Training Approaches PDF

Training Approaches 1. Instructor-led 2. Technology-based 3. On-the-job training 4. Blended approach 5. Adjunct aids/ training materials Dr. Maha Alnashmi, 2023-24 0  Training Approaches 1. Instructor-led Training ( ILT) Classroom techniques that...

Training Approaches 1. Instructor-led 2. Technology-based 3. On-the-job training 4. Blended approach 5. Adjunct aids/ training materials Dr. Maha Alnashmi, 2023-24 0  Training Approaches 1. Instructor-led Training ( ILT) Classroom techniques that engage the participants, such as, active participation, group activities, hands-on exercises, and other various instructional approaches enhance attention and learning Classroom training is high-cost and labor- intensive Dr. Maha Alnashmi, 2023-24 0  Training Approaches, Cont 1. Technology-based / eLearning Uses technology to teach technology Computer-based training Web-based training Lower-cost training alternative Typically viewable on any computer Less flexible than classroom training Dr. Maha Alnashmi, 2023-24 0  Training Approaches, Cont 1. On–the-Job Training / just-in -time Appropriate for short sessions Subject to interruptions May or may not catch all the people who need training Uses a trainer or super user to walk providers through the processes Dr. Maha Alnashmi, 2023-24 0  Training Approaches, Cont 1. Blended learning Maximizes retention Targets different learning styles Encourages active participation Mixes web- or print-based instruction with classroom time Lower cost than classroom training Dr. Maha Alnashmi, 2023-24 0  Training Approaches, Cont 5- Adjunct training materials – Job aids – E-mail reminders – Ongoing training tips – Easily accessible audio-video clips – Ongoing presence of trainers and super users in work areas Dr. Maha Alnashmi, 2023-24 0  2. Administrative Approach Risk analysis: risks attacks network component at any time. Its important to have real time management system 1. Boundary definitions : detailed inventory of I.S systems 2. Threat identification: list of all potential threats, human, natural , environmental 3. Vulnerability identification: weakness or flaws in system design 463 HIS, Dr. Maha Alnashmi,2023-24 0 1. Administrative Approach, cont. 1. Security control analysis: 1. preventive control: access control , authentication, procedures 2. Control design : audit trials and alarms 2. Risk likelihood determination: rating system as high, medium , low risk 3. Impact analysis : impact of security on organization 4. Risk determination 5. Risk control 463 HIS, Dr. Maha Alnashmi,2023-24 0  2. Administrative Approach, cont. Administration must work with IS personnel to establish the following centralized security functions: 1. A comprehensive security plan 2. Accurate and complete information security policies 3. Information asset ownership and sensitivity classification 4. Identification of comprehensive security program 5. Information security training and user support 6. An institution –wide information security awareness 463 HIS, Dr. Maha Alnashmi,2023-24 0  2. Administrative Approach, cont Chief Security officer – Reports to CIO – Manage security plans – Apply sanctions and influence employees 463 HIS, Dr. Maha Alnashmi,2023-24 0  3. Technical Safeguards 1. Access control 2. Entity authentication 3. Audit trail 4. Data encryption 5. Firewall protection 6. Virus checking 463 HIS, Dr. Maha Alnashmi,2023-24 0  1. Technical Safeguards, cont. 1. Access control – Need to know 1. User-based access : who and how, read, write edit, execute, print 2. Role based: who and how, adding new application privileges easily assigned 3. Context based: who, how and context 463 HIS, Dr. Maha Alnashmi,2023-24 0  3. Technical Safeguards, cont. 1. Entity authentication: The process of determining whether someone is who he or she professes to be Entity authentication includes: – Something you know: passwords, PIN – Something you have: ATM cards, Token, swipe cards – Something you are: biometric fingertips, voice scan, iris or retina scan 463 HIS, Dr. Maha Alnashmi,2023-24 0  3.Technical Safeguards, Access authentication cont. Methods used in access authentication are: 1. Access codes 2. Logon passwords 3. Digital certificates 4. Public or private keys used for encryption 5. Biometric measures , Voice recognition, Fingerprints 463 HIS, Dr. Maha Alnashmi,2023-24 0  3.Technical Safeguards, Access authentication cont. Passwords: Collection of alphanumeric characters that the user types into the computer May be required after the entry of an access code or user name Assigned after successful system training Inexpensive but not the most effective means of authentication 463 HIS, Dr. Maha Alnashmi,2023-24 0  1. Technical Safeguards, cont. 1. Audit trails: record activity, both by system and application process and by user activity, of systems and applications. Individual accountability Reconstructing electronic events Problem monitoring Intrusion detection Security violations Performance problems Flaws in applications 463 HIS, Dr. Maha Alnashmi,2023-24 0  Security Mechanisms Automatic sign-off = Mechanism that logs a user off the system after a specified period of inactivity on his or her computer 463 HIS, Dr. Maha Alnashmi,2023-24 0  Security Mechanisms Firewall = A component of a computer system or network designed to block unauthorized access while permitting authorized communications. A barrier created from software and hardware Application security – Employs security-testing techniques to look for vulnerabilities or security holes in applications Two types: Packet filter, network level ( router) 463 HIS, Dr. Maha Alnashmi,2023-24 0 Proxy server, application level ( gatekeeper)  Security Mechanisms , cont Antivirus Software: Computer programs that can locate and eradicate viruses and other malicious programs from scanned memory sticks, storage devices, individual computers, and networks Ransomware : A type of malware that hijacks user files, encrypts them, and then demands a ransom or payment for the decryption key 463 HIS, Dr. Maha Alnashmi,2023-24 0  Security Measures , cont. Antivirus and spyware detection – Signature- base scanning: works by organizing a unique patterns or signature of the virus – Terminate and –stay resident monitoring: software runs in the background while an application runs in the front ground – Multilevel generic security: use expert analysis technique 463 HIS, Dr. Maha Alnashmi,2023-24 0  Security Measures , cont. User sign-on and passwords or other means of identity management Access on a need-to-know basis Automatic sign-off Physical restrictions to system access 463 HIS, Dr. Maha Alnashmi,2023-24 0  Security Measures , cont. Spyware Detection Software: a type of software that installs itself without the user’s permission, collects passwords, PIN numbers, and account numbers and sends them to another party 463 HIS, Dr. Maha Alnashmi,2023-24 0  Security Measures , cont. Proper Handling and Disposal Acceptable uses Audit trails to monitor access Encourage review for accuracy Establish controls for information use after hours and off-site Shred or use locked receptacles for the disposal of items containing personal health information 463 HIS, Dr. Maha Alnashmi,2023-24 0  Clinical Data Repository Online transaction processing (OLTP), traditional data collection method. They support daily operations a health care organization but less suited for decision support. Difficult to track data patterns or trends. clinical data repository : A large database that gets data from various data stores within application systems across organization. Dr. Maha Alnashmi, 2023-24 0  Real Time Vs. Patch Processing Real-time processing occurs immediately or almost immediately; used when speed is important Batch processing usually occurs once daily at the end of the day (traditionally when there were fewer demands on the processor) Dr. Maha Alnashmi, 2023-24 0  Classification of interoperability There are three classifications for interoperable data, according to the Office of National Coordinator for Health Information Technology (OCHIT): – Emerging – Pilot – National The best available interoperability standards and implementation specifications are given in Table 14-1 of the textbook ver. 6th. Dr. Maha Alnashmi, 2023-24 0  Types of Interoperability Syntactic (functional)—ability to exchange the structure of the data, but not the meaning Semantic—guarantees meaning of the exchanged data on both ends of the transaction – Critical for clinical data Dr. Maha Alnashmi, 2023-24 0  Health information exchange( HIE) Health information exchange (HIE) = The electronic movement of health-related information or clinical data that follows patients across delivery settings, according to nationally recognized standards Dr. Maha Alnashmi, 2023-24 0  Effort for Interoperability Health Level Seven (HL7) Clinical Document Architecture (CDA) European Committee for Standardization (CEN) EN 13606-1 (EHRcom) openEHR Service oriented architecture (SOA) Dr. Maha Alnashmi, 2023-24 0  Integration issues Massive undertaking Vendors failure to deliver on promises Lack of agreement on standards Politics and power – Lack of agreement on data dictionary, data mapping, and clinical data repository – Fear of change – Competition Dr. Maha Alnashmi, 2023-24 0  Benefit of Interoperability Improved access to information Improved physician workflow, productivity and patient care Improved safety Fully standardized health care information exchange Estimated savings = 5% annual U.S. health care expenditures Dr. Maha Alnashmi, 2023-24 0  Data Exchange Standards HL7 – Health Level 7 – Major standard for the exchange of clinical data DICOMM – Digital Imaging and Communications In Medicine – Production, display, storage, retrieval and printing of medical images Dr. Maha Alnashmi, 2023-24 0  Steps in Developing a Preparedness Program Program management Planning Implementation Loading… Testing and exercise Program improvement Dr. Maha Alnashmi, 2023-24 0  Steps of the Continuity Planning Process Business Impact Assessment or Analysis (BIA) Planning Implementation of strategies for continuity Evaluation Dr. Maha Alnashmi, 2023-24 0  Planning Process Secure top management support and commitment Select the planning committee Risk Assessment: identify the following information: 1. Types of disaster, risk range low-high 2. Potential impact or a particular disaster 3. Estimated cost of lost/damage 4. Cost to replace and restore records 5. Set processing and operating priorities Establish processing and operating priorities Data Collection Write the plan Dr. Maha Alnashmi, 2023-24 0  Threats To Business Operation And Information Systems (IS) Environmental disasters Overtaxed infrastructure Human error Power fluctuations and Sabotage outages Acts of terrorism and Equipment failure bioterrorism Operating system or High-tech crime application software Viruses bugs Dr. Maha Alnashmi, 2023-24 0  Data Backup Goal: Continuous delivery of services Options for zero downtime are expensive Common anti-disaster protection: – Automated backups – Off-site media storage – Data mirroring – Server replication – Remote data replication Dr. Maha Alnashmi, 2023-24 0  Downtime or Backup Procedures Different means to accomplish a common task than what is ordinarily used such as paper requisitions Loading… Dr. Maha Alnashmi, 2023-24 0  Recovery Cost Lost consumer confidence and profits Temporary services, space, equipment, utilities, personnel Shipping and installation costs Post-disaster replacement of equipment and repairs Overtime hours for staff Reconstruction of lost data Dr. Maha Alnashmi, 2023-24 0  Data → Wisdom Data—characters, numbers, or facts gathered for analysis and possibly later action Information—interpreted data, i.e., B/P readings Loading… Knowledge—synthesis of information from several sources to produce a single concept Wisdom—occurs when knowledge is used appropriately to manage and solve problems Dr.M.Alnashmi_463_HIS  Forces Driving Information Technology 1. Push for patient safety Accurate Patient Identification Computerized Provider Order Entry (CPOE) E-Prescribing Bar-Code and RFID Medication Administration Decision support software (DSS) Dr.M.Alnashmi_463_HIS  Forces Driving Information Technology 1. Increase accessibility of information 2. The move towards evidence-based practice 3. Genomics 4. Demands for cost-efficient, quality care 5. Research 6. Pay for performance Dr.M.Alnashmi_463_HIS Hospital Information Systems Lecture 1 Informatics in the Healthcare Profession And Information Technology overview Dr. Maha Alnashmi Dr.M.Alnashmi_463_HIS  Hospital Information Systems Lecture 2 Ensuring the Quality of information Electronic Communication and the Internet Dr. Maha Alnashmi Dr.M.Alnashmi_463_HIS  System Checks Mechanism provided by the computer system to prompt users to complete a task, verify information, or prevent entry of inappropriate information – Data cleansing software at point of entry—verify selection of the “right” patient to eliminate redundant records – Forcing users to complete “required” fields to progress – Alerting users of duplicate entries – Generating reports of actions that have not been completed Dr.M.Alnashmi_463_HIS  Data Storage Outsourcing Considerations Speed/Frequency of access needed Environmental conditions and Must consider hazards costs Control of equipment and media – Personnel Contingency planning – Space Storage period for each record – Equipment type – Maintenance Media degradation – Expertise Obsolescence of hardware and software Maintenance of access devices Dr.M.Alnashmi_463_HIS  Quality Information Timely Free from bias Precise Comprehensive Accurate Appropriate to the Numerically user’s needs quantifiable Clear Verifiable by Reliable independent means Convenient Rapidly and easily available Dr.M.Alnashmi_463_HIS  Data Mining Knowledge Discovery in Databases (KDD) Technique that Similar to data mining uses software Rapidly expanding field to look for Seeks to use the data hidden patterns repository to provide and information useful for relationships in multiple purposes large groups of including research, data outcome measurement, and efficacy of treatments Dr.M.Alnashmi_463_HIS Hospital Information Systems Lecture 3 Healthcare Information Systems History and evolution of health care systems Dr. Maha Alnashmi Dr.M.Alnashmi_463_HIS  Information Systems Use of computer hardware and software to process data into information Healthcare information system (and hospital information system)—a group of systems used to support and enhance health care Dr.M.Alnashmi_463_HIS  Why health care lags in IT 1. Health care information is complex – Include texts, images, pictures and graphics. – No single standards procedures for diagnosing, treating, and managing patents – health terminology are complex 2. Health care is highly sensitive and personal 3. Health care IT is expensive – confidentiality 4. U.S. health systems is a glomeration of systems – Integration of heterogeneous systems Dr.M.Alnashmi_463_HIS  Types of Information Systems Clinical information Administrative systems (CISs) systems – Directly support – Indirectly support care patient care – Individual systems – Individual systems may be stand alone may stand alone – Goal: data exchange – Goal: data among systems exchange among systems Dr.M.Alnashmi_463_HIS  Clinical Information Systems Support provider order entry, results retrieval, documentation, evidence-based practice, and decision support across distributed locations and by different disciplines Dr.M.Alnashmi_463_HIS  Clinical Information Systems (CISs) Nursing Emergency Multidisciplinary department Monitoring Physician practice Laboratory management systems Pharmacy Long-term Radiology Homecare Dr.M.Alnashmi_463_HIS  Monitoring Comprised of devices that monitor temperature, pulse, respirations, blood pressures, oxygen saturation, or other measures automatically feeding the input into a clinical information system Alarms notify caregivers of readings that are outside the range of “normal Dr.M.Alnashmi_463_HIS  Order Entry Systems Orders entered into the computer are transmitted to the appropriate areas such as the pharmacy, laboratory, radiology, social service Direct entry of orders by the physician, nurse practitioner, physical therapist, or other provider is preferred (CPOE) Dr.M.Alnashmi_463_HIS  Administrative systems Client management (registration) Financial Payroll Human resources Quality assurance Contract management Risk management systems Materials management Dr.M.Alnashmi_463_HIS  CPOE Computerized provider order entry Initiative by the Institute of Medicine and Leapfrog Group to improve the quality of care and reduce medication errors – Eliminates transcription error – Expedites treatment – Encourages more accurate, complete Dr.M.Alnashmi_463_HIS  Laboratory Information Systems ↓ Turnaround time, duplicate testing, errors Can – Alert providers when new or stat tests results are back or values are critical – Send results to clinical system for view – Accept input from bedside devices – Generate labels for specimen collection – Use rules to order additional tests when indicated Dr.M.Alnashmi_463_HIS  Radiology Information systems Allows direct order entry or accepts orders from other systems Provides scheduling of diagnostic tests Generates client instructions Permits transcription of results Provides picture archiving and transmission of images and tracking of film Generates charges once procedures done Dr.M.Alnashmi_463_HIS  Pharmacy Information Systems Provide checks in order and administration process using evidence-based guidelines ↓ Errors when used with bar code technology Use lab results, allergy, and interaction information from clinical systems Track medication use, costs, billing information Dr.M.Alnashmi_463_HIS  Pharmacy Information Systems, cont May include more than one system – In pharmacy dispensing systems (robots) – Unit-based dispensing cabinets in care areas – Barcode and RFID Medication Administration E-prescribing – Process that allows the physician to enter a prescription which is then electronically sent to the pharmacy from computers, PDAs Dr.M.Alnashmi_463_HIS  Barcode and RFID Medication Administration Quality initiative identified by the Leapfrog Group and the Veterans Administration’s National Center for Patient Safety Uses barcode on the unit-dose medication package and patient bracelet to ensure right patient, right drug, right dose, right time, right route Dr.M.Alnashmi_463_HIS  E-prescribing Benefits Provides a longitudinal prescription record Checks formulary compliance and reimbursement Provides alerts about drug interactions Generates reminders to order home meds for the discharged client Eliminates phone authorization for refills Dr.M.Alnashmi_463_HIS  Physician Practice Management Systems Features include capture of demographic and insurance data, scheduling, billing, outcome tracking, and report capability May, or may not, connect to hospital electronic patient records or maintain separate patient records Dr.M.Alnashmi_463_HIS  Home Healthcare Systems May communicate with hospital systems to exchange data Support demands for excessive documentation Improve payment for services because it is easier and quicker to find information needed for billing Dr.M.Alnashmi_463_HIS  Long-term Healthcare Systems Slow to come to this area Needed for the improved quality of care and efficiency Critical to business survival Integration with other systems needed to best serve patients Can include all features seen in other clinical information systems Dr.M.Alnashmi_463_HIS  Decision Support and Expert Systems …aid in and strengthen the selection of viable options using the information of an organization to facilitate decision-making and overall efficiency Decision support software organizes information to fit new environments Dr.M.Alnashmi_463_HIS  Registration Systems Admission/discharge/transfer(ADT) systems Collect and store demographic and insurance data that are verified and updated at the time of each visit Critical to operations to ensure correct patient identification and reimbursement for charges Dr.M.Alnashmi_463_HIS  Impact of mobile Computing Allows access to data at the point of care to facilitate treatment decisions – Test results – Evidence-based practice guidelines Facilitates documentation at the point of care for improved accuracy Dr.M.Alnashmi_463_HIS  Hospital Information Systems Lecture 4 I.T strategic Planning IT alignment and strategic planning Dr. Maha Alnashmi Dr. Maha Alnashmi_463_HIS 2024 0  Strategic planning Process Define the corporate vision and mission Specify achievable goals and objectives Develop strategies Loading… Set policy guidelines Determine products and services and markets Dr. Maha Alnashmi_463_HIS 2024 0  Strategic planning Process Technology must be factored into the strategic plan Strategic planning is an outcome of strategic thinking Dr. Maha Alnashmi_463_HIS 2024 0  Strategic Planning Provides the focus for how the vision will be achieved Dr. Maha Alnashmi_463_HIS 2024 0  Project Manager Role Define scope and results of project Identify tasks within the project Identify when tasks must occur Define who is responsible for each task Establish timelines for completion Establish process for project decisions Provide communication about project status Dr. Maha Alnashmi_463_HIS 2024 0  Needs Assessment Initiated by someone with a vision of the future Analyzes the organization needs Looks at segments in the organization Identifies deficits and issues The selection committee uses data to generate a list of possible solutions Look at figure 8-2 sample template for developing a time line or Gantt chart Dr. Maha Alnashmi_463_HIS 2024 0  Steering Committee Members Key to process Membership – Board members (ensure congruence with organizational strategic plan) – Representatives from all departments impacted (↓possibility of missing potential problems) – Must include end-users – Chair should be a member of administration Dr. Maha Alnashmi_463_HIS 2024 0  Committee Considerations Steering Committee members must receive release time from other responsibilities Want users with functional expertise, good communication, and ideally a computing background May use input from consultants Dr. Maha Alnashmi_463_HIS 2024 0  Analysis of Current System A process produces a blue print or details of hardware and software. Thorough understanding is essential Must determine what information is used, who uses it, and how it is used May use questionnaires, observation, and interviews to assess the internal environment Must weigh strengths and weaknesses Dr. Maha Alnashmi_463_HIS 2024 0  Technical Criteria Hardware and software needed for the desired level of system performance Type of architecture (does it work with other systems) Response time Downtime Test and training environments Support for other technology Dr. Maha Alnashmi_463_HIS 2024 0  Administrative Criteria Compliance with regulatory and legal requirements Report capabilities Ease of use Loading… Purging and restoring data Security level Dr. Maha Alnashmi_463_HIS 2024 0  Request for Information (RFI) Brief document sent to vendors that states plans to purchase and install a system Asks the vendor for a description of the system, its capabilities, and perhaps: – About the company – Number of installed sites – Service capabilities – Technical capabilities – Updates Dr. Maha Alnashmi_463_HIS 2024 0  Request for Proposal (RFP) Formal document sent to vendors that describes system requirements sought Detailed Solicits proposals from vendors that describe their capabilities to meet the “wants” and “needs Responses are used to narrow the choices Dr. Maha Alnashmi_463_HIS 2024 0  Request for Proposal (RFP) , cont. Sections of the RFP may include: 1. Instructions for vendor 2. Organizational objectives 3. Background of organization 4. System goals and requirements 5. Vendor qualifications 6. Proposal solutions 7. Criteria for evaluating proposals 8. General contractual requirements 9. Pricing and support Dr. Maha Alnashmi_463_HIS 2024 0  System Implementation and Maintenance and Role HIM Professionals lecture 6 Dr. Maha Alnashmi Dr. Maha Alnashmi_463_HIS 2024 0  System Implementation Third phase of the life cycle Begins with purchase of the system Requires planning before purchase Entails selection of the implementation committee Dr. Maha Alnashmi_463_HIS 2024 0  System Implementation Process 1. Organize the implementation team and identify a system champion 2. Determine project scope and expectation 3. Establish and institute a project plan Dr. Maha Alnashmi_463_HIS 2024 0  Typical component of an implementation plan 1. Workflow and process analysis – Analyze current process and procedures – Identify opportunities for improvement – Identify sources of data , including interfaces to other system – Determine locations and number of workstations needed – Redesign physical location needed Dr. Maha Alnashmi_463_HIS 2024 0  Typical component of an implementation plan , cont. 1. System installation – Determine system configuration – Order and install hardware – Prepare computer room – Upgrade and implement IT infrastructure – Install software and interfaces – Customize software – Test-retest Dr. Maha Alnashmi_463_HIS 2024 0  Test Environment Copy of the information system software that is used to make changes from the off-the-shelf version from the vendor Programmed changes are tested to ensure that they work as designed Dr. Maha Alnashmi_463_HIS 2024 0  Typical component of an implementation plan, cont. 1. Staff training – Train staff. Train the trainer method – Update procedure manuals 2. Conversion – Convert data. Data should be cleaned first. – Test data 3. Communications – Establish mechanism for identifying problems and constrains Dr. Maha Alnashmi_463_HIS 2024 0  Typical component of an implementation plan, cont. 1. Preparation for go-live date – Select date when patient volume is relatively low – Ensure sufficient staff are on hand – Set up mechanism for reporting and correcting problems – Review and effect process reengineering Dr. Maha Alnashmi_463_HIS 2024 0  Go-Live Planning Go-live—system running and used to collect and process actual client data Implementation strategy—staggered/all Conversion—bring in old data Develop the support schedule Develop evaluation procedures Develop a procedure to request post go-live changes Dr. Maha Alnashmi_463_HIS 2024 0  Implementation Pitfalls Underestimate for time and resources Ongoing addition of changes and more features (scope creep and feature creep) Failure to consider costs for annual maintenance and other expenses Problems with testing or training Lack of system “ownership” by users Dr. Maha Alnashmi_463_HIS 2024 0  The Role of HIM They have an input to integrate clinical and financial information because they understand the origins and content of patient data. Dr. Maha Alnashmi_463_HIS 2024 0  HIM Responsibilities During the Analysis Phase Assist in identifying problems with current health record system Assist the need of various user group Assist the project team in identifying user specification for RFP. Dr. Maha Alnashmi_463_HIS 2024 0  HIM Responsibilities During the Design Share knowledge Phase into EMR selection process ( experience with various vendor’s systems) Attend vendor’s demonstration, conduct site visit and evaluate vendor responses to the RFP Provide valuable input when security and confidentiality. Dr. Maha Alnashmi_463_HIS 2024 0  HIM Responsibilities During the Maintenance and Support Phases Evaluate the system’s impact on the department on an ongoing basis Identify and communicate problems to vendors and IT personnel Develop an ongoing training program Dr. Maha Alnashmi_463_HIS 2024 0  HIM Responsibilities During the Implementation Could become Phase team part of implementation Participate in system testing, train the staff, identify errors, develop backup and disaster recovery plans. Dr. Maha Alnashmi_463_HIS 2024 0