PharmEcon Exam 4

EHR implementation

- EPIC, cerner, meditech are the largest providers/vendors - differences in vendors' functions can provide benefits and challenges to consumers - variables include: area of clinical care, hospital size, financial management

deep learning in regards to neuro networks

- a form of machine learning that uses neural networks - neural networks consist of individual neurons (nodes in the system) that each take inputs of data, conduct mathematical computations, and then produce an output - multiple layers in neurons: input layer, one or more hidden layers, and an output layer - turn raw input into meaningful input

challenges to privacy regulations with health data

- big data is used with AI for analytics - large amount of digital information - involves sensitive information that can be compromised by cyberattacks or exploited by insurance companies - substantial security measures are necessary

CDSS

- clinical decision support systems - computer-based software that empowers physicians, healthcare staff, and patients with key information targeted in specific individuals or situations

access to electronic devices

- due to the increased availability of electronic devices, development in electronic health access and information sharing has increased - can use CHI tools to support access and patient engagement/education - in genome medicine, patients have improved access to electronic devices and can have their data tracked to health inform clinical decisions

advantages of EHR over EMR

- equally good health information and data management capabilities - improved results management - added decision support - ease of administrative processes - more timely - more accessible by patients

factors driving interoperability

- government mandates - desired to increase efficiency - desire to limit paperwork - desire to create real-time communication - higher ROI

5 goals for healthcare system

- improve quality - safety and efficacy - engage patients - increase coordination of care - improve health status of population and improve privacy and security

electronic pill

- ingestible digital capsules that pass through the GI tract, delivering real-time information to the healthcare professionals' data monitoring device - gathers temp, pH, and pressure information to help diagnose: stomach-released disease, malabsorption disorders, unexplained bleeding and inflammatory bowel illnesses

linked databases

- linking databases can add value to an organization's database - linking databases presents new security challenges and concerns

What is artificial intelligence

- mimics human cognition to analyze medical data sets and hidden patterns, machine learning, algorithms, and other cognitive technologies - can be used to analyze data to better predict healthcare outcomes while reducing costs - applied to meet the fundamental needs of healthcare organizations and can leverage decision-making processing beyond human capability

drug delivery and nanomedicines

- nanomachines can interact on a small scale with body processes and can influence treatment plans - most well-developed functionality of nanomachines is drug delivery - difficult-to-reach tissue can be accessed, and pharmaceutical cargo delivered

quantitative data examples

- numerically expressed - typically in the form of test scores, experimental results, surveys, or market reports

peer-reviewed literature

- peer-reviewed journal articles have gone through an evolution process in which journal editors and other expert scholars critically assess the quality and scientific merit of the article and its research - articles that pass this process are published in the peer-reviewed literature

HITECH act

- provided incentives and support for care providers and prompted healthcare facilities to adopt electronic health records for patient accessibility - allows patients to view their records online, manage and restrict health information disclosure

What is precision medicine

- targets patients needs based on genetic, phenotypic, or psychosocial characteristics to develop individualized treatment recommendations - Examples: drug metabolizing enzymes are influenced by genetic variation and provide an avenue of proof of the effectiveness of PM - Subsets: consumer genetics, pharmacogenomic testing

technical solutions for cyber security

- technical solutions can include backing up database files, good password management, and periodic password changes, using firewalls, security questions, and limiting access to track where and when data has been permitted for convenient access - more complex methods: active antivirus programs

call bell

- used to alert medical personnel to provide help to a patient - can be used for patients who cannot speak - connect to the nursing station to alert them so they can answer promptly

direct to consumer genetic testing

- various benefits and provides different opportunities - faces concerns regarding the ability of providers to make claims about their testing capabilities - companies also do not understand when clients need this kind of testing or whether it is appropriate - healthcare providers require skill to manage uncertainties and provide effective responses

digital therapeutics

-Applications that deliver evidence-based treatment online - Allows patients to access care remotely and can improve treatment and med adherence -Underserved locations in mental healthcare can access treatment options with or without a clinician

in vivo sensors

-Implantable, ingestible, or invasive sensors that go beyond wearable devices - examples: pressure sensors, electronic pills, strip-type glucose monitoring systems and smart tattoos

machine learning techniques

-ML: technology that learns from data to enable a system function - taxonomy of techniques: supervised learning, unsupervised learning, reinforcement learning, deep learning - predicts patterns and trends

data warehouse

-a combination of different visual analytics presentation logic and query interfaces created for different groups of users such as physicians and caregivers, hospital users, executives, automated report generation for outcomes and clinical research projects - subject-oriented, integrated, time variant and non-volatile collection of data that supports the decision-making process

a network

-a computer network is a set of computers sharing resources located on or provided by network nodes - examples: indian health information exchange, Massachusetts health data consortium, New England health care exchange network, Nationwide health information network - EHR systems require software to build networks and create bridges and gateways

paro

-a robotic animal that can simulate pet-like interactions - has sensors that include tactile, audition, temperature, and posture

What is a smart tattoo

-an epidermal electronic system made of soft flexible sensors that are adhered to the surface of the skin - works via Bluetooth - example of an in-vivo sensor - incorporates biosensors into the skin and allows individuals to monitor their health without requiring use of batteries - monitors UV exposure, HR, O2 levels and glucose levels from perspiration

core discipline of public health

-behavioral science and health education - biostatistics - epidemiology environmental health - health administration and policy

big data analytics applications in clinical settings

-can assist virtual assistants in providing analysis and health recommendations for their patients while they respond remotely - can help simplify imaging technology and combine image acquisition and reconstruction techniques to assist in diagnosing illnesses - can benefit pathology, improving accuracy, precision, and consistency of disease prediction - can be used in oncology to determine difference between benign and malignant growths

core elements of CDSS design

-data management layer - processing layer - user interface

benefits of CHI

-decreases cost for both patient and facility - improves operation efficiency and prioritizes health access

phishing tests

-email phishing is a prevalent issue - it is believed even when trained, 20% of employees in an organization will fail phishing tests

telehealth

-is a consumer healthcare informatic (CHI) - used digital communication to provide medical care to patients in different locations than the physician is in - usage has spiked and remained high, indicating a need for the service - home telehealth should reduce hospitalization, improve quality of life, and improve effectiveness of health interventions

benefits of genetic testing

-learn about ancestry - addressing medical health issue - curiosity

gaps in public health informatics

-low uptake - multiple systems used in various jurisdictions that do not communicate with one another - inconsistent and improper use of technology

big data analytics in research

-machine learning can make clinical trials quicker and less expensive by using predictive models to identify eligible subjects - social media analysis can assist in uncovering consumer behaviors, preferences, and eventual satisfaction with their purchasing experience - can be used for both patient and providers to extract patient discussions about treatment, emotions, med side effects, and ratings for their providers - NNs can be used to monitor epidemics, and outbreak predictions worldwide

safeguarding

-mandatory by federal and state governments to maintain trust with consumers seeking medical care - threats: technology, cost of security, types of threats

METEOR

-methodist environment for translational and enhancement of outcomes research - enterprise clinical and research data warehouse - houses: demographic data, imaging data, pathology data, laboratory data, treatments data, administrative data, ETC

redundancy

-overlapping and fragmented information sources - unnecessary cost

examples of CHI

-personal health records - telehealth - mobile health - precision medicine - consumer genomics

key factors of interoperability

-poor quality of data - inconsistent tech standards - complexity of interoperability - privacy issues

wearable technology

-provides a way for patient health data to be updated more regularly, thus impacting a patient's diagnosis, treatment, and healthcare management - increased risk to PHI security, if sensors are compromised, can cause life-threatening malfunctions

Proximity layer

-proximity layer is the health device or sensor proximity - tele, derma, in vivo

ransomware and malware

-ransomware: when information is stolen and is held as ransom - malware: programs that infiltrate systems without use consent and cause harm - malware steals information, encrypts it and holds it for ransom - 4 types of malware: virus worms trojan, spyware

consent for health and health data

-refers to one's given approval toward an action taken about them or their data - could refer to a patient consenting to a procedure/treatment or a patient consenting to release their data to a healthcare provider or research organization - consent for minor requires a parent or guardian - consent for someone incapacitated must be dealt through a healthcare proxy - this can be difficult

characteristics to distinguish types of malware

-self replication: the ability of malware to copy itself - population growth: overall change in malware instances resulting from self replication - parasitic: whether it requires piece of code to function

interoperability

-the ability of health information systems to work together within and across organizational boundaries in order to advance the effective delivery of healthcare for individuals and communities - EHRs can be designed with interoperability in mind so that patient information can be shared among providers

public health

-the organized efforts of society to keep people healthy and prevent injury, illness, and premature death - it is a combination of programs, services, and policies that protect and promote the health of all

3D printing

-used to create usable medical tools that may be produced cheaper, more efficiently and with no complexity (can improve medical device manufacturing efficiency) - generates objects from computer-based blueprints

smart skin adhesive patches

-uses skin to monitor vital physiological signs via real-time health monitoring systems - continuously measures vital signs like: ECG, heart rate, heart rate variability, respiratory rate, temperature

8 V's of big data

-volume: size of data - velocity: speed of data generation - variety: type of data - veracity: accuracy of data - validity: accuracy of data for intended - volatility: age of data - visualization: readability of data - value: desired worth of data

fatigue regarding health staff

-with the various alert-based methods of CDSS systems, alert fatigue can become a problem for physicians and patients - care providers and patients can begin to ignore repeated messages because of desensitization to alarms

when did robotics start being used in healthcare

1980s

Cas 9/Crisper

9 Edits genes by precisely cutting DNA and then letting natural DNA repair processes take over

___ refers to software that empowers physicians, healthcare staff, and patients with key information targeted on specific individuals or situations

Clinical decision support systems

worms

Computer program, but do not modify other programs, it replicates itself more and more to cause the computer system to slow down

viruses

Computer software or program that connects itself to another program to harm the computer system

METEOR is one example of a well-executed __ warehouse

Data

Adopting CHI tools benefits patients and health organizations by ___ the cost for both patient and facility

Decreasing

A smart headband would be an example of a(n) ___

Derma Sensor

True or false? AI and machine learning have limited utility in health care

False

True or false? Continuous glucose monitoring systems are more efficient but also more invasive than blood glucose meters that collect data from the bloodstream.

False

True or false? Direct to consumer genetic testing is a good way for health consumers to guide decision making.

False

True or false? HIPAA has a more comprehensive approach to electronic health information regulation than EU's GDPR.

False

True or false? Health informatics has had little impact in health care delivery.

False

True or false? In consumer genetics data handling is of little concern.

False

Safeguarding patient information is critical and is mandatory to adhere to ___ and state laws

Federal

CHI tools

Genomics, mobile health, precision medicine, patient engagement, telehealth

HIPAA and the EU

HIPPA oversees private health information General data protection regulation with EU

A ____ is a group that provides a secure environment for information access, holding PHI for interorganizational collaboration and sharing

Health Data exchange

___ typically refers to the practice of sending an additional code to a separate device or account upon logging into a system

Multifactor authentication

____ is a subset of consumer genetics that tests for genetic variations relating to how one responds to certain medications

Pharmacogenomic testing

__ Organized efforts of society to keep people healthy and prevent injury illness and premature death there's a combination of programs services and policies that protect and promote the health of all

Public health

A(N) ____ is a type of proposed nanorobot able to collect oxygen and transfer co2 from tissues to lungs

Respirocyte

__ can assist in uncovering consumers' behaviors preferences and eventual satisfaction with their purchasing experience

Social media analysis

Mobile health allows for consumers to receive both appointment reminders and prescription management through ___

Text message

True or false? Algorithmic biases have the potential to cause patient harm

True

True or false? Biocompatibility poses challenges to the use of in vivo sensors.

True

True or false? Health organizations are required to have insurance to deal with potential data breaches under HIPAA regulations

True

True or false? Knowledge-based systems function via literature and practice-based information

True

True or false? The office of the national coordinator (ONC) for health information technology (health IT or HIT) is responsible for ensuring every American has access to personal electronic health information via HIT connectivity.

True

True or false? There can be both civil and criminal penalties for breaches of HIPPA regulations.

True

true or false? Various studies have shown that diseases can present themselves in a variable fashion from person to person.

True

telehealth and telemedicine

Uses telecommunications to provide medical information and services

HIPAA breaches

an impermissible use or disclosure under the privacy rule that compromises the security or privacy of the protected health information

core function of public health

assessment and surveillance: information for action - health promotion - health protection - disease and injury prevention - emergency management

oncology informatics

big data analytics can be used in oncology to determine differences between benign and malignant growths

trojan

do not replicate itself, it is a hidden piece of code that steals the important information of the user

digital therapeutics and health conditions

includes epilepsy, various neurological disorders, diabetes, obesity, CVD

who interacts with EHRs the most

nurses

nanomedicines

offer the potential for microscopic functionality of various systems within the body

health literacy in regard to Americans

only 12% of American adults are health literate

equity

provision of resources based on need, in order to achieve as equal an outcome as possible

equality

provision of the same resources/services to everyone (equal opportunity)

confidentiality

refers to the duty of the information holder to ensure that private information is only released to authorized individuals

drawbacks of robots and medicine

robots do not have the capacity for emotional intelligence, empathetic decision-making, adaptability, and the dexterity range of humans

What is a health data information exchange

sharing of personal health information - needs to be driven by strict requirements, federal incentives, and payment approaches that emphasize coordination of care - legislation is progress that will further reform how personal health information is handled

spyware

software that enables a user to obtain information about another's computer activities by transmitting data covertly from their hard drive

validity with big data

the accuracy of data for intended use

telemedicine

transfers medical information through technology

telehealth

uses digital communication to provide medical care to patients in different locations than the physician