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currency

-is the information current? -facts compare with related print or other online sources. -links provided to quality web resources.

objectivity

-is the purpose of the site clear, including any particular viewpoint? -statement of purpose and scope -intended audience -information presented as factual or opinion, primary or secondary in origin. -criteria for inclusion of information. -disclosure of sponsorship or underwriting.

usability

-is the site well-designed and stable? -site organization logical and easy to maneuver -content readable by intended audience -information presented is error free (spelling, punctuation) -readily identifiable link back to the institutional or organizational home page. -site readily accessible -pages load quickly.

authority

-with regard to topic-who is responsible for the site? -author of site (individual, or institutional affiliation, organization). -credentials, expertise, experience -contact information (name, email, postal address) -URL type suggests reputable affiliation.

The answer is C because usability is the criterion that is related to the organization of information on the site and the user-friendliness of the site.

A nurse is preparing a presentation and is reviewing websites to collect information on stem cell research. One site does not contain headings to direct the reader, and hyperlinks do not connect to the stated information. Which criterion to establish a reputable website is missing? A. Authority B. Objectivity C. Usability D. Currency

EHR interoperability

EHR systems that have the ability to share and transfer patient data seamlessly across healthcare systems and settings in a standardized manner that protects the reliability, confidentiality, privacy, and Security of the information.

EHR "meaningful use"

a defined set of EHR capabilities and standards that EHR systems must meet to ensure that their full capacity is realized and for the users (hospitals and physician/provider practices) to qualify for financial incentives from Medicare (now known as the "promoting interoperability program").

Electronic health record (EHR)

a digital version of a patient's chart with real-time patient records that make information available instantly and securely to authorized users; in addition to patient data, the EHR may allow for access to evidence-based tools to help providers make decisions about a patient's care and sharing of information with other health care providers and organizations. The longitudinal electronic record of patient health information generated by one or more encounters in any care delivery setting has the ability to support other care-related activity such as, evidence-based decision support, quality management, and outcomes reporting.

downsides in CDS

both alert fatigue as well as clinical burnout

accuracy

is the information accuate?

EHR Access Considerations

privacy, confidentiality, and security

Decision support tools

software programs that process data to produce or recommend decisions by linking with an electronic knowledge base controlled by established rules for combining data elements; the knowledge base and rules mimic the knowledge and reasoning an expert health professional would apply to data and information to solve a problem.

Meaningful use of point-of-care technology

technologies that allow real time data retrieval, documentation, and decision support at the bedside or wherever direct care is provided.

Promoting interoperability program

the Centers for Medicare and Medicaid Services renamed "meaningful use" in 2018 to refocus efforts to increase interoperability and improve access for patients to their health care data.

Information technology

the hardware and software that enable information to be stored, retrieved, communicated, and managed.

Health information technology

the use of various forms of technology to improve the quality of health services to individuals and communities.

Point-of-care Technology Wearables

· A digital tool that has made huge strides since 2010 is the use of wearable devices. · In fact, the use of wearables more than tripled from 2017 to 2020, and this number will continue to grow as wearable technology becomes more accessible and standardized. · Wearables include technologies such as smartwatches, fitness trackers, biosensors, an interoperable monitors. · Fitness trackers have made many leaps recently, including the ability to track heart rates, sleep cycles, and daily steps tracking. Fitness trackers have been around for some time, but their more powerful cousin, the smart watch is taking over in certain markets. · No longer just tools to tell time and count your steps, they now have advanced functionality to contribute to health care and science in new and innovative ways. · The Apple Watch is not only one of the first to incorporate an ECG monitor (far rhythms such as atrial fibrillation) But also has movement disorder API that contributes to Parkinson's disease research. · There is new wearable technology for patients with Alzheimer's disease that tracks their progression by monitoring walking mechanics, or gait speed, symmetry, and stride length. · Wearable technology has also progressed in the straight health care arena for tools such as wearable ECG monitors, oxygen saturation monitors, and blood pressure monitors. All are fully integrated and interoperable with either mobile applications, such as on a cell phone, or even the ordering providers office. · In December of 2019, a company called current health produced the first FDA approved artificial intelligence medical monitor wearable, called current. It can monitor patient's vital signs from home or an inpatient location.

Telehealth

· A discussion about digital health technology would be incomplete without mentioning telehealth-the use of telecommunications technology to assess, diagnose, and, in some cases, treat persons who are at a distance from healthcare provider. · Nurses, physicians, radiologist, psychiatrist, and others use this technology via telephone, computers, interactive videos, and teleconferencing. · In many instances, telehealth makes possible the delivery of healthcare services to underserved populations, Such as rural communities, older adults, and prisoners, who may have difficulty accessing necessary services. · Demonstrated benefits of telehealth include improved quality of care, enhanced community of care, increase the availability of experts, improve access to care, improve decision making and time savings, and higher quality records related to incorporation of digital information. · Innovation and progress seemed to be at their best during a crisis. Pandemics are no exception. During the time of COVID-19, the burst of telehealth and telemedicine implementation and utilization skyrocketed. · Several telehealth modalities used by healthcare providers to deliver high quality patient care have been identified. These include: · Synchronous: this includes real time telephone or live audio video interaction typically with a patient using a smartphone, tablet, or computer. In some cases, peripheral medical equipment (digital stethoscopes, otoscopes, ultrasounds) can be used by another HCP (nurse, medical assistant) physically with the patient, while the consulting medical provider conducts a remote evaluation. · Asynchronous: this includes store and forward technology where messages, images, or data are collected at one point in time and interpreted or responded to later. Patient portals can facilitate this type of communication between provider and patient through secure messaging. · Remote patient monitoring: this allows direct transmission of a patient's clinical measurements from a distance (may or may not be in real time) to their HCP. · With the rapid surge of COVID-19 cases and the government relaxation of restrictions regarding the use of telemedicine, Interstate licensing, reimbursement, and data confidentiality

EHR Data Management

· A fully functional EHR is a complex system. · Consider a single data element (datum), such as person's weight. This System must be able to capture, or record, the weight, then store it, process it, communicate it to others, and present it in a usable format, such as a bar graph or chart. · All of this must be done in a secure environment that protects the patient's confidentiality and privacy. · The complexity of these issues and the development of the necessary systems help explain why adoption of fully functional, certified EHR systems has been slow.

Digital Health Technologies

· According to the US Food and Drug administration (FDA), "digital health includes categories such as mobile health, health information technology, wearable devices, telehealth and telemedicine, and personalized medicine." · The FDA has created the digital health center of excellence to educate and empower digital health users and stakeholders. Services provided by the center include the following: · Digital health policy and technology support and training · medical device cybersecurity · artificial intelligence/machine learning · regulatory science advancement · regulatory review support and coordination · Advanced manufacturing · real world evidence and advanced clinical studies · regulatory innovation · strategic partnerships · their current timeline for education through sustaining Capacity goes from fall 2020 (phase one) through winter 2021 and beyond (phase three). The center has laid out the timeline for the FDA's goals related to digital health innovation.

Electronic Health Records

· An EHR is a system that captures, processes, communicates, secures, and Presence data about the patient. · In addition to capturing patient data, other components of an EHR include clinical rules, patient education materials, evidence-based practice guidelines, and payer rules related to reimbursement. · A CEHRT is an EHR that meets specific standards laid out by CMS and the ONC. These standards must be met to qualify for PIP. · Examples of these required standards include technological capability and functionality of reporting and data sharing, as well as data security and the ability to maintain patient confidentiality. · When these elements work together in an integral fashion, the EHR becomes much more than a patient record-it becomes a knowledge tool. · The system is able to integrate information from multiple resources and provide decision support; thus the EHR serves as the primary source of information for patient care and quality improvements in the health care system

Computerized Provider Order Entry (CPOE)

· Another component of EHR relevant to safety and quality is CPOE, defined as the "the process of providers entering and sending treatment instructions-including medication, laboratory, and radiology orders-via a computer application rather than a paper, fax, or telephone." · CPOE contributes to safety and quality by eliminating lost orders in a legible handwriting; generating related orders automatically (a laboratory test needed to monitor a specific medication); monitoring for duplicate or contradictory orders; and reducing time to fill orders. · Several of the proven benefits of CPOE integration include: · Reduced error and improved patient safety (legible, complete orders) · improved efficiency · and improved reimbursements. · Basically, CPOE has proven to be safer and more efficient for providers and patients.

Clinical decision support

· Automatic reminders about preventive practices · Drug alerts for dosing and interactions · Electronic resources for data interpretation and clinical decision making.

EHRs and the Health Insurance Portability and Accountability Act

· Because What the increase in the number of EHR's in the 1990s and the anticipated penetration of EHR's in healthcare, experts advocated for the standardized protocols and clinical practice guidelines to ensure privacy and security. · HIPAA was signed into law in 1996. · HIPAA regulations focus on the privacy and security of patient data, including standard formats for transmitting electronic patient information. · By April 2005, healthcare institutions have to comply with federal HIPAA regulations. · The HIPAA requires that every organization or facility that gathers or collects personal health information (PHI) to name an individual as a privacy officer and to develop policies and procedures to ensure the privacy and security of PHI (or electronic/ ePHI as the situation may dictate). · The protection of PHI/ePHI extends to every employee, new hire, and patient. · Those found in violation of HIPAA regulations may be subject to criminal penalties and civil monetary penalties. · Federal regulations: · Personal health information [PHI] · Privacy and security · HIPAA compliance and the student nurse · Institutional privacy officer · Policies & procedures · Subject to criminal penalties

Clinical Decision support (CDS)

· CDS is a particular relevance to nursing practice because it contributes to safety and quality by providing automatic reminders about preventive practices, such as computerized, evidence based alerts and reminders, severity indexes for specific illnesses, identifying preventative care screenings (mammograms), immunizations, drug alerts for dosing and interactions (including drug, environment, and food interactions), and electronic resources for data interpretation and clinical decision making. · The ONC defines CDS as providing "clinicians, staff, patients, are other individuals with knowledge and person specific information, intelligently filtered or presented at appropriate times, to enhance health and health care. CDS encompasses A variety of tools to enhance decision making in the clinical workflow."

Security

· Computer based patient record systems provide better protection of confidential health information than paper based systems because such systems incorporate controls designed to ensure that only authorized users with legitimate uses have access to health information. · Security functions address the confidentiality of private health information and the integrity of the data. · Security functions must be designed to ensure compliance with applicable laws, regulations, and standards. · Security systems must ensure that access to data is provided only to those who are authorized and have a legitimate purpose for its use. · Security functions also must provide a means of auditing for inappropriate access. · According to the Department of Health and Human Services, with the implementation of the 1996 health insurance portability and accountability act (HIPPA), there are safeguards to be addressed when keeping your EHR in patient data secure: · access control, such as unique passwords and PINs to limit access to patient information to only authorized users. · Encryption of stored patient information, meaning only a user with a "key" could read or understand your data. · Audit trail feature that records keystrokes and who accessed patient information. · federal law requiring clinicians, Hospitals, and others to report data breaches to patients. This also includes federal notification of large data breaches that impact more than 500 patients in a region.

Information processing

· EHR functions provide for effective retrieval and processing of data into useful information. · These include decision support tools, such as "info buttons" and alerts and alarms for drug interactions, allergies, an abnormal laboratory results. · Reminders can be provided for appointments, critical path actions, medication administration, and other activities. · The systems also may provide access to consensus and evidence driven diagnostic and treatment guidelines and protocols. · The nurse could integrate a standard guideline, protocol, are critical path into a specific individual's HER, modify to meet unique circumstances, And use it as a basis for managing and documenting care. · Outcome data are communicated from various caregivers and healthcare recipients themselves also may be analyzed and used to continually improve guidelines and protocols. · Data may also be downloaded into statistical software programs, such as IBMs SPSS statistics, tableau, are Microsoft Excel, far more sophisticated analysis for research purposes. · Organizations are increasingly using EHR's for electronic surveillance to monitor trends and indications of potential critical incidents to prompt preventive and/or responsive actions in advance of an actual disease outbreak. · An excellent example would be the use of EHR infectious disease CDS alerts for early detection and treatment of COVID-19 patients in 2020.

Internet search

· Effective and efficient Internet searching is a must in today's information overloaded society · Professional association and societies are a good starting point for professional information · Scientific and research information usually requires literature resources that can only be found in scholarly databases such as CINAHL · Authority · Who is the author of the site? · What is the URL? Affiliation of the website is important · .edu = educational institutions · .org = nonprofit organization · .com = commercial enterprise · .net = Internet service provider · .gov = governmental body · .mil = military · Objectivity · Is the purpose of the website clear? · Is the information factual or opinion? · Is the information primary or secondary in origin? · Who is sponsoring the site? · Accuracy · Look for documentation and referencing · Compare information on the website with other sources · Currency · Look for dates · Compare the last update with current literature · Usability · Is the site well designed, stable, and easy to use? · Content should be error-free and readable by the intended audience

opportunities to EHR

· Financial incentives from the federal government to promote adoption · Quality care, safety, and efficiency · Continuity of care · Reduce cost/prevent duplication · Interoperability · Mining data/examining trends · Improve population health

IOM Core Functionalities of EHRs

· Health information and data: information to make sound clinical decisions, such as past medical history, laboratory test, allergies, current medications, and consent forms. · results management: electronic reports of laboratory results in radiology procedures with an automated display of previous results; electronic consultation reports. · order entry and order management: computerized provider order entry with or without decision support to eliminate lost orders and eligible handwriting, generate related orders automatically, monitor for duplicate or contradictory orders, and reduce time to fill orders. · decision support: enhance clinical performance by providing reminders about preventive practices, such as immunizations, drug alerts for dosing and interactions, and clinical decision making · electronic communication and connectivity: electronic communication between healthcare team members and other care partners, such as radiology and laboratory personnel, and connectivity to the patient record across multiple care settings. · patient support: computer based patient education and home monitoring where applicable · Administrative processes: scheduling systems, billing and claims management, insurance eligibility, and inventory management. · reporting and population health management: meeting of public and private sector reporting requirements at the federal, state, and local levels; addressing of internal quality improvement initiatives.

Health Information Technology In The United States

· Health information technology has been a hot topic for more than two decades, specifically in relation to the need for improved quality and safety of patient care. · Since 2011, meaningful use (MU) has challenged healthcare leaders to implement certified EHR technology (CEHRT) across all settings, from hospitals to ambulatory care settings to home health agencies and nursing homes. · Per the office of national coordinator for health information technology (ONC), in 2017, 99% of the nation's larger hospitals and 80% of office based physicians had met MU criteria with CEHRT. · For EHR systems to have the greatest impact on cost and quality, they must be interoperable, with the ability to exchange information across systems and settings in a standardized manner that protects the reliability, confidentiality, privacy, and security of the information. · Within the United States, there are two major influences on the adoption of EHR's: · the federal government and America's health insurance plans · both of these entities can set certain requirements regarding EHR's as a condition of payment for Services. · In the past, measuring adoption rates of EHR's in the United States was not a challenge because it depended on self-reporting. However, in 2011, the Centers for Medicaid and Medicare services (CMS) offered payment incentives to providers-hospitals and physician/provider practices-that qualify in adopt certified EHR's that meet the MU criteria. · This was renamed in 2018 to the promoting interoperability program. · In the middle of the CMS PIP initiatives came the 21st century cures act. This act, signed into law by U.S. President Barack Obama in 2016, contains key provisions related to EHR's that will advance interoperability; promote access, exchange, and use of electronic health information (EHI); support patients access to their EHI; and address information blocking. · Information blogging is defined as practices conducted by either a health IT developer or a health care provider that may prevent or interfere with access, exchange, are use of EHI. · The 21st century cures act is legislating the final push for EHR certification requirements, full EHI interoperability, and easy access by patients. · Reduce cos

Health Information Technology Across the Globe

· Health information technology, or technology used to promote the health and well-being of patients and the community, is ever increasing, as technology rapidly advances. · Consumer driven demands for greater knowledge and access about care options have driven many of the technology integrations within healthcare settings, including nursing academia and practice. Additionally, regulatory and accrediting bodies are requiring or strongly recommending the integration of technology into all aspects of nursing academia and practice. · Expansion of the Internet, through search engines and mobile device applications, is also responsible for promoting access to health resources and information. · The need for EHR interoperability is changing the functionality of patient portals, mobile device applications, and EHR's. · Global integration of technology has advanced the possibilities for networking, education, provider consultation, and disaster response without regard to geographic limitations.

Information communication

· Information communication refers to the interoperability of systems and linkages for exchange of data across disparate systems. · To integrate health data across multiple systems at different sites, identifier systems (unique numbers or other methodology) for health care recipients, caregivers, providers, payers, and sites are essential. · Local, regional, and National Health information infrastructures that tie all participants together using standard data communication protocols are essential. · Hundreds of types of transactions or messages must be defined and agreed to by participating stakeholders. · Vocabulary and cold systems must permit the exchange and processing of data into meaningful information, · EHR systems must provide access to point of care information databases and knowledge sources, such as pharmaceutical formularies, referral databases, and reference literature.

Opportunities and Barriers to EHR

· Meeting the guidelines for the original MU, as well as PIP, was and is strenuous and often costly for community based ambulatory services and small rural inpatient centers. Federal dollars had been allocated for this endeavor, And incentive monies we're available for facilities and providers meeting the criteria. · Originally, Medicare providers had to start in 2011 to have qualified for the maximum incentive payment. Medicaid providers came into the MU program in 2016 and their payments can be received through 2021. The MU system moved to penalties in 2015 for not adopting CEHRT for dual Medicare/Medicaid providers. · The power of sharing data across healthcare settings surpasses the benefits to an individual patient. Obviously, patients benefit when there are different providers have access to the same comprehensive patient record. Shared records promote continuity of care across systems and potentially reduce cost by eliminating duplicate diagnostic testing and services. Moreover, much can be learned when data are shared across systems. · Aggregate data from such systems can be evaluated and predict outcomes in a particular population, Disease, complication, are extended hospital stay. The ability to predict outcomes from data entered across systems, termed mining data or examining trends, can be highly beneficial for examining population health outcomes. · Great strides have been made in the use of EHR's to increase patient and provider communication, decrease errors, and streamlining the workflow process. However, despite the evidence for these positive results, there is continued resistance to EHR's from providers and nurses. The immigration of technology, including the use of EHR's will continue to change the practice of nursing, prompting the need for more research to explore patient centered care practices within this new paradigm.

Data capture

· Refers to the collection and entry of data into an EHR. · The origin of the data may be local or remote from patient-monitoring devices, direct from the individual recipient of health care, or even from others who have information about the recipients health or environment, such as relatives, friends, and public health agencies. · Data may be captured by multiple means, including key entry, pattern recognition (voice, handwriting, are biologic characteristics), and transmission from medical devices such as interoperable smart pumps used for medication and fluid delivery and vital sign machines.

Storage

· Refers to the physical location of data. · Data need to be distributed across multiple systems at different sites. For this reason, common access protocols, retention schedules, and universal identification are necessary. · Access protocols permit only authorized users to obtain data for legitimate uses. · The systems must have backup and recovery mechanisms in the event of failure. · Retention schedules address the maintenance of data in active and inactive forms, as well as the permanence of the storage medium. · A person's identity can be determined by many types of data in addition to common identifiers, such as name and number. · Universal identifiers or other methods are required for integrating health data of an individual distributed across multiple systems at different sites.

Mobile Devices

· Smartphones and tablets promote evidence based clinical decision making at the point of care. These palm sized computers can store medical applications and access healthcare journals, calculators, databases, and more through their wireless capabilities. · Nowadays, even EHR vendors have catered to the needs of clinicians using mobile devices. This includes vendors who design applications for direct patient interactions, such as the patient portals are interoperable electronic signature devices used by patients to sign important documents. · One of the greatest advantages of smartphones and other mobile devices is the convenient and quick access to references and tools for patient education and care. For example, nurses can teach patients about tracking their health by using tools on smartphones or display pictures that show proper procedures. Some of the benefits of using smartphones for nursing include: · provides for enhanced coordination of care (two way, instant support, team building) · enables communication at the point of care · improves time management · helps lessen nursing burnout (fosters teamwork, lessens physical fatigue, lessens stress) · integrated communication streams and devices (let's devices for a nurse to carry around) · mobile devices, such as tablets, are being used in many organizations as standards of care to promote safety and quality via enhanced communication among team members. One example is the use of tablets for virtual handoffs. Virtual handoffs use video technology to include the patient and his/her family in the introductions and initial conversations about the transfer, reducing anxiety and promoting rapport. · Nurses have found these virtual first encounters helpful in confirming patient information and promotion of accountability. · Another was the increased use of tablets for inpatient use, in the communication efforts with COVID-19 patients who are isolated and alone, with limited clinician interaction as well as no family members allowed to visit. · Mobile health applications are increasingly being used in the clinical environment by providers and patients. One example is the use of mobile apps for home monitoring of infants recently discharged from the neonatal inte

Exciting Technology Trends

· Social media will no longer be a source of informal content · Cloud computing is making another surge in the computing world · Patient-centered care will be driven by advancements in gene therapy, immuno-oncology, personalized medicine, artificial intelligence, and wearable digital devices · Gaming will continue to expand by promoting health maintenance, physical activity, and cognitive skills that may lead to improved health behavior · Availability of biosensors, such as self-adhesive patches for vital sign data collection, will continue to advance

EHRs and Meaningful Use (MU)

· The American recovery and reinvestment act of 2009 directed the meaningful use of EHR systems for hospital and physician practice settings and provided for financial incentives from the CMS to providers who adopt and use EHR's that meet MU standards. · Meaningful use refers to a complex set of capabilities and standards to be met by EHR use in a series of three stages over several years. · Stage one MU (2011-2012) criteria primarily addressed the capture of health information, access to comprehensive patient health data, exchange of clinical information among the healthcare team, and reports for quality improvement in public reporting requirements. · Stage two criteria, effective in 2014, focused on continuous quality improvement at the point of care and structured information exchange (for example, the electronic exchange of diagnostic test results). · Stage 3, implemented in 2017, focuses on using CEHRT to improve health outcomes and also serves to introduce the final rule to ease reporting requirements and align with other quality reporting programs. · As previously mentioned, MU has been renamed to PIP. According to CMS, PIP historically has three stages: · stage 1: set the foundation for PIP; set requirements for EHI data, including providing patients with their EHI. · Stage 2: focused on advancing clinical processes and ensuring that the MU of EHR supported the national quality strategy; encourage the use of CEH art for continuous quality improvement at the point of care. · Stage 3: in 2017 to now, focuses on CEHRT to improve health outcomes. · Although great progress in EHR adoption and usage has been made, the full capacity has not yet been realized. This situation may be due in part to barriers that impede the universal adoption of EHR's in the United states.

Information Literacy [il] for Nurses

· The Association of College and Research Libraries defines information literacy as the "ability to identify an information need; find and evaluate information; assess information; use information ethically; and document. -It is dangerous to assume that nurses can rely on memory alone when practicing in a complex and dynamic health care environment; therefore, IL skills are necessary for the provision of safe and quality care as well as evidence-based practice. -Set of skills needed to find, retrieve, analyze, and use information. -The IL skills that equip the nurse for the timely retrieval of information necessary to plan, deliver, and evaluate evidence-based care also support independent lifelong learning. Additionally, many leading organizations, including the Institute of Medicine and accrediting bodies, promote the use of technology by nurses at all levels of practice to prevent errors, to enhance care coordination and communication, and to support clinical decision making. -Unfortunately, there is great discrepancy in the levels of IL skills possessed by both new and experienced nurses. As a result, many nurses turn to less reliable sources (e.g., coworkers) for critical information. -. Like critical thinking, IL is a concept that must be emphasized within both academic and practice settings. The emphasis includes removing barriers to accessing online information at the point of care and providing ongoing training to nursing staff to improve these competencies. -The ACRL published the Information Literacy Competency Standards for Nursing in 2013. These standards are based on the nursing profession's fundamental values of evidence-based practice and translational research. -According to these standards, the information-literate nurse is one who: (1) defines and articulates the need for information, (2) accesses needed information effectively and efficiently, (3) critically evaluates the procured information and its sources, and as a result, decides whether or not to modify the initial query and/or seek additional sources and whether to develop a new research process, (4) individually or as a member of a group, uses information effectively to accomplish a specific purpose, and (5) understands many of

LHC Group • Myers School Of Nursing Student Handbook

· The Department of Nursing adheres to the provisions of the HIPAA Act of 1996 which was designed to ensure the privacy and security of protected individually identifiable information. Students and faculty must comply with HIPAA-related policies of the department and of the clinical agencies with which the Department is affiliated to safeguard patient/client/recipient of care protected health information. Nursing students and faculty must complete mandatory HIPAA-related training sessions as deemed necessary by the Department of Nursing and/or the clinical agencies with which the Department is affiliated. · Nursing students have the ultimate responsibility for their own actions and may be liable for their own negligence if they violate patient/client/recipient of care protected individually identifiable information. Students must not remove ANY identifiable information from clinical agencies. Violation of the Department of Nursing policy related to HIPAA compliance will lead to the dismissal of the student from the nursing program of studies at UL Lafayette.

· the answer is B because HIPAA was enacted to protect patient data, allowing access only to those who need the information to provide care and with consent of the patient

· The Health Insurance Portability and Accountability Act (HIPAA) provides: A. health insurance at a group rate in the event of unemployment B. regulations to ensure privacy and security of patient data C. the ability for individuals within an organization to choose between different types of health insurance, such as health maintenance organizations or preferred provider organizations D. a method to ensure that providers are ordering only necessary diagnostic testing to limit out-of-pocket spending

Key functions of the EHR

· The Institute of Medicine (IOM) was an early leader in providing definitions for EHR components. · In 2003, IOM published a letter report recommending that EHR systems offer the following eight functionalities: · health information and data capture, results/data management, provider order entry management, clinical decision support, electronic communication and connectivity among providers, the health care team and patients; patient support, administrative process support, and reporting and population health management. · Similar to these IOM recommendations, the current PIP, core functions should also be considered: · coordination of care through patient engagement, health information exchange, public health reporting, and collection and reporting of quality care measures.

Consumer health information technology

· Today, individuals are more involved than ever in searching for information about their health on "the web." · There are many versions of the web in existence. · Web 1.0 consisted of passive web page usage by individuals; typically, not a lot of new content develop what's happening. This led us into what we now refer to as Web 2.0. · Web 2.0 tools, such as social media, collaboration sites, interactive websites, and Internet bulletin boards or blogs, encourage individuals to be more involved and more knowledgeable about their own health. · Web 2.0 saw more individuals creating content, interacting with sites, and participating in the social media boom. · The information that patients and families gleaned from such sites can be a challenge for providers because as patients are better informed, healthcare providers are required to answer more directed questions. Further, the health care provider must inform patients how to be good consumers of health information. · Because providers are seen as the experts, it is the provider's responsibility to ensure that patients are well informed about how to evaluate content and protect the privacy of others while engaged in discussion via either the Internet or other forms of wireless connection. · Health consumers of all ages are increasingly turning to social media for information about health promotion such as healthy eating, exercise, and ways to reduce stress. Consumers often access YouTube, Facebook, Twitter, and LinkedIn to learn more about health, health prevention, and health promotion. · Web 2.0 tools are designed to allow any Internet user to become an author of content. With the growing number of Internet users, content is also expanding exponentially so that one can find information about virtually anything, including the most obscure illnesses, home remedies, procedures, and medications. · For this reason, information accessible on the Internet may not necessarily be accurate or created by experts. Consumers of information on the Internet, especially health information, Must be knowledgeable and must evaluate the credibility and accuracy of the source. · Now we see web 3.0, or 3D web. According to the experts, this version is not easily defined and referre

Point-of-care Technology

· With advancing technologies and the movement towards universal use of EHR's, there is a greater demand for HIT at the point of care. This means hit directly at the bedside or within close proximity to the area where services are delivered. · Point of care technology is no longer 90 central but is paramount to delivery of safe, efficient, high quality patient care with access to patient data and evidence based guidelines. · The technology must provide access to past and current patient data, references, policies, procedures, an evidence based literature to guide clinical decisions at point of care. · A variety of technology tools support point of care decision making and documentation, such as hand held computers, tablets, and smartphones. · It is nearly impossible to visit a healthcare facility or office and Nazi providers using mobile technology. These small devices are as robust as laptops or desktop computers but are more convenient for on-the-go health care providers. These systems have wireless Internet capabilities so that the patient information and other resources can be accessed anywhere, anytime, within the confines of the firewall-protected health care environment to maintain privacy, security, and confidentiality of the data. · Small laptops also allow providers to access pertinent information at the point of care. These laptops are usually secured to a mobile cart, so they have names like computer on wheels (COWs), mobile point of care (MPOC), And computer at bedside (CAB). · Point of care technology is an essential component of nursing as it shifts from a practice that relies on memory to one that emphasizes continuous use of as needed resources. This means that nurses must transform from being technical experts to knowledge workers and must rely on the ever increasing and reliable computer memory versus the overburdened and fallible human memory. · Computer based alerts and reminders provided by point of care technology are helpful in detecting and preventing potential adverse drug events related to drug-drug interactions and abnormal laboratory values.

Future Health Information Technology Trends

· With technology advancing at warp speed, it is difficult to imagine the future, but some of our current technologies offer some insight about the possibilities. To better understand how technology will shape health care, let's review some of the waste technologies currently shaping our lives: · social media will no longer be a source of informal content. With over 3.5 billion users worldwide, it will be interesting to see the discussion around enforced regulation expand. Lack of regulation leads to fake news, cyberbullying, and decrease trust in the sciences. Education to Aid the public (and healthcare workers) did she tell the difference between reputable and misleading resources will be paramount. · Cloud computing (applications and data stored and accessed through the Internet) is making another surge in the computing world, with a 2020 cloud computing survey reporting that 59% of respondents stating that most are all of their computing would be cloud based within 18 months. · Patient centered care driven by rapid change and unlimited opportunity will include advancements in gene therapy, immune-oncology, personalized medicine, artificial intelligence, and wearable digital devices. · Gaming will continue to expand health technologies by promoting health maintenance, physical activity, and cognitive skills that may lead to improved health behavior. This includes developments for things such as patient physical therapy, as well as virtual reality based training tools for surgeons. · The availability of biosensors, such as self adhesive patches for vital sign data collection, we'll continue to advance. Preliminary data suggests that using such a device can provide up to an 89% reduction in cardiac or respiratory arrest. · Security is paramount for healthcare data. Future health information technologies will integrate more biometric technology for authentication and security. Biometric technologies use human characteristics, such as fingerprints, retinas, irises, voices, and facial patterns, to authenticate or grant access to data or information. More and more healthcare information systems are including biometric options to provide an additional layer of security. It's almost incomprehensive to imagine heal

benefits in CDS

· increase quality of care and health outcomes · avoidance of errors and adverse/never event · and improved efficiency, cost, as well as clinician satisfaction.

confidentiality

· the act of limiting disclosure of private matters. -Once a patient has disclosed private information to a health care provider, that provider has a responsibility to maintain the confidentiality of that information and not to reveal the information to others who do not have a legitimate need to know.

security

· the means to control access and protect information from accidental or intentional disclosure to unauthorized persons and from alteration, destruction, or loss. -When private information is placed in a confidential EHR, the system must have controls in place to maintain the security of the system and not to allow unauthorized persons access to the data.

privacy

· the right of a person to keep information about himself/herself from being disclosed to anyone else. -If a patient has had an abortion and chooses not to tell a health care provider this fact, the patient would be keeping that information private.

barriers to EHR

• Meeting guidelines is strenuous and costly • Lack of interoperability • Corporate competition • EHR implementation cost • Continued resistance from providers and nurses


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