Health Informatics- Module 1-Chapter 1.pptx
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The document provides an overview of health informatics, detailing its history, significance, and the impact of information technology on healthcare. It discusses the importance of data, information, knowledge, and the barriers to the adoption of health information technology, including costs, privacy concerns, and workflow changes. Key players in this field include patients, healthcare providers, researchers, and technology vendors, and there is a growing demand for professionals skilled in health informatics.
Health Informatics- Module 1-Chapter 1.pptx
- 2. Module 1: Chapter 1 OVERVIEW OF HEALTH INFORMATICS HEALTHCARE DATA, INFORMATION AND KNOWLEDGE SIGNIFICANCE OF INFORMATION SYSTEMS
- 3. Module Content Overview of Health Informatics: survey of fundamentals of health information technology, Identify the forces behind health informatics, educational and career opportunities in health informatics. Healthcare Data, Information and Knowledge: How to use healthcare data to fuel modern health care organizations. Significance of Information Systems: how information technology enables patient care, how information technology is used by healthcare providers.
- 4. SurveyOf FundamentalsOf Health InformationTechnology Health informatics began as a new field of study in the 1950s-1960s but only recently gained recognition as an important component of many aspects of healthcare. Its emergence is partly due to the multiple challenges facing the practice of medicine today. The growth in the volume of medical knowledge and patient information that has occurred due to better understanding of human health has resulted in more treatments and interventions that produce more information. Likewise, the increase in specialization has also created the need to share and coordinate patient information. Furthermore, clinicians need to be able to access medical information expeditiously, regardless of location or time of day.Technology has the potential to help with each of those areas.
- 5. Data, Information, Knowledge, Wisdom Hierarchy With the advent of the internet, high speed computers, voice recognition, wireless and mobile technology healthcare professionals today have many more tools available at their disposal. Additionally, the volume of data and rapidly changing technologies, there is a great need for ongoing informatics education of all healthcare workers. Informatics is the science of information and the blending of people, biomedicine and technology. Individuals who practice informatics are known as informaticians or informaticists, such as, a nurse informaticist.There is an information hierarchy that is important in the information sciences.
- 6. Data, Information, Knowledge, Wisdom Hierarchy As data are consumed and analyzed the amount of knowledge and wisdom produced is much smaller.The following are definitions to better understand the hierarchy: Data are symbols or observations reflecting differences in the world. Note that there is no meaning associated with data; the ‘5’ could represent five fingers, five minutes or have no real meaning at all. Information is meaningful data or facts from which conclusions can be drawn by humans or computers. For example, five fingers has meaning in that it is the number of fingers on a normal human hand. Modern computers do not process information, they process data.This is a fundamental problem and challenge in informatics. Knowledge is information that is justifiably considered to be true. For example, a rising prostate specific antigen (PSA) level suggests an increased likelihood of prostate cancer. Wisdom is the critical use of knowledge to make intelligent decisions and to work through situations of signal versus noise. For example, a rising PSA could mean prostate infection and not cancer.
- 7. Informatics Definitions Health informatics is the field of information science concerned with management of healthcare data and information through the application of computers and other technologies. The definition of health informatics is dynamic because the field is relatively new and rapidly changing.The following are several definitions frequently cited: “science of information, where information is defined as data with meaning. Biomedical informatics is the science of information applied to, or studied in the context of biomedicine. Some, but not all of this information is also knowledge” “scientific field that deals with resources, devices and formalized methods for optimizing the storage, retrieval and management of biomedical information for problem solving and decision making” “application of computers, communications and information technology and systems to all fields of medicine - medical care, medical education and medical research”
- 8. Health DataSources EHR=Electronic Health Records, PHR=Personal Health Record, HIE=Health Information Exchange Health information technology (HIT) facilitates the processing, transmission and analysis of information and HIT interacts with many important functions in healthcare organizations and serves as a common thread Health information management (HIM) traditionally focused on the paper medical record and coding.With the advent of the electronic health record HIM specialists now have to deal with a new set of issues, such as privacy and multiple new concepts such as voice recognition.
- 9. Forces behind health informatics There are multiple forces driving the adoption of health information technology, but the major ones are the need to: Increase the efficiency of healthcare (improve physician, nurse and overall healthcare productivity) Improve the quality (patient outcomes) of healthcare, resulting in improved patient safety Reduce healthcare costs Improve healthcare access with technologies such as telemedicine Improve communication, coordination and continuity of care Improve medical education for clinicians and patients Standardize of medical care
- 10. HealthIndicatorsWarehouse: ACaseStudy Subject: Medicare, population statistics, administrat Topics: chronic disease and conditions, demographics, disabilities, geography, health behaviors, health care, health care resources, health outcomes, health risk factors, hospital referral region, infectious disease initiative, injury and violence, maternal and infant health, mental health and substance abuse, occupational health and safety, oral health, physical environment, population, prevention through healthcare, public health infrastructure, social determinants of health and women's health Geography: state or county Initiative: County Health Rankings, 2008 Community Health Status Indicators, Healthy People 2020, CMS Community Indicators Data is available to developers via an open application programming interface (API). ive, safety, health care providers, other, health care cost, biomedical research, epidemiology, children’s health, Medicaid, quality measurement, treatments Agency: Department of Health and Human Services, National Institutes of Health Sub-agency: Centers for Medicare & Medicaid Services, Department of Health & Human Services, Centers for Disease Control and Prevention, national Library of Medicine, Administration for Children and Families, U.S. Food and Drug Administration, Agency for Healthcare Research and Quality, National Institutes of Health, Administration for Community Living, National Cancer Institute, National Institute on Drug Abuse, NewYork State Department of Health Date coverage period start: 1984-2013 Collection frequency: annually, semi-annually, quarterly, monthly, weekly, daily Geography: ZIP code, country, state, county, city, street address, MSA, sub-national region, Latitude/Longitude Coordinate Media format: CSV, query tool, API, XLS, Widget, Text, XML, Feed, RDF, query tool 1
- 11. Historical Highlights The following are some of the more noteworthy developments related to health information technology: Computers.The first general purpose computer (ENIAC) was released in 1946 and required 1,000 sq. ft. of floor space. It is thought that the origin of the term medical informatics dates back to the 1960’s in France (“Informatique Medicale”). MEDLINE. In the mid-1960s MEDLINE and MEDLARS were created to organize the world’s medical literature. Artificial intelligence (AI) medical projects such as MYCIN (Stanford University) and INTERNIST-1 (University of Pittsburg) appeared in the 1970s and 1980s. Human Genome Project. In 2003 the Human Genome Project (HGP) was completed after thirteen years of international collaborative research. Nationwide Health Information Network (NwHIN).The concept was developed in 2004 as the National Health Information Infrastructure and renamed the Nationwide Health Information Network (NwHIN). It was again renamed the eHealth Exchange in late 2012.
- 12. HumanGenomeProject: ACaseStudy In 2003 the Human Genome Project (HGP) was completed after thirteen years of international collaborative research. Mapping all human genes was one of the greatest accomplishments in scientific history. Finalizing a draft of the genome is the first step.What remains is making sense of the data. In other words, we need to understand the difference between data (the code), information (what the code means) and knowledge (what we do with the information). Data from mega-databases will likely change the way we practice medicine in the future. https://youtu.be/MvuYATh7Y74
- 13. Key Players in Health Information Technology Patients: Online searches for health information and research choice of physician, hospital or insurance plan Smartphone technology for test message reminders, health and fitness apps, internet access, etc. Web portals for storing personal medical information, making appointments, checking lab results, e-visits, drug refills, etc. Online patient surveys Online chat, blogs, podcasts, vodcasts and support groups andWeb 2.0 social networking Personal health records Limited access to electronic health records and health information exchanges (HIEs) Telemedicine and home telemonitoring
- 14. Key Players in Health Information Technology Physicians and Nurses: Online searches with PubMed, Google and other search engines Online resources and digital libraries Patient web portals, secure e-mail and e-visits, telehomecare Physician web portals Clinical decision support, e.g. reminders and alerts Electronic medication administration record (eMAR) and bar coding medications Electronic health records (EHRs) Smartphones loaded with medical software and remote access to EHRs Telemedicine and telehomecare Voice recognition software Online continuing medical education (CME) Electronic prescribing Disease registries Picture archiving and communication systems (PACS) Pay-for-performance (P4P) Health information organizations (HIOs) E-research Electronic billing and coding
- 15. Key Players in Health Information Technology Support Staff: Patient enrolment Electronic appointments Electronic coding and billing EHRs Web-based credentialing Web-based claims clearinghouses Telehomecare monitoring Practice management software Secure patient-office e-mail communication Online educational resources and CME Disease registries
- 16. Key Players in Health Information Technology Public Health: Incident reports Syndromic surveillance as part of bio-terrorism program and Meaningful Use program criteria Establish link to all public health departments Geographic information systems to link disease outbreaks with geography Telemedicine Disease registries as part of EHRs or health information exchanges Remote reporting using mobile technology
- 17. Key Players in Health Information Technology Federal and State Governments: Nationwide Health Information Network (HealtheWay) Financial support for EHR adoption and health information exchange Development of standards, services and policies for HIT Information technology pilot projects and grants Disease management Pay-for-performance Electronic health records and personal health records Electronic prescribing Telemedicine Broadband adoption Health information organizations (HIOs) Regional extension centers Health IT workforce development
- 18. Key Players in Health Information Technology Medical Educators: Online medical resources for clinicians, patients and staff Online CME PubMed searches Telehealth via video teleconferencing, podcasts, etc.
- 19. Key Players in Health Information Technology Insurance Companies (Payers): Electronic claims transmission Trend analysis through data analytics Physician profiling Information systems for quality improvement initiatives Monitor adherence to clinical guidelines Monitor adherence to preferred formularies Promote claims-based personal health records and information exchanges Reduce litigation by improved patient safety through fewer medication error
- 20. Key Players in Health Information Technology Hospitals: Electronic health records Electronic coding and billing Information systems to monitor outcomes, length of stay, disease management, etc. eMARs Bar coding and radio frequency identification (RFID) to track patients, medications, assets, etc. Wireless technology E-intensive care units (eICUs) Patient and physician portals E-prescribing Member of health information organizations (HIOs) Telemedicine Picture archiving and communication systems (PACS)
- 21. Key Players in Health Information Technology Medical Researchers: Database creation to study populations, genetics and disease states Online collaborative research web sites Electronic case report forms (eCRFs) Software for statistical analysis of data e.g. SPSS Literature searches with multiple search engines Randomization using software programs Improved subject recruitment using EHRs and e-mail Smartphones to monitor research Online submission of grants
- 22. Key Players in Health Information Technology TechnologyVendors: Applying new technology innovations in the field of medicine: hardware, software, genomics, etc. Data mining Interoperability Certification
- 23. Educational and career opportunities in health informatics The timing is excellent for a career in health informatics.With the emphasis on increasing adoption of electronic health records and health information exchange, coupled with support from the HITECH Act there has been tremendous interest in health informatics. Healthcare organizations and HIT vendors will be looking for workers who are knowledgeable in both technology and healthcare.
- 24. Barriers to Health Information Technology Adoption Inadequate time. This complaint is a common thread that runs throughout most discussions of technology barriers. Busy clinicians complain that they don't have enough time to read, learn new technologies or research vendors.They are also not reimbursed to become technology experts.They usually have to turn to physician champions, local IT support, Regional HIT ExtensionCenters or others for technology advice. Inadequate information. Clinicians need information, not data. Current HIT systems are data rich but information poor.This is discussed in detail in the Healthcare Data, Information and Knowledge chapter. Inadequate expertise and workforce. In order for the United States to experience widespread HIT adoption and implementation, it will require education of all healthcare workers.
- 25. Barriers to Health Information Technology Adoption Inadequate cost and return on investment data. The literature on the economic aspects of HIT adoption and implementation is mixed and based on different assumptions and methods. High cost to adopt. It is estimated that a Nationwide Health Information Network (eHealth Exchange) will cost $156 billion dollars over five years and $48 billion annually in operating expenses.74 Technologies such as picture archiving and communications systems (PACS) and electronic health records are also very expensive. Lack of interoperability. Electronic health records and the NwHIN cannot share medical information until data standards are adopted and implemented nationwide. Interoperability and data standards are covered in more detail in other chapters. Change in workflow. Significant changes in workflow will be required to integrate technology into the inpatient and outpatient setting. As an example, clinicians may be accustomed to ordering lab or x-rays by giving a handwritten request to a nurse who actually places the order. Now they have to learn to use computerized physician order entry (CPOE).
- 26. Barriers to Health Information Technology Adoption Privacy concerns. The Health Insurance Portability and AccountabilityAct (HIPAA) of 1996 was created initially for the portability, privacy and security of personal health information (PHI) that was largely paper-based. HIPAA regulations were updated in 2009, and again in 2013, to better cover the electronic transmission of PHI or (ePHI). Legal issues. The Stark andAnti-kickback laws prevent hospital systems from providing or sharing technology such as computers and software with referring physicians. Behavioral change. Perhaps the most challenging barrier is behavior. InThe Prince by Machiavelli, it was stated “there is nothing more difficult to be taken in hand, more unsafe to conduct, or more uncertain in its success, than to take the lead in the introduction of a new order of things.”
- 27. Key Points Health informatics focuses on the science of information, as applied to healthcare and biomedicine Health information technology (HIT) holds promise for improving healthcare quality, reducing costs and expediting the exchange of information Barriers to widespread adoption of HIT include: time, cost, privacy, change in workflow, legal, behavioral barriers and lack of high quality studies Many new degree and certificate programs are available in health informatics A variety of health informatics resources are available for a wide audience Interoperability and health information exchange is a major priority of the federal government but is challenged by sustainable issues.
- 28. ThankYou!