Data Management and Health Care Technology Flashcards
Health Information Technology (HIT)
Healthit.gove 2017
HIT-the application of information processing involving both computer hardware and software that deals with the storage, retrieval, sharing, and use of hc information, data, & knowledge for communication and decision making
Data management & HC technology
A. Data standards
B. Data management
C. Data analysis, application, and transformation
D. Hardware, software and peripherals
Metadata and semantic representation
Metadata: set of data that describes and gives information about other data (author, date created, file size)
Semantic representation: relates to the meaning of language or logic. It pertains to the meaning or interpretation of a work or sign
a. nomenclatures b. terminologies c. destination/final stop d. interoperability
Standardized Nomenclatures
Nomenclatures are terminologies or naming conventions (especially in science)
Technical standards
Standardized Terminologies
ANA Recognized:
1. Interface terminologies
a. Clinical Care Classifications (CCC)
b. International Classification for Nsg Prac (ICNP)
c. North Am Nursing Dx Assoc-Int’l (NANDA-I)
d. Nursing interventions classification sys (NIC)
e. Nursing outcomes classification sys (NOC)
f. Omaha system
g. PeriOperative Nursing Dataset (PNDS)
h. Nursing Minimum Data Set (NMDS)
I. Nursing Mgmt Minimum Data Set (NMMDS)
2. Multidisciplinary Terminologies:
a. ABC Codes
b. SNOMED CT
c. Logistical obsv ident names & codes (LOINC)
3. Administrative Terminologies
a. CPT
b. ICD (9 & 10)
c. HCPCS
Technical Standards
Health Level 7 (HL7)
Fast Healthcare Interoperability Resources (FHIR)
International Organization for Standardization (ISO)
Data Communication Standards
- Am National Standards Institute (ANSI) x12
- Am Society for Testing Materials ( ASTM31)
- Inst of Electrical & Electronic Engineers (IEEE)
a. 802.11-1997 - Fast Healthcare Interoperability Resources (FHIR)
- Digital Images & Communication in Medicine (DICOM)
- Natl Council of RX Drug Programs (NCPDP)
- Logical Obsv Ident Names & Codes (LOINC)
- Intl Standard Org (ISO)
- Health Level 7 (HL&)
Data Management
Database types, integration, and data warehousing
a. enterprise data warehouse (EDW)
Data archiving concepts and principles
Backup process
Downtime and disaster recovery
Patient-generated data (iWatch, fitbit etc)
Cerner Millenium is example of relational database
Data Analysis, Application, Transformation
- Metastructures: data, information, knowledge, wisdom
- Querying and reporting from databases (data mining)
- Data analytics (Big Data)
- Data representation
- Patient safety, quality and risk management
Data Analysis, Application, Tansformation
Querying and reporting from databases (ex: SQL, SAS)
AND
OR
NOT
Big Data
- Large volume of data too difficult to process using standard database techniques
- Characteristics: volume, variety, velocity, variability
- Analysis requires Hadoop, Mongo (not SQL)
Data Representation
Selecting appropriate depiction of the data (ex: graphs, charts, images, reports)
Histograms
Dashboard-real-time displays
Dashboard:
Current real-time display of key metrics
Patient Safety, Quality, Risk Management
Proactive approach
- Core measures
- Patient satisfaction surveys
- Root cause analysis
- Close call events, QSEN, TQM, Six Sigma, LEAN, Value Stream Mapping-futility/wastefullness
- Failure Mode Effect Analysis (FMEA)
Root Cause Analysis (RCA)
Retrospective approach
Structured retrospective method to analyze adverse events
ID Underlying problems that increase the likelihood of errors
Uses a systems approach
Failure Mode Effect Analysis
Proactive Approach
- A systematic proactive method to evaluate a process to identify where and how it might fail
- Aimed at prevention of tragedy
- Does not require previous bad experience or close call
- Makes system more robust
Hardware Overview
- Legacy Systems
- Technical Specifications
- Devices (biometrics, monitoring, barcode scanners, dispensing cabinets, IV pumps, auto disp cabinets)
- Storage
- Networks
- Platforms
- CPU
- Protocols
Legacy systems
In computing, a legacy system is an old method, technology, computer system, or application program, “of, relating to, or being a previous or outdated computer system,” yet still in use. Often referencing a system as “legacy” means that it paved the way for the standards that would follow it.
Hardware-Technology Specs
- Platform (i.e. 6.0)
- Server Designation: (i.e. File Server, Background job server, Transaction server)
- Requirements: (i.e. 2 Ghz+ dual-core processors, 64-bit, SAN attached etc)
Hardware Device Strategy
Device types appropriate clinical scenario:
Input
Output
Storage
Wireless
CPU (executes machine instructions)
Communicates with I/O and storage
Hardware Input Device PRS
Personal Response System (handheld device with keypad)
Used for input/voting, assessment, attendance, discussion, experimentation
Hardware-Wireless Solutions
Wireless mobile transmission of ECGs
Digital visual enhancement & touch screen capabilities
Automatic access to historical data
Used in patient monitoring, cardiology, and OB
Output Mechanisms
Monitors Printers Microfilm/Microfiche Digital Images Magnetic Media (tape, floppy disk) Optical (CD-ROM, DVD, etc) Voice
Hardware Processor
CPU-
Central processing unit:
hardware
brains of the computer
Carries out instructions of computer program
Controls of I/O operation
Hardware Storage
RAM-Random access memory
ROM-Read only memory
Solid State, Disks, Virtual
Magnetic Disk Storage (diskettes, hard disk drives)
Optical Disk Storage (laser disk, CD-ROM, CD-RW, DVD)
Magnetic Tape
Considerations for Hardware Choices
Cost-initial and replacement Durability Infection Control Human factors-footprint size, weight, visibility Electrical, telecom, network solutions Facility/Setting structure and support
Networks
Topology
Local Area
Wide Area
Internet Access
Network Topologies
- Tree,
- Star-centralized
- Ring-like a xmas light set, if one goes down they all go down
- Bus-all connected to one hub. If one goes down, they all go down.
Local Area Networks
Network cable Network Interface card/wireless radio Router Gateway Protocols-ethernet, token ring
Protocols
An agreed-upon format for transmitting data between two devices:
a. TCP/IP-transmission control protocol/Internet protocol (ports 0-1023) b. FTP-file transfer protocol (ports 20&21): upload/download files from distant servers c. SMTP-simple mail transfer protocol (465) d. SMS-short message service e. HTTP-hypertext transmission protocol f. VOIP-voice over internet protocol
Client/Server Computing
Peet to peer architecture
Acts like a server
Server (Zulily)—–>Client (purchaser)
File/Server Architecture
Application server:
Google docs
Thin clients
Health Information Exchange (HIE)
Promote interoperability
CommonWell
Immunization Registry
Communication Link Types
- Twisted Pairs
- Coaxial cables
- Fiber optics
- Microwave transmission
- Satelite transmission
- MODEM
Classifications of computers
- Supercomputer
- Mainframe-server
- Desktop
- Laptop/Notebook
- Tablet computer
- Smart phone
Software categories
- Operating system
- Applications & utilities (i.e. eClipboard, McAfee)
- Programming languages & development tools (JAVA, C++, Python)
Operating system functions
- Manage the computer’s resources
- Establish a user interface between the application s/w and h/w
- Execute and provide services for applications software
Operating system functions
- Manage the computer’s resources
- Establish a user interface between the application s/w and h/w
- Execute and provide services for applications software
Various operating systems
- DOS, OS/2, UNIX (AIX, Solaris), AS-400, Mac OS X
- VM or virtual machine (>1 OS on a computer)
- Windows 95, 98, 2000, Vista, Windows CE, NT, XP, Vista, 7, 8, 8.1, 10
- Linux (Ubuntu-type of Linux)
Software Applications
- Commercial off the shelf vs in-house
- Types of applications:
a. Databases, e-mail, graphics
b. Statistics, utilities, tools
c. Tracking & scheduling
d. Integrated packages “suite”
Languages & development tools
- Assembly, Machine, C++, JAVA, NET, Visual Basic
* Levels of programming languages (low-high or generations)
Software generations
*First-machine language
*Second- (2GL) assembly languages
*Third (3GL) high-level language
a. COBOL, FORTRAN, BASIC, Pascal, C
*Fourth- (4GL) Very high-level languages
a. tools, report generators
b. power builder, HTML, XML
Fifth (5GL)-Natual languages
a. Problem-solving, knowledge-based, artificial intelligence,
b. PROLOG
Communication Technologies
- . Collaborative tools (SharePoint, WebEx, Skype, Wiki, Blogs, Slack
- Encryption
- Wireless connectivity (Bluetooth)
- Radio frequency identification (RFID)
- Voice over internet protocol (VOIP)
- Tokens
Social Media-changing communication
- Web-based and mobile technologies for interactive discussions based on Web2.0
- Collaborative projects, blogs-Wikipedia, twitter
- Content communities-YouTube
- Social networking sites-Facebook,
- Blogs, picture-sharing, wall postings, email, instant messaging, music-sharing, crowdsourcing, voice over IP
Healthcare technology trends
- Devices: wearable, swallowed, implantable
- Mobile devices, barcode scanners
- Social media apps
- Robots, biometrics
- Nanotechnology
- Telehealth
- Clinical simulation in education
- Genomic informatics
- Consumer health
- Analytics & population health
- 3D printing
- Virtual reality
- Internet of things
