Test 1
Which of these home health clients is least suited for telehealth services?
A 54 year old client with congestive heart failure who is developing new onset chest pain
Which of these is the best example of a monitoring system?
A bedside monitor automatically transfers patient information into the computer system and alerts the nurse of any abnormal values
data mining
A technique that uses software to look for hidden patterns in a system. --In healthcare it is used to gain a competitive edge or for consumer-based companies to find potential customers
Teleheath is a tool that allows health care professions to do which of the following? Select all that apply.
A. Approved the overall quality of the client's record B. Assess and monitor clients C. Tackle isolation and loneliness D. Decrease hospital visits for clients with chronic conditions E. Extend scarce health care resources
What are the advantages of telehealth? Select all that apply.
A. Decreased travel time or distance B. Ease of reimbursement for costs-NOT this one C. Immediate access to care D. Early detection of disease processes or health issues E. Ownership of healthcare and feeling of empowerment All are correct except B
web based training
A: can be accessed form an networked PC, provides 24 hour availability, easily updated and revised, may allow user to bookmark and return to the same spot, can test proficiency D: requires knowledgeable webmaster, requires an existing intranet that can be accessed by all employees
instructor lead training
A: flexible, easy to update, can include demonstration, allows for individual help, can test proficiency D: often relies on lecture, increase in class size will decrease effectiveness of demonstrations, consistency varies with trainer, difficult to maintain pace good for all
on job training
A: individualized, permits immediate application, can test proficiency D: trainer often does not know educational principles, may lose productivity of two workers, seasoned employees may pass on poor habits, difficult to achieve with many interruptions
computer based training
A: self- paced, interactive, increased retention- used technology to teach technology, 24 hour availability, can be offered online or off line, can be done in increments, facilitates mastery learning, emulates "real" system without threat of harm D: time and labor intensive to develop and revise, requires great attention to accompanying materials, limited usefulness of vendor supplied materials that are not specific to customization, lacks the flexibility of access to an actual information system- only programmed options can be tried
Which of the following is an example of data cleansing/scrubbing?
Abbreviations are compared using software to ensure standard language is used -looking for inconsistencies
Protected Health Information (PHI)
All individually identifiable health data including information re: treatment and care that may be transmitted or maintained in any form or medium (electronic, paper, oral, etc...)
Information systems interact to provide checks and alerts throughout medication ordering and admin process. Which of the following are steps in this process in which bar codes are utilized for medication ordering and adeministration?
Bar code on patient's ID bracelet is scanned
online info types
Blogs Wikis Journals Newspapers Organizations
offline storage
CD, DVD, thumb drive, USB
data
Characters, numbers, or facts gathered for analysis and possibly later action
Which statement is true regarding telehealth?
Clients may stay within their own community to be assessed and treated, lowering potential costs
types of inflammation systems
Clinical information systems (CISs) --Directly support care --May be stand alone or integrated systems --Goal: quick, safe access to patient information Administrative systems --Indirectly support patient care by supporting the processes involved in providing the care --Individual systems may stand alone
Security is an important issue for all websites. Which measure best protexts the overall security of a health-based website?
Constructs separate firewalls for each web server
data management
Controls the collection, storage, retrieval, and use of data Optimizes accuracy Safeguards data
online info evaluation
Credentials Validity Accuracy Complete Date Sponsorship or bias Navigation Intended audience Disclaimers Accreditation Privacy
radiology info systems
-Allows direct order entry or accepts orders from other systems -Provides scheduling of diagnostic tests -Generates client instructions -Permits transcription of results -Provides picture archiving and transmission of -images and tracking of film -Generates charges once procedures done
Radiology
-Allows direct order entry or accepts orders from other systems -Providers scheduling of diagnostic tests -Generates client instructions -Permits transcription of results -Provides picture archiving and transmission of images and tracking of film -Generates charges once procedures done
Clinical Information System: Monitoring
-Comprised of devices that monitor VS -Automatically input into a clinical information system -Alarms notify caregivers of readings that are outside the range of "normal"
what are system checks
-Data cleansing -Forcing users to complete "required" fields to progress -Alerting users of duplicate entries -Generating reports of actions that have not been completed
fraudulent information
-Financial loss --Organization --Payer -Potential negative credit reporting -Patient harm or death -Prevention strategies --Biometrics --ID --Acknowledgement that fraud is illegal
HIPAA applies to:
-Health care provider: --Doctor --Nurses --Nursing homes -Health plan: HMO, PPO, Medicare -Healthcare clearinghouses -Any health care provider who electronically transmit any health information in connection with transactions for which HHS has adopted standards
Nursing Information System Advantages
-Improved access to information -Better documentation -Improved quality of care -Improved productivity and communications -Tracking capability -Enhanced regulatory compliance
educational opportunities
-Increased access to education -HITECH Act -Help clinicians to develop needed competencies -Develop and implement information technology Generate new knowledge
Which of the following measures should organizations take to protect PHI?
-Keep medical records in supervised or locked area -Require passwords to access computerized medical records -Put policies in place that prohibit employees from looking at records unless it is required for their job
home health
-May communicate with hospital systems to exchange data -Support demands for excessive documentation -Improve payment for services because it is easier and quicker to fin information needed for billing
pharmacy
-May include more than one system --In pharmacy dispensing systems (robots) --Unit-based dispensing cabinets in care areas --Barcode and RFID Medication Administration -E-prescribing
nurse licensure compact
-Need for professional licensure in both sites -Participating states "recognize" the licensure of the original state in which the nurse practices eliminating the need to be licensed in the second state -Currently recognized in approximately half of the states -Supported by the national council of state boards of nursing -Ex: Arkansas telehealth nurses must practice with the Arkansas State Board of Nursing's standards of nursing practice. Nurses who have their primary license in Arkansas are apart of the licensure compact. This allows nurses to practice in 24 states under the same license.
application of nursing informatics
-Nursing Practice -Nursing Administration -Nursing Education -Nursing Research
intranet
-Only accessible by organization's employees -Collaborative sharing of information among employees of organization -Internal publications like organizational policies Protected by firewalls
Clinical Information System: Order Entry Systems
-Orders entered into the computer are transmitted to the appropriate areas such as the pharmacy, laboratory, radiology, social service -Direct entry of orders by the physician, nurse practitioner, physical therapist, or other provider is preferred (CPOE)
concerns related to the internet
-Overload -Contamination --Viruses --Worms --Other Malware
training plan components
-Philosophy -Identification of training needs -Approach -Timetable and training schedule -Resources --Instructors --Budget -Evaluation strategy
The informatics nurse specialist
-Possesses a sophisticated level of understanding and skill in information management and computer technology -Demonstrating most of the competencies seen at the previous three levels -Innovator who sees the broad vision of what is possible and how it may be attained -Conducts informatics research and generate informatics theory roles includes: project management and administration
The individual has advanced preparation in information management and possess the following skills:
-Proficiency with informatics applications to support all areas of nursing practice including: quality improvement activities, research, project management, system design, development, analysis, implementation, support, maintenance, and evaluation -Fiscal management -Integration of multidisciplinary language/ standards of practice -Skills in critical thinking, data management and processing, decision making, and system development and computer skills -Identification and provision of data for decision making
pharmacy info systems
-Provide checks in order and administration process using evidence-based guidelines -Errors when used with bar code technology -Use lab results, allergy, and interaction information from clinical systems -Track medication use, costs, billing information
E-prescribing Benefits
-Provides a longitudinal prescription record -Checks formulary compliance and reimbursement -Alerts about interactions -Reminders to order home meds for discharged patient -Eliminates phone authorization for refills
extranet
-Sits outside protected internal network -Electronic commerce for outside suppliers or customers-may be used to price and purchase health care products -More private than public website, but more open than intranets -More prone to hackers and viruses than intranet
Longterm Healthcare Systems
-Slow to come to this area -Needed for the improved quality of care and efficiency -Critical to business survival -Integration with other systems needed to best serve patients -Can include all features seen in other clinical information systems
The evaluation for online website CANT
-Sponsorship: A commercial product may be sponsoring a website and may influence the posters opinion. -Navigation: Sites should be well organized, easy to navigate, and have links to other current valid websites. -Audience: Reading level and terminology should be appropriate to intended audience (healthcare providers vs. general public) -Disclaimers: If a someone has posted their opinion on a site vs. facts, this needs to be stated. -Accreditation: There is voluntary compliance to ensure that all data contained on a site is reliable. If a site has participated in this accreditation you may see a seal. -Privacy: If personal information is being collected from the user, the site needs to identify what is being collected and why so that users have a chance to choose to use the site or not.
Nursing Information System (NIS)
-Supports the use and documentation of nursing activities -Provides tools for managing the delivery of nursing care Two goals: --Nursing function --Nursing practice ---Access to online databases
Entry- level core competencies
-The beginning of nurse focuses primarily on developing and using skills that rely upon the ability to retrieve and enter data in an electronic format that is relevant to patient care, the analysis and interpretation of information as part of planning care. -The use of informatics applications designed for nursing practice and the implementation of policies relevant to information Basic computer literacy including the ability to use basic desktop applications and electronic communication -Ability t o use IT to support clinical and administrative process, which presumes information literacy to support evidence based practice -Ability to access data and perform documentation via computerized patient records -Recognition of the role of informatics in nursing
What is the history of telehealth
-interest declined with a decrease in funding during 1980s -technical developments in recent years makes telehealth feasible -the military developed applications that feed images from the battlefield for the treatment of casualties and robotics equipment for surgery 1996 telecommunications Act: telephone services were able to compete with each others markets -US government sponsored efforts -NSAS -Military -Indian health services - underserved --populations -Grant monies -State- sponsored efforts -Healthcare for inmates → if dangerous could use video conferencing -Telehealth has been around for decades and began with the use of telephone consults
nursing roles
1. data gatherer 2. information user 3. knowledge user 4. knowledge builder
types of informatics
1. medical informatics 2. nursing informatics 3. consumer health informatics 4. public health informatics
issues in health care with informatics implications
1. nursing shortage 2. workflow changes 3. IT as a means to retain aging nurses 4. Evidence-Based Practice 5. Pressure to implement IT 6. Magnet status push 7. Consumer demand for cost effective care 8. 24 hour access to care 9. Online report cards 10. Consumer transparency (pricing) 11. Remote clinical monitoring 12. Disease management 13. Health Literacy 14. Research 15. Pay for performance
Email is an efficient means of disseminating information quickly and inexpensive. However, HIPPA regulations affect email use and routing infrastructures. When may potentially sensitive information be sent via email?
E-mail is sent encrypted
Which of thee is an advantage of implementing as CPOE system?
Each department is notified simultaneously as orders are processed through the system
To reduce input errors
Educate staff Perform system checks Verify data Minimize fraudulent information
No agreement exists among health care groups in the US regarding a common electronic data interchange standard. This statement is true because of which of the following
Experts have not yet finished the discussion phase leading to an agreement
telehealth services
Health promotion Disease prevention Diagnosis Consultation Education Therapy
information system
Healthcare information system (and hospital information system)—a group of systems used to support and enhance health care.
Should I store online or offline?
Immediacy of need for particular data is a key factor in determining whether it is stored online or offline
Which of these are true about using automated pharmacy systems?
Individual patient data is made available to pharmacist with up to date information about allergies
Patient Rights Regarding Privacy of PHI
Individuals have the right to: Obtain a copy of health records. Request amendment or addendum to their PHI (not always granted) Receive notice of an agency's privacy practices and how an agency will use PHI ONLY for treatment, payment, operations (TPO) - not for sales/marketing etc. Permission required to use and disclose PHI. Required to obtain authorization to disclose PHI to person or agency outside the facility Must be specific: What PHI is to be shared With whom For what purpose May be revoked
security
Information security and confidentiality of personal information represent major concerns in today's society amidst growing reports of stolen and compromised information.
Which of the following methods should not be considered when planning training programs that may alleviate anxiety among staff?
Inhibiting ____ from voicing concerns
Minimum Necessary
Limits disclosure to the minimum necessary to accomplish the intended purpose of the use or request.
Which of the following can be used with CISs to allow information entry and retrieval at the point of car or whenever is needed by heath care professional?
Mobile and wireless technology
Which of the following is considered a threat to information quality?
Not verifying information as correct prior to entry into the computer
Which of the following is not considered an issue pertaining to the practice of telenursing?
Nurses must be certified in telehealth nursing
Which statement regarding pressures that drive the Healthcare delivery system today is not accurate?
Nursing shortage can be eliminated by instituting technology enhancements in acute care settings
wisdom
Occurs when knowledge is used appropriately to manage and solve problems
Authentication
Process of determining whether someone is who he or she professes to be
Organization responsibilities with data storage
Proper storing environment Secure storage Backup copy Required data storage time (regulatory) Transfer to a new storage method before the data is lost
______are employees who are proficient in the use of the information system and can serve as mentors to others in their department.
Super-users
knowledge
Synthesis of information from several sources to produce a single concept
teleconsultation
Teleconsultation: videoconferencing between two healthcare professionals or healthcare professional and a client
Which of the following statements is true about telehealth?
Telehealth can be used to treat prisoners
Over 40 years, the US government played a major role in the development and promotion of telehealth through various agencies. Which of the following was the first telehealth service provided?
Telephone consultations
HIPAA
The Health Insurance Portability and Accountability Act
Medication errors have been on the ride over the past decease. A national initiative to minimize or eliminate the errors can be supported through which of the following responses?
The bar codes of the clients identification bracelets and prescriptions medication are scanned and compared
Which of the following is an example of a system check?
The nurse asks clients to verify their names when prompted by the computer system
confidentiality
The protection of healthcare information is mandated by the Health Insurance Portability and Accountability Act (HIPAA) and the Joint Commission requirements.
How can the trainer create an environment in which the staff will retain the information?
Train when employees do not have clinical duties
A proficiency examination is planned to ensure that employees have the required knowledge to use a new electronic medical record(EMR) system. What is the most appropriate method of demonstrating proficiency?
Use of computerized, scenario based questions and specific actions the learner must complete
telehealth
Use of telecommunication technologies and computers to exchange healthcare information -Provide services to patients at a location different from that of the provider
One major barrier to telehealth was removed with the passage of the Telecommunications Act of 1996. Which of the following was the outcome of removing this barrier?
Vendors of cable and telphone services were allowed to compete in each others' markets
confidentiality
a situation in which a relationship has been established and private information is shared with the expectation that it will not be re-disclosed
privacy
a state of mind, freedom from intrusion or control over the exposure of self or of personal information
data mining
a technique that uses software to look for hidden patters in a system --this is the knowledge management tool that engages software to uncover inter-relationships within large data sets --Data mining looks at groups of patients, or populations to identify trends and document problems such as fall risks --Used in huge population to seek large treatments
Which of the following are considered to be appropriate uses of telenursing? Select all that apply.
a. Making follow-up calls b. Obtaining test results c. Checking biometric measurements d. Telephone triage
data integrity
ability to collect, store, and retrieve correct, complete, and current data so it will be available to authorized users when needed
information literacy
ability to recognize when information in needed as well as the skills to find, evaluate, and use needed information correctly forms basis of ongoing learning
A certified nursing assistant at a local nursing home logs on to the facility's clinical information system. The CAN can only see information about the clients that were assigned by the registered nurse for that day. The CAN cannot see financial data regarding any of the assigned clients. The situation is an example of which of the following?
access levels
The nurse gathers much data when caring for clients; which is an example of the higher-level "information" useful in caring for clients?
after receiving Rocephin 1.0g IV yesterday, the client has a decreased temperature & reported feeling better (information is data that is interpreted and explained - decreased temp has been interpreted)
Informatics nurse specialist (INS)
an EN with advanced graduate education in the IT area may have ANCC certification
Informatics nurse (IN)
an RN with experience but no formal education in the area—shown aptitude of electronic medical records
informatics
art and science of turning data into information, using computers.
nursing process
based on traditional documents with nursing diagnosis as organizing framework, may use standardized nursing languages
data storage
can be done on/offline
How does computer literacy differ from information literacy?
computer literacy is the basic personal
data management
controls the collection, storage and retrieval and use of data; optimizes accuracy, safeguards data
information
data that has been interpreted (trending) You put data together to get information ex: Blood pressure
health literacy
degree to which individuals can obtain, process, and understand basic health information and services needed to make appropriate health decisions
computer literacy
familiarity with the use of personal computers, including the use of software tools such as word processing, spreads sheets, databases, presentation graphics and email ex: looking things up on the web and finding information
user class
group of individuals who perform similar functions, and for the purpose of information system training and use, require instruction on how to access and use the same set of system features
To be able to process data into information, it is important to:
have quality data
HON
health of the net foundation
End user
healthcare workers who use an information system to view or document client information
biometrics
identification based on a unique biological trait, such as a fingerprint, voice or iris pattern, retinal scan, hand geometry, face recognition, ear pattern, smell, blood vessels in the palm, or gait recognition, or keystroke cadence
What is the main goal for using technology in Healthcare today?
increased patient safety
online storage
information saved to an online network; often the computer system will trigger you to perform an online storage -Provides access to current data -Used rapid, high-speed hard disks drives or storage space allocated on the network -if your computer crashes and you lose data it is still online
Which of the following is the protection of information against threats to its integrity, inadvertent disclosure, or availability?
information security
information (again)
interpreted data
system checks
mechanism provided by a computer system to assist users by prompting them to complete a task; verify information or prevent entry of inappropriate information
information security
protection of confidential information against threats to its integrity or inadvertent disclosure
E-care
provision of health information, products, and services online as well as the automation of administrative and clinical aspects of care delivery
e-care
provision of health information, products, and services online as well as the automation of administrative and clinical aspects of care delivery
data cleansing (scrubbing)
software that will internally clean up data inconsistencies within a system. Essential to data warehousing. Why? Abbreviations may not mean the same thing from one database to another. Default fields may create problems.
How and with what can we ensure the quality of online information?
source credentials
super user
staff person who has become proficient in the use of the system and mentors others
quality information
supports best practice in the translation of nursing science to the point of care by providing high-quality and cost effective care
e- health
term used interchangeable with telehealth
E-health
term used interchangeably with telehealth
Firewall
the "gateway" to a computer which examines material coming into the computer before permitting access. The more firewalls, the better for safety. **Reduces hacker attacks.
information system security
the ongoing protection of both information housed on the system and the system itself from threats or disruption
consent
the process by which an individual authorizes healthcare personnel to process his or her information based on an informed understanding of how this information will be used Entails making the individual aware of risks to privacy and measures to protect it
treatment
the provision, coordination, or management of health care and related services by one or more health care providers.
telecare
the remote delivery of healthcare services into the persons home facilitate d by communication technologies that include the use of person centered reactive monitoring devices
Teletherapy
the use of interactive video conferencing to provide therapy and counseling
Which example is the most appropriate use of data mining? -looks for hidden problems
to document quality improvement when problems are identified and targeted on a medical-surgical unit
Protected health information is covered under HIPPA's privacy rule whether
true
A(n) ___ is one of the greatest threats that may come from inside sources, namely employees, contractors, consultants, outsourced services, and vendors who view information inappropriately, disrupt information availability, or corrupt data integrity?
unauthorized user
Data cleansing/data scrubbing
use of a software that improves quality of data by checking for inconsistencies and duplications and make sure it is accurate enough for use in data mining and warehousing-also called data scrubbing. example could be comparing abbreviations using software to ensure standardized language. software checking for inconsistencies ex1: prompt to enter allergies not filing medication order until allergy field has been entered ex2: drug omission report to show any medications that have been omitted
telenursing
use of computer technology and telecommunications for the delivery of nursing care
telehealth
use of telecommunication technologies and computers to exchange healthcare information
URAC utilization review accreditations commission
utilization review accreditations commission
