question answers

Chapter6HealthInformationTechnology.pptx

Home >Nursing homework help >question answers

Strategic Planning and Health Information Technology

Chapter 6

“The difference between what we do and what we are capable of doing would suffice to solve most of the world's problems.”

—Gandhi

Learning Objectives

Understand the concept of healthcare information, including how it is collected, stored, accessed, and used.

Communicate technical health information system concepts in a language that can be understood by healthcare staff.

Articulate an understanding of the role of health information system development and integration.

Demonstrate the use of healthcare information in management and organizational decision making.

Critically analyze current issues surrounding health information systems within the healthcare environment.

Identify the strategic impact of health information systems.

Key Terms and Concepts:

Big data

Clinical information systems

Critical access hospital

Direct-to-consumer telehealth

E-health

Health information technology (HIT)

Healthcare data analysts

Healthcare data warehouse

Meaningful use

Patient portal

Telehealth

Value-based purchasing

Introduction

This chapter discusses the use of health information technology (HIT)—the comprehensive management of health information across computerized systems and its secure exchange between consumers, providers, government, quality entities, and insurers.

Organizations will need to manage population health as they shift from fee-for-service reimbursement to bundled payment and value-based purchasing.

Simply having a data repository in the electronic health record (HER) is not enough. We must be able to interpret and manage the data through data analytics to obtain information that is useful in improving patient outcomes.

What Technology/Data Is Used in Healthcare?

Clinical information systems are technology applied at the point of care and designed to support the acquisition of information and storage and processing capabilities.

The use of big data will allow healthcare professionals to use millions of cases to improve the standard of care, participate in population health, and identify and intervene on behalf of groups at risk for poor outcomes (Riskin 2012).

Improvement in patient care (e.g., comprehensive med list) and ease of sending and receiving information within the referral network were among the most common reasons for adoption of HIT.

Major barriers included cost and loss of productivity (Cochran et al. 2015).

Meaningful Use

Meaningful use: A CMS-sponsored program imposing a standard for using certified EHR technology to improve the overall quality of healthcare by providing financial incentives (i.e., using data in a meaningful way in order to improve care).

Meaningful use is being implemented in three stages:

Stage 1, enacted 2011–2012, devoted to data capture and sharing.

Stage 2, in 2014, focused on advancing clinical processes such as implementation of computerized provider order entry and medication reconciliation.

Stage 3, to begin in 2017, will deal with improved outcomes (HHS 2015b).

For more information: https://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/EducationalMaterials.html

E-Health/Telemedicine/Telehealth

These terms are often used interchangeably by both healthcare providers and consumers.

Telemedicine was originally used to describe medical service provision across a distance.

As telemedicine became a broader possibility with more applications, the term telehealth was introduced to reflect a broader scope of health-related functions.

E-health, used to cover a broad range of data processing and computer networking applications (including the Internet) in healthcare, has emerged.

Impact of the ACA on E-Health

As healthcare organizations respond to the Affordable Care Act (ACA), they will increasingly use digital health data to reduce costs and improve accountability.

The growth of health systems and ACOs requires analyzing and sharing patient data securely across the continuum of care, leading to wireless devices and mobile applications.

As of January 2014, 58% of American consumers reported having a smartphone, and 42% had a tablet computer (HIMSS Analytics 2014b).

Direct-to-Consumer Telehealth

Marketing telehealth services directly to the consumer is a growing trend.

This change was driven in great part by search engines such as Google, which created an infrastructure that allows individuals to search for health information and then connect with a doctor from a healthcare organization. (See patient portal information for marketing in Chapter 5).

Patients are becoming more savvy and asking questions based on Internet searches.

Sample Search for Esophageal Cancer

Patient Portals

Secure websites that give patients 24-hour access to personal health information.

Advanced patient portals allow patients to do the following:

Communicate via secure e-mail with their healthcare teams

Request prescription refills

Schedule appointments

Check insurance coverage

Update personal information

Make payments

Download and complete forms

View educational materials.

In 2014, 62 percent of US hospitals had a patient portal.

However, only 23 percent of those portals allowed patients to access their EHR and diagnostic results (HIMSS Analytics 2014b).

Use of Smart Phones by Providers

In 2014, more than half of US hospitals reported the use of smart phones and tablet computers at their facilities.

In addition, 59 percent of hospitals reported that they used these devices to access clinical information.

Only 33 percent of hospitals stated that all clinical data could be accessed via these devices (HIMSS Analytics 2014a).

Institutions will need to invest in these devices in the future to maximize efficiency and use of technology.

Healthcare Data Warehouses

Data warehouse: Database that integrates multiple types of data, such as patient demographic information, comprehensive clinical information, and resource utilization data.

These databases are large and require special software for storage, management, and analysis.

As of 2015, these databases can be measured in terabytes (thousands of gigabytes); however, as technology advances they will increase in size.

This new technology furnishes an opportunity to improve the global economy and enhance US healthcare by fostering an environment of innovation.

Clinical Information Systems Initiatives

In 2015, worldwide IT spending was on pace to total $3.5 trillion (Lovelock et al. 2015).

HIT will represent a $10 billion market by 2020 (Manyika et al. 2011).

HIMSS Analytics EMR Adoption Model

HIMSS’s Electronic Medical Record (EMR) Adoption Model measures the level of clinical information systems adoption in US hospitals.

It rates hospitals’ level of adoption using a seven-stage scale, where Stage 0 indicates the lowest level of adoption and Stage 7 indicates the highest level of adoption.

As of February 2015, more than nine out of ten hospitals eligible for the Medicare and Medicaid EHR Incentive Program had achieved meaningful use of certified HIT or Stage 1 of the Adoption Model.

Evidence-Based Medicine Initiatives

Personalized medicine is driving continuous change in evidence-based medicine (Raths 2015).

President Obama’s 2016 budget included $215 million to provide clinicians with new tools, knowledge, and therapies that will work best for individual patients.

Personalized medicine can involve genetic mapping to identify which medications will have the maximum effect on a specific cancer.

Dustin's story

Exhibit 6.2

Data Security

Ensuring data security and compliance with all HIPAA requirements is critical to any strategic HIT initiative.

Use of firewalls and password protection should be a part of the IT infrastructure.

There are several examples of huge data breaches in recent years.

2013, Target: 40 million credit and debit cards were stolen.

2014, Sony Pictures: e-mails, pictures, executive salary information, etc.

2015, US Office of Personnel Management: Four million current and former federal employees had personal information exposed (Pettypiece 2015).

How to Help Keep Data Safe

Dispose of paper documents containing patient information in secured containers. Shred documents if not recycled or burned.

Prevent unauthorized access by password-protecting all of your devices and using unique, complicated passwords for your online accounts.

Be vigilant to phishing on all digital devices.

You should never log in to financial accounts or shop online while using public wi-fi, and make sure to password-protect your wi-fi at home.

It is best to review your credit reports and bank accounts periodically looking for suspicious activity and errors that could signify identity theft.

Do not allow use of nonencrypted jump drives on institutional computers.

Healthcare Data Analysts

Individuals hired by healthcare organizations to compile, validate, and analyze crucial medical data.

Healthcare data analysts use cutting-edge tools in advanced analytics to help interpret data, discover new information, and evaluate data quality.

Project examples:

Optimization of operating room schedules to maximize productivity and utilization rates

Optimization of appointment scheduling to meet patient demand

Simulation for capacity operation in the emergency department during seasonal peaks

Analysis of service-line volume to identify potential new markets

Forecasting workload and revenue by departments

Forecasting changes in key performance metrics in the dashboard

Healthcare Information Resources

The Internet offers a wide variety of informational resources useful to healthcare strategic planners.

The following slides discuss some of those resources.

International Data

NationMaster is a central data source to compare nations.

It is a vast compilation of data from such sources as the CIA World Factbook, UN, and OECD.

www.nationmaster.com

Contains:

Information on disasters

Economic information, such as GDP, per capita income, etc.

Health statistics from countries around the world

National Data

Center for Medicare and Medicaid Services (CMS)

CMS research, statistics, data, and systems

www.cms.hhs.gov

Contains data on annual Medicare and Medicaid expenditures and national healthcare expenditures

National Data

Healthy People 2020 outlines opportunities to avoid preventable diseases, disability, injury, and premature death.

www.healthypeople.gov

Innovative approaches to helping communities track their progress as they develop an agenda for health improvement.

National Data

FedStats provides access to the full range of official statistical information produced by the federal government.

https://fedstats.sites.usa.gov/

The site provides links to more than 100 agencies that provide data and trends on such topics as economic and population trends, crime, education, healthcare, aviation safety, energy, farm production, etc.

National Data

US Census Bureau provides extensive information from the American Community Survey broken down at the Zip Code level.

www.census.gov

The American Community Survey lets communities see how they are changing by filling in the gaps between each ten-year census.

National Data

National Center for Health Statistics, part of the CDC/Department of HHS, is the nation’s principal health statistics agency. It compiles statistical information, mainly through surveys (e.g., the National Ambulatory Medical Care Survey), to guide health policy and improve the health of the population.

www.cdc.gov/nchs/

US State Data

StateMaster is a statistical database on US states. Primary sources: the US Census Bureau, the FBI, and the National Center for Educational Statistics.

StateMaster goes beyond the numbers to provide you with visualization through pie charts, maps, graphs, and scatterplots.

www.statemaster.com/index.php

Provides information on the health of your state, such as life expectancy and obesity levels by region.

US State Data

State Health Facts is a statistical database sponsored by the Kaiser Health Foundation with extensive state healthcare demographic information.

www.statehealthfacts.org/index.jsp

It includes information about states’ residents, including demographics, income, employment, etc.

US State Data

California HealthCare Foundation

California has the largest population in the United States. Its more than 36 million residents represent 12 percent of the total US population.

www.calqualitycare.org

Quality data on California hospitals—e.g., timeliness of care, overall patient experience, and adherence to recommended patient safety practices

Florida Department of Health

Florida is one of the most populous states in the United States. Its 17.7 million residents represent more than 6 percent of the total US population.

www.floridahealth.gov

Annual vital health statistics data, public health data, information on hurricanes, practitioner profiles, and professional licensure listings

Hospital Data

Agency for Healthcare Research and Quality (AHRQ): A federal government website with links to data, survey reports, and tools, including AHRQ’s Healthcare Cost and Utilization Project.

www.ahrq.gov

Funds research in the following areas: quality improvement, patient safety, outcomes, effectiveness of care, clinical practice, technology assessment, healthcare delivery systems, primary care, preventive services, healthcare costs and financing.

Hospital Data

Guidestar provides organizational and financial data on not-for-profit corporations.

www.guidestar.org

Discuss recent Form 990, or find out more about its mission, programs, and finances.

Hospital Compare Quality Data

CMS and the Hospital Quality Alliance (HQA) are working together to create and publicly report hospital quality information.

www.hospitalcompare.hhs.gov

Includes patient experience (HCAHPS), timely and effective care, complications, readmissions and deaths, use of medical imaging, payment, and value of care.

Nursing Home Compare Quality Data

Evaluate nursing home facilities by local, state and national comparisons.

Includes the CMS’s Online Survey, Certification, and Reporting (OSCAR) database, with nursing home characteristics and health deficiencies found during state inspections.

www.medicare.gov/NHCompare/home.asp

Quality measures come from the MDS Repository, which is collected for every resident in a Medicare- or Medicaid-certified nursing home.

Summary

Health information technology has important strategic value in healthcare.

Leadership support of IT steering committees and leadership involvement in the development of IT disaster recovery plans are particularly important.

Most vital, future advances in personalized medicine provide opportunities for improved clinical outcomes for individual patients.

References

Cochran, G. L., L. Lander, M. Morien, D. E. Lomelin, H. Sayles, and D. G. Klepser. 2015. “Health Care Provider Perceptions of a Query-Based Health Information Exchange: Barriers and Benefits.” Journal of Innovation in Health Informatics 22 (2): 302–8.

DeGaspari, J. 2015. “Making Sense of an Onslaught of Data in Public Health.” Healthcare Informatics. Published January 21. www.healthcare-informatics.com/article/top-ten-tech-trend-making-sense-onslaught-data-public-health.

Fatehi, F., and R. J. Wootton. 2012. “Telemedicine, Telehealth or E-health? A Bibliometric Analysis of the Trends in the Use of These Terms.” Journal of Telemedicine and Telecare 18 (8): 460–64.

HealthIT.gov. 2015. “What Is a Patient Portal?” Accessed August 13. www.healthit.gov/providers-professionals/faqs/what-patient-portal.

HIMSS Analytics. 2015. “Validated Stage 6 & 7 Providers List.” Accessed August 27. www.himssanalytics.org/stage7.

———. 2014a. “Essential Brief: Mobile Devices Study.” Published December 9. www.himssanalytics.org/research/essentials-brief-mobile-devices-study

References

———. 2014b. “Essentials Brief: Patient Engagement Series: Patient Portal Study.” Published October 28. www.himssanalytics.org/research/essentials-brief-patient-engagement-series-patient-portal-study.

Hsiao, C., and E. Hing. 2014. “Use and Characteristics of Electronic Health Record Systems Among Office-Based Physician Practices: United States, 2001–2013.” National Center for Health Statistics Data Brief 143 (January): 1–8.

Lovelock, J.-D., K. Hale, A. O’Connell, W. L. Haden, R. Atwal, and C. Graham. 2015. “Forecast Alert: IT Spending, Worldwide, 2Q15 Update.” Gartner. Published June 29. www.gartner. com/doc/3084417.

Manyika, J., M. Chui, B. Brown, J. Bughin, R. Dobbs, C. Roxburgh, and A. H. Byers. 2011. “Big Data: The Next Frontier for Innovation, Competition, and Productivity.” McKinsey & Company. Published May. www.mckinsey.com/insights/business_technology/ big_data_the_next_frontier_for_innovation.

Pennic, J. 2014. “Only 8 Hospitals Have Attested for Meaningful Use Stage 2.” HIT Consultant. Published June 17. http://hitconsultant.net/2014/06/17/only-8-hospitals-have-attested-for-meaningful-use-stage-2/.

References

Perna, G. 2015. “Direct-to-Consumer: Alternative Methods of Telehealth Take Hold.” Healthcare Informatics. Published January 21. www.healthcare-informatics.com/article/ top-ten-tech-trends-direct-consumer-alternative-methods-telehealth-take-hold.

Pettypiece, S. 2015. “Rising Cyber Attacks Costing Health System $6 Billion Annually.” Bloomberg Business. Published May 7. www.bloomberg.com/news/articles/2015-05-07/ rising-cyber-attacks-costing-health-system-6-billion-annually.

Raths, D. 2015. “Setting the Roadmap for FHIR.” Healthcare Informatics. Published January 21. www.healthcare-informatics.com/article/top-ten-tech-trends-setting-roadmap-fhir.

Riskin, D. 2012. “Big Data: Opportunity and Challenge.” Healthcare IT News. Published June 12. www.healthcareitnews.com/news/big-data-opportunity-and-challenge.

Staheli, R. 2015. “4 Ways Healthcare Data Analysts Can Provide Their Full Value.” Health Catalyst. Accessed August 29. www.healthcatalyst.com/healthcare-analytics-best-practices.

US Department of Health and Human Services (HHS). 2015a. “Framework.” Accessed August 29. www.healthypeople.gov/sites/default/files/HP2020Framework.pdf.

References

———. 2015b. “Meaningful Use Definition and Objectives.” Accessed January 29. www. healthit.gov/providers-professionals/meaningful-use-definition-objectives.

US Department of Veterans Affairs (VA). 2015. “Where Do I Get the Care I Need?” Accessed August 29. www.va.gov/health/FindCare.asp.

US Office of Personnel Management (OPM). 2015. “OPM Announces Steps to Protect Federal Workers and Others from Cyber Threats.” Published July 9. www.opm.gov/news/ releases/2015/07/opm-announces-steps-to-protect-federal-workers-and-others-from-cyber-threats/.

Walker, M. B. 2015. “Leidos, Cerner win ‘DHMSM,’ DoD’s $11B Electronic Health Record Contract.” FierceGovHealthIT. Published July 29.

www.fiercegovhealthit.com/story/breaking-leidos-cerner-win-dhmsm-dods-11b-electronic-health-record-contract/2015-07-29.

West, D. M. 2013. “Improving Health Care Through Mobile Medical Devices and Sensors.” Brookings Institution. Published October 22. www.brookings.edu/research/ papers/2013/10/22-improving-health-care-mobile-medical-devices-apps-sensors-west.