Test 1 Flashcards
Health Information Technology (HIT)
The use of computers and communications technology in healthcare and the public health setting.
Computer-based Patient Records
Earliest forms of Electronic Health Records; circa 1990’s.
Clinical Trials
Research projects that involve direct management of patients and are generally aimed at determining optimal modes of therapy, evaluation, or other interventions.
Four Issues Slowing the Building of EHRs
1) Standards for clinical terminology.
2) Data privacy, security, and confidentiality.
3) Physician data entry
4) Integrating record systems with other information resources in a health setting.
Backbone Network
A high-speed communication network that carries major traffic between smaller networks.
Biomedical Informatics
The interdisciplinary field that studies and pursues the effective uses of biomedical data, information, and knowledge for scientific inquiry, problem solving, and decision making, driven by efforts to improve human health.
Office of the National Coordinator for Health Information Technology (ONC)
An agency within the US Department of Health and Human Services that is charged with supporting the adoption of health information technology and promoting nationwide health information exchange to improve health care.
Meaningful Use
The set of standards defined by the Center for Medicare and Medicaid Services (CMS) Incentive Programs that governs the use of electronic health records and allows eligible providers and hospitals to earn incentive payments by meeting specific criteria.
-Belief that health providers using EHR in an effective way can improve health care quality and efficiency.
Medical Computer Science
The subdivision of computer science that applies the methods of computing to medical topics.
Information Science
The field of study concerned with issues related to the management of both paper-based and electronically stored information.
Cognitive Science
Area of research concerned with studying the processes by which people think and behave.
Information Theory
The theory and mathematics underlying the processes of communication.
Biomedical Computing/Biocomputation
The use of computers in biology or medicine.
Field encompassing the modeling and simulation of tissue, cell, and genetic behavior.
Medical Informatics
The sub-field of clinical informatics that deals with the management of disease and the role of physicians.
-Former term for Biomedical Informatics
Medical Information Science
The field of study concerned with issues related to the management and use of biomedical information.
Health Informatics
Term increasingly used solely to refer to applied research and practice in clinical and public health informatics.
-Synonym for Biomedical Informatics
Bioinformatics
The study of how information is represented and transmitted in biological systems, starting at the molecular level.
Biomedical Information Science and Technology Initiative (BISTI)
An initiative launched by NIH in 2000 to make optimal use of computer science, mathematics, and technology to address problems in biology and medicine.
Hospital Information System (HIS)
Computer system designed to support the comprehensive information requirements of hospitals and medical centers, including: patient, clinical, ancillary, and financial management.
Basic Science
The enterprise of performing basic research.
American Medical Informatics Association (AMIA)
A working group created in the 1980’s to develop a formal definition for the field.
-Responsible for the core competencies for graduate training.
BMI Defined: Scope and Breadth of Discipline
Investigates and supports reasoning, modeling, simulation, experimentation, and translation across the spectrum from molecules to individuals and to populations, from biological to social systems, bridging basic and clinical research and practice and the health care enterprise.
BMI Defined: Theory and Methodology
Develops, studies, and applies theories, methods, and processes for the generation, storage, retrieval, use, management, and sharing of biomedical data, information, and knowledge.
BMI Defined: Technological Approach
Builds on and contributes to computer, telecommunication, and information sciences and technologies, emphasizing their application in biomedicine.
BMI Defined: Human and Social Context
Draws upon the social and behavioral sciences to inform the design and evaluation of technical solutions, policies, and the evolution of economic, ethical, social, educational, and organizational systems.
History of the Punch Card
- Invented by Herman Hollerith
- First used for vital statistics by NYC Board of Health in several states
- Adopted for use in 1890 census
- 1928: Hollerith’s company renamed IBM.
Cards for Computers
- Complex, formatted cards to hold data.
- Printed with a format specific to the needs of programmers.
IBM Calculator Instruction Card
-Printed in the 1950’s for use with the IBM 701, the first general purpose computer.
History of HIT: Burroughs 3rd Generation computer
Provided one of the earliest hospital information systems in Charlotte, NC.
History of HIT: Shared Data-Processing Centers
Provided hospitals with business and financial system processing.
History of HIT: SNOP (1965)
American College of Pathology begins work on systematizing the language of pathology.
-Precursor to SNOMED
History of HIT: Late 1960’s
Some HIT systems include patient diagnoses and other patient information, including care plans based on physician orders and nursing orders.
History of HIT: Late 1960’s-Early 1970’s
Health departments and community health organizations partner with vendors to develop systems to provide the statistical reports required by government agencies.
History of HIT: Social Security Act amendment (1965)
Social Security adds Medicaid and Medicare.
- Qualifying for reimbursement is dependent on data provided by nurses regarding care delivered.
- Department of Health and Human Services responsible for reimbursement.
History of HIT: Minicomputers
- Arrived in early 1960’s
- Low cost and small.
- Allowed computer access to individual departments and small organizations, causing a surge in the development of computer applications, particularly in universities and industry.
History of HIT: Microprocessor (1971)
Lay the groundwork for hobbyists to build home computers (microcomputers).
- Personal Computer (PC): Made it possible for individual users, i.e. physicians, to own their own systems.
- aka “Computer on a chip”
Biomedical Engineering (BME)
The application of engineering principles and design concepts to medicine and biology for healthcare purposes.
-Includes: drugs, imaging equipment, prostheses, and regenerative tissue growth.
Medical Information: Low Level Processes
- Receptive to mathematical treatments.
- Computer programs only require numerical programming.
Medical Information: High Level Processes
Human processes raise complex issues to which conventional logic and mathematics are less readily acceptable.
High Level Processes: Artificial Intelligence
Any device that perceives its environment and takes action to maximize its chances of success for a given goal; the mimicking of behaviors that people associate with the human mind.
-aka Machine Intelligence (MI)
Global Forces Affecting Biomedical Computing and its Assimilation
1) New developments in computer hardware and software.
2) A gradual increase in the number of individuals cross-trained in medicine and BMI.
3) Following changes in healthcare financing designed to control the rate of growth in health-related expenditures.
Clinical Datum
Any single observation of a patient
Five Elements of Datum:
1) The Patient in question
2) The Parameter being observed
3) The Value of the parameter
4) The Time of the observations
5) The Method by which the observation is made.
Types of Clinical Data
Narrative, Textual, Numerical, Genetic, Recorded Signals, Drawings/Photographs
Who Collects the Data?
Physicians, Nurses, Admission personnel, Radiologists, Pharmacists, Allied Health Professionals, Technological Devices
Uses of Health Data
- Create basis for historical record.
- Supports communication among providers
- Anticipate future health problems
- Record standard preventative measures
- Identify deviations from expected trends
- Provide a legal record
- Support clinical research
Disadvantages of Paper-Based Records: Storage
Consume too much space; easily lost.
Disadvantages of Paper-Based Records: Accessibility
- Can only be shared by one provider or allied health professional at a time.
- Unavailable approximately 30% of the time in larger facilities.
Disadvantages of Paper-Based Records: Quality
- Ink can fade, becomes illegible
- Susceptible to the elements (e.g. water, fire)
Disadvantages of Paper-Based Records: Fragmentation
Due to disparate documentation and billing systems across multiple providers, the possibility of a comprehensive, longitudinal history is nearly impossible.
- Each provider holds only a limited portion of the health record at any given time
Disadvantages of Paper-Based Records: Security
- Unauthorized access is too easy.
- Paper breaches on the rise in recent history
Disadvantages of Paper-Based Records: Illegible Handwriting
- A leading cause in quality care errors.
- Also poor syntax due to inconsistent medical terminology
The Human Genome Project
International research effort to determine the sequence of the human genome and identify the genes that is contains.
- Unearthed unprecedented amounts of data that need to be sorted and configured for use.
- 1990-2003
Structure of Clinical Data: Classification
A system of grouping similar diseases and procedures and organizing related information for easy retrieval.
Structure of Clinical Data: Nomenclature
A system of terms structured according to pre-established naming rules.
Structure of Clinical Data: Terminology
A set of terms representing the system of concepts in a particular field of study or practice.
International Classification of Diseases (ICD)
An adisagnostic coding scheme created by the WHO
ICD Tenth Revision
- The newest version of the ICD
- US gov’t mandated health care to update to this version in 2009.
Key Issues for Update to ICD-10
- ICD-9 was out-of-date and running out of space for new codes.
- ICD-10 is the international standard to report and monitor disease and mortality.
- ICD Codes are essential to the success of HIT and updating to the latest version is necessary for HIT to reach its full potential.
ICD-10-CM
- Used for diagnosis coding
- Uses 3-7 digits
- Uses the format of code sets but with increased coding complexity
ICD-10-PCS
- Used for inpatient procedure coding
- Uses 7 alphanumerical digits
- Much more specific than its predecessor
Healthcare Terminologies: Human Genome Nomenclature (HUGO)
- Each known gene is assigned a unique gene name and symbol by the Human Genome Nomenclature Committee (HGNC)
- All gene names are stored in the HGNC database.
- Unique names allow for ease of query and conversation about specific genes.
Healthcare Terminologies: Universal Medical Device Nomenclature System (UMDNS)
Standard international nomenclature and computer coding system.
-Used in applications ranging from hospital inventory and work-order controls, to national agency medical device regulatory systems, to e-commerce and procurement.
Healthcare Terminologies: Systematized Nomenclature of Medicine - Clinical Technology (SNOMED-CT)
- Enables providers and EMRs to communicate in a common language, increasing quality care across many different providers.
- Used in the US and internationally.