informatics test 3

security

refers to the measures implemented to prevent unauthorized user access to the personal health information of patients

privacy

refers to the right of patients to control what happens to their personal health information

What is health numeracy?

the ability of a consumer to interpret and act on all numerical information, such as graphical and probabilistic information to make effective health care decisions. - US scored 257 (25-288)

What is interoperability?

the ability of two or more systems to pass information between them and to use the exchange of information

What are three parts of the patients record?

- EMR electronic medical record - EHR electronic health record - PHR personal health record

What test has a client read an ice cream label? what is the purpose?

- NVS - test both health literacy and health numeracy

What is a tethered PHR?

- PHR is linked to a specific healthcare organizations EHR system/ health plan's information system - patients can access own records through patient portal

What are the basic contents of a smart card?

- a microcontroller for managing data - a secure encrypted microchip to store data - a contactless radiofrequency (RF) interface - a contact interface ( usually gold colored)

What are the functions of patient portals?

- ability to make routine appointments, flu shots, or immunizations - upload blood or glucose results, then provide feedback on glucose control - assisting diabetics to manage their chronic condition and improving quality of life( saving healthcare dollars) - patients with metastatic cancer can report their symptoms in real time, providing alerts to clinicians ( shown major benefits, including longer survival rates) - most contain some type of decision support using computerized prompts - secure email messaging features - meets the needs of the comsumer who expect personal attention - personalized info targeted directly for them

What is direct exchange?

- ability to send and receive secure information electronically between providers to support coordinated care.

What is the benefit de-identified data?

- aggregated form to assess patterns of disease - quickly identify potentially dangerous side effects of medication - detect disease outbreaks *** contains no personal identifiers

What is the benefit of having healthcare data in electronic format?

- allows the use of de-identified data

What is the PHR?

- allows users to maintain/ manage their own health information and communicate the information with authorized providers * PHRs tethered with EHRs are private, secure, confidential and protected by HIPAA * stand alone PHRs are not protected by HIPAA

what information can you use to evaluate a website for the quality of health information?

- authority, qualifications, and credentials of the authors - the about us section: * purpose of site * disclaimer that acknowledges that the website health information does not replace the advice of a health professional * a privacy and confidentiality statement acknowledging that the website does not keep personal identifiable information for website users * a website contact email address * funding resources information - reference for all medical information - last update date

What are the three key forms of HIE ( health information exchange)?

- direct exchange - query based exchange - consumer mediated exchange * need internet to access

What are the skills needed for health literacy?

- evaluating information for credibility and quality - analyzing relative risks and benefits - calculating medication dosages ( and dosing intervals) - interpreting test results - locating health information To accomplish these task individuals need to be: - visually literate ( able to understand graphs, etc. ) - computer literate ( able to operate a computer) - information literate ( able to obtain and apply relevant information) - numerically or computationally literate ( able to calculate or reason numerically) Oral language skills are important as well. Patients need to : - articulate their health concerns and describe their symptoms accurately - ask pertinent questions - understand spoken medical advice or treatment directions

What are the levels of interoperability?

- foundational interoperability - structural interoperability - semantic interoperability

What are the benefits of PHRs?

- further collaborative care - consumers can collaborate in the creation and maintenance of their healthcare record - ability to manage ones disease treatment more effectively - tethered PHR permits the provider to share individualized info with client, providing more personalized, higher quality care - improved communication - tethered EHR reduces administrative cost assoc. with prescription refills and scheduling appointments

What is semantic interoperability?

- highest level of interoperability - information transmitted so that it is understandable, information exchanged between two computers without human intervention - effectiveness depends on the interaction between algorithms (rules), the data used in the message, and the terminology used to designate the data - allows users to receive information from different EHRs to plan and provide safe and effective care. - provides data exchange between providers as well as the lab and the pharmacy

(USB) universal serial bus

- identification device - inserts into usb port - used to hold medical information for use in emergencies - also called flash drive

What is the goal in consumer informatics?

- improve consumer decision making processes and healthcare outcomes with electronic information and communication

What is structural interoperability?

- intermediate level, defined by message formats - purpose: to coordinate work processes - refers uniform format or strcture of the exchanged messages - data exchange between systems allow or interpretation at the data field level

What problem can arise between patient and provider due to information from the internet?

- lack of trust - second guessing providers plan of care

What are writing strategies associated with improving readability?

- limit the number of word syllables; Ex: drug instead of medication, doctor instead of physician - use plain language instead of medical terminology or jargon - use bullets to highlight critical points - use graphs with captions to reinforce the meaning of words - keep sentences short - balance words with white space

What is foundational interoperability?

- lowest and most basic level of interoperability - refes to the ability of one system to transmit data and another to recieve data without the ability of receiving system to interpret the data * able to send and receive usable data from different systems

What are the benefits of HIE?

- makes it easier for patient to supply an up-to-date record - provides safer care in the advent of an emergency when regular records may not be available - a record of all prescriptions can reduce adverse drug effects - can assist in identifying those who abuse prescription drugs

What is a stand alone PHR?

- patient fills in information from their own records - stored on patients computer or the internet - patient can add diet and exercise information to track progress over time

What are the four major ethical priorities of EHRs?

- privacy and confidentiality - security breaches - system implementation - data inaccuracies

What are the barriers to PHR?

- protocols ( a system of rules for exchange of data by computers) and procedures still evolving - providers reluctance to use PHR data - no unique identifier to connect EHR and EMR data - clients must create multiple log-ins and passwords for each entity - concerns about security and privacy, interoperability, data presentation, and cost - lack of reliable internet access - patients not using patient portals - lack of support and fear of eroding existing personal relationships with healthcare providers were key barriers to initiating portal use - cost

what are patient portals?

- provide patients access to their EHR data

What are the benefits of smart cards?

- provides a positive patient identifier - requires employee credentials for strong authentication for HIPAA - provides immediate access to lifesaving information - provides data portability - guards against healthcare fraud, abuse, and misuse - resolves language issues associated with health record information - reduces administrative cost - supports the NwHIN standards

What is mapping?

- refers to matching a concept in one standardized terminology with a concept in another standardized terminology ex: the NANDA diagnosis "ineffective airway clearance" could be mapped with the CCC nursing diagnosis " airway clearance impairment"

What handicaps healthcare providers by preventing complete information about a patient?

- scattered healthcare records

What are the three main formats for the PHR?

- software applications : computer or flash drive - web portals : information on computer remotely - hybrid PHR : allow remote storage of health info, as well as the ability to store the info on personal computer or flash drive

What are the two different types of PHR?

- stand alone -tethered

What is interface terminology?

- terminology that allows the exchange of computer clinical information with the user.

What are the general rules for effective oral communication ?

- use eye contact - speak slowly and use plain language - limit communication to three to five things that are essential to know - repeat important information - encourage questions - use pictures, models, or drawings - use "teach back" technique, where you ask the client to explain what you said in their own words

Readability scores

-Flesch-Kincaid reading Ease- 68.3 -Flesch-Kincaid grade level - 6.9 - Gunning-Fog score- 8.5 - Coleman-Liau Index- 12.5 - SMOG index- 6.2 - Automated Readability Index- 7.6

What is the effectiveness of secure information dependent on?

-each health care provider using electronic patient care records - records being accessible by those designated by the patient anywhere in the US - patient having access to their healthcare records

When did HIPAA pass a law allowing patients the right to see their own health care records?

1996

An electronic record that cannot interface with outside agencies is not a true ______________.

EHR

What are the focus of most healthcare agencies?

EMR * the institution that creates EMRs own and manage them

What is the EMR?

a digital healthcare record created by healthcare providers or agencies, such as hospitals * EMRs that meet national standards for interoperability will be able to share health information with EHR

What is cyerchondria?

a term that describes people who become distressed and frightened after repeated and excessive web searched for health information * anxiety disorder

What is consumer mediated exchange?

ability for patients to aggregate and control the use of their health information among providers

What is a query based exchange?

ability for providers to find and/ or request information on a patient from other providers, often used for unplanned care

Health care providers become more of an ___________ while patients become clients or consumers.

adviser

What is the EHR?

an interoperable electronic health care record that contains data from the EMRs of all healthcare providers including care facilities, clinicians, laboratories, and pharmacies involved with the patients care * Provides real time informations and Evidenced based decision support tools

PHR and EHR can threaten the ______________ of some healthcare providers who still was to practice in the traditional model.

autonomy

What is Flesch Reading ease?

calculates a value from a formula usinf the average sentence length and the average number of syllables per word. - recommended score is between 60-70 - higher scores correlated with easier readability

What does interoperable mean?

can be shared electronically

_____________- is an important measure to maintain privacy and security of personal health information.

confidentiality

Clients need to think of themselves as healthcare ________________ with a responsibility to to participate actively in their healthcare.

consumers

What is granularity?

describes the detail that is captured by a term or phrase * the greater the granularity, the greater the detail * at clinical level, very granular data are usually needed

The inability to access health information problems can be ________________ ________________ in an emergency.

life threatening * seen in Hurricane Katrina in 2005, paper records either destroyed or inaccessible

What is health literacy?

not simply to read, but to obtain, process, and understand basic health information and services need to make appropriate decisions US scored 272 on ALL test 269-274 - includes the capacity to understand instructions on prescription bottles, appointment slips, medication education brochures, doctor's directions, consent forms, and the ability to negotiate complex healthcare systems

What are the consequences of not utilizing standards to promote interoperability?

ongoing drain on financial resources through actions such as duplication of tests, the inability to mitigate medical errors because of lack of information, and decrease in the ability to quickly respond to natural or manmade epidemics and disasters * interoperability is the technologic solution to a lack of communication among disparate systems

confidentiality

refers to authorized care providers maintaining all personal health information as secret, except to other care providers who need access to that information and others that the patient has consented to allow access