Informatics Flashcards
What is knowledge viability?
Knowledge viability refers to applications (most technology based) that offer easily accessible, accurate, and timely information obtained from a variety of resources and methods and presented in a manner so as to provide the necessary elements to generate new knowledge.
What does RDBMS stand for?
Relational Database Management System
What is a Relational Database Management System?
A relational database management system (RDBMS) is a collection of programs and capabilities that enable IT teams and others to create, update, administer and otherwise interact with a relational database.
What is the purpose of RDBMS?
RDBMSes store data in the form of tables, with most commercial relational database management systems using Structured Query Language (SQL) to access the database. However, since SQL was invented after the initial development of the relational model, it is not necessary for RDBMS use.
The RDBMS is the most popular database system among organizations across the world. It provides a dependable method of storing and retrieving large amounts of data while offering a combination of system performance and ease of implementation.
What are the benefits of RFIDs over Barcodes?
Can identify individual objects without direct line of sight.
Can scan items from inches to feet away, depending on type of tag and reader.
Data can be updated in real time.
Require a power source.
Read time is less than 100 milliseconds per tag.
Contain a sensor attached to an antenna, often contained in a plastic cover and more costly than barcodes.
What are the differences between a RDBMS and DBMS?
An RDBMS is a type of database management system (DBMS) that stores data in a row-based table structure which connects related data elements. An RDBMS includes functions that maintain the security, accuracy, integrity and consistency of the data. This is different than the file storage used in a DBMS.
Other differences between database management systems and relational database management systems include:
Number of allowed users. While a DBMS can only accept one user at a time, an RDBMS can operate with multiple users.
Hardware and software requirements. A DBMS needs less software and hardware than an RDBMS.
Amount of data. RDBMSes can handle any amount of data, from small to large, while a DBMS can only manage small amounts.
Database structure. In a DBMS, data is kept in a hierarchical form, whereas an RDBMS utilizes a table where the headers are used as column names and the rows contain the corresponding values.
ACID implementation. DBMSes do not use the atomicity, consistency, isolation and durability (ACID) model for storing data. On the other hand, RDBMSes base the structure of their data on the ACID model to ensure consistency.
Distributed databases. While an RDBMS offers complete support for distributed databases, a DBMS will not provide support.
Types of programs managed. While an RDBMS helps manage the relationships between its incorporated tables of data, a DBMS focuses on maintaining databases that are present within the computer network and system hard disks.
Support of database normalization. An RDBMS can be normalized, but a DBMS cannot.
What is RFID
RFID (radio frequency identification) is a form of wireless communication that incorporates the use of electromagnetic or electrostatic coupling in the radio frequency portion of the electromagnetic spectrum to uniquely identify an object, animal or person.
What are disadvantages of Barcodes?
Direct line of sight required for scanning.
Require closer proximity for scanning.
Data is read-only and can’t be changed.
No power source needed.
Read time is half a second or more per tag.
Printed on the outside of an object and more subject to wear.
What three components are needed for RFID to work?
Every RFID system consists of three components: a scanning antenna, a transceiver and a transponder.
What are the main challenges of RFID?
Reader Collision and Tag Collision
Reader collision
Reader collision, when a signal from one RFID reader interferes with a second reader, can be prevented by using an anti-collision protocol to make RFID tags take turns transmitting to their appropriate reader.
Tag collision
Tag collision occurs when too many tags confuse an RFID reader by transmitting data at the same time. Choosing a reader that gathers tag info one at a time will prevent this issue.
CPT - Current Procedural Terminology
The Current Procedural Terminology (CPT) code set, maintained by the American Medical Association (AMA), accurately describes medical, surgical, and diagnostic services. It is designed to communicate uniform information about medical services and procedures among physicians, coders, patients, accreditation organizations, and payers for administrative, financial, and analytical purposes. In addition to descriptive terms and codes, it contains modifiers, notes, and guidelines to facilitate correct usage.
Used to code traditional medical treatments, provided by physicians or NPs
ICD-10: The International Statistical Classification of Diseases and Related Health Problems: Tenth Revision
The International Statistical Classification of Diseases and Related Health Problems: Tenth Revision (ICD-10) is the most recent revision of the ICD classification system for mortality and morbidity, which is used worldwide. Both underlying or primary cause of death and non-underlying causes (other causes) are coded. Used to code for diseases, which are classified numerically by etiology and anatomic system
ICD-10-CM/PCS - Clinical Modification
Replaced ICD-9-CM. Used for classification of diseases and procedures associated with hospitalization
RxNorm
RxNorm is a standardized nomenclature for clinical drugs and drug delivery devices produced by the National Library of Medicine (NLM). Because every drug information system follows somewhat different naming conventions, a standardized nomenclature is needed for the consistent exchange of information, not only between organizations but even within the same organization. RxNorm contains the names of prescription and many nonprescription formulations that exist in the United States, including the devices that administer the medications.
NMDS
ANA Recognized Data Element Set. Nursing Minimum Data Set.
For All Nursing and contains Clinical Data elements
NMMDS
Nursing Management Minimum Data Set. ANA Recognized Data Set. Used in all settings and contains Nursing Administrative Data Elements
CCC System
Clinical Care Classification System. ANA Recognized Terminology. Used for all nursing care and other health professionals. Contains Diagnoses, Interventions, and outcomes. Started as home health care system.
ICNP
International Classification for Nursing Practice. ANA recognized terminology. Used by all nursing and contains Diagnoses, interventions, and outcomes.
NANDA
NANDA International. ANA recognized nursing terminology. Used by all nursing and contains diagnoses.
NIC
Nursing Interventions Classification. ANA recognized terminology. Used by all nursing and contains interventions.
NOC
Nursing Outcomes Classification. ANA recognized terminology. Used by all nursing and contains outcomes.
Omaha System
ANA recognized terminology. Used in Home care, public health and community. Contains Diagnoses, interventions, and outcomes. Began as rehabilitation system.
PNDS
Perioperative Nursing Data Set. ANA recognized data set. Used in perioperative care settings. Contains Diagnoses, interventions and outcomes.
ABC - Alternative Billing Codes
ABC Codes. Multidisciplinary terminology recognized by ANA. Used by nursing and other health professionals. Contains interventions. Used to code alternative medical treatments and unlicensed practices such as yoga, because these services are often provided by nonphysician or unlicensed practitioners
LOINC
Logical Observation, Identifiers, Names and Codes. Multidisciplinary terminology recognized by ANA. Used by nursing and other health professionals. Contains outcomes and assessments. a universal standard that is comprised of more than 71,000 observation terms primarily used to represent laboratory tests, measurements, and observations. It is also a clinical terminology for laboratory test orders and results, clinical measures such as vital signs, and other patient observations. identified by the Health Level Seven (HL7) Standard Development Organization (SDO) as a preferred code set for laboratory test names in transactions between healthcare facilities, laboratories, laboratory testing devices, and public health authorities
SNOMED CT
Systematic Nomenclature of Medicine Clinical Terms. Multidisciplinary terminology recognized by ANA. Used by nursing and other health professionals. Contains Diagnoses, interventions and outcomes. Considered to be the most comprehensive, multilingual healthcare terminology in the world and integrates concepts from many nursing terminologies. one of a suite of designated standards for use for the electronic exchange of health information, and also is a required standard in interoperability specifications of the U.S. Health Information Technology Standards Panel/
Which nursing standard terminologies contain diagnoses, interventions and outcomes?
CCC (Clinical Care Classification) System, ICNP (International Classification for Nursing Practice), Omaha System, PNDS (Perioperative Nursing Data Set), SNOMED (System Nomenclature of Medicine Clinical Terms).
Which nursing terminology standard only contains diagnoses?
NANDA
Which nursing terminology standards only contain interventions?
NIC (Nursing Intervention Classification), ABC Codes
Which nursing terminology standards contain only outcomes and/or assessments?
NOC (Nursing Outcomes Classification), LOINC (Logical Observation, Identifiers, Names and Codes).
Data Set
A data set is a collection of related, discrete items of related data that may be accessed individually or in combination or managed as a whole entity.
What are the Nursing Minimum Data Set (NMDS) Data Elements?
Nursing, Patient or Client Elements, Service Elements
Describe the Nursing Data Element in the NMDS
Care Elements - Nursing Diagnosis, Nursing Intervention, Nursing outcome, Intensity of Nursing Care
Describe the Service data element of the NMDS.
Unique facility/service agency identifier, Unique identifier of principal registered nurse provider, Episode admission or encounter date, Discharge or termination date, Disposition of patient/client, Expected payer of most of this bill
What are the two data elements in the NMMDS?
Environment and Nursing Resources
Describe the Environment data element of the NMMDS.
Facility unique identifiers, type of nursing delivery unit/service, patient/client population, volume of nursing delivery unit/service, care delivery structure and outcomes, patient/client accessibility, Accreditation/Certification licensure
Describe the Paitent/Client Demographic Elements in the NMDS
Personal Identification, Date of Birth, Sex, Race and ethnicity, Residence
Describe the Nurse Resources data element NMMDS.
Staffing, satisfaction, nurse demographics per unit /service, clinical mental work, environmental conditions, and EHR implementation stages.
Interface Terminology
Designed for use at the point of care. They use terms and concepts that are familiar to practicing nurses. Interface terminologies vary in scope, structure, and content
Reference Terminology
acts as a common reference point that can facilitate cross-mapping between interface terminologies.
What type of system does Knowledge viability rely on?
A system that is adaptive and can manage situations and scenarios that are complex. A viable system is able to respond in a variety of ways to changing situations in order to survive.
Database
Organized collection of data
Database Management System (DBMS)
software that contains the database as well as a collection or set of programs for accessing and processing these data in the database thereby identifying relationships between the data. It is important to realize that different databases can manage the same database.
Benefits of DBMS
allows the storage, curation, and retrieval necessary to turn data without context into data that can be used to generate information and knowledge useful in making wise patient care decisions.
What are the two components of DBMS?
Front-end and Back-end
What is the Front-end of a DBMS?
Provides an application in which a user can view, manipulate, and interpret data
What is the Back-end of DBMS?
Where data is stored
Describe the DBMS structure.
the ability to store data in a central repository as well as the ability to manage the data in a central location thereby reducing data redundancy, increasing data consistency, and improving access to data
What is Data redundancy?
occurs when one stores the same data in the database more than once or stores it in more than one interrelated database. In healthcare there are many examples of data redundancy. Patients may be working with several physicians all of whom may store their patient records in their own database that is not accessible by other healthcare providers or healthcare institutions, thereby requiring the patient to either provide that information again or obtain their records from the other doctor or facility. The patient’s active medication list may be in both the electronic medical record that the primary provider maintains, in a pharmacy that fills the medication prescriptions, and in the electronic record at a healthcare institution. A well-designed automated database links these records and updates them in one place, and then allows users access to it from this single location regardless of the location of the end user.
Data inconsistency
results as each user working with different databases updates or changes the data. For example, when a doctor admits a patient to a hospital, different caregivers will ask the patient to identify medications he or she is taking at home. Sometimes the patient will list only prescription medications; other times the patient will include over-the-counter drugs the patient takes on a routine basis. Sometimes the patient will forget to include a medication. If caregivers record these different lists in different sections of the medical record, inconsistency occurs. In a well-designed integrated automated database, each caregiver is working with the same list each time data are reviewed. An additional problem occurs if one uses different terms for the same data. For example, sometimes one might use a generic name while other times one might use the brand name for that drug. This is why standards such as standard languages (i.e., SNOMED) are key to the design of EHRs. An automated database design that uses recognized standards as well as consistent input and access to data is imperative to creating databases necessary for the efficient and effective delivery of quality healthcare.
Most modern DBMS utilize what type of configuration?
Client-server model
What is the Client-Server Model?
Most modern DBMSs utilize the client-server model. In this scenario the client contains the front end and talks to the server which houses the data in the back end. The client and the server are often on different computers with the database residing on the server.
Cloud-hosted DBMS
The back-end of a DBMS is accessed through the internet on the cloud
In-house DBMS
In-house hosted system the server that houses the database is on site
Centralized DBMS
one where there is a single, central computer that hosts a database and the DBMS. Many hospitals today are examples of this type of system. The hospital is the “hub” and hosts the system where many users on the network access this database.
Distributed DBMS
A distributed system is one where there are multiple database files located at different sites. The main difference between these two options is one of control. Conversely, in a distributed system there is no centralized control structure. With the changing direction of healthcare to keeping the patient out of the hospital by monitoring them at home, the digitization of all patient records, patient portals, and so forth, there is a shift to a more distributed system or decentralized system
Describe the structure of DBMS
a DBMS consists of data that designers structure into tables and join by relationships. Each table consists of attributes and data points associated to those attributes
Relational Database Models - RDBMS
tables are related to each other through a system of keys. Each table has a primary key which allows the system to request one record at a time. Tables can be combined in such a way to allow the system to generate reports based on all of tables. The main features of this type of a system are tables, attributes, and keys where attributes are the columns in the tables and keys are what allows us to find one record in the table. The functions they provide include creating, updating, or changing data, deleting data, and querying generally by means of Structured Query Language (SQL) statements.
NoSQL DBMS
NoSQL is an agile system that easily processes unstructured data and semi-structured data. It is cloud-friendly and a new way of thinking about databases. NoSQL doesn’t adhere to traditional RDMS structure, has a rich query language, and is easily scalable
Entity Relationship DBMS
database features the organization of the data around entities (Mullins, 2013). It is a flow chart on how entities—people, objects, and concepts—relate to each other. ER models use symbols and connecting lines to depict interconnectedness entities, their relationships, and attributes. The ER Model is closely tied to the Relational Database Model and often serves as the underlying organization for the tables and relationships. Entities are usually the participants in a system.
Graph-Oriented Object Data Model (GOOD)
A graph-oriented object database model (GOOD) is introduced as a theoretical basis for database systems in which manipulation as well as conceptual representation of data is transparently graph-based. In the GOOD model, the scheme as well as the instance of an object database is represented by a graph, and the data manipulation is expressed by graph transformations. These graph transformations are described using five basic operations and a method construct, all with a natural semantics. The basic operations add and delete objects and edges as a function of the matchings of a pattern. The expressiveness of the model in terms of object-oriented modeling and data manipulation power is investigated
Data Warehouse
The purpose of a data warehouse is to provide a place to store multiple forms of data in a lightly summarized way. Once the data is generated, cleaned, and stored in a data warehouse it is not modified. Although new data may be added to the data warehouse, the data that already exist in the system provide an archive of information to be used by an organization.
Data Warehousing
the process of extracting, integrating, transforming, and cleansing data and storing it in a consolidated database
Describe the function of Data warehouse
function of the data warehouse is to serve as a central information repository. In true data warehouse situations, once the data are curated and stored in the data warehouse, there is no need to search for data anywhere else. In order to do this the data warehouse must be able to extract data from the variety of computers systems and import that data into the warehouse. Healthcare industry has many legacy systems and multivendor applications. Healthcare facilities may use their data warehouses to perform clinical analytics, financial forecasting, etc. This, however, can only happen if the correct data is in the system
What is a data mart?
a DBMS that is for a single unit of work and may contain a subset of data stored in a warehouse. For instance, a hospital may have a data warehouse where all information is housed, and a single department may have a data mart. Although the definition and distinction are still not agreed upon (Mullins, 2013), it is important to recognize that the main difference lies in the scope of the people who are accessing the data. The advantages of a data mart include quick response time due to less data than a warehouse, simplicity in implementation, greater cost-effectiveness than a data warehouse, value to specific groups like a unit or department in a hospital, and ease of maintenance. The main disadvantage to a data mart is that it cannot provide the organization with organization-wide data analysis; it can only provide departmental or unitwide analysis
What is a data lake?
a freer form of a DBMS where the structure of the data is loose and varied including structured, semi-structured, and unstructured data. Input processing can be in batch, real-time, or one-time loads. Sources of data for a data lake can be databases, social media, monitoring devices, e-mails, and so forth (AWS, 2019). A data lake is often characterized by the flow of data into a central repository, similar to rivers flowing into a lake. Often, data in a data lake is diverse in nature and may include, for example, images as well as sound clips. There is no fixed limit on size or file type. The main distinction between a data lake and a data warehouse or a data mart is that the data in the data lake stays in its original form. It is not extracted, integrated, transformed, cleaned, or processed.
What are Data stores?
a generic term used to describe a DBMS that lumps several diverse data sources together. Since the main advantage of modern DBMSs is to be able to look at diverse sets of data and impose a structure on them, the type of structure that the designer chooses should be tied to the purpose of the data store in the first place.
Data Mining
“the process of finding anomalies, patterns and correlations within large data sets to predict outcomes” (SAS, 2019, para 1). In more detail, data mining is the computational process that allows us to use our data in order to “mine” insights that we may not have seen without the assistance of a computer. Usually, data mining is performed on sets of data that are so large there is no way to pick out the patterns by observation alone. In healthcare the purpose is to assist in providing quality care, predicting best treatment choices, and utilizing healthcare resources in a cost-effective manner.
Nationwide Health Information Network (NwHIN)
Primary purpose of the Nationwide Health Information Network is to ensure secure internet exchange of information through standards policies and services. Funded by the Office of the National Coordinator for Health Information Technology (ONC). Primary goal is to assist healthcare providers to move from a system of paper medical records to a secure electronic health record that can be easily accessed by various healthcare providers and utilized to evaluate the quality of care
Data Reduction
the process of reducing the amount of capacity required to store data. Data reduction can increase storage efficiency and reduce costs. Storage vendors will often describe storage capacity in terms of raw capacity and effective capacity, which refers to data after the reduction.
What are the three main types of data reduction?
Data deduplication, compression and single-instance storage
Data deduplication
also known as data dedupe, eliminates redundant segments of data on storage systems. It only stores redundant segments once and uses that one copy whenever a request is made to access that piece of data. Data dedupe is more granular than single-instance storage.
Single-instance storage
Single-instance storage finds files such as email attachments sent to multiple people and only stores one copy of that file. As with dedupe, single-instance storage replaces duplicates with pointers to the one saved copy.
Data Compression
works on a file level. It is accomplished natively in storage systems using algorithms or formulas designed to identify and remove redundant bits of data. Data compression specifically refers to a data reduction method by which files are shrunk at the bit level. Compression works by using formulas or algorithms to reduce the number of bits needed to represent the data. This is usually done by representing a repeating string of bits with a smaller string of bits and using a dictionary to convert between them
Clustering
Data reduction technique. Cluster groups of statistical units into clusters (classes) in order to reduce the overall number of statistical units. A cluster is comprised of elements that are similar to each other and dissimilar to other clusters, so clustering is essentially a method of grouping. To determine why the groups are different, then a different data reduction technique, factor analysis, must be used.
Which is cheaper VOIP or Analog telephone system?
VOIP
What does VOIP stand for?
Voice over internet protocol
What are the 3 means of using VoIP Service?
Analog Telephone Adaptor, IP phones, Computer to computer
What is a “warm site”?
A site with patient data that can be activated within 8 hours. This backup system should be capable of running the EHR if the home system fails. This warm site should be natural events such as hurricane, tornado, and flooding as well as terrorist attacks. The location should be more than 50 miles away and more than 20 miles from the coast to lessen the change that the same disaster would strike both facilities.
Wahat does a Rummler-Brache swim lane diagram show?
The processes and individual/departmental responsibilities
What more be done prior to creating a swim lane diagraphm?
Determine the purpose and the process or processes to focus on
What does the horizontal roes indicate in a swim diagram?
Individuals/departments
What is sunsetting?
Intentionally phasing out or terminating something.
Foundational interoperability
basic data reception from one system to another without interpretation
Structural Interoperability
more complex and depends on consistency of clinical terminology and meaning of the data
Semantic Interoperability
depends on data that is consistent and codified allowing for information system interpretation and analysis of the data. Semantic interoperability is considered the highest and most complex form of interoperability. Semantic interoperability is necessary for seamless health information exchange
What is the SAFER guide?
consist of nine guides organized into three broad groups by the ONC. These guides enable healthcare organizations to address EHR safety in a variety of areas. Most organizations will want to start with the Foundational Guides, and proceed from there to address their areas of greatest interest or concern.
Interoperability
The ability to transfer, share, and utilize information from one system to another
Health Information Exchange first step in implementing EHR
Assess readiness to transition from paper to EHR or to upgrade current system. Assessment should review current procedures for data collection and clinical workflows as well as determine the knowledge base of staff members related to computers. Internet access should be assessed to ensure high-speed internet is available. Determine if the organization has enough financial capital
How often should data be encrypted, backed up, and transferred to an offsite data storage?
Weekly
How often should backup systems be tested?
Regularly at least on a monthly basis
Why is a backup necessary
To ensure that information is not lost in the event of a system breakdown or failure
NDF-RT
National Drug File- Reference Terminology is used to code medication classes such as antibiotics. Developed by the VA as a reference terminology. Standard adopted by Consolidated Health Informatics (CHI). Part of the Federal Medication Terminologies (FMT) initiative. FDA structured Product Labeling (SPL) initiative and Established pharmacologic class (EPC) concepts supported
RxNorm
Used to code specific medications such as clindamycin.
Hardware and software must undergo testing when?
Before and after going live
When a system first goes live what should be available?
Command Center
What is the purpose of a command center during go-live
Provide communication, exercise control and coordinate all activities
Where should the command center be located and who should be present?
As close to the “live” areas as possible with vender representatives available
What are the three steps to Shannon’s Information Theory?
Communication of a message 1. Encoding the message, 2. transmitting the message, and 3. decoding.
Bits, words, icons describe what part of Shannon’s information theory?
Encoding the message
Transmitting the message can be done how?
Voice, radio or computer
Shannon’s information theory is utilized to evaluate the effectiveness of
Communication systems
What are the elements in evaluating communication systems from information theory?
Signal to noise ratio (S/N), channel capacity, and entropy
What is Channel Capacity
The maximal amount of information that can be transmitted with minimal error
What is entropy
Amount of energy, code, or bits needed for storage or communications of one symbol
Small form Factor (Footprint) SFF
Computers typically that have less volume than standard computers for that they take up less desk space. Due to decrease sized they have fewer expansion slots and may be shaped as cubes, books or boxes.
What are the 5 stages of brenner’s clinical competence?
- Novice
- Advanced beginner
- Competent
- proficient.
- expert
What is a novice?
Little experience and rule-governed
Advanced beginner
Some experience with new situations
Competent
has 2 to 3 years of experience and ability to master new situations but who needs extra planning time and may lack flexibility
Proficient
thinks holistically an relies on experience and is adaptable
Expert
has wealth of experience and acts intuitively
Snowflake schema
a fact table at center surrounded by dimensional tables composed of multiple lookup tables representing different levels of hierarchy
Data Backup
Act of copying data from a primary to a secondary location, to protect it in case of a disaster, accident or malicious action
Data Warehousing
is the secure electronic storage of information by a business or other organization. The goal of data warehousing is to create a trove of historical data that can be retrieved and analyzed to provide useful insight into the organization’s operations.
Data Mining
the process of sorting through large data sets to identify patterns and relationships that can help solve business problems through data analysis. Data mining techniques and tools enable enterprises to predict future trends and make more-informed business decisions.
Data archiving
process of moving data that is no longer actively used to a separate storage device for long-term retention.
Knowles Theory of Angragogy
synonymous to adult education. According to Malcolm Knowles, andragogy is the art and science of adult learning, thus andragogy refers to any form of adult learning. (Kearsley, 2010).
What are the 5 assumptions of Andragogy?
- Self-Concept
- Adult Learner Experience
- Readiness to Learn
- Orientation to Learning
- Motivation to Learn
Self-concept
As a person matures his/her self concept moves from one of being a dependent personality toward one of being a self-directed human being.
Adult Learner-Experience
As a person matures he/she accumulates a growing reservoir of experience that becomes an increasing resource for learning.
Readiness to Learn
As a person matures his/her readiness to learn becomes oriented increasingly to the developmental tasks of his/her social roles.
Orientation to learning
As a person matures his/her time perspective changes from one of postponed application of knowledge to immediacy of application. As a result his/her orientation toward learning shifts from one of subject- centeredness to one of problem centeredness.
Motivation to learn
As a person matures the motivation to learn is internal.
What are the 4 principles of Andragogy?
- Adults need to be involved in the planning and evaluation of their instruction.
- Experience (including mistakes) provides the basis for the learning activities.
- Adults are most interested in learning subjects that have immediate relevance and impact to their job or personal life.
- Adult learning is problem-centered rather than content-oriented.
Give examples of how Andragogy is applied in computer training.
- There is a need to explain the reasons specific things are being taught (e.g., certain commands, functions, operations, etc.)
- Instruction should be task-oriented instead of promoting memorization – learning activities should be in the context of common tasks to be performed by the others.
- Instruction should take into account the wide range of different backgrounds of learners; learning materials and activities should allow for different levels/types of previous experience with computers.
- Since adults are self-directed, instruction should allow learners to discover things and knowledge for themselves without depending on people. However, learners should be offered guidance and help when mistakes are made.
Describe Weiner’s Attribution Theory
Weiner’s attribution theory states that an individual’s causal attributions of achievement affect subsequent behaviors and motivation. One of the primary assumptions of attribution theory is that people will interpret their environment in such a way as to maintain a positive self-image
Usability Study/Testing
evaluating a product or service by testing it with representative users. Typically, during a test, participants will try to complete typical tasks while observers watch, listen and takes notes. The goal is to identify any usability problems, collect qualitative and quantitative data and determine the participant’s satisfaction with the product.
Describe the steps in a usability study
- Define the purpose of the study because this is necessary in order to choose the testing method.
- Evaluate constraints such as time, resources, and staff
- Refine components depending on the HCI Framework
- Determine the emphasis of testing (overall or one aspect)
- Select testing methods, taking into account the identified constraints and evaluation of HCI
Describe Thinking aloud in performance testing
The process of thinking aloud is used for performing testing. When a user or a group of users utilizes the computer system during performance testing, the users verbalize their experiences, perceptions, and feelings during the activities as these comments help the informatics nurse to identify problems (as well as positive aspects) that users will encounter when using the system. The users are also observed for facial expressions, eye tracking, and general behavior.
What is low-level inputting or outputting data error example?
User executes the wrong sequence of steps. Usually results in some type of alarm or hard stop of the program until corrected, so the error can usually be corrected fairly easily
What is a moderate level inputting error
Inputting data that are incompatible with the computer system
What is high level input error?
being unable to make a decision about the correct action or being unable to correctly interpret the outcomes data
What is a cognitive walkthrough?
a structured approach to evaluating usability of a product. It involves the tester, who is not a user, asking four simple questions about the way a specific user journey is conducted. Used in prototype testing as it helps to identify problems with usability. A thorough study is completed to outline each step in a process needed to complete a task. Users carry out the steps in the process while using “thinking aloud” procedures to describe their experiences. Users are assess for the ability to use the system and to carry out the steps. Sessions are often video or audiotaped for further evaluation, and users may be given a post-test to evaluate understanding and retention
What is the purpose of alpha and beta testing?
Types of user acceptance testing that mainly focus on discovering the bugs from an already tested product and they give a clear picture of how the product is used by the real-time users. They also help in gaining experience with the product before its launch and valuable feedback is effectively implemented to increase the usability of the product.
Goals and methods of Alpha & Beta Testing do switch between themselves based on the process followed in the project and can be tweaked to be in-line with the processes.
What is alpha testing?
This is a form of internal acceptance testing performed mainly by the in-house software QA and testing teams. Alpha testing is the last testing done by the test teams at the development site after the acceptance testing and before releasing the software for beta test.
Alpha testing can also be done by potential users or customers of the application. Still, this is a form of in-house acceptance testing.
What is beta testing?
This is a testing stage followed by the internal full alpha test cycle. This is the final testing phase where companies release the software to a few external user groups outside the company’s test teams or employees. This initial software version is known as the beta version. Most companies gather user feedback in this release.
In short, beta testing can be defined as the testing carried out by real users in a real environment.
Though companies do rigorous in-house quality assurance from dedicated test teams, it’s practically impossible to test an application for each and every combination of the test environment. Beta releases make it easier to test the application on thousands of test machines and fix the issues before releasing the application to the public.
How often should clinical information such as order sets and patient education materials be reviewed?
Biannually and more frequently depending on changes to the system, change in order sets, changes in clinical practice or user feedback suggesting a need for modification or change.
What is the purpose of a master patient index?
To ensure accurate patient identification. Because patients may have same or similar names, the master patient index should contain the name as a well as other identifying information, such as birthdate, social security number, patient ID number, and zip code. An alert should sound if a person attempts to enter data or search for data about a patient with the same name as an existing patient.
What is BIRADS?
Breast Imagining Reporting and Data System. Created by American College of Radiology. It is used to store and report mammography results so that the results are standardized. BI-RADS provides mammography assessment categories that range from 0 - inconclusive to 6 -proven malignancy with biopsy. BI-RADS categories breast composition: A:Fatty, B:scattered density, C:Dense, D:extremely dense.
Why are high alert override rates a concern?
If soft and hard stops are overridden frequently it may indicate that there is too much flexibility in the system, unnecessary or excessive alerts which might need to be downgraded from hard to soft.
EHR percentage of verbal or paper orders should be below what?
10%
Read-only memory (ROM)
a type of computer storage containing non-volatile, permanent data that, normally, can only be read, not written to. ROM contains the programming that allows a computer to start up or regenerate each time it is turned on.
Random Access Memory RAM
the hardware in a computing device where the operating system (OS), application programs and data in current use are kept so they can be quickly reached by the device’s processor. RAM is the main memory in a computer.
Virtual memory
applications and many system processes always reference memory by using virtual memory addresses. Virtual memory addresses are automatically translated to real (RAM) addresses by the hardware.
Cache memory
Cache memory is a chip-based computer component that makes retrieving data from the computer’s memory more efficient. It acts as a temporary storage area that the computer’s processor can retrieve data from easily. This temporary storage area, known as a cache, is more readily available to the processor than the computer’s main memory source, typically some form of DRAM.
Cache memory is sometimes called CPU (central processing unit) memory because it is typically integrated directly into the CPU chip or placed on a separate chip that has a separate bus interconnect with the CPU. Therefore, it is more accessible to the processor, and able to increase efficiency, because it’s physically close to the processor.
What is a parallel port?
In computing, a parallel port is a type of interface found on early computers (personal and otherwise) for connecting peripherals. The name refers to the way the data is sent; parallel ports send multiple bits of data at once (parallel communication), as opposed to serial communication, in which bits are sent one at a time. To do this, parallel ports require multiple data lines in their cables and port connectors and tend to be larger than contemporary serial ports, which only require one data line.
There are many types of parallel ports, but the term has become most closely associated with the printer port or Centronics port found on most personal computers from the 1970s through the 2000
Cognitive science
the interdisciplinary, scientific study of the mind and its processes with input from linguistics, psychology, neuroscience, philosophy, computer science/artificial intelligence, and anthropology. It examines the nature, the tasks, and the functions of cognition (in a broad sense).
Communication science
the study of the reason behind communication disorders. Work in the field involves the use of various techniques, methods, and treatments to assist individuals with communication impairments, allowing them to communicate at a functional level in day-to-day life.
Information Science
the science and practice dealing with the effective collection, storage, retrieval, and use of information. It is concerned with recordable information and knowledge, and the technologies and related services that facilitate their management and use.
Social Science
any branch of academic study or science that deals with human behaviour in its social and cultural aspects. Usually included within the social sciences are cultural (or social) anthropology, sociology, psychology, political science, and economics.
Logic
a system or set of principles underlying the arrangements of elements in a computer or electronic device so as to perform a specified task.
Perception
the ability to see, hear, or become aware of something through the senses.
Intuition
the ability to understand something immediately, without the need for conscious reasoning.
Rationalism
a belief or theory that opinions and actions should be based on reason and knowledge rather than on religious belief or emotional response.
Cognitive Work Analysis
is a framework that was developed to model complex sociotechnical work systems. The framework models different types of constraints, building a model of how work could proceed within a given work system. The focus on constraints separates the technique from other approaches to analysis that aim to describe how work is actually conducted, or prescribe how it should be conducted.
The CWA approach can be used to describe the constraints imposed by the purpose of a system, its functional properties, the nature of the activities that are conducted, the roles of the different actors, and their cognitive skills and strategies. Rather than offer a prescribed methodology, the CWA framework instead acts as a toolkit that can be used either individually or in combination with one another, depending upon the analysis needs. These tools are divided between phases. The exact names and scopes of these phases differ slightly dependent on the scope of the analysis; however, the overall scope remains largely the same. As defined by Vicente (1999), the CWA framework comprises five different phases; work domain analysis, control task (or activity) analysis, strategies analysis, social organisation and co-operation analysis, and worker competencies analysis.
Strategies analysis
evaluates the manner in which work is actually carried out by users
Worker competencies analysis
considers design restraints associated with the users
Control Task analysis
considers the control structure with which the user must interact
Work domain analysis
evaluates system functions and the information needed by users.
Heuristic evaluation
a process where experts use rules of thumb to measure the usability of user interfaces in independent walkthroughs and report issues. Evaluators use established heuristics (e.g., Nielsen-Molich’s) and reveal insights that can help design teams enhance product usability from early in development.
ANA role and scope of practice for Informatics nurse specialist
- identify the issue or problem
- identify alternative solutions
- choose and develop a solution
- implement solutions
- evaluate and adjust solution
ANA standards of professional performance
- Quality of practice
- performance appraisal
- education
- collegiality
- ethics
- collaboration
- research
- resource utilization
- communication
Steps for ethical dilemma
- Examine issue in detail
- collect as much information as possible to determine what the exact issue is that must be decided
- comprehending and considering possible alternatives
- hypothesize ethical arguments, compare arguments, choose one of the alternatives and act on it
- reflect on chosen solution and consider outcomes
HCPCS II
Healthcare Common Procedure Coding System II used to code for services and equipment often provided for outpatients such as ambulance, chemotherapy and durable medical treatment
FOCUS ( Find-Organize-Clarify-Uncover-Start)
Find: Identify a problem within the organization
Organize: Identify team members with an understanding of the problem
Clarify: Use brainstorming techniques to determine issues and steps in solving the problem
Uncover: Analyze to determine the reason that the problem has occurred
Start: Identify a starting point for the change process
Fishbone diagram
Commonly used to help identify root causes for performance improvement because it helps to visualize the relationship of causes and effects
What does the head represent in a fishbone diagram?
The effect or problem
What does the bones represent in a fishbone diagram?
The causes
What are the three standard categories for causes in a fishbone diagram?
S: Surroundings, suppliers, systems, and skills
P: People, prices places, policies, procedures, products
M: methods, materials, machines, measures, manpower
What does a parallelogram represent in a flowchart?
Input and output
Start/End
What does an arrow represent in a flow chart?
Direction of flow
What does a diamond-shape represent in a flow-chart?
Conditional decision: Yes/No or True/False
What do circles represent in a flow-chart?
Connectors with diverging paths with multiple arrows coming in but only one going out
All - in- one computers disadvantages
Cannot be upgraded easily or in some cases at all
Tend to run hotter and should not be left running for long periods
More difficult to repair
Require more proprietary components
Case management information system
Identifies trends (patterns or variances) in patient’s EHRs
Trends are identified then the system utilizes decision support to guide preventative measures and development of the care plan
Provides standardized plans of care that support best practices
Goal is to reduce or prevent complications and promote recovery
Can track patients both inpatient and outpatient
Communication and information system
Communications and information system means a network of electronic communications, an information system, a registry, industrial process management system and digital information retained, processed, restored or transmitted for the purpose of their management, use, protection and maintenance.
Business information system
Business information systems is a field of work that helps businesses improve efficiencies by using computer systems. It involves programming, networking, database management and IT governance. The business information systems field only grows as businesses become more advanced technologically.
Acuity systems should facilitate what 5 staffing rights
- Right number of staff
- Right skills
- Right Location
- Right time
- Right patient assignments
Gantt chart
Created after completion of a timeline
Is the best type of display to use tasks associated with quality improvement projects
What does a square represent in a data flow diagram
External entity(named)/ Sources of data or data destinations
What does a rounded rectangle mean in a data flow diagram
Named with verb and object only, not including the word “process”
Process used inputting and outputting data
What does an arrow mean in a data flow diagram
Direction of data flow
What does a three-sided open rectangle mean in a data flow diagram?
Named and numbered but not including the word “file”: Data storage
What is the primary focus of Total Quality Management?
meeting the needs of the customers.
Encourages all staff at all levels of an organization to participate to bring about organizational change
Six Sigma
refers to a set of quality-control tools that businesses can use to eliminate defects and improve processes to help boost their profits.
Lean Six Sigma is a team-focused managerial approach that seeks to improve performance by eliminating waste and defects while boosting the standardization of work.
Six Sigma is a management ideology that focuses on statistical improvements to a business process and advocates for qualitative measurements of success over qualitative markers. As such, Six Sigma practitioners are business people who use statistics, financial analysis, and project management to achieve improved business functionality.
Six Sigma is a statistical benchmark that shows how (well) a business process works.
As mentioned above, an error happens when an event occurs with six standard deviations from the mean with no more than 3.4 occurrences per million events. This means that a process is considered to be efficient if it produces less than 3.4 defects per one million chances. A defect is anything produced outside of consumer satisfaction.
What are the 5 steps of Sigma Six?
- A team of people, led by a Six Sigma champion, defines a faulty process on which to focus, decided through an analysis of company goals and requirements. This definition outlines the problem, goals, and deliverables for the project.
- The team measures the initial performance of the process. These statistical measures make up a list of potential inputs, which may cause the problem and help the team understand the process’s benchmark performance.
- Then the team analyzes the process by isolating each input, or potential reason for the failure, and testing it as the root of the problem. The team uses analytics to identify the reason for process errors.
- The team works from there to improve system performance.
- The group adds controls to the process to ensure it does not regress and become ineffective once again.
What is lean Sigma SIx?
Lean Six Sigma is a team-focused managerial approach that seeks to improve performance by eliminating waste and defects while boosting the standardization of work. It combines Six Sigma methods and tools and the lean manufacturing-lean enterprise philosophy, striving to reduce waste of physical resources, time, effort, and talent while assuring quality in production and organizational processes. Any use of resources that do not create value for the end customer is considered a waste and should be eliminated.
What are the belt rankings for Sigma Six?
White belt: Individuals with a white belt have not gone through any formal training or certification. This belt gives professionals a basic framework, which allows them to take part in certain quality control and waste reduction projects.
Yellow belt: This level provides additional training beyond the white belt level. Yellow belts can become contributing project team members. They may help managers who have higher belts.
Green belt: Those who pass this level must take part in a complete course that trains them to come up with process improvement techniques. The green belt certification is ideal for individuals who work in certain industries, such as project or financial management, as well as health care. Graduates often become project leaders.
Black belt: People who graduate from the green belt level can move up to the black belt certification. Successful graduates can break down and deal with more complex jobs and projects. They are taught how to tackle large-scale changes that can impact their companies through lean Six Sigma projects.
What is QIP (quality improvement process)
Quality improvement is a structured approach to evaluating the performance of systems and processes, then determining needed improvements in both functional and operational areas. Successful efforts rely on the routine collection and analysis of data. A quality improvement plan describes an ongoing, or continuous, process through which an organization’s stakeholders can monitor and evaluate initiatives and results.
What are the characteristics of QIP?
Quality improvement is data driven and regards the quantitative approach as the only reliable means to influence the qualitative elements. This principle is expressed in the following saying of quality improvement guru W. Edwards Deming: “The right data in the right format in the right hands at the right time.”
QI focuses on processes, not people. In other words, the individual is never at fault.
QI involves people as part of the improvement solution and looks for what is attributed to Deming as “the smart cogs,” the employees who are directly involved in and best understand the processes in an organization.
What is main focus of QIP?
Quality improvement aims to create efficiencies and address the needs of customers. In healthcare, the main purpose of quality improvement is to improve outcomes. In healthcare settings, quality improvement may be associated with continuous quality improvement, the method used to identify problems and implement, monitor, and provide corrective action.
What are the 4 broad steps of FADE (Focus, Analyze, Develop, Execute) QI Model?
FOCUS: Define and verify the process to be improved
ANALYZE: Collect and analyze data to establish baselines, identify root causes and point toward possible solutions
DEVELOP: Based on the data, develop action plans for improvement, including implementation, communication, and measuring/monitoring
EXECUTE: Implement the action plans, on a pilot basis as indicated, and
EVALUATE: Install an ongoing measuring/monitoring (process control) system to ensure success.
Describe the PDSA Cycle
PLAN: Plan a change or test of how something works.
DO: Carry out the plan.
STUDY: Look at the results. What did you find out?
ACT: Decide what actions should be taken to improve.
Repeat as needed until the desired goal is achieved
What is FMEA?
Failure Modes and Effects Analysis (FMEA) is a systematic, proactive method for evaluating a process to identify where and how it might fail and to assess the relative impact of different failures, in order to identify the parts of the process that are most in need of change.
What is the process of FMEA?
A 12-step process that begins with describing the process in detail and developing a team that creates a flow chat listing each step in a process and then brainstorms each step to determine potential causes for failure and potential adverse outcomes, which are rated according to severity, occurrence, and detection and a risk priority number is assigned. The team then brainstorms methods to reduce potential failures and identify performance measures
What are core objectives of Meaningful Use?
Record and chart changes in height and weight
Using CPOE for medication orders
Implementing drug/drug and drug/allergy interaction checks
Maintaining current problems, medication, and allergy lists
Recording demographics
Recording and charting changes in height, weight, BMI, and BP as well as growth charts for children
Recording smoking status for patients at least 13 years
Implementing one clinical decision support rule of a high priority hospital condition
Providing electronic copies health information and discharge instructions on request
Protecting electronic health information
What is used in Sigma Six model to develop new processes?
DMADV ( Define, measure, analyze, design verify
What is used in Sigma Six model to improve an existing process or products?
DMAIC - Define, measure, analyze, improve, and control
