NCM 110A [FINALS].pdf

NCM 110A FINALS NURSING INFORMATICS INTERNET NSFNET (National Science Foundation Network) was created. Due to the advancement, many computers were also allowed to be linked with NSFNET. Worldwide network of interconnected computer networks that operates using a standard set of communications Any com...

NCM 110A FINALS NURSING INFORMATICS INTERNET NSFNET (National Science Foundation Network) was created. Due to the advancement, many computers were also allowed to be linked with NSFNET. Worldwide network of interconnected computer networks that operates using a standard set of communications Any communications network that can carry two-way digital data can also carry Internet traffic; thus, Internet traffic flows through networks that use conventional copper wire, coaxial cable, optical fiber and radio waves. The internet is named after the Internet Protocol, the standard communications protocol used by every computer on the internet. 1990 Computers were looking up to NSFNET giving birth to Internet TECHNOLOGIES BEHIND THE INTERNET BRIEF HISTORY OF INTERNET Internet vs. internet An internet (small "i") refers to any network of computers The Internet (large "I") is a specific name Given to the communication network comprised of hundreds of thousands of inter-connected 1969 Department of Defense DOD of USA started a network called ARPANET (Advanced Research Projects Administration NETwork) One computer California and 3 Utah Later, Universities and R&D Institutions were allowed to connect Due to the success of ARPANET the network was broken into two smaller parts ○ MILNET for Managing Military sites ○ ARPANET for managing non-military sites Standard protocols enable the Internet to function. It can be treated as the standard language for the Internet. Protocols determine the following: ○ Data transmission between 2 devices ○ The type of error checking that will be performed. ○ Data compression ○ Signals and notifications The main protocols on which the functioning of the Internet is dependent: Transmission Control Protocol (TCP) - allows computers to connect to a network and exchange data; carries the task of breaking messages into small packets (datagrams) Internet Protocol (IP) - considered a lower-level protocol which is responsible for making decisions on the packets and routing them. Other protocols used on the Internet are the following: Hypertext Transmission Protocol (HTTP) - which supports the World Wide Web (WWW) File Transmission Protocol (FTP) permit users to send all types of electronic files over the Internet 1980 NCM 110A | MUNSAYAC 1 ANATOMY OF A WEB ADDRESS Web addresses are also referred to as URLs. It can identify a specific machine, directory and file of that machine Example: https://www.facebook.com/ HTTP - short for Hypertext Transfer Protocol described as the transmission protocol, introduces a web document or directory WWW - Short for World Wide Web Directory - The directory or folder(s) in the web server that contains a group of related web pages Domain Name - identifies the computer name, web server name, web name or host name. The Internet Domain Name System (DNS) permits users to give globally unique names to networks. Top level domains: ○.edu - educational site (for a university or college) ○.com commercial business site/computer gov ○.gov - government/non military site ○.mil - military sites or agencies ○.net - networks, internet service providers, but the rest of the page is lagging behind Chains - After clicking several websites, a chain of internet pages are created and explored backward or forward. Reload - refreshing the page to ensure that the latest copy is loaded Stopping - Stopping the loading process of a site anytime the user wants. Restarting Stopping the connection and clicking the same link again Few examples of Search Engines: Yahoo! Google Ask.com Two types of Search Engines: Directories good at identifying information Ex.: Yahoo Directory general Indexes Identify text on the given criteria by searching contents of websites through the use of software and programs called robots and spiders that analyze millions of web pages Ex.: Google & Yahoo Search 4 DOMAINS AND 5 BASIC TECHNIQUES IN WEB NAVIGATION ELECTRONIC MAIL (E-MAIL) Directions: Back - go back to the previous page (alt left arrow key) Forward - go forward to a new page after going back (alt right arrow key) Link - click a link and jump to a new page Jump - select a new page from external source such as bookmarked sites Techniques: Surfing - Jumping ahead of the browser if the link is already loaded Program was developed by Ray Tomlinson in 1972 He introduced the @ symbol In 1973, 75% of the traffic was E-mail One of the most popular uses for the Internet remains the ability to send & receive electronic mail Ex.: Yahoo Mail, Gmail & Hotmail ANATOMY OF AN EMAIL NCM 110A | MUNSAYAC Example: hyper_ [email protected] Name (Username) - the name of the owner of the address. Users 2 can devise their own name based on their availability. Email Provider/Organizational Code - denotes the email providers or Organizational Code in conjunction with the organizational website Domain - corresponds to the high level domain names Evaluating Quality Health Information on the Internet The health summit working group has identified the major criteria to evaluate an internet site. WIRELESS DEVICES AND WIRED DEVICES Wireless devices and devices with wires almost perform the same functions but wireless devices have many advantages over the other devices with wires. It facilitates people to work in different places where they cannot take the devices with wires attached to them, The criteria identified include the following: Credibility - source of information & timeliness of the content Content - to help judge accuracy, examine the hierarchy of events and presence of original sources Disclosure - the purpose & moderator of the site Links - the quality of links provided by the site Design - site accessibility & convenience of use Other electronic devices: Laptop - a wireless computer that anyone can take with him or her with all the data stored in it. USB - with the help of USB, one can transfer the data from one place to another by taking that stick in his or her pocket Cell phones - Cell phones have become the most used wireless device by people in which the communication is done by using radio frequencies through different service provider stations PDAS Radio, etc. MOBILE COMPUTING IN NURSING NURSES AND THE INTERNET Mobile Computing in Nursing provides valuable insights into how nurses are using computing solutions at the bedside & how these solutions can best be used to solve existing workflow inefficiencies. Mobile computing makes it easy to stay connected no matter where you are; or gamers enjoy peer-to-peer interaction; photographers can send immediate downloads; and employees can telecommute from different time zones Tablet PCs are wireless devices that provide the most promising trend in mobile computing. NCM 110A | MUNSAYAC Contemporary nursing practice has changed tremendously over the last decade. Professional competencies for new nurses now include informatics, case management, health care policy, cultural sensitivity and disaster preparedness. The study of nursing involves life sciences, psychology, social services, patient education, and ethics, in addition to the traditional medical knowledge base. The ability to use the internet is an essential skill for both nursing students and nurses, both to support their studies, especially as nursing students spend a lot of their time in placement away from the university campus and to support their development of skills in using 3 what is becoming an increasingly essential tool for professionals. US GOVERNMENT MEDICAL AND HEALTH INFORMATICS The US federal government provides some of the most important sources of online information for medical professionals as well as health consumers. NLM Gateway A handy entry point for searching the resource at the National Library of Medicine. Provides a global search function for PubMed, PubMed Central, and MedlinePlus. Search results include consumer health information. An excellent place to begin a search for health related government information. gateway.n.m.nih.gov/gw/Cmd Agency for Healthcare Research and Quality (AHRQ) This federal agency both conducts and sponsors research on healthcare quality, safety and cost effectiveness. It's "Consumers & Patients" links provide information on specific conditions, health insurance plans, prescriptions, National Institute of Nursing Research One of the National Institutes of Health, this organization's mission is to support research in nursing in clinical and community settings through grants and other funding Programs It provide information on its own funding initiatives, including diversity programs and resources, links to nursing organizations for various specialties, and. publications from national PubMed Central A free digital archive of life sciences journal literature. A free archive of life sciences journals The site offers access to the full text of more than 160 high-quality, open access life sciences journals from various Center for Disease Control and Prevention It's mission is to monitor public health, put forth prevention initiatives, investigate health problems & promote health Healthfinder This consumer health information site is maintained by the National Health Information Center of the US Department of Monitand Human It is a hand selected directory of the health related websites of more than 1,500 organizations Medline Plus A consumer health resource that brings together information from various government agencies including the National Library of Medicine, the National Institutes for Health Its medical encyclopedia, drug and herbal supplement information, current health news, and superior interactive tutorials are excellent NON-GOVERNMENTAL PORTALS BioMed Central This resource publishes more than 140 open access journals covering all areas of biology and medicine Included are journals on nutrition, public & international health & BMC nursing Mayo Clinic: Tools for Healthier Lives Though aimed at the layperson, nurses and students will welcome the plethora of information and tools provided by the Mayo Clinic NCM 110A | MUNSAYAC 4 Users can choose disease and condition, drugs and supplements, treatment decisions, healthy living, ask a specialist, and Health tools. Online Journal of Issues in Nursing OJIN is a free, peer reviewed, international journal addressing topics affecting nursing practice, research, education and the wider health care sector. OJIN presents timely information required by nurses and other health care professionals to provide current and informed patient care, to be socially responsive healthcare professionals and to developmental needs Public Library of Science PLoS is an initiative by scientists & doctors to publish quality, peer reviewed literature and make it freely available to the public and other researchers publishes journals in biology, medicine, clinical trials and genetics NURSING SPECIALTIES AND DISEASE SPECIFIC SITES Oncolink University of Pennsylvania cancer specialists launched this site in 1994 to "help cancer patients, families, health care professionals and the general public get accurate cancerrelated information” AMA Medical Ethics Web pages The American Medical Association (AMA) offers resources and information about medical ethics. One especially helpful resource for nursing students is their "Virtual Mentor", an interactive, Web based forum for analysis and discussion of ethical & professional issues Geriatric Assessment-Case Studies The Virtual Health Care Team Web Site is sponsored by the School of Health Professions and the School of Medicine at University of Missouri. The approach, as explained by the authors, is an integrated team approach in which "team members actively coordinate care and services across disciplines in a process resembling problem-based learning." Gray's Anatomy of the Human Body It features 1,247 pictures from the classic 1918 publication, as well as a subject index with 13,000 entries. Human Anatomy Online Easy to navigate, the user begins by choosing among ten systems: skeletal, digestive, muscular, lymphatic, endocrine, nervous, cardiovascular, male or female reproductive and urinary. "Graphics are interactive and users can view animations of the system, tutorials and description Merck Manual of Diagnosis and Therapy The Merck Manual's 17th, Centennial Edition is available free, searchable by keyword or the table of contents. It also offers two other complete manuals through this site: The Merck Manual of Geriatrics The Merck Manual of Health & Aging Physical Exam Study Guides Created by the University of Florida Medical Program, these guides are thorough and clear. The exams offered are: ○ Vital Signs ○ Back & Extremity ○ Chest & Lung ○ Cardiology ○ Head and Neck ○ Eye ○ Abdominal NCM 110A | MUNSAYAC 5 ○ ○ ○ Breast Pelvic Neurologic & Mental Status RN CENTRAL Created by nurses for nurses and students, this site offers good resource links, but the highlight is its "Care Plan Corner," with predefined nursing care plans under 3 categories: ○ Altered/Alterations ○ Impaired/Impairment ○ General Users can copy, save or print and modify any of the plans, and there is also a blank plain template to print out and fill in Rx List Information provided for each drug includes the description, clinical pharmacology, indications and dosage, side effects and drug interactions, warnings and precautions, drug overdose contraindications and patient information. Words in the articles and descriptions that may need to be defined for the layperson or student PHILIPPINE BASED NURSING RESOURCES Philippine Nurses Association Founded on September 2, 1922 as Filipino Nurses Association (FNA) in a meeting of 150 nurses presided by then Anastacia Giron Tupas (Mrs. Tupas), the FNA was incorporated in 1924. The International Council of Nurses accepted the FNA as one of the member organizations during the Congress held in Montreal, Canada on July 8-13, 1929. The FNA became the PNA (Philippine Nurses Association) in 1966, which was the same year that the office at 1663 F.T. Benitez Street, Malate, Manila was inaugurated. Today there are a total of 368,589 licensed nurses (February 2005) in the Philippines and produces an average of 13,000 new nurses every year. The PNA was awarded the Most Outstanding Accredited Professional Organization by the Professional Regulation Commission in 2003 besting 40 other professional associations and was five-time nominee for the same award. Nurse Directory Contains information regarding nursing industry including Nurse Companies, Nursing Review Centers, Nursing Schools, Care Givers, and Nursing Articles Decision Support System DSS are automated tools designed to support decision making activities and improve the decision-making process and decision Such systems are intended to use on enormous amounts of data that exist in information systems to facilitate decision process Clinical Decision Support Systems As explained by Wyatt and Spiegelhater, they regard CDSS as active knowledge systems that use two or more items of patient data to generate case specific advice Designed to integrate a medical knowledge base, patient data and an inference engine to generate case specific advice A CDSS is designed to support healthcare providers in making decisions about the delivery and management of patient care GOALS include: Patient safety and improved outcomes for specific populations Compliance with clinical guidelines, standards of NCM 110A | MUNSAYAC 6 practice, and requirements. regulatory HOW TO SEARCH EFFECTIVELY 1. Integrated Real Time Patient Database Combines patient data from multiple sources Ex.: Lab, Radiology, Pharmacy Data, etc. This is needed to provide context for results interpretation 2. Data-driven Mechanism Allows event triggers to go into effect and activate alerts and reminders automatically 3. Knowledge Engineer Translate the knowledge representation scheme used in the system so clinical knowledge in the system can be extracted and translated into machine executable logic 4. Time driven mechanism Permit automatic execution of programs at a specific time to alert healthcare provider to carry out a specific function or ensure that action has been completed Ex: Medication administration, Time Alerts 5. Long Term Clinical Data Repository Data collected over time from a variety of sources allowing longitudinal patient records. COMPUTER APPLICATIONS THAT SUPPORT NURSING RESEARCH Literature Searches- It is a systematic, thorough search of all types of literature in a certain topic. It search to find key literature on a topic to complete a thorough literature search you should: ○ define what you are searching for ○ decide where to search ○ develop a search strategy ○ refine your search strategy ○ save your search for future use. 1. IDENTIFY SEARCH WORDS OR KEYWORDS ANALYZE YOUR RESEARCH TOPIC QUESTION What are the main ideas? Write down your main ideas, synonyms. related words or phrases 2. WHERE TO SEARCH: DATABASES It is advised to search for several databases to make sure you do not miss a key paper related to your topic. Saved searches - in many databases you can save a search to run a later date particularly if your search statement is complex and lengthy to enter 3. SEARCH TECHNIQUES Once you have your keywords, combine them. Boolean logic which allows you to link your search terms. It requires the use of Boolean operators AND, OR, and NOT 4. EVALUATING INFORMATION You will need to evaluate the literature you find for quality and relevance 5. ORGANIZING INFORMATION When conducting a literature search recording the information you find in an organized manner is essential. Literature searches require you to read and keep track of articles. Bibliographic management tools can be used to help organize the references. RELIABLE SEARCH ENGINES AND DATABASE DATABASE NCM 110A | MUNSAYAC It allows you to efficiently search for published information such as 7 magazine, journal and newspaper articles. SEARCH ENGINES A search engine such as Google, uses computer algorithms to search the internet and identify items that match the characters and keywords entered by the user. Why use a Database? Reliable - many articles found in databases have undergone a peer review process and are generally more reliable than information found on the internet, and it provides all the information you need to evaluate a source for credibility (such as publication details and author's name) Relevant - databases allow you to customize your search to get the most relevant result. Search for keywords, terminology, subject headings and descriptors. You can also search by author or title Accessible - databases often provide access to the full-text of an article so you do not need to go to the library to retrieve it in person. Also allows us to access information at no charge. Why use a Search Engine? Search Engines are useful for finding information produced by Governments, Organizations, groups, and individuals. Examples you can find through a search engine include freely available articles published by a government agency. EDUCATIONAL SEARCH ENGINES Google Scholar Google Books Microsoft Academic WorldWideScience Science.gov Wolfram Alpha Refseek Educational Resources Information Center Virtual Learning iSeek ResearchGate BASE Infotopia PubMed Central Lexis Web TYPES OF DATA COLLECTION QUANTITATIVE DATA Data that is expressed in numbers and summarized using statistics to give meaningful information is referred to as Quantitative data. Examples: Heights, students Weights, or ages of QUALITATIVE DATA When we use data for description without measurement, we call it Qualitative data. Such data cannot be easily summarized using statistics. Example: Employees attitude towards work PRIMARY DATA When data is obtained directly from individuals, objects or processes. Quantitative or Qualitative data can be collected using this approach. Advantage: No customizations needed to make the data usable. One can control how the data is collected SECONDARY DATA NCM 110A | MUNSAYAC When you collect data after another researcher that initially gathered STATISTICAL TOOLS 8 Statistical methods are mathematical formulas, models, and techniques that are used in statistical analysis of raw research data. The application of statistical methods extracts information from research data and provides different ways to assess the robustness of research TYPES OF TEST USE Correlational These tests look for an association between variables Pearson correlation Tests for strength of association between continuous variables Spearman correlation Chi-square the the two Tests for the strength of the association between two ordinal variables (does not rely on the assumption of normal distributed data) Tests for strength of association between categorical variables the the two Comparison of Means: look for the difference between the means of variables Paired T-test Tests for difference between two related variables Tests for difference between two independent variables ANOVA Tests the difference between group means after any other variance in the outcome variable is accounted for Regression: assess if change in one variable predicts change in another variable Simple regression Tests how change in the predictor variable predicts the level of change in the outcome variable Multiple regression Tests how change in the combination of two or more predictor variables predict the level of change in the outcome variable Non-parametric: are used when the data does not meet assumptions required for parametric tests Wilcoxon rank-sum test Tests for difference between two independent variables - takes into account magnitude and direction of difference Wilcoxon sign-rank test Tests for difference between two related variables takes into account magnitude and direction of difference Sign test Tests if two related variables are different - ignores magnitude of change, only takes into account direction Independent T-test NCM 110A | MUNSAYAC 9 illness, medical procedure, method, plan, or product. ONLINE QUESTIONNAIRES These are designed through the careful construction of questions to identify facts and opinions from specific groups of respondents. Using a questionnaire to gather research data is often an attractive proposition as they are arguably more precise and focused than alternative methods such as interviewing and observation by researchers. Online Questionnaires to Research ADVANTAGES 1. Inexpensive 2. Practical 3. Fast result 4. Scalability 5. Comparability 6. Easy Analysis 7. Validity and Reliability 8. No Pressure Nursing SURVEY MONKEY DISADVANTAGES 1. Dishonest Answers 2. Interpretation Issues 3. Accessibility Issue DIGITAL POLLS Advantages: 1. Can reach a wider audience 2. Easier for people to respond to and access 3. Instant delivery of results 4. Ease of processing and display (graphs, bar charts, and other diagrams and graphics to display results) A digital poll (AKA online poll) allows participants to communicate responses via the Internet, typically by completing a questionnaire on a web page. May allow anyone to participate OR may be restricted to a sample drawn from a larger panel. Allows one to ask a single multiple choice question. Participants can choose among predefined answers (can be restricted to one answer or multiple answers). Advantages of digital polls to nursing research Opinion polls are a way of estimating public opinion on a certain matter. In nursing research, digital polls are useful for assessing probable public reaction to an SVMK Inc., doing business as Survey Monkey, is an online survey development cloud-based software as a service company. It was founded in 1999 by Ryan Finley and Chris Finley. The company provides surveys, and a suite of paid back-end programs. How does SurveyMonkey Work Gather opinions and transform them into People Powered Data (PPD). 1. Easily create surveys, quizzes, and polls for any audience. 2. Gather feedback via weblink, email, mobile chat, social media, and more. 3. Automatically analyze your results and get powerful analysis features. 4. Export your results or integrate your data with your favorite apps. 4. Use your insights to make better, data-driven decisions. How does it Improve Health Care Supports patient-provider communication by getting feedback 1. Measures employee satisfaction 2. Monitor patients' health and safety habits 3. Probe the efficacy of patient safety culture Helps gather and analyze more information faster 1. custom health surveys or rely on expert templates. NCM 110A | MUNSAYAC 10 2. Distributes surveys more efficiently 3. Platform to analyze the results and export professional charts. Types of HealthCare Surveys Patient satisfaction - quality: doctors, staff, facilities Employees and staff - engaged org; training and tools ○ Employee engagement ○ Patient safety culture ○ Training feedback and incident reports ○ Event and meeting feedback ○ Performance evaluation and reviews ○ Exit interviews and other HR surveys Medical Research - specific population &/or vs others Set Benchmarks - point of reference = specific improvement Spreadsheets an arrangement of cells in columns and rows used to organize, analyze, calculate, and report information, usually in numerical form. The first electronic spreadsheet was named Visicalc, short for visual calculator, and was created in 1979 for the Apple personal computer. It is given credit for the popularity of Apple and the acceptance of a personal computer as a tool for business. Microsoft Excel is curlently the industry standard for spreadsheets and worksheets. It is the most used spreadsheet and is available for Windows, MacOS, Android, and iOS. Other programs used include Google sheets, a cloud web-based program, LibreOffice, and several more. Microsoft Excel is a spreadsheet developed by Microsoft for Windows, Mac OS X, Android and ios. It features: 1. calculation, 2. graphing tools, 3. pivot tables, 4. a macro programming language called Visual Basic for Applications. Component of a Spreadsheet function- an operation applied to a range of cells, always beginning with an "=" sign. ○ e.g. =SUM(A1:A5) formula- an algebraic expression. must begin with an equal sign “=". Can contain any combination of: cell- a box where all data is inputted within a spreadsheet. A cell can contain: labels e.g. Company. numbers e.g, 32.4 functions e.g. SUM(B5:B8) formulas e.g, = 2*2. OR e.a, = 2" SUM(B5:88) APPLICATION OF SPREADSHEET To manage the name list of data records. to perform mathematical calculations easily in daily business. Inventory management. Create forms and consolidate results Analytical tools. Corporate budgeting. Many medical professionals, from doctors' offices to researchers, use Excel to manage their data. Excel is a powerful tool for keeping track of Patient Appointments, Scheduling Doctors, and organizing other information, such as contact numbers or insurance data. Many clinics, hospitals and practitioners use Excel for these functions. Excel can also be used to keep track of medications, prescriptions and other health information Statistical Package for the Social Sciences(SPSS) used by various kinds of researchers for complex statistical data analysis. NCM 110A | MUNSAYAC 11 SPSS is used by market researchers, health researchers, survey companies, government entities, education researchers, marketing organizations, data miners, and many more for the processing and analyzing of survey data. SPSS can open all file formats that are commonly used for structured data such as; spreadsheets from MS Excel or OpenOffice; plain text files (.txt or.csv); relational (SQL) databases; Stata and SAS. The Core Functions of SPSS SPSS offers four programs that assist researchers with their complex data analysis needs. Statistics Program- provides a plethora of basic statistical functions, some of which include frequencies, cross tabulation, and bivariate statistics. Modeler Programenables researchers to build and validate predictive models using advanced statistical procedures. Text Analytics for Surveys Programhelps survey administrators uncover powerful insights from responses to open ended survey questions. Visualization Designerthis program allows researchers to use their data to create a wide variety of visuals like density charts and radial boxplots with ease. running inferential statistics such as ANOVA, regression and factor analysis. saving data and output in a wide variety of file formats. SAS program components DATA steps typically create or modify SAS data sets, but they can also be used to produce custom-designed reports. For examples, you can Use DATA steps to: Put your data into a SAS data set Compute the values for new variables Check for and correct errors in your data Produce new SAS data sets by sub-setting, merging, and updating existing data sets PROC (procedure) steps typically analyze and process data in the form of a SAS data set, and they sometimes create SAS data sets that contain the results of the procedure. PROC steps control a library of prewritten routines that perform tasks on SAS data steps, such as listing, sorting, and summarizing data. For example, you can use PROC steps to ○ Print a report ○ Produce descriptive statistics ○ Create a tabular report ○ Produce plots and charts WRITING REPORT WITH SAS With SAS procedures, SAS DATA steps, and SAS features such as the Output Delivery System (ODS) and the macro facility, you have the tools to succeed at the writing program that analyzes your data and creates reports. The example shows that the SAS program solves many common report writing tasks. The examples range from simply listing the observation in a data set to computing summary statistics to creating customized report with SAS DATA step statements to tailoring report output by including ODS features NVIVO NVivo is the premier software for qualitative data analysis. Qualitative researchers describe, evaluate and interpret social phenomena. They analyze data from interviews, surveys, field notes, web pages and journal NCM 110A | MUNSAYAC 12 articles and work in sectors from social science and education to healthcare and business. NVivo allows them to organize, analyze and visualize their data, finding the patterns it contains. Excel easily accessible everybody has it with office sweep support is widespread not design for advance statistics designed for graphs they import data to excel to make nice looking graphs SAS usage is decreasing because cost a lot of money good for advance and complex statistics ○ Difficult to use ○ Coding based ○ Very expensive including health-care services, health surveillance, health literature, and health education, knowledge and research." Three main core areas According to World Health Organization (Werld Health Organization, n.d.) three main core areas of eHealth are: Delivery of health Information, for health professionals and health consumers, through the Internet and telecommunications. Using the power of IT and e-commerce to Improve public health services, ○ e.g., through the education and training of health workers. The use of e-commerce and e-business practices in health systems management. APPLICATION OF HEALTH INFORMATICS Clinical Practice E-health Telemedicine Electronic health record Administration Clinical and Administrative Health Information System Education E-learning Teleconferencing Webinar 10 E’S OF EHEALTH The "10 e's," as spelled out by Gunther Eysenbach an article on the Journal of Medical Internet Research website, include: 1. Efficiency 2. Enhancing quality 3. Evidenced-based 4. Empowerment 5. Encouragement 6. Education 7. Enabling 8. Extension 9. Ethics 10. Equity E-HEALTH use of digital technologies and telecommunications, such as computers, the Internet, and mobile devices, to facilitate health improvement and health care services. The World Health Organization (WHO) defines eHealth as "the cost-effective and secure use of information and communications technologies in support of health and health-related fields, TELEMEDICINE NCM 110A | MUNSAYAC the remote diagnosis and treatment of patients by means of telecommunications technology. It has a wide range of uses, including online patient consultations, remote control, telehealth nursing, and remote physical and psychiatry rehabilitation. 13 FEATURES OF TELEMEDICINE FOR HEALTHCARE 1. Chronic Health Management 1.1 Care following a hospitalization 1.2 Hyper specialty care 1.3 Team-based medicine 2. Throughout Care 2.1 Remote follow-up visit 2.2 More flexible practices 2.3 Effective Chronic disease care 3. Prescription Compliance 3.1 Virtual Opinion 3.2 Lifestyle 4. Store-and-Forward Digital health technologies 1. Mobile healing apps 2. Wearable devices 3. Telebe health 4. Electronic Health Records (EHRs) 5. Personalized medicine 6. Telemedicine 7. Electronic Medical Records (EMRs) Barriers 1. CONFIDENTIALITY 2. COMPLEXITY 3. PATIENT PRIVACY 4. DATA ACCURACY 5. MEDICAL LIABILITY 6. FRAUD AND ABUSE 7. CASES OF MISDIAGNOSIS 8. CONTROLLED SUBSTANCES Limitations There is a serious issue of hacking patient's medical data, especially if the patient connects to telemedicine from a public network or an unencrypted channel When a person requires emergency care, this technology can cause the medication to be delayed, mainly because a doctor cannot deliver life-saving care or laboratory tests remotely. State rules differ, and physicians will be unable to practice medicine across state boundaries based on the state in which they are licensed and the state in which the patient resides. If a patient fails to report an important symptom that should have been detected during in-person care, medication could be jeopardized Poor communication will also make it impossible to provide reliable care. ELECTRONIC HEALTH RECORD an electronic version of a patient's medical history key administrative clinical data relevant to that persons ○ demographics, progress notes, problems. medications, vital signs, past medical history, immunizations, laboratory data and radiology reports automates access to information streamline the clinician's workflow. support other care-related activities directly or indirectly through various interfaces ○ evidence-based decision support, quality management, and outcomes reporting THE PAST OF ELECTRONIC HEALTH RECORDS Late 1960 first introduced Physicians taking notes and detailing information on paper. Errors in information, Lost or misplaced files Security incidents Conversations between PCP and other HCP were extremely limited. CONCERNS SURROUNDING MODERN EHR Patient data security Physician burnout Interoperability User error Patient-provider relationship BENEFITS OF MODERN EHR Help streamline patient visits and care NCM 110A | MUNSAYAC 14 Patients can access their own information via an online portal Allows PC to share information with other specialty providers THE FUTURE OF ELECTRONIC HEALTH RECORDS 1. GPS TECHNOLOGY AND REAL-TIME REMINDERS AND ALERTS FOR PATIENTS Patients will be able to receive better care through personalized alerts and reminders, all through your practice's EHR. 2. VIRTUAL INTERACTIONS WITH PATIENTS OUTSIDE OF THE OFFICE Personal interactions via live video streaming have become exceedingly popular in recent years. In the future, we expect this trend to carry into many EHR platforms, allowing patients to have face-to-face time with their physician from the comfort of their own home. 3. IMPROVEMENTS IN INTEROPERABILITY-EASE OF ACCESS FOR A VARIETY OF HEALTHCARE INSTITUTIONS Interoperability is one of the weaknesses of the current EHR. In the coming years, you should expect this issue to be improved, allowing you to share patient data and other important information with relevant healthcare providers seamlessly through your EHR. 4. A MORE STREAMLINED WORKFLOW PROCESS While we have seen recent improvements, physician workflows should become more streamlined in the future. This will not only improve patient care but also alleviate additional physician stress and time. 5. ADAPTATION OF MORE UNIQUE EHR SYSTEMS-LESS GENERAL, "ONE SIZE FITS ALL" ELECTRONIC HEALTH RECORDS Currently, many healthcare facilities use a general EHR that isn't customized to fit their practice. This "one size fits all" approach doesn't always work, and is a source of frustration for many in the medical industry. Sooner than later, we expect to see more practices customizing their EHR to work better for their staff and practice. 6. OUTSOURCING MEDICAL TRANSCRIPTIONS FOR OPTIMIZED EHR We expect more practices to begin outsourcing their medical transcriptions to save their physicians time, save their practice money and optimize their EHR. Outsourcing is becoming more popular in the healthcare industry, and we predict more awareness of the benefits of outsourcing medical transcriptions in the coming years. EHR (electronic health records) EMR (electronic medical A digital record of patient health information A digital version of a chart Streamlined sharing with other providers and labs, etc. of updated, real-time information Not designed to be shared outside the individual practice Allows a patient's medical information to move with them Patient record does not travel outside the practice Access to tools that providers can use for decision making Mainly used by provider diagnosis and treatment Health Informatics created two main categories such as clinical and administrative information systems to meet NCM 110A | MUNSAYAC 15 the needs of one or more departments within the healthcare organization. EDUCATION E-LEARNING CLINICAL INFORMATION SYSTEM It is set to meet the needs in improving patient care. categories provide nurses information systems (NIS) that support the way nurses document the care that is given to the patients. ADMINISTRATIVE INFORMATION SYSTEM Financial Information systems Monitor and control financial aspects of facility Human Resources information systems - Track and manage people within the organization Decision support systems Assist management and staff in making decisions Master patient Index - Provides permanent record of patients treated at the facility Patient Registration - Systems collect info on patients receiving treatment Scheduling Systems - Allow the facility to make efficient use of resources such as operating rooms Practice Management Systems Combine a number of applications required to manage a physician practice Materials Management Information systems - Manage supplies and equipment within the facility Facilities Management systems Allow physical plant operations to control the automated systems within the facility for patient safety and comfort - that is, heating and air systems, automated key control, and preventive maintenance on computerized systems on many software applications used in facility A learning system based on formalized teaching but with the help of electronic resources While teaching can be based in or out of the classrooms, the use of computers and the Interet forms the major component of E-learning. How e-learning work There are three main criteria an enterprise should follow to ensure an effective e-learning program: ○ Mobile-friendly. ○ Social features. ○ Instructional design. TWO TYPES SYNCHRONOUS AYNCHRONOUS instructor-facilitated Self-directed, self-paced Requires all the participants to be virtually present at the same time Does not require all the participants to be virtually present at the same time Scheduled and timed online tests, virtual classmoms, web conferencing technelngy and interactive shared whiteboards Uses message boards, discussion grouas and seif-paced online courses Advantages of e-learning ON-DEMAND AVAILABILITY NOT REQUIRING TRAVEL COST EFFICIENCY FLEXIBILITY Disadvantages of e-learning NEED FOR HUMAN CONTACT TECHNICAL ISSUES LACK OF TRANSPARENCY TELECONFERENCING NCM 110A | MUNSAYAC 16 a live audio or audiovisual meeting with two or more parlicipants. With the ability to teleconference, remote teams in an organization can collaborate and communicate, even when geographically dispersed. Types of teleconferencing 1. Audio teleconferencing These voice-only calls are conducted similar to normal telephone calls but can support up to 100 participants. 2. Video teleconferencing This form of teleconferencing combines live visual and audio mediums. Depending on the vendor, video conferencing can support over 100 participants. Users in the meeting can use features such as screen sharing or file sharing. 3. Web teleconferencing A web teleconference is an umbrella term that describes teleconference services or mediums provided online, which includes web meetings, webinars and webcasts. A video conference is, therefore, a type of teleconference Advantages 1. Is cost-effective Teleconferencing saves remote employees the cost of transportation. 2. Enables users to communicate over long distances Teams can be geographically dispersed and still hold meetings. 3. Offers flexibility Employees can attend a teleconference call from almost any device from any location. Group chat funcions can enable users to further communicate and collaborate on projects while remote. 5. Enables users to keep records Affendees can record calls for reference or for other employees who cannot make it to a meeting. 6. Offers scheduling Scheduling and calendar tools can simplify setting up meetings. 7. Provides security Participant access codes can help ensure unauthorized users do not join meetings. Disadvantages 1. Impersonal A teleconference call can be impersonal, even with video, as it lacks real, in-person interactions. 2. Difficult to monitor Calls with a large number of attendees are difficult to manage. This includes making sure affendees are present and attentive. WEBINAR A.K.A "webcast", "online event" or "web seminar". an online event that is hosted by an organization/company and broadcast to a select group of individuals through their computers via the Internet. COMPETENCY DEVELOPMENT IN THE USE OF NURSING INFORMATICS AND TECHNOLOGY 4. Helps users collaborate NCM 110A | MUNSAYAC Training and development in e-leaming and nursing informatics E-learning is the use of technological processes to access learning material outside of a traditional classroom or office. E-learning is also often referred to 17 as online learning or web-based training. Training and development in e-learning and nursing informatics The delivery of education and training ranges from one-off, in-service training sessions through to long-term education via certificates, diplomas, first degrees, and even higher degrees. The mode of delivery depend upon the education and training requirements NURSING INFORMATICS AND THE NURSE ENTREPRENEUR Qualifications of a nurse informaticist A nursing informaticist is a nurse who combines their clinical skills with a knowledge of technology. computers, and data. Informaticists take on complex tasks like using health data to analyze patient care outcomes or train nursing staff in new patient care technology. Roles and competencies Nursing informatics competencies can be defined as adequate knowledge, skills and abilities to perform specific informatics tasks (Hunter et al.. 2013). Informatics competencies include three features: basic computer skills, informatics knowledge and informatics skills Career Opportunities Clinical Informatics Consumer health Informatics Educational Health informatics Research in Nursing informatics Clinical Informatics In a health care organization, nurses will typically fill applied/professional positions in the IT department or expert/liaison positions in the nursing department. Nurses hold similar roles in corporations that develop and sell health care information technology and in consulting firms that assist health care organizations in selecting, implementing, and evaluating health care information technology. Consumer Health Informatics In the 20th century, the focus of health care informatics shifted from supporting business processes like billing and registration to supporting health care professionals in decision making. education, and other professional activities. In the 21st century, informatics is expanding rapidly to deliver information resources to consumers via the Internet and other electronic media (Brennan and Starren, 2006). With the current emphasis on health promotion. disease prevention, self-management, and patient-centered care, the role of patients and their family members as collaborators has become vital (Committee on Quality of Health Care in America, Institute of Medicine, 2001). Consumer Health Applications (CHIA) Health 2.0 mHealth Games for Health Telehealth Informatics Educational Health Informatics students in nursing and other health care professions are benefiting from online ond Web-enhanced courses, as well as from the integration of healin care information technologies into their clinical courses. Informatics nurses and specialists, who focus on education may develop, select, implement, and evaluate learning resources for NCM 110A | MUNSAYAC 18 consumers or for health care professionals (Nahm et al., 2006) Public Health Informatics Nurse clinicians and scientists practicing in public health and epidemiology focus on obtaining. synthesizing, and providing access to information and knowledge related to community and population health for consumers, for other health care workers, and for policymakers. The fledgling field of Public Health Informatics (PHI) addresses the information needs of policymakers and public health professionals by applying informatics principles at the community and population levels (McNabb et al, 2006) Research in Nursing Informatics the ANA sees research as an important function of the informatics nurse specialist using systematic, sclentific methods to collect and analyze data, the INS can gradually bulld knowledge that applies across settings and applications. Research in Nursing Informatics During a system life cycle, the INS will assess the: ○ readiness of an organization for new technology ○ needs for information technology ○ adequacy of available technologies to meet the needs ○ factors associated with successful implementation ○ Impact of the technology on workflow and organizational dynamics DEPENDABILITY OF HEALTH INFORMATION SYSTEM easily 95% of all their success (and the other 5% is just someone finding her glasses). INSPECTOR GADGET This guy literally lives and breathes his work of fighting crime with gadgets that are a part of his body. Despite a lot of malfunctioning (and arguably a lot of general incompetence), he's clearly made a big commitment to his role, I mean, his name is his actual job title. ELMER FUDD For a guy who does nothing but hunt rabbits, you'd think he'd be better at it - but Fudd's failures don't affect the dedication to his work. He's been humiliated, injured, I'm pretty sure he's even died a couple times? SPONGEBOB SQUAREPANTS I dare you to find a single character, cartoon or otherwise, more serious about their job than this kid (or adult? does anyone really know?). He can't be making more than minimum wage, if that, he just does it for the love of the Krabby Patty. What an inspiration. DEPENDABLE SYSTEM VELMA DINKLEY What does the rest of the gang even think they're doing? Velma is NCM 110A | MUNSAYAC Is the measure of the reliability, integrity and performance of the system. Trustworthiness of a computing system which allows reliance to be justifiability placed on the service it delivers. Availability performance and its influencing factor such as reliability performance, maintainability performance and maintenance support performance. Measure of the effectiveness of the healthcare delivery, quality of service and quality of care through the use of health information system. 19 FACTOR THAT AFFECTS DEPENDABILITY OF SYSTEM ERROR Discrepancy between actual results and behavior from the expected or the reference condition or expected performance. Resulted when an incorrect reading is registered in the measuring equipment, the measuring device is malfunctioning unnoticedoly, mishandling of data, incorrect reading of data (honest mistake), the computer system does not properly process the data, a potential bug s existing in the processing of tables and indexes. The Error is a human mistake. An Error appears not only due to the logical mistake in the code made by the developer. Anyone in the team can make mistakes during the different phases of software development. For instance: BA (business analyst) may misinterpret or misunderstand requirements. The customer may provide insufficient or incorrect Information. The architect may cause a flaw in software design. People on the team can also make mistakes due to unclear or Insufficient requirements, time pressure, lethargy, or other reasons. Types of Errors 1. Surface Error 2. Error Handling 3. Syntactic Error 4. Calculation Error 5. Testing Error 6. Hardware Error FAULT Due to computer program bug which is considered a defect in a system. Presence of a fault in health information system may or may not lead to failure. A Defect is a variance between expected and actual results. An Error that the tester finds is known as Defect. A Defect in a software product reflects its inability or inefficiency to comply with the specified requirements and criteria and, subsequently, prevent the software application from performing the desired and expected work. FAILURE Condition in which the system performs unnecessarily or the function is contrary to its specification or the expected condition, An error may not necessarily cause a failure but a persistent fault can have an impact that mitigates a failure condition. FAILURE MAY BE A CAUSE OF Any physical damage or overheating in the hardware can cause the whole system to fail. If the software is not compatible with the hardware, then also the system performs unexpectedly. Failures also happen by environmental conditions like a radiation burst, a strong magnetic field. electronic fields, or pollution could cause faults in hardware or software FAILURES CAN ALSO Happen due to a human error in interacting with the software, like entring an incorrect input value, or misinterpreting an output. Occur when someone deliberately tries to produce system failure or cause malicious damage. NCM 110A | MUNSAYAC 20 Happen because of the mishandling of test data, test environment, etc. Such conditions are known as defects, but they arent actually a Detect Sometimes, tests that result in undetected detects can also cause failure. CAUSES OF ERRORS IN Time pressure Human fallibility Inexperienced or insufficiently skilled project participants Miscommunication between project participants The complex of the code, design, architecture, or the technology to be used New, unfamiliar technologies Environmental conditions "A PERSON CAN MAKE AN ERROR (MISTAKE), WHICH PRODUCES A DEFECT (FAULT, BUG) IN THE CODE, IN SOFTWARE OR A SYSTEM, OR A DOCUMENT. IF THE EXECUTION OF THE DEFECT IN CODE HAPPENS, THE SYSTEM WILL FAIL TO DO WHAT IT SHOULD DO (OR SOMETHING IT SHOULDN'T, WHICH CAUSES A FAILURE" - Thomas Muller MINIMUM DATA SET Paper-based to electronic/computer health record Minimizes irregularities in workflow process and decision-making process To accurately and consistently document, accumulate, combined, translate, and retrieve health information data, fields, data set, and data elements must have an equivalent vocabularies and terminologies within the healthcare record before it store in the databases. Provides the specific reference information for the user such as the drug uses, dosage requirement, and direction for use, active ingredients, dates, relevant information. and other NURSING MINIMUM DATA SET Provides a formal structure for electronic healthcare data elements and components to support nursing care in all settings. Comparable to other hedith care data sets except that it includes an additional nursing care elements and a unique provider number for each healthcare provider. Categorization scheme for the standardization of collection, integration, storage, classification, retrieval and reporting of essential nursing data. Allow for the analysis and sharing of nursing data, nursing strategies and nursing application. 3 CATEGORICAL SCHEME 1. Nursing Care Elements Nursing diagnoses Nursing intervention Nursing outcome Nursing care intensity 2. Patient demographic elements Personal identification Date of birth Sex Nationality Residence 3. Service elements Unique facility or agency number elements Unique patient health record number Unique number of principle registered nurse Episode admission Discharge or termination date Disposition of patient Expected payer for medical bill NCM 110A | MUNSAYAC 21