Healthcare informatics comes in many shapes and sizes depending upon the specific need for computerized information. Of the many specialties, health information management, nursing informatics, and public health informatics stand out from the rest due to the impact that each area has had on informatics and healthcare. The informatics field has exploded in the last few decades, forever changing the way healthcare workers practice medicine.
Ranking the areas that have had the greatest impact on informatics starts with health information management (HIM) as the first most significant, followed by nursing informatics (NI), and finally public health informatics (PHI). The thought process behind the ranking system is prompted by the impact that each
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organization has on informatics and patients. Later in the document, the impact of each specialty is explained, along with a history of when each began. The older area, HIM, influenced the newer areas to arise, and is therefore more significant. NI is concerned with using information technology to directly affect individual patients, thus impacting the lives of others on a personal level. PHI was ranked last because the area is less personal than NI, and was not the foundation of informatics in healthcare; although, each area is incredibly important for its own reasons. To begin with, health information is any type of data that goes into a patient’s medical record (“Health Information 101,” n.d.). For example, health information includes the patient’s signs/symptoms, vital signs, medical history/diagnoses, physical examination…etc. The American Health Information Management Association defines health information management as, “the practice of acquiring, analyzing, and protecting digital and traditional medical information vital to providing quality patient care” (“Health Information 101,” n.d.). Health information management is extremely important to the informatics field because its history, in a sense, built the foundation for the use of electronic medical records. The concept of health information management began in 1928 (Mervat, Grostick, & Hanken, 2014, p.
41). It was around this time that healthcare organizations started to recognize the importance of tracking health information and setting standards to which each facility should adhere to; thus, accreditation organizations such as JCAHO (Joint Commission on the Accreditation of Healthcare Organizations) were born (Mervat, Grostick, & Hanken, 2014, p. 44). Fast forwarding a few decades, during the 1980s personal computers were more easily accessible and affordable, and the healthcare industry took the opportunity to begin integrating computers into the field, resulting in storing patient records in databases (Mervat, Grostick, & Hanken, 2014, p. 45). Throughout the 1990s, policy was updating and developing; healthcare workers recognized the need to protect patient privacy (Mervat, Grostick, & Hanken, 2014, p. 47). In 2010, healthcare information management set a goal to move toward a paperless health record (Mervat, Grostick, & Hanken, 2014, p. 47). Today, health information management is responsible for “EHRs and accompanying technology like health information exchange, computer-assisted coding, voice recognition software, and patient portals” (Dimick, …show more content…
2012). Ranking in second place, nursing informatics “integrates nursing science with multiple information management and analytical sciences to identify, define, manage, and communicate data, information, knowledge, and wisdom in nursing practice” (“What is Nursing Informatics?” n.d.). In 2015, a survey conducted revealed that nursing informatics positively impacted the quality of patient care (HIMSS, 2015). The idea of combining nursing and computers first came about in the early 1970s (Ozbolt & Saba, 2008). When the first personalized computers came out in the 1980s, nursing informatics began to bloom with “small-scale prototyping of nursing informatics applications” (Ozbolt & Saba, 2008). In 1992, the American Nurses Association officially recognized the field as a specialty (Hunt, Sproat, & Kitzmiller, 2004, p. 22). Throughout the 1990s and the early 2000s, standards in the field were being developed and continuing to evolve (Ozbolt & Saba, 2008). In 2004, President Bush deemed necessary that every American has an electronic medical record by 2014 (Ozbolt & Saba, 2008). By 2008, nursing had a standardized terminology tool that would allow universal comparison of patient records (Ozbolt & Saba, 2008). Today, nurses are able to discover ways to find and prevent health issues with informatics as a resource to help them access that data (Ozbolt & Saba, 2008). Third in ranking, public health is the category of healthcare that provides medical services to the individual patient and to the surrounding community (Mervat, Grostick, & Hanken, 2014, p. 516). The field collects and analyzes data of the health status of the population, develops strategies to improve health, and monitors the outcome in order to advance to future goals (Mervat, Grostick, & Hanken, 2014, p. 527). This is where informatics comes into play in today’s society. The help of electronic databases has made an enormous impact on data collection because the information is categorized and more easily accessible, as opposed to the old paper system. The data collected is reported to the CDC, and is used to change people’s behaviors and to change policies in order to improve health (Mervat, Grostick, & Hanken, 2014, p. 527 & 534). Based on an article posted on the BioMed Central website, the history of public health information systems is broken down into three waves. The first wave included state and federal data collection that could not share information. The second wave was a federally funded system which allowed the states to exchange data. The third wave includes today’s electronic data storage system “to solve the information needs of public health workers at different organizational levels, across organizations and with various health care and government stakeholders” (Reeder, Hills, Demiris, Revere, & Pina, 2011). The healthcare field, in general, is working on moving away from a “fee-for-service model,” with a goal in mind to base payment off of quality of healthcare (p. 58). What that means is that instead of putting a price tag on having staples applied to close a laceration to the scalp, the facility receives funds based on patient surveys; more money for quality care, less money for bad service. The goal “is to improve patient safety and quality while reducing healthcare costs and striving for affordable care” (p. 58). As healthcare continues to work toward its goal, there is a high demand for the health information management field (identified field of interest), to continue to meet the needs and expectations necessary for the plans going live (Kloss, 2016, p. 2-3). Some trends and challenges that impacted HIM in 2016 included the basic competence in information management for those who work in healthcare (Kloss, 2016, p. 3). Generally, healthcare workers are given complex tools to use in order to do their jobs effectively, but they do not necessarily have enough training on these tools, which results in technological problems (Kloss, 2016, p. 3). Another trend includes HIM working closer to those in a clinical role, which helps HIM to identify problems in a live environment that they might have not recognized prior to that (Kloss, 2016, p. 3). In the future, HIM faces the development of unique patient identifiers that allow the patient record to follow the individual from one facility to the next (“Achieving Interoperability That Supports Care Transformation,” 2015).
Other future goals include strengthening policy, offering “basic IM training for all who contribute to the electronic health record,” developing policies to manage long-term records, and more (Kloss, 2016, p. 5). With these objectives in mind, HIM hopes to achieve better collaboration skills with other professionals in order to create an easier environment for information exchange (Kloss, 2016, p.
5). In order to understand healthcare informatics as a whole, one must analyze the individual specialty areas beginning with the origin, present projects, and future plans. Informatics has impacted the healthcare world in infinite ways, as technology is continuously changing. Of the many specialties, health information management, nursing informatics, and public health informatics stand out from the rest due to the impact that each area has had on informatics and healthcare. Patients should look forward to their future care; informatics is creating a safer environment for people to receive the best care possible.
As the evolution of healthcare from paper documentation to electronic documentation and ordering, the security of patient information is becoming more difficult to maintain. Electronic healthcare records (EHR), telenursing, Computer Physician Order Entry (CPOE) are a major part of the future of medicine. Social media also plays a role in the security of patient formation. Compromising data in the information age is as easy as pressing a send button. New technology presents new challenges to maintaining patient privacy. The topic for this annotated bibliography is the Health Insurance Portability and Accountability Act (HIPAA). Nursing informatics role is imperative to assist in the creation and maintenance of the ease of the programs and maintain regulations compliant to HIPAA. As a nurse, most documentation and order entry is done electronically and is important to understand the core concepts of HIPAA regarding electronic healthcare records. Using keywords HIPAA and informatics, the author chose these resources from scholarly journals, peer reviewed articles, and print based articles and text books. These sources provide how and when to share patient information, guidelines and regulation d of HIPAA, and the implementation in relation to electronic future of nursing.
The federal government has taken a stance to standardized care by creating incentive programs that are mandated under the Health Information Technology for Economic and Clinical Health Act (HITECH) of 2009. This act encourages healthcare providers and healthcare institutions to adopt Meaningful use in order to receive incentives from Medicare and Medicaid. Meaningful use is the adoption of a certified health record system that acquires or obtains specified objectives about a patient. The objectives or measures are considered gold standard practices with the EHR system. Examples of the measures include data entry of vital signs, demographics, allergies, entering medical orders, providing patients with electronic copies of their records, and many more pertinent information regarding the patient (Friedman et al, 2013, p.1560).
Introduction “Health informatics is the science that underlies the academic investigation and practical application of computing and communications technology to healthcare, health education and biomedical research” (UofV, 2012). This broad area of inquiry incorporates the design and optimization of information systems that support clinical practice, public health and research; understanding and optimizing the way in which biomedical data and information systems are used for decision-making; and using communications and computing technology to better educate healthcare providers, researchers and consumers. Although there are many benefits of bringing in electronic health systems there are glaring issues that associate with these systems. The
The goal of the program is to increase EHR adoption, improve quality, safety, reduce disparities, and improve public health (HMSA, 2012). The Meaningful Use program was set up for implementation in three stages over a five-year period. The first stage ended in 2012 and involved evaluating health trends, and finding out methods to engage patients and families in their own care. Stage two focuses on advanced data sharing, such as e-prescribing and electronic exchange of patient information between professionals. Stage three’s focus will be on outcomes, patient access to care and self-help care tools for patients, such as access to their medical records.... ...
Health informatics is best described as the point where information science, medicine, and healthcare all meet. It encompasses the resources, devices, and methods required to optimize the acquisition, storage, retrieval, and the use of information in health and biomedicine. Health informatics incorporates tools such as: computers (hardware and softwar...
Unfortunately, the quality of health care in America is flawed. Information technology (IT) offers the potential to address the industry’s most pressing dilemmas: care fragmentation, medical errors, and rising costs. The leading example of this is the electronic health record (EHR). An EHR, as explained by HealthIT.gov (n.d.), is a digital version of a patient’s paper chart. It includes, but is not limited to, medical history, diagnoses, medications, and treatment plans. The EHR, then, serves as a resource that aids clinicians in decision-making by providing comprehensive patient information.
“An electronic health record (EHR) is a digital version of a patient’s paper chart. EHRs are real-time, patient-centered records that make information available instantly and securely to authorized users.” (healthit.gov) The EHR mandate was created “to share information with other health care providers and organizations – such as laboratories, specialists, medical imaging facilities, pharmacies, emergency facilities, and school and workplace clinics – so they contain information from all clinicians involved in a patient’s care.” ("Providers & Professionals | HealthIT.gov", n.d., p. 1) The process has proved to be quite challenging for providers. As an incentive, the government began issuing payments to those providers who “meaningfully use certified electronic health record (EHR) technology.” (hhs.gov) There are three stages that providers must progress through in order to receive theses financial incentives. Stage one is the initial stage and is met with the creation and implementation of the HER in the business. Stage two “increases health information exchange between providers.” ("United States Department of Health and Human Services | HHS.gov", n.d., p. 1) Stage three will be the continuation and expansion of the “meaningful use objectives.” ("United States Department of Health and Human Services | HHS.gov", n.d., p. 1) The hospital, where I work, initiated the HER mandate many years ago. In this paper, I will discuss the progression and the challenges that my hospital encountered while implementing the EHR mandate.
According to the National Alliance for Health Information Technology (2008) and the American Health Information Management Association (AHIMA) (2012), the personal health record (PHR) is defined as the individual lifelong electronic health records. Its features are electronic, readily available, personal control, standardization, resource sharing, and portability. Although the PCEHR is currently being implemented in several countries of the world, it still has many controversial disadvantages. Hoy, Yoshihashi, & Bailey, 2012) mention that some of the ideal functions of PHR, include patient controlled, longitudinal record, interoperable and resource sharing, portability, automated input of clinical reports, as well as the integration of clinician workflow. "The PCEHR is aimed to be a secure electronic summary of people's medical history stored and shared in a network of connected systems from a central electronic hub (Australian Nursing Journal, Aug. 2012; Kerai, Wood, &Martin, March 2014)”. The Australian Government has clear legal provisions on PCEHR implementation, including the conditions of participation, target participants, methods and procedures of registration, informed consent, security requirements, penalties for violation of privacy and mitigation strategies (Australian Nursing Journal, Aug. 2012; Australia Government ComLaw, 2012; Williams, 2013; Wilson, 2012). However, The Australian (2013, September 17) notes that the Australia government has invested 1 billion on the project, but only 0.6% of people actually using this program registered at about 65 million electronic health record conditions.
The confidentiality of patient visits and medical records are essential in providing the highest quality of health care. Under penalty of law, a patient's medical records or any other information regarding the patient may only be released with his or her authorization. Exceptions to this are certain cases specified by law for example, health care providers are required to report certain communicable diseases such as measles. Many organizations and laws have been developed to maintain patient's rights of confidentiality and access to their medical record. Guided by the principle that confidentiality is essential in developing strong trust between patients and healthcare providers, the American Health Information Management Association (AHIMA) members are committed to ensuring that patient records are disclosed and only available to medical personnel and others acquired by law. In July 1999, the Health Care Financing Administration (HCFA), introduced a new Patient's Rights Condition of Participation (CPO) that hospitals must meet to be approved for, or to continue participation in the Medicare and Medicaid programs. The Health Insurance and Accountability Act of 1996 (HIPAA) addresses the security and privacy of health data and also issues standards for electronic health care transactions. The vast accumulations of personal medical data gives rise to serious privacy concerns as a result of the potential for misuse.
The health industry has existed ever since doctors bartered for chickens to pay for their services. Computers on the other hand, in their modern form have only existed since the 1940s. So when did technology become a part of health care? The first electronic health record(EHR) programs were created in the 1960s around the same time the Kennedy administration started exploring the validity of such products (Neal, 2013). Between the 1960s and the current administration, there were little to no advancements in the area of EHR despite monumental advancements in software and hardware that are available. While some technology more directly related to care, such as digital radiology, have made strides medical record programs and practice management programs have gained little traction. Physicians have not had a reason or need for complicated, expensive health record suites. This all changed with the introduction of the Meaningful Use program introduced in 2011. Meaningful use is designed to encourage and eventually force the usage of EHR programs. In addition, it mandates basic requirements for EHR software manufactures that which have become fragmented in function and form. The result was in 2001 18 percent of offices used EHR as of 2013 78 percent are using EHR (Chun-Ju Hsiao, 2014). Now that you are caught up on some of the technology in health care let us discuss some major topics that have come up due to recent changes. First, what antiquated technologies is health care are still using, what new tech are they exploring, and then what security problems are we opening up and what is this all costing.
Advances in technology have influences our society at home, work and in our health care. It all started with online banking, atm cards, and availability of children’s grades online, and buying tickets for social outings. There was nothing electronic about going the doctor’s office. Health care cost has been rising and medical errors resulting in loss of life cried for change. As technologies advanced, the process to reduce medical errors and protect important health care information was evolving. In January 2004, President Bush announced in the State of the Union address the plan to launch an electronic health record (EHR) within the next ten years (American Healthtech, 2012).
Healthcare is changing daily and with technology these changes are occurring faster. Health informatics is one of these changes. It combines healthcare, information technology and business. This technology makes it easier for healthcare personnel to access client information and for clients to manage their healthcare.
My overall vision is to develop and promote information technology solutions to better improve health outcomes, patient safety, and prevention of medical errors in underserved countries. In closing, Health informatics and Health Information Management is an exciting program that is designed to provide me with a suite of resources to help me develop essential leadership, teamwork, and healthcare management skills that will help me to become successful leader in healthcare
To better understand the roles needed to enhance the public health infrastructure; one must first know the purpose of a health informatician. An informatician is a person who studies or work in the field of informatics. According to the American Medical Informatics Association Inc., “Public Health Informatics is the application of informatics in areas of public health, including surveillance, prevention, preparedness, and health promotion. Public health informatics and the related population informatics, work on information and technology issues from the perspective of groups of individuals” (2016). In order to build a solid infrastructure
The term informatics describes using technology to obtain, control, and apply information when making economical decisions. Health care informatics is an application of computers and computer technology to assist the gathering of electronic health records, data sharing, communications, and coding to improve the quality and safety of patient care. The definition of health informatics is dynamic because the field is rapidly changing but healthcare informatics is more than just collecting data it is a device that can formalized methods to manage information for problem solving and decision making.