Mod 48: Informatics

Ergonomics

"the science of fitting workplace conditions and job demands to the capabilities of the working population". Ergonomics examines the type of work being done, the tools being used, the body mechanics of both the work and the tools, and then suggests the best way to do that work with those tools to limit overuse and harm

Telehealth

(telemedicine, remote client monitoring) uses telecommunications technologies (e.g., video conferencing, streaming media, real-time forwarding imaging, and land-based and wireless communications) to allow clients access to care that they might not otherwise be able to obtain (Box 48-3). Telehealth allows a higher acuity of care for clients in locations without access to critical healthcare needs, such as rural health settings or even a client's home

T.I.G.E.R.

Technology Informatics Guiding Educational Reform

Nursing Informatics

a specialty that integrates nursing science, computer science, and information science to manage and communicate data, information, knowledge and wisdom in nursing practice. Nursing Informatics supports consumers, patients, and other providers in their decision-making in all roles and settings. This support is accomplished through the use of information structures, information processes, and information technology

Clinical decision support systems

a type of artificial intelligence that analyzes data and provides information about evidenced-based practices. These systems can help improve client safety and quality of care. However, they cannot take the place of sound nursing judgment

clinical information system

allows multiple disciplines to simultaneously access the client's chart and record data that can be viewed and analyzed by a number of healthcare providers in real time, providing the most accurate and current information about the client so that the best decisions can be made concerning the care of that client.

Clinical decision support systems

an important addition to electronic health records. They are designed to give healthcare providers tools to supplement decision-making processes during and after client care. These tools can include diagnostic support, documentation templates, clinical guidelines, alerts and reminders, condition-specific order sets, reference information, and focused data reports and summaries

Electronic health records (EHRs)

give a broader view of the client's health. They are designed so that multiple clinicians from multiple disciplines (e.g., family practice, nursing, pharmacy, specialists) can all have simultaneous access to the client's health information. This access provides clients with more comprehensive management of their health and is designed to improve the quality of care they receive. Clinicians have the advantage of up-to-the-minute information about clients' health and access to other clinicians' assessments and plans for client care. The goal of electronic health records is to move with the client, whether to another provider, to a different hospital system, or to another state

Case managers

help manage the care of certain client populations, including clients with chronic medical conditions, such as diabetes; clients recovering from acute conditions, such as those receiving joint replacement; and clients managing psychiatric disorders. Electronic health records can assist the case manager by allowing trending of client progress, documentation of client education, and observation of quality metrics to help decrease readmission rates for these populations. Electronic health records also allow improved coordination of care between providers because they are all working off one chart.

Computer vision syndrome

or eyestrain, is the most common sequela of computer use. Using the computer for more than 3 hours a day puts one at risk, so many individuals are affected

Repetitive strain injury

or repetitive motion disorder, occurs when the limbs are subjected to repetitive use, awkward positions, or forced positions. These injuries can affect nerves, tendons, and muscles. Tendinitis is a common occurrence, but carpal tunnel syndrome is more serious and can lead to permanent disability if not treated

dashboard

presents information about a healthcare facility's key performance indicators and displays the information in an easy-to-read format, often with charts or graphs. Some information can be displayed in real time. Electronic health records can create reports that track data over short-term periods (the past week) or long-term periods (the past year).

administrative information system

provides support and management on the business side of health care. The business side includes human resources, financial data, materials management, risk management, and quality performance.

Point of care

refers to interventions or testing that takes place using transportable, portable, or handheld devices near the client. This setup provides on-the-spot information about the client rather than having to wait for the results from blood or urine samples sent to the laboratory.

Electronic medical records (EMRs)

similar to an electronic chart used in a clinician's office. Their focus is on diagnosis and treatment. They can help track information over time (weight, blood pressure, cholesterol readings) and identify when clients are due for routine preventive health maintenance such as vaccines and mammograms. A disadvantage of these types of systems is that most of them are designed to stay within a clinical setting and are not meant to travel beyond it. A client who needs to see a specialist may need a paper printout of the electronic medical record to take to the specialty appointment

Health Level 7 (HL7)

terminology, which provides a framework and composes standards "for the exchange, integration, sharing, and retrieval of electronic health information that supports clinical practice and the management, delivery and evaluation of health services" Information that is sent to a client's electronic health record is sent as messages via an HL7 record. Examples of information sent via HL7 include billing information, vital signs, and laboratory data

geographic information system (GIS)

uses location to capture, manage, and analyze data. This technology has been used both inside and outside of health care. It relies on satellite imaging and global positioning systems (GPSs) to capture geographical data. That data is then managed and stored on a database. Healthcare policy makers, researchers, and public health professionals use GIS to understand a health problem, decide the best response to that problem, and plan ways to avoid or control the same or a similar problem from occurring again. GIS is being increasingly used to analyze population- or location-based data, such as disease transmission, cancer rates, trends in diseases such as diabetes, and environmental data (e.g., water quality). Lifestyle choices, such as obesity rates, lack of proper nutrition, use of tobacco, and physical activity rates, also can be plotted and analyzed

E-health

utilizes electronic information that can be retrieved online or through a mobile device to improve a person's health or health care

Device integration

which automatically enters client vital signs into the electronic record, is possible in some systems (intensive care units and anesthesia are two areas where device integration is being widely used). Device integration allows real-time accurate data to be recorded in the client's chart directly from the device (e.g., a blood pressure monitor). It allows the nurse to more quickly analyze and interpret that data and make adjustments to the plan of care based on the most current information. It also gives nurses more time to be at the bedside rather than in the nursing station recording vital signs. As electronic health records evolve, more departments are likely to utilize device integration.