HIM 301 Introduction to Health Informatics WK4-A

Week 4 Assignment

The assignment is to create a policy and include the following:

· Policy Title

· Version Number

· Effective Date

· Date Ratified

· Ratified By

· Introduction (Rationale for the policy)

· Definition

· Policy

· General Guidelines

Do not tell me what a policy is but rather create the policy.  How do you write a policy? In doc sharing, I uploaded a file on writing a policy as a resource for you.

Textbook reading additional information:

Chapter 19 addresses Privacy, Confidentiality, Security and Data Integrity. You may think, you know about this from your legal course, but we are looking at the topic from an informatics perspective. The Code of Ethics serves several purposes:

1. Ethical guidance in the professional realm of informatics.

2. A set of principles used as a benchmark for comparison with other processionals.

3. To provide the public with a clear statement of the ethical considerations for Health Information Professionals.

Chapter 20 Patient Safety and Quality initiatives in Informatics. While some of this is addressed in HCA 375, this again is looking at quality from an informatics perspective.  Look at Page 325 in the textbook.  How many of those organizations have you heard of before?

Be sure to review Figure 20-1 A framework for patient safety and quality research design. Does Donebedian come to mind when you see structure, process and outcome? There are great expectations of systems like electronic health records.

As we see from the continued follow-up in the industry after the Institute of Medicine Reports (mentioned in your text Pgs 400-401), there is an expectation on the part of health care stakeholders that investment in certain types of Health Information Technology, like decision support systems- (CPOE and the like) will reduce error in health care organizations. Health sciences and public health research teams continue to quantitatively study the effects of using decision support EHR systems (CDSS) systems.

Moja, Kwat, Lytras, Bertizzolo et al (2014) studied 28 randomized control studies published on the results of the use of CDSS or clinical decision support systems integrated within EHRs. Their results on health care services equipped with versus health care not equipped with CDSS or Clinical Decision Support Systems suggest that this technology does not result in substantial benefits or risks for patients in terms of mortality. This effect, when it occurs in the randomized control studies (RCTs) evaluated, is largely dependent on the disease and setting characteristics. Having said that, the technique used in this Meta Analysis, called subgroup analyses, can lead to misleading claims when the overall data are limited and unavoidably weak because of inherent design problems.

Analysis of morbidity shows a slightly more causal relationship between morbidity and the use of CDSS systems. Effects on morbidity might exist and the magnitude of the effect, in the order of 10% to 20%, could be large enough to impact mortality if appropriate follow-up is ensured. The results of this study provide enough evidence to continue advance the debate on the benefits of CDSSs and the need for rigorous scientific studies in this field.

Chapter 21 Improving the User Experience for Health Information Technology Products. In Week 1, one of the recommended resources was a YouTube video on the  The ballad of go-live: CareConnect electronic health record implementation . Do you see the connection with this chapter?  A hot topic right now is also Nurse dissatisfaction with the E H R. Medical Practice Insider posted an article in October 2014 about why nurses dislike their E H R.  Most common reasons for dislike?

· Someone else selected the system with little if any input from the end users.

· End users find it difficult to operate

· The system is a drain on productivity.

This chapter is addressing these issues.

Chapter 22 Standards.  This topic is addressed in more detail in another informatics course, so I encourage you to keep this book. It will be helpful in other courses and this is an excellent example why.  If you have completed a coding course, some of the terminology or classification will be familiar to you, but some of the other examples are probably not.  When you look at Table 22-1, think of it as what is this terminology or classification claim to fame.  When or how it is used.   Do pay close attention to the Omaha System in Table 22-6.

Chapter 23 Health Information Technology Governance.  This is a hot topic in the health care industry although our chapter is very short.  There is a new course under development that spends the entire time talking about this topic. If you complete a search engine query on Data governance or Business Intelligence (BI) there are millions of possibilities. So what is it all about? Think of it as accountability for:

· Master Data

· Transactional Data

· Reference Data

· Metadata

· Historical Data

· Temporary Data

· or other types

Fun Fact: If you own a credit card and have ever gotten a call or text from your credit card company when traveling, then you have experienced the use

Chapter 24 Legal Issues, Federal Regulations and Accreditation. You will recognize three familiar phrases from your Legal course. See page 387 for an excellent summary of the security safeguards.  A great reference page to keep in your portfolio of helpful information for the future.

· Administrative Safeguards

· Physical Safeguards

· Technical Safeguards

Be sure to review Table 24-1 on page 380 of the textbook.  Previously, I mentioned that in healthcare, when there is change, often it is related to money “follow the money.”  Can you think of examples where money was the driving force for change in healthcare?

· DRGs

· Readmissions

· Nosocomial infections

· Implementation of the E H R

· ?  Can you think of more examples?

Chapter 25 Health policy and Informatics.  We are almost at the conclusion of the course.  Can you see how the Informatics topics overlap in a myriad of areas and professions?

References

Moja, L., Kwag, K. H., Lytras, T., Bertizzolo, L., Brandt, L., Pecoraro, V., & ... Bonovas, S. (2014). Effectiveness of computerized decision support systems linked to electronic health records: a systematic review and meta-analysis. American Journal of Public Health, 104(12), e12-e22. doi:10.2105/AJPH.2014.302164