Quiz 4 Flashcards
Why is the infrastructure of Health Information Technology important?
-It has consequences for the overall system
–supports individual functions
–supports overall clinical workflow
-It has a unique aspect compared with other industries
-It is important to the implementation of success
EHR Component Model- Synchronous care
-repository
-master person index
-clinical applications
-data dictionary
-knowledge base
-clinical decision support system
EHR Components Model: Clinical Data Repository
-storage for pt data
-key aspects: accessibility, reliability, security
-characteristics:
–central versus distributed storage model
–encounter-based versus longitudinal record
Central Storage
-single repository is used to store all (or most) of the clinical data and is used as there primary source for reviewing data
Distributed Storage
-each data collection application stores its own information in its own repository, and data are then federated through a realtime data access methodology
EHR Component Model: Master Person Index
-is a repository of information that uniquely identifies the pt
-usually includes demographic data
-maps a pt unique identifiers to a single, “master” identifier
-is used by clinical and administrative applications to search for and identify pt
Encounter-Based
-data are collected according to the current pt encounter and then are usually purged or achieved from the repository when the pt is discharged
Longitudinal
-stores data across all encounters. Is often referred to as a “cradle-to-grave” or “womb-to tomb” repository because data ay span the entire life span of an individual
Clinical Applications
-user-facing views of the EHR
-variety of technologies and user-interface paradigms: rich pt, web-based app, mobile apps
-functional areas: reviewing and reporting, data collection, pt management, clinician productivity
Data dictionary
-in the source for medical vocab terms used in the system
-source for term relationships (hierarchical, associative)
-provides unique codes for terms stored in pt records
-is the key to a “content-driven- infrastructure
Knowledge Base
-stores and organizes enterprise info and knowledge
–orderable items, order sets
–policy documents
–searchable medical subject matter
–clinical guidelines
–decision support rules
-Is the organized according to metadata for knowledge content
-may be human-readable content (medical journal articles) or machine-readable (decision support)
-Is another important key for a “content-driven” system
-Knowledge management tools and processes are important
Clinical Decision Support System
-provides the environment for automated assistance with clinical and healthcare processes
-clinical decision support system (CDSS) parts:
inference engine
data services
communication system
-can be data-driven, time-driven, or user driven
System Integration and Interoperabilities
-must be able to integrate and interoperate with many systems in the health IT infrastructure
-Interface engines are critical integration components
-Interoperability standards for messaging and terminology exist
Networking Systems
-sharing info across institutions is a necessity for quality, financial, and regulatory purposes
-Regional health info org (RHIOs), health info exchanges (HIEs), and health info org (HIOs) are examples of structures
-Nationwide Health Information Network (NwHIN)
Other Infrastructure Models
-Applications Service Provider(ASP)
–clinical app are hosted at a vendor site
–relieves the healthcare enterprise of operations and maintenance (O&M) responsibilities
–some loss of control occurs; is harder to integrate with local systems
-Cloud computing
–computing services are supplied by public or private org and shared by the community
–examples are a software as a service, Infrastructure as a service, and platform a service
