Prev Med 2 Flashcards
who is a clinical informatician?
Enhances individual and population health outcomes, improves patient care, and strengthens the clinical-patient relationship; design, implement, and eval info and communication systems
2 main pathways to become a clinical informaticist: noncertified vs certified
Practice track w/out formal education
Practice track w/ formal education (Masters degrees/PhDs)
vs
practice track: work exp –> cert (subspecialty board exam)
standard track: 2y fellowship –> cert (subspecialty board exam)
HIPAA vs PPACA
protects health ins to personnel & fam when they lose/change jobs vs inc affordability, access, avail of health ins
stage 1 vs 2 vs 3 HITECH
2011: capture & share data, incentive funds vs 2014: integrate data into HIT & EHR vs 2016: hosp showed HIT improved pt outcomes; penalties for not adopting health info systems & EHR
factors shaping healthcare delivery: econ vs consumer vs payment vs demographics vs EBM vs govt vs edu
income inequal, ins, inc cost of care vs pts find their own info or have own access; from txing illness to preventing illness vs self-ins, concierge med, indep to integrated systems vs aging, from acute to chronic care vs integrating best approach into pt care vs HIPAA, ACA, HITECH, MACRA vs drop in primary care, some residency specialty shortage
2001: Institute of Medicine has what 6 core values?
pt safety, equity, timeliness, pt centered care, effic, EBM/effectiveness
triple vs quadruple aim
improve pop health –> reduce prevalent costly chronic dz, experience of care –> motivate & engage pts in health, reduce per capital cost –> dec resrc util & readmissions vs + provider satisfaction –> address provider burnout and access to tools
clinical decision support
provides clinicians, staff, patients with knowledge and person-specific information, intelligently filtered, to enhance pt care
5 rights of clinical decision support
right info
right ppl
right channel
right format
right time
optimize info flow to docs
protected health info
all individually identifiable health information held or transmitted by a covered entity or its business associate
best practices for your health data security
encrypt, use spam filters, update security, scan for threats, implement Data Loss Prevention
w/ health info systems, you might have a single EHR or niche products: PACS vs LIS vs DMS vs practice management suite vs pt portal
stored DICOM imgs vs where labs = process & stored –> results to go to EHR vs where scanned docs = located vs billing, scheduling vs pt access their health info
healthcare disparities vs social determinants of healh
diff access/avail of health services & dz occurrence based on SES vs conditions in places ppl live/work/interact that affect wide range of health risks & outcomes
lean & six sigma
standardized process breaking down workflow into individual pieces –> understand impacting factors such as error, efficiency, cost, and waste
lean vs six sigma
minimize waste errors & delays –> effic. transport, unnecessary inventory & motion, waiting, overprocessing, overprod, defects vs process improvement and variation reduction –> quality and consistency. Define, measure, analyze, improve, control
workflow process mapping
Determine the process boundaries
List all steps in the process
Place steps in order
Use right symbols
Check works
usability heuristic. methods for this?
making health tech more usable. predictable system w/ similar terminology, recognition > recall to minimize dr cog workload, aesthetic/minimal design for how dr likes to work
data integrity. physical vs logical integrity?
accuracy, completeness and consistency of data + safety of the data from regulatory and compliance perspective. protection of entire data (from ransomware or disaster) vs assure the data = unchanged in the database
big data V’s: vol vs variety vs vel vs veracity vs value
number of data points in a data set vs number of features at each data point vs speed the data = updated vs accuracy and truthfulness of data vs social or economic value of data
scoring tool:
HEART Score
PERC
CURB 65
Well’s Criteria
ASCVD 10-year risk (Goff 2013)
ED risk of MI based on troponin level
risk of PE
risk of PNA
PE/DVT
cardiovascular disease risk
operational reporting. ex?
ready to analyze reports that show clear set of information generated in real-time to provide actionable insights. report for all pts due for colonoscopy
diff types of clinical trials: prevention vs screening vs diag vs tx vs behavioral vs QOL
how to prevent dz in new ppl or from returning vs how to detect dz vs test procedures for dxing a dz vs test new tx/drug, surg, rads therapy vs how to promote behavioral changes to improve health vs how to improve comfort & QOL for ppl w/ dz
hierarchy of clinical trials
RCT > Cohort > Case-Control > Cross-section > Case series > Case report
HIMSS Analytics AMAM Stages def
how far along are you in implementing various technology/tools to most effectively predict future of pt (scale 0-7, 7 is the furthest along)
interoperability. building blocks?
share info b/w systems. meaning –> using standardized healthcare vocab, transport –> email protocols, structure –> using HL7 transferring standards, security –> encrypt, service –> access API
foundational vs structural vs semantic operability
exchange data, but the data is not interpreted by the receiving system vs exchange data, data is unaltered and read-only vs exchange data that can be read, understood, and used by both systems (the most interoperable)
SNOMED CT v CPT4 v ICD10 v LOINC v RxNorm
multi-lingual core clinical terminology for EHR v IID med diag/procedures rendered vs by WHO, on death certs/vital records, know anatomy vs logical observations, identifiers, names, codes divided by lab related and clinically related medical terms. Used mainly in lab vs generic & brand names
governance = est who sets strategy & make decisions. measures?
priorities set
lg decisions not made w/o approval
org managed consistently
roles/responsibilities stated
procedures/policies set & can be changed prn
decision making tools vs project management phases of governance
situation, background, assessment, resolution vs initiation –> early planning, plan –> break down project & start project, execution, monitor/ctrl –> keep project on track & manage corrective action, closing –> tying all loose ends & report
change management. why does change management fail?
transition of org or individual into a desired future state; based on desire & ability to change. not communicating why change is needed, not emphasizing the urgency, not removing obstacles to the new vision, not making changes to culture
predictive modeling
human-computer interaction help users process lg amt of info esp in ICU; HCI can be iprove w/ other software
risk stratification
segmenting pts into distinct groups based on similar complexity and care needs –> ID right lvl of care
how to perform operational reporting. use cases: slice/dice vs mRankin
explain asmptns, reg communication, data visualization (like trends). self service tool for EHR users 6pt disability ranking for stroke victims
strategic planning. goals?
documenting goals of org to advance.
mission –> reason behind the organization’s existence
vision –> mental image of the ideal state
values –> organization’s core principles
strategic imperatives –> focus of an org over a 3-yr period, operating goals that drive outcomes
financial planning. operating vs capital financial plan
how will org afford its goals/objectives? –> budget and budget risk, cost, type/quantity of resrcs. annual/monthly budget including sales, market, expenditures vs whether an asset is worth pursuing; see project’s lifetime cashflow and see if they can afford objectives –> look at 5yr ROI
visual analytics
semiautomated approach to electronic data processing, guided by users
how did reimbursement shift in healthcare?
from vol to value; from fee for service to at risk model
analytics
data srcs –> extraction –> statistical processing –> prediction output. descriptive, diag, predictive, prescriptive
