NCM-110-REVIEWER-1-1.pdf

NCM 110: NURSING INFORMATICS BSN 2F | NEWJEANS, PERFECT FERSONS & MANUG BOT2X COURSE OUTLINE: MIDTERMS sciences to identify, define, manage and communicate data, inf...

NCM 110: NURSING INFORMATICS BSN 2F | NEWJEANS, PERFECT FERSONS & MANUG BOT2X COURSE OUTLINE: MIDTERMS sciences to identify, define, manage and communicate data, information, knowledge, and 1. Nursing Informatics wisdom in nursing practice. THEORIES, MODELS, AND FRAMEWORK REFERENCE BOOK INFORMATION SYSTEM IN HEALTHCARE insert apa citation here INDUSTRY insert apa citation here Informatics is the science of information, the practice of information processing, the practice of LESSON TITLE information, and the engineering of information system. It also develops its own conceptual and theoretical MAIN TOPIC foundations and utilizes foundations developed in other fields. TERM Generally speaking, information system is a definition collective term referring to a system of data records definition/ further explanation and activities that processes and translates the data o examples to information in an automates process. The processing of data involves the use of computer systems and specialized software that insert side notes here manipulates the information-processing activities of this could be additional info from your prof that is not the organization. provided/ stated on the ppt this may also include some info from the book/ other VARIOUS TYPES OF INFORMATION SYSTEMS IN references THE HEALTHCARE INDUSTRY Patient data profiling Transaction records processing systems SUB-TOPIC 1 Hospital information system Pharmacy health system Clinical information system ENUMERATION Electronic health records Patient care management TERM 1 definition Critical care system definition/ further explanation Ambulatory and laboratory information system o examples Nursing information system and many more. TERM 2 definition PRESERVATION OF HEALTHCARE QUALITY definition/ further explanation THROUGH NURSING INFORMATICS o examples Article 8, section 11 of 1987 Constitution provides TERM 2 definition that states “the state shall adopt an integrated and definition/ further explanation comprehensive approach to health development o examples which shall endeavor to make essential goods, health and other social services available to all the people”. The 14th congress of the republic of the Philippines, ADVANTAGES DISADVANTAGES introduced the implementation of health Information Technology (HIT). Nursing informatics will help patients aware of what ○ they are really getting and enables them to make ○ decisions that reflect their requirements and their ideals. Nutrition labels, for instance, made people conscious of their consumption in a new way, for the first time. They were able to judge the quality of SUB SUB-TOPIC 1 food, compare products, and make informed decisions about the foods they eat. NURSING INFORMATICS HEALTH INFORMATICS PARADIGM SHIFT INFORMATICS Information influences people to change their The science of processing data for storage and activities such as the proper way of eating balanced retrieval; information science. foods. Information also creates pressure for the hospital management to change scheme of pricing NURSING INFORMATICS the hospital services and implement new strategies which focus more on the healthcare service rather Is the specialty that integrates nursing science with than business. multiple information management and analytical 1I NCM 110: NURSING INFORMATICS BSN 2F | NEWJEANS, PERFECT FERSONS & MANUG BOT2X BASIC STEPS TO PROPERLY IMPLEMENT THE on how the various type of data could be processed NURSING INFORMATION SYSTEM IN THE to create useful information HOSPITAL Commencing the project Examples: Collecting and analyzing the data Translate data into information (with statistical PATIENTS DATA AND POSSIBLE METHODS OF process) MEDICAL RECORDS CONVERTING DATA INTO Dissemination of information INFORMATION Support from the client Project evaluation Systolic and Plot charts, create diastolic readings tables and identify DEFINING THE COMPONENTS OF NURSING Body temperature trends. INFORMATICS Body mass index, Find average, bone mass density typical readings, DATA Drug dosage and variances. It simply exists and has no significance beyond its requirement Present complex existence. Cost of data as a chart or It can exist in any form, usable or not. hospitalization, graph It does not have meaning of itself laboratory records, Monitor changes o Numbers, text, images, and sounds often patient mapping over time and in a form of facts or figures obtained from Accident records forecast future experiment or surveys, used as a basis for values. making calculation or drawing conclusions. Compare figures, identify similarities INFORMATION and prepare It is a data that has been given meaning by way of trending relational connection. Assess whether o A telephone service that supplies one this is related to another. telephone numbers to the public on request o Computer data that have been organized Collecting data is expensive and to merit and presented in a systematic fashion to the effort, you need to be very clear about clarify the underlying meaning. why you need it and how you plan to use it. KNOWLEDGE One of the reasons that organizations It is the appropriate collection of information with an collect data is to monitor and improve intent to be useful. When someone “memorizes” performance of healthcare delivery and information, then they have amassed knowledge. services. Some other data are irrelevant This knowledge has useful meaning to them, but it and does not provide accurate benefits in does not provide for, in and of itself, integration decision making. such as would infer further knowledge. The nurses must use the data correctly o All the information, facts, truths, and and process it properly wrong interpreting principles learned throughout time. the results may lead to more serious o Familiarity or understanding gaines problems. through experience or study. CONVERTING INFORMATION INTO KNOWLEDGE UNDERSTANDING It is an interpolative and probabilistic process. The tremendous amount of information that is It is cognitive and analytical translated in only useful if it can be applied to create It is the process by which i can take knowledge and knowledge that is significant to the nurse and synthesize new knowledge from the previously held healthcare giver provider. knowledge. Building and managing knowledge is one of the greatest challenges that have to establish. The difference between understanding and knowledge is Information on its own will not create knowledge-based system but as a guide in the the difference between “learning” and “memorizing”. decision making we can simply conclude that information and knowledge are the building blocks People who have understanding can undertake useful of the decision making process. actions because they can synthesize new knowledge, or in The right information fuels the development of some case, at least new information, from what is previously intellectual capital which in turn drives innovation known (and understood). and performance improvement. CHARACTERISTICS OF DATA QUALITY CONVERTING DATA INTO INFORMATION The characteristics of data quality are frequently Patient data, medical records and nursing describes in terms of data relevancy, completeness, documents become information when it is applied to accuracy, precision, accessibility, and timeliness. some purpose and adds value for the recipient. It is Sometimes referred as data integrity. 2I NCM 110: NURSING INFORMATICS BSN 2F | NEWJEANS, PERFECT FERSONS & MANUG BOT2X Information from an input device or from the computer’s memory is communicated via the BUS RELEVANT DATA ITEMS to the central processing unit (CPU), which is the part of the computer that translate commands and PRIMARY Name runs the programs. Age The CPU is a microprocessor chip—that is, a single Sex piece of silicone containing millions of tiny microscopically wired electrical components. SECONDARY Occupation Information is stored in a CPU memory location Health habits called a Register. Environment BUS IRRELEVANT Hobbies A set of parallel conductors in a computer system Favorite color that forms a main transmission path. organization An instruction is analyzed by a decoder, which determines what the instruction will do. DATA RELEVANCY Any data the instruction needs are retrieved via the Data are meaningful to the performance of the bus and placed in the CPU’s register or copied to process or application for which they are collected. specific memory location via a bus. The CPU executes the instructions, and the results are stored in another register or copied to specific LEGALITY OF DATA COLLECTION memory location via bus. Data items should be easily obtainable or legal to The entire sequence of steps is called an collect such as weight, height, temperature, systolic instruction cycle. and diastolic reading. frequently, several instructions may be process simultaneously, each at a different stage in its DATA COMPREHENSIVE instruction cycle. This is called pipeline All the data items required should be included. The processing. data collection scheme should anticipate future sta needs; as such flexibility of data is essential. FOUR MAIN FUNCTIONS OF COMPUTER 1. Accepts data DATA APPROPRIATENESS 2. Processes data Data attributes and their values should be defined 3. Produces output at the correct level of details. 4. Stores results DATA TIMELINESS MAIN COMPONENTS OF A TYPICAL COMPUTER Data gathering has to be done on real-time so that immediate preparedness will be applied to CENTRAL PROCESSING UNIT (CPU) unaffected areas or community and proper The microprocessor “brain” of the computer system. response from the healthcare provider are provided Everything that a computer does is overseen by the instantaneously (e.g. dengue case, age/area CPU. affected the most, and the like) MEMORY DATA CONSISTENCIES & DATA UNIQUENESS This is a very fast storage used to hold data. It has The values should be the same and consistent to be fast because it connects directly to the within the hospital and clinic department and microprocessor. outside the hospital (e.g. health institutions, regulatory and policy makers, schools and universities, health agency, etc. SEVERAL SPECIFIC TYPES OF MEMORY IN A COMPUTER COMPUTER SYSTEM RANDOM Used to temporarily store Aims to enhance the quality of healthcare system. ACCESS information that the computer is (the inadequacy and inefficiency of manual data MEMORY currently working with. collection is in question if the integrity is at risk). (RAM) It simply duplicates the performance of a manual system with lower maintenance cost. READ ONLY A permanent type of memory MEMORY storage used by the computer WHAT IS COMPUTER? (ROM) for important data that do not A special machine that performs tasks, such as change (e.g. programs) calculations, data processing and handling, electronic communication etc. under the control of a BASIC A type of ROM that is used by set of instructions called a program. INPUT/ the computer to establish basic When a computer is turned on, it searches for OUTPUT communication when the instructions in its memory. SYSTEM computer is first turned on. Usually, one of the first sets of these instructions is (BIOS) a special program called the operating system, which is the software that makes the computer work. 3I NCM 110: NURSING INFORMATICS BSN 2F | NEWJEANS, PERFECT FERSONS & MANUG BOT2X Is a collective term in information technology used CASHING The storing of frequently used to describe the function or the contribution of the data in extremely fast RAM that sets of commands, procedures in computer system. connect directly to the CPU It is a set of instructions with step by step algorithm that directs the computer hardware to perform VIRTUAL Space on a hard disk used to specific task. MEMORY temporarily store data and One has to understand that computer cannot swap it in and out of RAM as directly understand human language; you have to needed translate it to a higher language compatible with machine language. MOTHERBOARD There is already a direct and simple execution of commands because of the systems’ software. This is the main circuit board that all of the other Software is the information that the computer uses internal components connect to. to get the job done. Computer programs allow users to complete tasks. POWER SUPPLY A program can also be referred to as an application An electrical transformer regulates the electricity and the two words are used interchangeably. used by the computer. EXAMPLES OF SOFTWARE PROGRAMS OR HARD DISK APPLICATION: This is large-capacity permanent storage used to Operating system - windows 9x/ Millenium/ XP hold information such as programs and documents. Database - patient records Internet browser OPERATING SYSTEM (OS) Email This is the basic software that allows the user to And many others interface with the computer. COMPUTER NETWORK INTEGRATED DRIVE ELECTRONICS (IDE) Is a group of interconnected computer system. CONTROLLER A computer network is an interconnection of various This is the primary interface for the hard drive and computer system located at different place. CD-ROM In computer network, two or more computers are linked together with a medium and data communication devices for the purpose of PERIPHERAL COMPONENT INTERCONNECT (PCI) communicating data sharing resources. BUS Networks may be classified according to a wide The most common way to connect additional variety of characteristics, which are categorized components to the computer, PCI uses a series of according to the basic components of a network. slots on the motherboard that PCI cards plug into. COMMON TYPES OF COMPUTER NETWORKS: SCSI (SMALL COMPUTER SYSTEM INTERFACE) Pronounced “scuzzy”, a method of adding additional 1. PERSONAL AREA NETWORK (PAN) device such as hard drives or scanners, to the Is a computer network used for computer communication among computer devices to close to one person such as the AGP (ACCELERATED GRAPHIC PORT) computer system in hospital departments Is a very high-speed connection used by the (pharmacy, laboratory, nursing, etc.) graphic card to interface with the computer. examples of such device includes printers, fax machines, telephones, and scanners. SOUND CARD 2. LOCAL AREA NETWORK (LAN) This is used bu the computer to record and play Are computer network covering a small audio bu converting analog sound into digital physical area such as hospitals and inter information and back again. department computer systems. GRAPHICS CARD 3. METROPOLITAN AREA NETWORK (MAN) This translate image data from the computer into a A network that connects two or more local format that can be displayed by the monitor. area networks but does not extend beyond boundaries of the immediate town/city HARDWARE 4. WIDE AREA NETWORK (WAN) The hardware are the parts of computer itself Is a computer network that covers a broad including the CPU and related microchips and area. WAN is a network that uses routers micro-circuitry, keyboards, monitors, case and and public communication link (e.g. drives (floppy, hard, CD, DVD, etc…) internet) Other extra parts called peripheral components or devices include mouse, printers, scanners, etc… OPEN WARE Together they are often referred to as personal Open source technically means that the application computers or PCs. software is free to users as well as programmers. In addition, most open source software has COMPUTER SOFTWARES communities that support the user and work on 4I NCM 110: NURSING INFORMATICS BSN 2F | NEWJEANS, PERFECT FERSONS & MANUG BOT2X mutual partnership on the development and Part of the challenge of measuring outcomes rest in finalization of the software. defining what outcome really is. They could relate to Open source means that the program source code individual patients across several encounters or is available to all potential users, and they are free they might measure a system. to use, modify, and redistribute the source code (a computer program in its original programming Outcome measurement can relate to any of the language). following areas: - Organizational performance FREE WARE (FREE SOFTWARE) - Clinical effectiveness The source code is not readily accessible, as such it - Patient satisfaction does not guarantee compatibility to the system. You - Service quality can use freeware but there is a very little potential - Appropriateness of care way to improve for it. A freeware is just an - Patient responses to treatments advertisement or product endorsement. - Cost of services SHAREWARE - Efficiency of services delivered Is a different concept. You can download and try Thethe shareware for free, but if you use it, you are NURSING SHORTAGE supposed to pay for it. In the world of prove-it healthcare, if it is not It is developed and released by someone who documented, it was not done. If nursing cannot keeps full control of the intellectual property. establish its contributions to patient outcomes, The user does not have access to the source code nursing becomes invisible and in fiscally tightened and cannot modify it. market, invisibility can mean expendability. Nursing COMPUTER DATA PROCESSING must have a way to substantiate its role in healthcare process and its vitality outcomes. In nursing informatics system, the term is defined as any computing process that transforms patient and NURSING MANAGEMENT ADMINISTRATIVE NEEDS healthcare data into information or knowledge The rapid proliferation of nursing information necessary for the medication use process. systems compels nursing to face the vast challenge The computer data processing system should to learn and working within the age of technology. IT simply be equipped facility that remotely accessing influences the manner in which practice, how they data and translate it using the statistical information system to become information such as charts, are educated and the methods of providing and tables, index, forecast, etc. documenting patient care. Two level of nursing administrator: END OF MODULE 1 o Nurse manager o Nurse executive MODULE 2 THE REAL COST OF ADMINISTRATIVE SYSTEM ADMINISTRATIVE APPLICATIONS OF To determine the true cost of automation, one must INFORMATION TECHNOLOGY FOR NURSING take three things into account: MANAGERS IN DIFFERENT SETTINGS o Cost of hardware and software o Cost of education THREE MAJOR ISSUES o Intellectual resources Three major issues have an administrative impact of on the workplace, the profession, and the future HOW NURSING BENEFITS FROM INFORMATION of nursing managers and administrators. Issues are TECHNOLOGY as follows: Improve communication o The nursing shortage Improve continuity of care o Increased demand for patient safety Improve order entry o Need for visibility Contributes efficiency Minimizes errors NURSING SHORTAGE Steep population growth and an aging population WHAT NURSING ADMINISTRATORS NEED TO which are increasing the need for health care KNOW ABOUT SELECTING A SYSTEM? services. User-friendly system interface Many nurses leaving the field. Data repositories to facilitate data sharing An aging nursing workforce and more. Specialized manage care software Standards INCREASED DEMAND FOR PATIENT SAFETY Interoperability Patient safety is an international issue. Standards focusing on the patient well being cut AMBULATORY CARE across all models of care, categories of disease and health conditions and all types of providers Ambulatory care or outpatient care is medical care provided on an outpatient basis, including 5I NCM 110: NURSING INFORMATICS BSN 2F | NEWJEANS, PERFECT FERSONS & MANUG BOT2X diagnosis, observation, consultation, treatment, intervention, and rehabilitation services. MANAGEMENT INFORMATION SYSTEM (MIS) This care can include advanced medical technology It is a computer system consisting of hardware and procedures even when provided outside of and software that serves as the backbone of an hospitals. organization's operations. An MIS gathers data from multiple online systems, analyzes the FINANCIAL BENEFIT information, and reports data to aid in management decision-making. The implementation of an automated information system include a cost-effective and timely bill 4 DOMAINS OF MIS submission process resulting in decreased days in accounts receivable and the reduction of rejected 1. Public health claims. In financial arena, client benefits need to be - focused on population interventions and verified and accurate insurance information outcomes related to epidemiologic and/or obtained. mortality and morbidity trends. NOTE: 2. Home health A correct bill must be submitted to the proper payor. - focused on skilled nursing care for individuals in the home and the outcomes related to care delivery for individuals or aggregated populations. 3. Special Population Community Practice - (mental health) focused on specific diagnostic care and/or treatment needs and outcomes related to the care provided to those groups. 4. Outpatient care - focused on intermittent, episodic, and preventive care for individuals and/or put together groups inclusive of national health HEALTHCARE INFORMATION MANAGEMENT prevention standards. SYSTEMS (HIMSS) Formed an Ambulatory Care Committee TELEMEDICINE was created in response to trends such as the Being implemented to replace face-to-face home aging population, the increasing prevalence of visits. Refers to electronic transfer of medical info chronic diseases, and the development of and services (voice, data, and video) from one site minimally-invasive procedures that can be to another using telecommunications technology. performed without hospitalization. It refers to the practice of caring for patients remotely when the provider and patient are not COMMUNITY HEALTH APPLICATIONS physically present with each other. NOTE: COMMUNITY HEALTH NURSING Telehealth is different from telemedicine in that it a synthesis of nursing practice and public health refers to a broader scope of remote health care practice applied to promoting and preserving the services than telemedicine. health of populations. Informatics is not only used in hospitals but also in Requires a comprehensive understanding and disaster response. knowledge of the framework of the community, its resources and the sociocultural issues impacting people within a community. CENTER FOR DISEASE CONTROL AND o Health promotion PREVENTION (CDC) o Health maintenance The Centers for Disease Control and Prevention o Health education (CDC) is a federal agency that conducts and o Health management supports health promotion, prevention and o Coordination continuity of care using a preparedness activities in the United States, with holistic approach the goal of improving overall public health. Established in 1946 and based in Atlanta, the CDC COMMUNITY-BASED INFORMATION SYSTEMS is managed by the Department of Health and A community-based information system (CBIS) Human Services involves data collection, management, and analysis of health services that exist within a community outside of health facilities. 6I NCM 110: NURSING INFORMATICS BSN 2F | NEWJEANS, PERFECT FERSONS & MANUG BOT2X BIOTERRORISM CHALLENGES FOR HOSPITAL AND PUBLIC HEALTH: A biological attack, or bioterrorism, is the Reporting system lacked standardization intentional release of viruses, bacteria, or other No central place for accessing information germs that can sicken or kill people, livestock, or crops. Bacillus anthracis, the bacteria that causes INFORMATION SOLUTIONS: anthrax, is one of the most likely agents to be used Healthcare members in St. Luis developed a bar in a biological attack. code system to log and track victims East Carolina university testes the in-place SYNDROMIC SURVEILLANCE telehealth networks. is an investigational approach where health department staff, assisted by automated data Inability to access electronic health data creates barriers acquisition and generation of statistical alerts, to continuity of care, quality of care, cost analysis, and monitor disease indicators in real- time or near vulnerable to exposures during bioterrorism events. real-time to detect outbreaks of disease earlier than would otherwise be possible with the traditional The development of National Health Information public. Infrastructure (NHII) will come an improved public health information network (PHIN). At the same time, data EVIDENCED-BASED NURSING sharing has to be carefully planned in order to stay in compliance with the HIPPA. Is the process by which nurses make clinical decisions using the best available research evidence, their clinical expertise and their patient II. FEDERAL RESPONSIBILITIES FOR preferences. Three areas of research competence HEALTHCARE PROVIDERS are: interpreting and using research, evaluating practice and conducting research DEPARTMENT OF HEALTH AND HUMAN SERVICES (DHHS) Is responsible for the education of healthcare MODULE 2 SUPPLEMENTAL professionals in preparedness for emergencies, READINGS including potential terrorism Three units focusing on emergency planning and response: INFORMATICS SOLUTION FOR EMERGENCY o CDC - Centers for Disease Control and PREPAREDNESS AND RESPONSE Prevention o AHRQ - Agency for healthcare Research INTRODUCTION Impetus for informatics solutions for emergency and Quality preparedness and response: o HRSA - Health Resources and Services o September 11, 2001 - catapulted US into Administration realization that the country was not adequately protected for terrorism. PRESIDENTIAL DIRECTIVE #8 o Anthrax Outbreaks - stressed the public The definition of first responder was expanded to health infrastructure to the point that include healthcare providers. Thus, allowing bioterrorism arose as an additional threat. healthcare community to be eligible for funding from the DHS. CHANGES IN FEDERAL SYSTEM AFFECTING EMERGENCY PREPAREDNESS AND RESPONSE A. CDC - CENTERS FOR DISEASE CONTROL AND PREVENTION I. A NEW DEFINITION OF COMMUNITY Recognized as the lead federal agency for protecting the health and safety of people-at home COMMUNITY HEALTH (US) and abroad, providing credible information to provision of healthcare outside the hospital enhance health decisions, and promoting health infrastructure. As such, the public health through strong partnerships. departments have been viewed as the major Dr. Julie Gerberding (the director), called for delivery system of healthcare. changes that would strengthen the organization, Federal funds were channeled through the centers particularly in the area of risk communication. for Disease Control and Prevention (CDC) to the states in order to strengthen the public health NATIONAL ELECTRONIC DISEASE infrastructure. SURVEILLANCE SYSTEM (NEDSS) Is an initiative that promotes the use of data and information system standards to advanced the development of efficient, integrated, interoperable 7I NCM 110: NURSING INFORMATICS BSN 2F | NEWJEANS, PERFECT FERSONS & MANUG BOT2X surveillance system at federal, state, and local Researchers at the children’s Hospital of Boston levels. building decision support models for information Purposes of NEDSS: systems of linked healthcare data Univ. of California at San Francisco examined the o To detect outbreaks rapidly and to monitor role of information technologies and decision the health of the nation support systems to assist in rapid diagnosis and o Facilitate the electronic transfer of a management of disease. appropriate information from CIS in the Boston children’s hospital and Harvard University healthcare system to public health developed a prototype database and Web site to departments facilitate clinician reporting to trends that will be used to diagnose possible bioterrorist attacks o Reduce provider burden in the provision of information SYNDROMIC SURVEILLANCE o Enhance both the timeliness and quality of Is loosely defined as detection of disease outbreak information provided before the actual disease of mechanism of HEALTH ALERT NETWORK (HAN) transmission is identified. Funded to develop capacity at the state and local levels for continuous, high-speed access to public REAL-TIME OUTBREAK AND DISEASE health information, and to broadcast information in SURVEILLANCE (RODS) support of emergency communications. A project undertaken by MPC Corporation, University of Pittsburgh and Carnegie Mellon University. This system provides early warning of possible infectious disease outbreaks caused by bioterrorism or other public health emergencies HELPING CLINICIANS RESPOND Univ. of Alabama @ Birmingham - Developed a continuing medical education training modules to teach healthcare professionals to identify various biological agents. Research Triangle Institute (RTI) - developed two prototype simulations to aid medical providers in responding to bioterrorist attacks and other public health emergencies. Practice-based research network (PBRN) - @ LABORATORY RESPONSE NETWORK (LRN) children’s Hospital Center in Cincinnati - developed Is charged with the task of maintaining an a system to allow for electronic solicitation of data using handheld devices and wireless integrated network of state and local public health, communications federal military, and international laboratories that Research @ Vanderbilt University Medical Center - can respond to both bioterrorism and chemical Have undertaken a study to determine the terrorism. effectiveness and efficiency of learning community Medical Reserve Corps. DIVISION OF PUBLIC HEALTH SURVEILLANCE AND INFORMATICS C. HRSA - HEALTH RESOURCES AND SERVICES ADMINISTRATION Their purpose is to provide and improve access to and use of public health information. A wide variety TWO GRANT MANAGEMENT PROGRAMS: of resources can be found on their Web site, including performance criteria for public health NATIONAL BIOTERRORIST HOSPITAL disease reporting systems, phone triage protocols, PREPAREDNESS PROGRAM and guidance for public health alerts and advisories. Its purpose is to aid state, territory, and selected entities in improving the capacity of the healthcare B. AHRQ - AGENCY FOR HEALTHCARE system, including hospitals, emergency RESEARCH AND QUALITY departments, outpatient facilities, emergency medical services systems, and poison control DECISION SUPPORT SYSTEMS centers, to respond to incidents requiring mass Assist in rapid diagnosis and management of immunization, isolation, decontamination, diagnosis, disease; facilitate clinician reporting of trends that and treatment, in the aftermath of terrorism or other will be used to diagnose possible bioterrorist public health emergencies. attacks; speed up the reporting process and enhance dissemination of relevant information. (IDSRN) integrated delivery system research BIOTERRORISM TRAINING AND CULTURAL network - to develop a computer simulation model DEVELOPMENT (BTCD) PROGRAM for citywide response planning for mass prophylaxis Provides continuing education and curricular and vaccination during emergencies. enhancement for practicing healthcare providers and current students. 8I NCM 110: NURSING INFORMATICS BSN 2F | NEWJEANS, PERFECT FERSONS & MANUG BOT2X Was designed to assemble healthcare volunteers OTHER CHANGES AFFECTING EMERGENCY who are willing to respond at their local levels PREPAREDNESS AND RESPONSE NATIONAL NURSES RESPONSE TEAM (NNRT) I. COMPETENCY - BASED LEARNING AND Comprise 10 regionally-based teams of 200 INFORMATICS NEEDS registered nurses who could be called on to assist in chemoprophylaxis or vaccination. A. NUCLEAR, BIOLOGIC, CHEMICAL (NBC) TASK AMERICAN RED CROSS FORCE Has a long history of volunteerism during disasters, Formed by ACEP to evaluate the status of abd has education requirement for nurses bioterrorism training in the US, identify barriers to depending on what roles they will play in disaster this training and offer recommendations for effective relief education. Nurse representatives to the task force: CHARACTERISTICS OF NATIONAL VOLUNTEER o Cheryl Peterson - ANA NURSES’ DATABASE: o Claudia Niersback and Bettina Stopford - Emergency Nurses Association - Verification licensure (can be multiple states) - Records of continuing education - Organization(s) volunteering for (will need to decide how to B. KRISTINE M. GEBBIE, RN, DrPH only count individual once during an event) Led an initiative funded by the CDC; published her work “Center for Healthy Policy”. Her work was - Activation instructions recently expanded to encompass specific - Prior emergency response experience (including dates of bioterrorism competencies for more job categories. service Gebbie went on to develop a - Security clearance level “competency-to-curriculum toolkit” that is a resource for those planning a curriculum in emergency IV. THE NATIONAL HEALTH INFORMATION preparedness and response. INFRASTRUCTURE (NHII) IN FIGHTING NATIONAL THREATS INT’L NURSING COALITION FOR MASS CASUALTY EDUCATION (INCMCE) DAVID J. BRAILER, MD, PHD Interested in promoting mass casualty education for nurses Appointed as the first national coordinator for Health Information Technology; charged with directing health IT within DHHS and coordinating them with JOHN HOPKINS UNIVERSITY EVIDENCE-BASED those of other relevant executive branch agencies. PRACTICE CENTER Concluded that there is a need for future research AMBULATORY CARE SYSTEMS into the most effective way to train clinicians in areas that will improve their ability to respond to a bioterrorist attack or other public health event. An PRESIDENT GEORGE BUSH update of the literature review on training practice April 27, 2004 (White House Executive Order, 2004) for bioterrorism, with new emphasis on disaster - Announced a goal to establish electronic drills, and best practice to accomplish successful health records (EHRs) for all citizens within drills was made. a 10-year time frame. - Created the position of national health II. INFORMATICS AND EMERGENCY OPERATIONS information technology coordinator to CENTER develop a nationwide interoperable health information technology infrastructure. A. INCIDENT MANAGEMENT SYSTEM (IMS) First used by firefighters to control disaster scenes TOMMY G. THOMPSON in a multijurisdictional and interdepartmental manner. Later on it was adapted for hospital use as Health and Human Services Secretary. is called Hospital Emergency Incident Command Announced the "Decade of Healthcare Information System (HEICS). Technology" and announced the publication of a report which reveals how vital it is to have B. INFORMATION MANAGEMENT EMERGENCY automation in the physician's and ambulatory OPERATION CENTER (IMEOC) offices. III. INFORMATICS AND VOLUNTEERISM DISASTER MEDICAL ASSISTANCE TEAM (DMAT) Teams that are willing to travel to other regions of the country in the event of an emergency. MEDICAL RESERVE CORPS INITIATIVE 9I NCM 110: NURSING INFORMATICS BSN 2F | NEWJEANS, PERFECT FERSONS & MANUG BOT2X FOUR MAJOR GOALS (DECADE, 2004) be verified and accurate insurance information obtained. A correct bill must be submitted to the proper payor. Larger ambulatory care organizations use electronic data interchange (EDI) to automate the exchange of data such as claims, submittals and remittances, and health plan eligibility information. The electronic or manual system must support adjudication which is the process of determining which payor pays which portion of the bill. The eligibility process needs to be conducted with each instance of service as clients may have changed insurance plans since the last contact with the healthcare organization. In the ideal electronic system, claims are edited prior to submission so that charges are paid and not rejected which necessities further processing, costing, time, and money. WHERE AMBULATORY CLIENTS ARE BEING ADMINISTRATIVE BENEFITS TREATED Reduction in the size of the record room. Ambulatory clinics and surgery centers, single and Reduced time spent finding and delivering charts multispecialty group practices, diagnostic Increase in the privacy of data laboratories, health maintenance organizations, Formats that are legible and comply with legal independent physician associations, birthing regulations centers, and college and university health services. Promotion of quality assurance Other organizations that serve the ambulatory Improved patient satisfaction population are faculty medical practices, community Ability for home access by physicians and nurse health centers, prison health centers, Indian health practitioners. centers, hospital-sponsored ambulatory health Alerts for incomplete data services, urgent and immediate care centers, Integration of clinical data office-based surgery centers and practices, pain o The patient scheduling system must link management clinics podiatry offices, networks, existing scheduling system so that mobile clinics, nurse managed centers, & groups of scheduled activities are coordinated ambulatory care organizations. across locations to schedule appointment times, providers, resources, and locations ISSUES FOR AMBULATORY CARE throughout the hospital or organization. o The physicians and nurse practitioners Those who work in ambulatory care are similar must be credentialed in order to provide across the healthcare enterprise including services. Credentialing is the exhaustive increased accountability, the need for continuous verification of the medical licenses and and documented service improvements, pressures qualifications. Healthcare providers must to control utilization, and the protection of be recredentialed on a regular basis. confidential information. CLINICAL BENEFITS APPLICATIONS NECESSARY IN THE Problem list: Automated ambulatory care provider order AMBULATORY ENVIRONMENT entry (ACPOE) Medical record Design to store Vital signs Manipulate Progress notes Retrieve information for planning, organizing, Results from laboratory & radiology departments directing, and controlling administratively. Flow sheets Clinical activities associated with the provision and Growth charts use of ambulatory care services and facilities. Immunization records Medication allergies FINANCIAL BENEFITS Profiles The implementation of an automated information Alerts system include a cost-effective and timely bill Reminders submission process resulting in decreased days in Follow-up system accounts receivable and the reduction of rejected e-Prescribing claims. In the financial arena, client benefits need to Evidence-based medicine 10 I NCM 110: NURSING INFORMATICS BSN 2F | NEWJEANS, PERFECT FERSONS & MANUG BOT2X Doctors view improvements in tablet personal 1. Patient master index - is the basis for collection of computers and wireless networks as assisting in the all patient-related data. adoptation of EHRs. 2. Master patient index - is a central repository for patient/member for information across the THE ROLE OF THE NURSE USING INFORMATICS enterprise including sophisticated tools for querying, CONCEPTS IN THE AMBULATORY ARENA updating, and managing the index. The Nurse is a user of the data contained in - The registration system collects patient automated systems. demographics and insurance information. Automated system can help in this management 3. Referrals - are required by many health plans when of data and the transformation from data to a patient is to be seen (or referred) to another information to knowledge. healthcare provider. MEMBER ASSOCIATIONS INVOLVED IN REGULATORY REQUIREMENTS AMBULATORY CARE Resource Based Relative Value Scale (RBRVS) Types of Organizations that serve the ambulatory - is a model designed by the Department of populations: Health and Human Services (DHHS). American Academy of Ambulatory Care Nursing NDC Directory (AAACN) - is limited to prescription drugs & a few - is a member oraganization specifically for selected over-the-counter products. nurses. - offers networking opportunities for the Medicare's ambulatory Payment Classification membership by geographic location (APC) through local networking groups. - is a prospective payment system for hospital out patient services. Special Interest Groups (SIGs) - mandated by Congress as part of the - is working to develop an ambulatory care Balanced Budget Act of 1997 (Public Law data set for nursing. 105-32). Software American Medical Informatics Association - is available to help ambulatory care (AMIA) organizations determine outpatient - has physicians and nurses amongst their payment and verify payment received. membership. Centers for Medicare and Medicaid Services Spring 2005 Meeting (CMS) - was dedicated to "Best Practices for - formely known as the Health Care ACPOE & Population Mangement with Financing Administration. EHR". Health plan Employer Data and Information Set (HEDIS) Medical Group Management Association - is a standardized, comprehensive set of (MGMA) indicators used to measure the - founded in 1926 & based in Colorado performance of a health plan. - is a major organization in the United States Outcome and Assessment Information Set representing physicians in group practice (OASIS) nationwide. - a data set for use in home health agencies and is an initiative from the Health Care Society for Ambulatory Care Professionals Financing Administration. - is associated with the American hospital - Its purpose is to provide a comprehensive Association. assessment for an adult home care patient - It is an organization of management and measure patient outcomes for professionals across the continuum of purposes of outcome-based quality healthcare services, including outpatient, improvement. ambulatory & home healthcare in hospital & freestanding settings. IMPLEMENTATION ISSUES AND CHALLENGES Based on 7,808 ambulatory care facilities, in 2004 Federated Ambulatory Surgery Association 84% were not automated, 13% had software (FASA) installed & 3% had a contract signed but the - is a nonprofit association representing the software was not implemented. Only 7% planned to interests of ambulatory surgery centers in purchase software (HIMSS, 2004). the United States. - conducts educational programs on a variety of topics. 11 I NCM 110: NURSING INFORMATICS BSN 2F | NEWJEANS, PERFECT FERSONS & MANUG BOT2X JOURNALS AND CONFERENCES American Association of Ambulatory Surgery Journal of Ambulatory Care Management Centers (AAASC) - is a quarterly publication. - is a member organization that promotes advocacy at the national level through Ambulatory Pediatrics relationships with the CMS & Congress, - is a publication of the Ambulatory Pediatric networking & educational opportunities. Association. Association for Ambulatory Behavioral Journal Healthcare - started in 1999 - is an international organization of - is available both on the World Wide Web & ambulatory mental healthcare providers in hardcopy for a fee. dedicated to the delivery of high-quality psychiatric & chemical dependency Journal for Healthcare Quality treatment within a continuum of care. - is a publication started in 1979 by the - its membership association which started National Asociation for Healthcare Quality. about 1975 is based in Fairfax, Virginia. Medical Group Management Association (MGMA) American Health Information Management - provides a wide range of educational Association (AHIMA) programs on topics that medical group - Its purpose is to foster the professional practices need to be aware of. development of its members through education, certification, & lifelong learning thereby promoting quality information to FUTURE DIRECTIONS FOR THE ADOPTATION OF benefit the public, the healthcare INFORMATION TECHNOLOGY IN AMBULATORY consumer, providers, and other users of CARE clinical data in any health-care setting. There is a move to use computerized provider order entry (CPOE) systems in ambulatory care. Healthcare Information Management Systems The biggest area of impact is that of medication Society (HIMSS) safety where it is thought that advance drug events - formed an Ambulatory Care Committee. could be prevented. - was created in response to trends such as A major area of concern is who should pay for the the aging population, the increasing implementation of these systems. Estimates for the prevalence of chronic diseases, and the use of electronic prescribing of medications is now development of minimally-invasive between only 5 and 8% of physician and other procedures that can be performed without clinicians. hospitalization. The Health Care Portability & Accountability Act of 1996: ACCREDITED ORGANIZATIONS Six Code sets Validate standards of practice and promote quality Current Procedural Terminology, 4th Edition care. (CPT) AMA, 2004 Accreditation Association for Ambulatory - describe medical procedures performed by Health Care (AAAHC) physicians and other health providers. - a private, not-for-profit organization was - to assist in the assignment of formed in 1979. Their mission is to develop reimbursement amounts to providers by standards and conduct a survey and Medicare carriers. accreditation program. COLA Ninth Revision of the International Classification - its purpose is to promote excellence in of Disease (ICD-9-CM) CMS, 2004 medicine & patient care through programs - It is designed for the classification of of voluntary education, achievement & morbidity and mortality information for accreditation. statistical purposes, for the indexing of National Committee for Quality Assurance hospital records by disease and (NCQA) operations, and for data storage and - is a private, not-for-profit oraganization retrieval. dedicated to assessing & reporting on the quality of managed care plans. Healthcare Common Procedure Coding System Joint Commission on Accreditation of (HCPCS) CMS, 2004 Healthcare Organizations (JCAHO) - is a collection of codes that represent - publishes Mangement of Information procedures, supplies, products, and Standards for Ambulatory Care. services which may be provided to 12 I NCM 110: NURSING INFORMATICS BSN 2F | NEWJEANS, PERFECT FERSONS & MANUG BOT2X Medicare beneficiaries & to individuals which involve assessment, nursing diagnosis, enrolled in private health insurance planning, implementation, and evaluation. programs. Codes - are designed to promote uniform reporting ASSESSMENT & statistical data collection of medical procedures, Involves collecting vital data and fundamental supplies, products & services. information necessary for the next process. National Drug Code (NDC) FDA, 2004 NURSING DIAGNOSIS - Identifies pharmaceuticals in detail Involves proper comprehension of the patient’s including the packaging. condition and responses. Diagnostic process is - Its use is required by the FDA for reporting complex and utilizes aspects of intelligence, critical & it is used in many healthcare information thinking, and deeper thoughts of understanding. systems to aid in reimbursement. PLANNING MODULE 3 Setting priorities, predicting expected outcome and establishing time tables are the main ingredients INFORMATICS APPLICATION IN and components of nursing care planning. EVIDENCE-BASED NURSING PRACTICE IMPLEMENTATION OBJECTIVE Is the action phase of the nursing process. To provide evidence-based nursing care using Documentation is essential on this part since it will nursing informatics and technology system. provide the details and record of the actual execution as well as the nursing behavior towards EVIDENCE-BASED NURSING PRACTICE (EBP) achieving expected outcome. Evidence-based decision making involves EVALUATION combining the knowledge arising from one’s clinical During evaluation, use the computer to record and expertise, patient preferences, and the research store observations, patient’s responses to nursing evidence within the context of available resources. interventions (independent & collaborative), and your own evaluation statements. EVIDENCE-BASED PRACTICE NURSING DOCUMENTATION Conscientious, explicit and judicious use of current Computerized documentation has many best evidence with clinical expertise, and patient advantages. It is typed and therefore legible. The values to make decisions about the care of patients. computer can be programmed to identify the data and time of all entries as well as the initials or the EVIDENCE-BASED NURSING PRACTICE name of the person making the entry. Is the process of shared decision-making between practitioner, patient and significant others. Based on END OF MODULE 3 research evidence, the patient’s experiences and preferences, clinical expertise, and other robust sources of information. COMPUTER-GENERATED NURSING CARE PLAN MODULE 4 POLICIES, GUIDELINES AND LAWS IN NURSING INFORMATICS OBJECTIVE Adhere to establish norms of conduct based on the Philippine Nursing Law and other legal regulatory and institutional requirements relevant to save nursing practice. INTELLECTUAL PROPERTY LAW REPUBLIC ACT NO. 8293 of June 6, 1997 NURSING PROCESS An act prescribing the intellectual property code and establishing the intellectual property office, Is a patient-centered and goal oriented processes providing for its powers and functions, and for other by which nurses deliver effective care to patients purposes 13 I NCM 110: NURSING INFORMATICS BSN 2F | NEWJEANS, PERFECT FERSONS & MANUG BOT2X INTELLECTUAL PROPERTY refers to anything created by someone, including but not limited to inventions, literary works, items created by artists (e.g. artwork and musical pieces), symbols, designs, images, pictures, and even names that are used for commercial purposes. All these creations are protected by the law, ensuring that the people behind it are given due recognition or remuneration for their effort. THE THREE CATEGORIES PATENT TRADEMARK COPYRIGHT PATENT the exclusive rights to a product or process, as well as its improvements granted that the product or process offers something new and useful. The inventor or creator with the patent has the right to choose as to who can use, sell, or even make something similar during its 2-year validity period. Examples of inventions or creations that can be filed as patents include: - new and useful machines - products and processes (non-biological and microbiological in nature) - improvements of machines, products and processes microorganisms The basic requirements for a creation to be patentable: - The creation would have a novel idea, inventive, and can be applied in an industrial setting. COPYRIGHT refers to the protection given to the owner of an original work covering: - literary works - musical pieces - Paintings - and computer programs, among others. the owner of the original work is entitled to economic rights and moral rights. Economic Rights - enable the creator to receive profit gains should his works be distributed by third parties Moral Rights - protect the connection between the creator and his work. Once the owner receives the rights to his work, unauthorized third parties are prohibited from selling or distributing the works, especially for trade purposes TRADEMARK a tool used to differentiate services and goods from one another. FORMS: - A word - A group of words - sign , logo or symbol helps consumers identify your brand among the many others in the market. To protect your business’ trademark, it is advisable to have it registered. 14 I NCM 110: NURSING INFORMATICS BSN 2F | NEWJEANS, PERFECT FERSONS & MANUG BOT2X What happens if the Patent, TM, or Copyright is in - Consultation another country ? - Use Section 3. International Conventions and - Consolidation Reciprocity. - Blocking, erasure or destruction of data. Any person who: In other words, processing of personal information - is a national is any operation where personal information is - is domiciled involved. Whenever your information is, among - has a real and effective industrial establishment in a other things, collected, modified, or used for country which is: some purpose, processing already takes place. - a party to any convention, treaty or agreement relating to intellectual property rights or the COLLECTION PROCESSING CONSENT repression of unfair competition, to which the collection of personal data “must be a declared, Philippines is also a party specified, and legitimate purpose” and further extends reciprocal rights to nationals of the provides that consent is required prior to the Philippines by law collection of all personal data. shall be entitled to benefits to the extent necessary It requires that when obtaining consent, the data to give effect to any provision of such convention, subject be informed about the extent and purpose treaty or reciprocal law, in addition to the rights to of processing, and it specifically mentions the which any owner of an intellectual property right is “automated processing of his or her personal data otherwise entitled by this Act. for profiling, or processing for direct marketing, and In simple terms, if there is a RECIPROCITY data sharing.” AGREEMENT, we have to respect the trademark Consent is further required for sharing information that they have in their country. with affiliates or even mother companies. THE MADRID PROTOCOL PERSONAL INFORMATION an international treaty, allowing trademark any information whether recorded in a material form registration in the Philippines or any country—as or not, from which the identity of an individual is long as they are part of the Madrid Protocol. apparent or can be reasonably and directly One would only need to file a single application. ascertained by the entity holding the information, or Should your application be ratified, the approved when put together with other information would mark will be protected in all the countries that are directly and certainly identify an individual.” part of the Madrid Protocol. SAN MIGUEL CORP. (Mother Company) DATA PRIVACY ACT Subsidiaries: (owned or controlled by the mother company) 1.Petron Corp. REPUBLIC ACT NO. 10173 of AUGUST 15, 2012 2. Bank of CommercePERSONAL INFORMATION AN ACT PROTECTING INDIVIDUAL PERSONAL 3. Magnolia (Ice cream & chicken) INFORMATION IN INFORMATION AND 4. San Miguel Brewery COMMUNICATIONS SYSTEMS IN THE 5.Great Food Solutions: San Miguel Foods ( coffee, GOVERNMENT AND THE PRIVATE SECTOR, processed meat, canned goods, etc.) CREATING FOR THIS PURPOSE A NATIONAL 6. Monterey Foods Corp PRIVACY COMMISSION, AND FOR OTHER 7. Culinary Center PURPOSES 8. San Miguel Properties Inc. ( Real Estate) a law that seeks to protect all forms of information, and many more. be it private, personal, or sensitive. It is meant to cover both natural and juridical Does the difference between personal information persons involved in the processing of personal and sensitive personal information matter? information. SCOPE - applies to any natural or juridical persons Yes. involved in the processing of personal information. Personal information may be processed, provided ; also covers those who, although not found or that the requirements of the Data Privacy Act are established in the Philippines: complied with. On the other hand, the processing of sensitive personal information is, in general, prohibited. PERSONAL INFORMATION versus SENSITIVE PERSONAL INFORMATION PERSONAL INFORMATION PROCESSING OF PERSONAL INFORMATION information that makes you readily identifiable refers to any operation or any set of operations performed upon personal information including, but SENSITIVE PERSONAL INFORMATION not limited to: race, ethnic origin, marital status, age, color, and - Collection religious, philosophical or political affiliations - Recording health, education, genetic or sexual life of a person, - Organization or to any proceeding for any offense committed or - Storage alleged to have been committed by such person, - updating or modification