet.

  • IoT devices range from home appliances to medical devices and industrial machinery.

  • Data collected helps individuals and businesses make decisions, improve efficiency, and automate tasks.

  • Concerns include privacy and security, as sensitive information can be collected and devices can be vulnerable to cyber attacks.

  1. Vulnerability in Nursing Informatics:
  • Refers to systems' or networks' susceptibility to unauthorized access, attacks, or failures.
  • Can arise from software bugs, misconfigured settings, human errors, or social engineering tactics.
  • Identifying, assessing, and mitigating vulnerabilities crucial to protect patient data and maintain trust.
  1. HIPAA Privacy Rule:
  • Protects individuals' medical records and personal health information.
  • Sets standards for how healthcare providers, plans, and clearinghouses must protect privacy.
  • Gives individuals rights over their health information, including access, correction, and informed consent.
  1. HIPAA Security Rule:
  • Protects confidentiality, integrity, and availability of electronic protected health information (ePHI).
  • Requires covered entities to implement administrative, physical, and technical safeguards.
  • Demands risk assessments and implementation of appropriate measures to manage identified risks.
  1. Characteristics of Malicious Programs:
  • Common types include viruses, worms, Trojan horses, logic bombs, and rootkits.
  • Viruses spread during normal operations, disrupting or damaging data.
  • Worms spread automatically over networks, often without human intervention.
  • Trojan horses disguise themselves as legitimate programs, executing malicious actions.
  • Logic bombs activate under specific conditions.
  • Rootkits gain unauthorized access and hide malicious activity.
  1. Ways to Avoid Malicious Software:
  • Install reputable antivirus software and keep it updated.
  • Use a firewall to block unauthorized access.
  • Use strong, regularly changed passwords.
  • Be cautious downloading files or clicking links from unknown sources.
  • Keep your operating system and software updated.
  • Disable or limit unnecessary browser plugins or add-ons.
  • Use caution when opening email attachments or clicking links in emails, even from trusted sources.
  • Back up important data regularly.
  • Educate yourself and family members about safe online practices.
  1. Threats to Information Systems:
  • Cybercrime involves using computers, networks, and the internet for illegal activities.

  • Opportunists exploit security vulnerabilities, often without much technical knowledge.

  • Hackers are more technically skilled, causing significant damage.

  • Computer or information specialists have a deep understanding of computer systems.

  • Other threats include malware, insider threats, and natural disasters.

  • Packet filter firewall: examines data packets based on pre-configured rules, provides basic security.

  • Stateful inspection firewall: monitors active connections, provides better security than packet filter.

  • Application-level gateway firewall: operates at application layer, provides advanced features like content filtering.

  • Circuit-level gateway firewall: operates at session layer, sets up virtual circuits, provides basic security.

  • Next-generation firewall (NGFW): combines features of stateful inspection, application-level gateway, and intrusion prevention system.

  • Ransomware attack: malicious software that blocks access to computer system or files, demands payment for decryption key.

  • Effective information security plan: requires participation of executives, managers, IT professionals, employees, third-party service providers, culture of security awareness.

  • Access to confidential information in HIS: should be restricted to authorized personnel, lapses can lead to breaches.

  • Audit trails: record of all activity within the system, provides history for security and compliance purposes.

  • Criteria for effective information security: confidentiality, integrity, availability, privacy, compliance.

  • Confidentiality: ensures sensitive information is not disclosed to unauthorized personnel.

  • Integrity: ensures data is accurate, complete, and trustworthy.

  • Availability: ensures authorized personnel have access to information when they need it.

  • Privacy: protects personal information from unauthorized access or disclosure.

  • Compliance: organization adheres to all applicable laws, regulations, and industry standards.

Test your knowledge on the legal and ethical implications of using informatics in the healthcare environment. Learn about the importance of protecting patient privacy and confidentiality, and understand the legal obligations of healthcare professionals in safeguarding sensitive health information.

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