Informatics 1- Health Informatics Flashcards
1
Q
Health Informatics
A
- Hardware
- Software
- Communication
- See what people are doing
- How long it takes to do it
- Using computers
- has a separate discipline
- analysis
- collecting data
- submitting data
2
Q
As medical knowledge grows (specialties)…
A
- unmanageable volume of knowledge
- limitations under which humans can process information
- specialties get more expensive…less accessible
3
Q
garbage information in
A
you will get garbage information out
4
Q
most important health care worker
A
janitor
5
Q
Europe expenditure on health sector
A
grew 52% faster than the entire European economy in the 90s
6
Q
transition to electronic records saved…
A
$66 millions from a total budget of $925 million (national hospitals)
-American health sector can save up to $77.8 billion a year by introducing standardized, interacting health information systems
7
Q
what is wrong with patient portals
A
- people want immediate gratification and understanding
- people dont understand medical terminology and freak out
8
Q
medical mistakes
A
-44,000-98,000 die every year as a result of wrong medical treatment, including medication errors
9
Q
medical mistakes that have been prevented by information systems
A
-American study estimates that improved information systems could have prevented 2 mil medication errors and 190,000 hospital admissions a year
10
Q
health services costs
A
- 15% of GDP- USA ($1.7 trillion)
- Organization for Economic Cooperation and Development (OECD) average -> 9% of GDP
- expected increase of 3-4% over the next 5 years
11
Q
Organization for Economic Cooperation and Development (OECD)
A
- 34 member countries that discuss and develop economic and social policy
- democratic countries that support free market economies
12
Q
most people that dont have money will spend it on
A
teeth
13
Q
increasing treatment costs
A
- focus on development of high cost (and high profit) procedures, tools, and medications
- mass medications of large population groups, customized actions and medicines
14
Q
90% rule
A
-10% of the population will use 90% of the resources
15
Q
global disparity
A
- doctors / are 10^5 citizens
- in angola for every 10^5 citizens there are 7.7 doctors
16
Q
global health challenges
A
- increasing health services costs (especially if privatized)
- increasing treatment costs
- 90% rule
- global disparity of doctors to people
- global population is getting older
- consumerism
- technology provides more knowledge on new methods and disease- always growing
17
Q
consumerism
A
-use of health services is a benefit for the rich
18
Q
global population is getting older
A
- 80+ is considered old
- not enough health care workers
- assisted living is expensive
- overpopulation
19
Q
why health informatics?
A
- health informatics provides information to make decisions (garbage in garbage out)
- better information leads to better decisions
- health care, management, planning and policy all need good information
20
Q
health care
A
- subjective
- individual- there are no two cases alike -> treat differently (computers dont know this)
- the most important characteristic of life itself
- ask the same things over and over -> the story changes every time
21
Q
medicine
A
- multidisciplinary (team), based on the natural sciences in its study of diseased, engineering science in development of tools and therapy, and with the purpose of understanding, treating, curing or relieving within a broad range of physiological, psychological and social problems
- *short term, oriented towards disease and actions
22
Q
health services
A
- knowledge intensive: about illness, phenomena, diagnoses, actions
- information intensive: about patients, care givers, supply, patient histories, observations, population, epidemiology, etc.
- *long-term, preventative, care giving (preventing people from getting sick)
23
Q
health informatics
A
- intersection of information science, computer science, and health care
- deals with resources, devices and methods required to optimize acquisition, storage, retrieval and use of information in health
- complex mixture of people, organizations, problems, illnesses, patient care and treatment
- tools include not only computers but also clinical guidelines, formal medical terminologies, and information and communication systems
24
Q
health + informatics
A
- information on illness, observations, events, causes, processes, decisions, treatments, medication, plans, actions, outcomes, guidance, goals, intentions, reactions,…
- observations- recording behavior -> observing sleep apnea, seizure (dont need person)
25
Q
bioinformatics
A
- analysis of biological information using computers and statistical techniques
- the science of developing and utilizing computer databases and algorithms to accelerate and enhance biological research
- long term
- algorithms
- 98% accuracy with bioinformatics -> then go to the clinical trials
- spend less money and time testing
26
Q
how much does developing a drug cost
A
$500 million
27
Q
information technology
A
is NOT informatics
- information technology is hardware and software that informatics uses
- IT is to nouns, as informatics is to verbs
- informatics helps IT work appropriately
- informatics is the collection, manipulation and use of information
- paper records are information systems (not technology)
28
Q
information hierarchy
A
from bottom to top
- data
- information
- knowledge
- wisdom
29
Q
data
A
- unorganized and unprocessed facts; static; a set of discrete facts about events
- no meaning attached to it as a result of which it may have multiple meanings
30
Q
information
A
- aggregation of data that makes decision making easier
- meaning is attached and contextualized
- answers questions: what, who, when, where
- fundamental problem and challenge in informatics
31
Q
knowledge
A
- doesnt mean you are smart, it makes you know a lot
- includes facts about real world entities and the relationship between them
- it is an understanding gained through experience
- answers the how question
32
Q
wisdom
A
- are embodies principles, insight and moral by integrating knowledge
- taking years of experience and using it
- knowledge answers why questions
- how can you approach something differently; the best
33
Q
data: level 1
A
- nonelectric data
- paper
34
Q
data: level 2
A
- unstructured, viewable electronic data
- scans of paper forms
35
Q
data: level 3
A
- structured
- viewable electronic data
- results
- orders
- electronically entered data that cannot be computed by other systems
36
Q
information
A
-external and internal data
37
Q
data: level 4
A
- computable electronic data
- electronically entered data that can be computed by other systems
38
Q
healthcare functions
A
- patient care
- medical records
- ancillary services: laboratory, radiology, pharmacy
- administrative: financial, business analytics
- research
39
Q
traditional perspective
A
- architectures for electronic medical records and other health information systems used for billing, scheduling, and research
- better the billing the better the money
40
Q
traditional perspective
A
- architectures for electronic medical records and other health information systems used for billing, scheduling, and research
- better the billing the better the money
- standards (DICOM, HL7) - to facilitate the exchange of information between healthcare information systems - these specifically define the means to exchange data, not the content
- controlled vocabularies…used to allow a standard, accurate exchange of data content between systems and providers
- software for specialists services and devices
41
Q
technology
A
- networks: internet, HIS, LIS, RIS
- databases
42
Q
technology
A
- networks: internet, HIS, LIS, RIS
- databases
43
Q
driving forces (EMR)
A
- increases efficiency of healthcare
- decrease medical costs
- improve physician productivity
- improve quality (pt outcomes) of healthcare
- improved pt saftey
- information brokerage
- sharing of a variety of information back and forth between people and healthcare entities
- better documentation -> passes to other people -> better care
44
Q
EMR
A
- slows down the process of seeing a pt
- you see less pts a day
45
Q
electronic health record (EHR)
A
- limited use due to amount of data generated
- goal is evidence base decisions
- how much data is collected and how much information is extracted
- this information allows us to make evidence based decisions
- better information better evidence based decisions
46
Q
goals of HIT
A
- health information technology
- improve- communication and continuity of care, quality of care, pt outcomes, clinician productivity, return on investment
- reduce- medical errors and litigation, duplication of tests
- standardize- medical care by individuals and organization
- accelerate- access to care and administrative transactions
- protect- privacy and ensure security (HIPPA)
47
Q
key players
A
- pts
- clinicians and nurses
- support staff
- public health
- federal and state governments
- medical educators
- insurance companies (payers)
- hospitals
- medical researchers
- technology vendors
48
Q
institute of medicine (IOM)
A
- safe, effective, patient centered, timely, efficient and equitable medical care
- developed in 2001
- to Err is Human (1999) and Crossing the Quality Chasm (2001)
- 98,000 deaths occur yearly due to medical errors
- computers dont mistakes, humans do
49
Q
association of American medical colleges (AAMC)
A
- better health 2010 report
- wrote report on best practices
- life long performance based learning
- support discovery, innovation and dissemination of research
- robust information environment
- education credentials
- how long you been working
50
Q
public vs private organization
A
- bridges to excellence
- eHealth Initiative
- Leapfrog
- Markle Connecting for Health
- National eHealth Collaborative (NeHC)
- Healthcare information technology standards panel (HITSP)
- the certification commission for healthcare information technology (CCHIT)
- National Committee on Vital and Health Statistics (NCVHS)
- the above organizations have public-private guidelines (Can go either way)
- public- state
- private- can do things their own way
- two different guidelines
- access to different and better technology (buying lists)
51
Q
government (USA)
A
- quality and cost
- American Recovery and Reinvestment Act (ARRA)
- health information technology for economic and clinical health (HITECH)
- department of health and human services (HHS)
- office of the national coordinator for health information technology (ONC)
52
Q
American Recovery and Reinvestment Act (ARRA)
A
- improve medical quality, pt safety, healthcare efficiency and reduce health disparities
- engage pts and families
- improve care coordination
- ensure adequate privacy and security of personal health information
- improve population and public health
53
Q
price does NOT
A
equal quality
54
Q
office of the national coordinator for health information technology (ONC)
A
- Agency for Healthcare Research and Quality (AHRQ)
- Centers for Medicare and Medicaid Services (CMS)
- Centers for Disease Control and Prevention (CDC)
- Health Resources and Services Administration (HRSA)
- these organizations look to each other
- checks and balances
55
Q
barriers
A
- we dont have enough time (to relax) -> immediate gratification
- not enough information
- not enough expertise and work force (imbalance of experience to new)
- cost
- lack of interoperability (communication with people and computers)
- change in workflow
- privacy
- legal
- behavioral change
56
Q
central challenges
A
- plethora of disconnected, inherited systems:
- accounting
- planning and logistics
- pt administration
- x-ray, lab systems, MR systems…
- low degree of information flow between organizations and service providers:
- a pt will roam between organizations and between doctors, with different illnesses and problems
- do we have the necessary means of communication to provide the pt with effective health services?
- get a SECOND opinion! -> too much information -> doctors may have different opinions
- relevant clinical information is not available for the right person at the right time and place
- relevant clinical knowledge is not available in the health information systems
- leads to people doing the same tests over again
- low quality of information: inconsistencies and errors
- the pt is not a part of the information flow: no control or participation
57
Q
key elements of informatics
A
- acquisition- gain information, capture data taking care to strive for quality (accurate, timely, reliable, complete)
- storage- save data so that it can be retrieved (trash bin will store data but its hard to retrieve) -> cloud
- communication- Data needs to be moved from point of collection to storage, for analysis, and finally to point of use (this may a very short distance and time where data is used near collection point or may be widely separated points.)
- manipulation- data usually needs to be manipulated in some way, combined with other data, aggregated, or compared -> makes the data useful
- display- How can the data be best displayed so that it can be easily understood and acted upon?
58
Q
decisions determine data
A
- understanding diseases and their treatment
- develop and test treatments
- ensure right pts receive right intervention
- service delivery, performance assessment
- this all ties into health records - how is it doing what its supposed to do, how does it benefit the doctors
