Quiz 1 Flashcards
4 sciences of health informatics
discipline sciences
info sciences
cognitive sciences
computer sciences
informatics
science of information mgmt in healthcare
DIKW Model
data, info, knowledge, wisdom
- Use information, apply knowledge to a problem and act with wisdom = basis of science of health professional practice
- info is composed of data
knowledge
awareness and understanding of a set of info and ways that info can be made useful to support a specific task or arrive at a decision
experience our environment and learn by acquiring, processing, generating and disseminating knowledge
information
data that is made functional through application of knowledge, interpreted for meaning
wisdom - what is it and how is it developed?
application of knowledge to an appropriate situation
Uses knowledge and experience to heighten common sense and insight to exercise sound judgment
Developed through knowledge, experience, insight and reflection
Ability to apply valuable and viable knowledge, experience, understanding and insight
when did HIPAA get signed into law
1996 - clinton
what is the intent of HIPAA (4)
curtail healthcare fraud and abuse,
enforce standards for health info,
guarantee the security and privacy of health info and
assure health insurance portability for employed persons
Who is responsible for implementing and enforcing the privacy regulation?
Office of Civil Rights
who proposed privacy rules in 1999
HHS - to balance pt right to privacy and providers need to access information
how did the HHS define protected health info
info r/t physical or mental health, provision of one’s health care, or payment for that healthcare that has been maintained or transmitted electronically - can be reasonably identified with the individual it applies to
do patients always have to authorize release of info
not always necessary - if directly r/t tx and payment for treatment
Also not required for research, medical/police emergencies, legal proceedings and collection of data for public health concerns
proposed privacy rules by HHS for HIPAA (1999)
- define protected health info
- determine when authorization has to be done by pts
- Establish patient ownership of the healthcare record and allow for patient initiated corrections and amendments
- Need a privacy official in healthcare organizations
- All outside entities that conduct business with healthcare orgs have to meet same standards for information protection/security
- Patients can’t access info in blinded studies
- *Applies only to health info maintained / transmitted electronically
when did privacy requirements for HIPAA go into effect
2003
privacy rules - patient’s rights
Right to request restrictions to access of health record
Right to request an alternative method of communication w/ a provider
Right to receive a paper copy of the notice of privacy practices
Right to file a complaint if pt believes his rights were violated
Right to inspect and copy one’s health record
Right to request an amendment to health record
Right to see an account of disclosures of one’s health record
who is responsible for enforcing electronic transaction and code set provisions of the law
Centers for Medicare and Medicaid (CMS)
what does HITECH stand for
Health Information Technology for economic and clinical health act
when was HITECH put into law
2009
Part of the American Recovery and Reinvestment Act (ARRA)= stimulus law
which part of the ARRA is HITECH and what does it address
Title XIII of Division A of the ARRA = HITECH Act
Addresses development, adoption, and implementation of HIT policies and standards and provides enhanced privacy and security protections for patient info
what is a certified EHR
an EHR that meets specific governmental standards for the type of record involved
HIT
hardware, software, integrated technologies or related licenses, intellectual property, upgrades, or packaged solutions sold as services that are designed for or support the use by healthcare entities or patients for the electronic creation, maintenance, access, or exchange of health information
qualified EHR
electronic record of health related info on an individual
Contains patient’s demographic and clinical health info and includes medical history and list of health problems
Provides support for clinical decisions
Entry for physician orders
what did HITECH establish within the HHS
ONC
headed by national coordinator = responsible for overseeing development of a nationwide HIT infrastructure to support the following ogals
how did HITECH change HIPAA
OCR is part of HHS and is responsible for enforcing HIPAA
privacy rule and security rule - mandatory for all covered entities
enhanced HIPAA and includes business associates of covered entities
privacy rule
patients have a right to expect privacy protections that limit the use and disclosure of their health info
security rule
providers are obligated to safeguard their patient’s health info from improper use or disclosure and maintain integrity of the info and ensure its availability
what is the OCR
part of HHS is responsible for enforcing HIPAA
Tracks complaints and investigations violations since 2003
who is responsible for regulating medical devices to ensure public safety
FDA under HHS
when is an app considered a medical device
defined as a medical device and can be subject to FDA regulation if the intended use of a mobile app is for the diagnosis of a disease, cure, mitigation, treatment or prevention of disease or if is intended to affect the structure or function of the body of man
escape from fire: 4 sources of resilience in organizations
- improvisation - ability to invent when old formulas fail
- Virtual role systems - refer to the ability of individuals to carry, as it were, a social system inside their heads to assume structures even when they are not externally apparent
- Attitude of wisdom
- Respectful interaction → allows for new options to be created
escape from fire: what are preconditions
shared assumptions that don’t tell us what future we need to build - but that give us a chance of staying in order long enough to tackle that issue → makes sense possible
escape from fire: 5 preconditions
- We need to face reality → need to get honest about the facts
- Drop the Pulaskis - current tools can’t do the job
- Stay in formation - need to make sense of all stakeholders - need to share in the solution
- Talk to each other and listen
- Leadership
why study informatics (3)
- health care info = info intensive
- interprofessional collab and communication are essential to promote safe, evidence based, efficient and cost effective care
- technology tools help us integrate, collect and manage clinical info
foundation of knowledge model: purpose
helps to explain ties b/w disciplinary science, informatics and knowledge
6 roles of healthcare workers (within the foundation of knowledge model)
- knowledge workers - generate knowledge as a product
- knowledge acquirers
- knowledge users
- knowledge engineers - design, develop, implement and maintain knowledge
- knowledge managers - capture and distribute
- knowledge developers/generators - change and evolve knowledge based on tasks at hands
5 components of the foundation of knowledge model
knowledge acquisition
knowledge dissemination
knowledge generation
knowledge processing - center and at core of cone
feedback - dynamic - circling around - acts and can transform all aspects of knowledge
knowledge generation
The creation of new knowledge by
changing and evolving knowledge based on one’s experience,
education, and input from others.
knowledge processing
The activity or process of gathering or
collecting, perceiving, analyzing, synthesizing, saving or storing,
manipulating, conveying, and transmitting knowledge.
knowledge acquisition
The act of getting knowledge.
knowledge dissemination
Distribution and sharing of knowledge.
what is this an example of? (acquisition, dissemination, processing or generation)
Understanding the EHR vendors that are currently in place to gain knowledge on what is currently working and what is not & How EHR is contributing to provider burnout.
acquiring
what is this an example of? (acquisition, dissemination, processing or generation)
“The National Academies’ report on Taking Action Against Clinician Burnout describes the
role of health information technology in clinician burnout,1 including some empirical evidence for the
impact of poor usability.2,3”
generation
what is this an example of? (acquisition, dissemination, processing or generation)
Acquisition + Life Experiences + Generation = Combining the information, processing and
recognizing the need for a change
processing
what is this an example of? (acquisition, dissemination, processing or generation)
Part of the goal on spreading the knowledge:
a. Vendors making reports of the changes they have made
b. Encouraging learning opportunities between EHR vendors and healthcare community
dissemination
is this D, I, K or W?
knowledge that there is nursing burnout and a main part of the job is using
EHR
data
is this D, I, K or W?
where is the burnout coming from in terms of using EHR
information
is this D, I, K or W
there is a connection between EHR and burnout of staff
knowledge
is this D, I, K or W
what is the next step, how can we take the knowledge and take the
correct action towards decreasing burnout and improving the usability of EHR
wisdom
what is this an example of? (acquisition, dissemination, processing or generation)
Systematic Review- Electronic databases/Articles chosen, Screening
and selection tool used and a template for intervention and description replication checklist.
Mixed method appraisal and cochrane risk of bias tools. -> research framework
Ex) Medline, proquest pubmed etc.
Prisma Flow Diagram - Tool used to report on systematic reviews. It maps the reviews chosen
within the article.
acquisition
what kind of knowledge is this an example of
Feedback from the apps, 5 articles reviewed in total post screening.
generation
what kind of knowledge is this an example of
Researchers analyses on the 5 articles and their previous experiences
processing
what kind of knowledge is this an example of
Publishing it as a journal article- Cogent psychology
dissemination
what kind of knowledge is this
Instrument review, document review, key
informant interviews
acquisition
what kind of knowledge is this
Synthesis of information gathered and putting
together field guide.
generation
what kind of knowledge is this
Reviewing the Field Guide and determining that
a web-based interface was better than pdf format
processing
what kind of knowledge is this
Website published on CRCCP sites and to
researchers practice partners and scholars
dissemination
what kind of knowledge is this
Research partners, CDC leadership and staff, and
CRCCP recipients
feedback
what kind of knowledge is this
AI system to evaluate improving clinical outcomes
acquisition
what kind of knowledge is this
Delphi process
○ four open ended questions on aspects viewed by the Delphi participants to be reported during early stage
clinical evaluation. The participating experts were then asked to rate.
○ In the second round, the participants were shown the results of the first round and invited to rate and
comment on the items in the revised list.
generation
what kind of knowledge is this
Feedback from the survey and evaluation of AI was based on the human interaction with computers on
Steering Group beliefs that the AI would help rather than replace human intelligence.
○ Clinicians would use the AI system and their satisfaction on using the AI system.
○ Improvement of clinical outcomes making clinicians more comfortable incorporating and using the AI system
processing
what kind of knowledge is this
Consensus Meeting:
■ an AI specific items list, which represents the main novelty of the DECIDE-AI guideline
■ second list of generic reporting items, which achieved high consensus but are not AI specific and
could apply to most types of studies
dissemination
what kind of knowledge is this
QI framework used to improve care by using standardized processes in order to
reduce variation and lead to more predictable outcomes for patients
acquisition
what kind of knowledge is this
AI/ML-based algorithms approved for clinical use by the United States Food and Drug Administration (FDA)
generation
what kind of knowledge is this
Hospitals may look to create dedicated Clinical AI departments, which would centralize efforts to develop, deploy, and maintain AI models in clinical care with the collaboration between model developers, clinicians, IT professionals, biostatisticians, and regulatory agencies
processing
what kind of knowledge is this
Statistical control charts used as a tool to help visualize and detect different
types of shifts
dissemination
what kind of knowledge is this
AI-QI teams will improve safety and effectiveness at hospital level, national level, and multi-national level with collaboration with clinicians, hospital administrators, information technology (IT) professionals, biostatisticians, model developers, and regulatory agencies.
feedback
what kind of knowledge is this
Traditional care
- Telehealth
acquisition
what kind of knowledge is this
Need d/t COVID-19 pandemic
- Need to improve access to health care
generation (research)
what kind of knowledge is this
Telehealth communication and application - Improved health treatment for rural communities - Virtual specialized clinics - Promotion of awareness of public health policies
processing
what kind of knowledge is this
Telehealth expansion
dissemination
