Nursing Informatics Chapter 20 Lecture Notes PDF

Chapter 20 Nursing Informatics With amendments by Paula Wyman MSN, RN, CNL, CMRN Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins 1 ANA Definition of Nursing Informatics “The specialty that integrates nursing science...

Chapter 20 Nursing Informatics With amendments by Paula Wyman MSN, RN, CNL, CMRN Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins 1 ANA Definition of Nursing Informatics “The specialty that integrates nursing science with multiple information management and analytical sciences to identify, define, manage, and communicate data, information, knowledge, and wisdom in nursing practice.” Copyright © 2019 Wolters Kluwer All Rights Reserved 2 Examples of Informatics Use in Today’s Nursing Profession  Electronic health record  Telehealth  Mobile devices  Patient portals  Data analytics  Technologies for educating nurses in academic settings  Technologies for conducting research Copyright © 2019 Wolters Kluwer All Rights Reserved 3 1  Meaningful Use of Electronic Health Record  Improve quality, safety, efficiency, and reduce health disparities  Engage patients and family  Improve care coordination and population and public health  Maintain privacy and security of patient health information Copyright © 2019 Wolters Kluwer All Rights Reserved 4 Results of Meaningful Use Compliance (EHR)  Better clinical outcomes  Improved population health outcomes  Increased transparency and efficiency  Empowered individuals  More robust research data on health systems Copyright © 2019 Wolters Kluwer All Rights Reserved 5 Components of System Development Lifecycle (SDLC)  Analyze and plan  Design and build  Test  Train  Implement  Maintain  Evaluate Copyright © 2019 Wolters Kluwer All Rights Reserved 6 2  Questions to be Answered in Analyze and Plan Phase of SDLC #1  What is the purpose of this new technology or change to the current technology?  What problem do we hope to solve?  What data do we have to indicate the current state of the issue (how bad is the problem)?  How will its use be incorporated into the current workflow of the nurse?  Will it streamline nursing documentation, or will it increase the burden of documentation? Copyright © 2019 Wolters Kluwer All Rights Reserved 7 Questions to be Answered in Analyze and Plan Phase of SDLC #2  Will it improve the overall usability and experience with the EHR?  What technological options are available if there are more than one? Copyright © 2019 Wolters Kluwer All Rights Reserved 8 Questions to Ask in the Design Phase of SDLC  What should the screen display look like? How should it be laid out to be consistent with other screen layouts?  Can the design support or improve the nurse’s workflow as mapped out during the analysis and planning phase?  Is there evidence supporting the effectiveness of the new technology and, if so, does it provide recommendations for the design?  Can we use standard nursing terminology in the electronic system to better capture nursing’s contribution to care delivery and patient outcomes? Copyright © 2019 Wolters Kluwer All Rights Reserved 9 3  Tasks Occurring During the Maintenance Phase for an EHR #1  Ongoing updates to hospital and ambulatory orders preference lists  Ongoing updates to hospital and ambulatory medication preference lists  Ongoing updates to provider patient lists  Ongoing updates to scheduling blocks (ambulatory, radiology, and procedure areas)  Monthly first data bank loads (new medications, medication pricing, and clinical alerts)  Error work queue maintenance (example billing errors, sure script errors, many types of interface errors) Copyright © 2019 Wolters Kluwer All Rights Reserved 10 Tasks Occurring During the Maintenance Phase for an EHR #2  Pricing updates  Quality measures updates  Clinical decision support tools/rules  Monthly updates from EHR vendor Copyright © 2019 Wolters Kluwer All Rights Reserved 11 Examples of Technology Evaluation Steps 1. Determine what will be evaluated 2. Determine the question 3. Conduct a literature search 4. Determine the needed data 5. Determine the study type 6. Determine the data collection method and sample size 7. Collect, analyze, and display data 8. Document your outcome evaluation Copyright © 2019 Wolters Kluwer All Rights Reserved 12 4  Important Informatics Concepts  System usability  System optimization  Standard terminologies  Interoperability  Security and privacy Copyright © 2019 Wolters Kluwer All Rights Reserved 13 Types of Nurse Informaticists  The Informatics Nurse  A registered nurse with an interest or experience in an informatics field. o Superuser o The Informatics nurse specialist  A registered nurse with formal graduate-level education in the field of informatics. o Often responsible for strategy development, implementation, and maintenance and evaluation of clinical systems requiring collaboration with multiple disciplines Copyright © 2019 Wolters Kluwer All Rights Reserved 14 Telehealth and Mobile Technologies Telehealth: the use of electronic information and telecommunications technologies to support and promote long- distance clinical health care, patient and professional health- related education, public health, and health administration. Copyright © 2019 Wolters Kluwer All Rights Reserved 15 5  Telehealth and Mobile Technologies Telemedicine: the use of telecommunications technologies to support the delivery of all types of medical, diagnostic, and treatment-related services, usually by physicians or nurse practitioners. Copyright © 2019 Wolters Kluwer All Rights Reserved 16 Telehealth and Mobile Technologies Copyright © 2019 Wolters Kluwer All Rights Reserved 17 Emerging Areas in the Field of Informatics Patient portals Health care analytics Data visualization Predictive analytics Big data Copyright © 2019 Wolters Kluwer All Rights Reserved 18 6  Uses of Patient Portals #1  Access medical history and other health information  Complete various forms and questionnaires online  Communicate securely and conveniently with providers  Request prescription refills  Pay bills  Review lab results  Schedule appointments  Receive reminders for appropriate screenings Copyright © 2019 Wolters Kluwer All Rights Reserved 19 Uses of Patient Portals #2  Enter clinical data, such as blood pressure, glucose levels, weight, Fitbit data, and other activity tracking data  Review progress notes  Access educational materials based on diagnosis or procedure Copyright © 2019 Wolters Kluwer All Rights Reserved 20 Benefits of Patient Portals  Better health outcomes  Chronic condition management  Timely access to care  Patient retention  Patient-centered medical home recognition Copyright © 2019 Wolters Kluwer All Rights Reserved 21 7  Genetics and Genomics: Precision Medicine  The field of genomics has the potential to significantly change the way health care is delivered.  Genomics play a role in 9 of the 10 leading causes of death, including heart disease, cancer, stroke, diabetes, and Alzheimer’s disease (WHO, 2004).  Because genomic health care is heavily dependent on data storage and interpretation, no other area is better suited than informatics to support this evolving work. 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