Chapter 21
Informatics and Health Care
Technologies
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Meaningful Use of Electronic Health
Record
Improve quality, safety, efficiency, and reduce health
disparities
Engage patients and family
Improve care coordination and population and public
health
Maintain privacy and security of patient health
information
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Results of Meaningful Use Compliance
(EHR)
Better clinical outcomes
Improved population health outcomes
Increased transparency and efficiency
Empowered individuals
More robust research data on health systems
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ANA Definition of Nursing Informatics
“The specialty that integrates nursing science with
multiple information management and analytical
sciences to identify, define, manage, and
communicate data, information, knowledge, and
wisdom in nursing practice.”
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Components of System Development
Lifecycle (SDLC)
Analyze and plan
Design and develop
Test
Train
Implement
Maintain
Evaluate
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Analyze and Plan #1
What is the purpose of this new technology or
change to the current technology?
What problem do we hope to solve?
What data do we have to indicate the current state
of the issue (how bad is the problem)?
How will its use be incorporated into the current
workflow of the nurse?
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Analyze and Plan #2
Will it streamline nursing documentation, or will it
increase the burden of documentation?
Will it improve the overall usability and experience
with the EHR?
What technologic options are available if there are
more than one?
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Design and Develop
What should the screen display look like? How
should it be laid out to be consistent with other
screen layouts?
Can the design support or improve the nurse’s
workflow as mapped out during the analysis and
planning phase?
Is there evidence supporting the effectiveness of the
new technology and, if so, does it provide
recommendations for the design?
Can we use standard nursing terminology in the
electronic system to better capture nursing’s
contribution to care delivery and patient outcomes?
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Testing
Unit testing
Function testing
Integration testing
Performance testing
User acceptance testing
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Maintenance #1
Ongoing updates to orders and medication
preference lists, provider patient lists
Ongoing updates to scheduling blocks (ambulatory,
radiology, and procedure areas)
Monthly loads (new medications, medication pricing,
and clinical alerts)
Error work queue maintenance (example billing
errors, sure script errors, many types of interface
errors)
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Maintenance #2
Pricing updates
Quality measures updates
Clinical decision support tools/rules
Monthly updates from EHR vendor
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Examples of Technology Evaluation Steps
1. Determine what will be evaluated
2. Determine the question
3. Conduct a literature search
4. Determine the needed data
5. Determine the study type
6. Determine the data collection method and sample
size
7. Collect, analyze, and display data
8. Document your outcome evaluation
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Important Informatics Concepts
System usability
System optimization
Standard terminologies
Interoperability
Security and privacy
Blockchain
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Emerging Areas in the Field of Informatics
Patient portals
Health care analytics
Data visualization
Predictive analytics
Big data
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Telehealth and Mobile Technologies
Telehealth: the use of electronic information and
telecommunications technologies to support and
promote long-distance clinical health care, patient
and professional health-related education, public
health, and health administration
Telemedicine: the use of telecommunications
technologies to support the delivery of all types of
medical, diagnostic, and treatment-related services,
usually by physicians or nurse practitioners
Telecare: refers to technology that allows consumers
to stay safe and independent in their own homes
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Uses of Patient Portals #1
Access medical history and other health information
Complete various forms and questionnaires online
Communicate securely and conveniently with
providers
Request prescription refills
Pay bills
Review lab results
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Uses of Patient Portals #2
Schedule appointments
Receive reminders for appropriate screenings
Enter clinical data, such as blood pressure, glucose
levels, weight, Fitbit data, and other activity tracking
data
Review progress notes
Access educational materials based on diagnosis or
procedure
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Benefits of Patient Portals
Better health outcomes
Chronic condition management
Timely access to care
Patient retention
Patient-centered medical home recognition
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Types of Health Care Analytics
Clinical
Populations
Administrative
Financial
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Genetics and Genomics: Precision
Medicine
The field of genomics has the potential to
significantly change the way health care is delivered
Genomics play a role in 9 of the 10 leading causes of
death, including heart disease, cancer, stroke,
diabetes, and Alzheimer’s disease (WHO, 2004)
Because genomic health care is heavily dependent
on data storage and interpretation, no other area is
better suited than informatics to support this
evolving work
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