PLEASE WRITE DISCUISSION ON 2 PAGE TH OTHER ONE PAGE FOR 3 STUDENT RESPONSE tHA

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PLEASE WRITE DISCUISSION ON 2 PAGE TH OTHER ONE PAGE FOR 3 STUDENT RESPONSE tHAT I WILL GIVE YOU AFTER i SUBMIT THE INITIAL ASSIGNMENT.
Review the Mini-Lecture
Mini-Lecture
I. Information Systems
An information system can be defined as the use of computer hardware and software to process data into information to solve a problem. Hospital Information Systems (HISs) are massive, integrated systems that support the comprehensive information requirements of hospitals, including patient, clinical, ancillary and financial management. The HISs comprises two major types of information system: clinical information systems (CISs) and administrative information systems (AISs).
CISs are large, computerized database management systems that support physician order entry, results retrieval, documentation, and decision support (Clinical Information Systems, 2002). Clinicians use these systems to access client/patient data that are used to plan, implement, and evaluate care. Some examples of CISs include nursing, laboratory, pharmacy, radiology, medical information systems, and physician practice management systems.
The AISs include client/patient management, financial, payroll, and human resources, and quality assurance systems.
CISs and AISs may be designed to meet the needs of one or more departments or functions within the organization. These can be implemented as stand-alone systems, or they may work with other systems to provide information sharing and seamless functionality for the users.
The relationship between various components of a HIS.jpg
Figure 1. Relationships among various components of a HIS.
Source: Hebda, T., Czar, P., & Mascara, C. (2005). Handbook of Informatics for Nurses & Health Care Professionals (3rded.). (pp.121). Upper Saddle River, NJ: Pearson Education, Inc.
II. Meaningful Use of EHRs
Please see the lecture in the attached ppt file. NURS6323_MU_of_EHR_LeeM.pdf Download NURS6323_MU_of_EHR_LeeM.pdf
CMS Promoting Interoperability Programs (Formerly CMS Meaningful Use EHR Incentive Program) Link (Links to an external site.)
III. Telehealth
Telehealth is defined as the use of interactive technology for the provision of clinical health care, patient and professional education, and health care administration over small and large distances. The defining aspect of Telehealth is the use of electronic signals to transfer various types of information from one site to another. Information ranges from clinical records to health promotion instructions to still-images of wound and motion-images demonstrating exercise routines. Throughout the published literature relevant to the health sciences, Telehealth is used interchangeably with Telemedicine, and every so often the term Telenursing will surface. The term Telehealth is embraced as the more encompassing concept, descriiptive of the state of technology use in the provision of health care; telemedicine and Telenursing are subsets of Telehealth. Telehealth can serve in nearly every area of health care, from emergency medical response systems to hospital, home, and community care. Telehealth has been heralded as the next wave in health care because of its potential of expanding health care services beyond traditional geographic boundaries and enabling community-dwelling persons greater access to a broader range of care options. It can be used for direct health care, patient education, or to assist health care personnel at distant sites. This broad definition includes several means of transmission, including the telephone and fax transmissions, interactive video and audio, store and forward technology, patient monitoring equipment, electronic patient records, electronic libraries and databases, the Internet and intranet, World Wide Web (WWW), electronic mail systems, decision and care planning support systems, and electronic documentation systems. Most nurses have already been involved in Telehealth without realizing it. Examples include telephoning or faxing a patient status report, telephone triage, and home health visits via telecommunication for monitoring and designing websites for educating patients. While much attention has been paid to technology and innovative equipment as a potential to enhance the access and availability of health care services for patients, regardless of where they live, very little work has been accomplished in the area of systematically reviewing the efficiency and effectiveness of its applications. An exception, though, is the use of the telephone for consultations.
Links for more information about Telehealth Nursing Practice: https://www.aaacn.org/telehealth (Links to an external site.)
IV. Personal Digital Assistants
Personal Digital Assistants (PDA) or handheld computers have many possible uses in health care and nursing practice and go way beyond the organizer concept. PDAs have been introduced for e-prescribing, charge capture, research, reference, patient education, accessing daily schedules, and as clinical tools. PDAs in nursing are used for example to monitor patients’ health status and to keep health care providers informed about a patient’s condition. They also provide guideline-based decision support and can identify serious clinical alerts using configurable, rule-based analyses of clinical information. Other applications are for supporting disease management and patient education.
Some usability issues though have been identified:
small screen size allows only for the display of limited information
small font size and limited backlight
most WWW sites are poorly formatted for PDA viewing
patient confidentiality during the use of PDA is an area of significant concern and potential problem.
While mobile devices previously existed as Personal Digital Assistants and were used by clinicians, their role was relegated to solely function as a mobile reference with locally stored, static resources because of the limited functionality and connectivity options. Also, the distribution model for software for these devices was a limitation in the expansion of mobile apps into the market (Aungst, Clauson, Misra, Lewis, & Husain, 2014).
V. Mobile Technologies for Health Care
There are thousands of medical applications for mobile devices targeting use by healthcare professionals. Healthcare professionals are increasingly using mobile devices to access information that they need to improve patient care. Schools and clinical training programs are also using mobile devices for education. Mobile technologies includes the use of mobile phones, smartphones, tablets or iPad, notebooks, and remote diagnostic and monitoring devices. These are just a few of the devices used in m-health, and this trend will surely continue with the advancement of technology. Table 1 provides key terms and definitions pertinent to mobile devices. Table 2 provides online sources to identify medical mobile applications. Figure 1 tells the types of mobile applications use by clinicians. Advantages of mobile technologies would be 1) enhanced access to patient information, 2) quick access to drug and clinical references, 3) ease of using data, 4) decreased data entry error, and 5) decrease in time spent on data management (Hardwick, Pulido, & Adelson, 2007)
Table 1 Key terms and definitions pertinent to mobile devices
Term
Definition
Mobile Application
Software that is operated on a mobile device that fulfills a particular function
Native
Software that comes pre-installed on a device. Examples include applications that operate a device’s built-in camera or applications that help operate the device and run system settings upon user preferences
Downloadable
Software that is not included with a device and requires installation through another source, usually a Mobile Application Store, where it is then downloaded to the device after payment
Web-Based
Software that downloads a portal to access material from the Internet that is streamlined for easy viewing on a mobile device. Requires constant internet connection to function
Mobile Application Store
Portal that facilitates the ability to download applications onto the device after making an electronic payment (if there is an associated fee)
Mobile Device
Handheld electronic equipment that operates applications. Examples include smartphones and tablet computers
Operating System (OS)
Software responsible for running a device and where applications are then incorporated. Each mobile device comes built with an OS installed for use. Examples include Apple’s iOS and Google’s Android OS
Source: Aungst et al. (2014). How to identify, assess and utilize mobile medical applications in clinical practice.International Journal of Clinical Practice, 68 (2), 155–162.
Table 2 Online sources for information about mobile medical applications
Online source
Website
Descriiption
iMedicalApps
http://www.imedicalapps.com/ (Links to an external site.)
Physician run website that peer-reviews mobile medical apps and mobile health technology and supplies news on recent developments in mobile health
MedCity News
http://medcitynews.com/ (Links to an external site.)
News site that covers recent advances in medical technology with a focus on startups and mobile technology
MedicalApp Journal
https://www.facebook.com/MedAppJournal/ (Links to an external site.)
Medical professional run website that peer-reviews mobile medical apps
MobiHealthNews
http://mobihealthnews.com/ (Links to an external site.)
News site that provides commentary on mobile technology and identifies mobile apps for clinicians
App Orchard
https://apporchard.epic.com/Gallery (Links to an external site.)
Through this gallery, health systems can:
Find products that interoperate with Epic software
Learn about those products and how they interface with Epic software
Learn how the vendor and product meet our community’s standards for safe, secure, private, reliable, and scalable solutions
Read and write consumer reviews
Learn who else is installing or live on a product
Contact vendors to learn more about their products
Source: Aungst et al. (2014). How to identify, assess and utilize mobile medical applications in clinical practice.International Journal of Clinical Practice, 68 (2), 155–162.
Mobile applications in health care.jpg
Figure 1 Mobile Applications in Health Care
Source: Aungst et al. (2014). How to identify, assess and utilize mobile medical applications in clinical practice.International Journal of Clinical Practice, 68 (2), 155–162.
VI. Issues on Mobile Health Applications
a) Content Validity and Reliability
Critically evaluating and appraising mobile medical apps for clinical use is ultimately the responsibility of the end-user, and therefore it is important to equip clinicians with the skills required to complete this competently. Several institutions have created guidelines of what are desirable facets to find in a mobile medical app (Aungst et al., 2014).
b) Ethical and legal issues
Ethical and legal issues are important aspects of mobile technologies, and nurses should take these issues into consideration when accessing and disseminating patient information. Electronic data must be kept private and secure, and a high level of security should be in place so that unauthorized users do not gain access to the information. Also, healthcare providers need to keep mobile devices in a safe place in order to maintain patient confidentiality.
Although there are many mobile applications for health care currently available, the current regulation of mobile applications for health care is still in infancy. Clinicians as the end-user will be ultimately responsible for ensuring the accuracy and efficacy of mobile applications to use in practice and must carefully review it to maintain patient safety (Aungst et al., 2014).
VII. Clinical Decision Support Systems
Improvements in care and its outcomes are dependent on optimal clinical decision-making. Clinical decisions heavily depend on the quality of the data available. A clinical decision support system (CDSS) is an automated decision support system that mimics human decision-making. It is a tool that allows nurses to analyze, evaluate, develop, and select alternative solutions to complex problems. A CDSS can facilitate the clinical diagnosis process, assists adherence with clinical guidelines, and also allows comparison of interventions and their outcomes and as thus promotes best practices. However, the acceptance and the integration of a CDSS depends on several usability and utility principles:
minimize memory overload
simple and natural feeling user interaction
consistency with current clinical practices and workflow
interactive feedback
built-in error prevention
alternative access to information
managing clinical complexity
There are many different approaches to the development of a CDSS; it can be non-knowledge-based (i.e. transforming data in the information that can be used in certain situations) or knowledge-based. (i.e. contextual knowledge is contained within the system). Knowledge-based systems can be descriiptive (i.e. know what if), procedural (i.e. know how to do), or reasoning (i.e. know why). In addition, a CDSS may be explanatory or predictive. However, the use of knowledge discovery and prediction techniques is a preferred way to improve clinical decision-making. Besides CDSS, different information technologies can also be used to facilitate practice but also to support the professional dimensions of each health care discipline.
For further information about CDSS, please read Kawamono & Fiol’s (2014) Chapter 10 Clinical Decision Support Systems in Healthcare. In R. Nelson, & N. Staggers. Health Informatics: An Interprofessional Approach. Mosby, an imprint of Elsevier Inc.
VIII. Administrative Decision Support Systems
Data currently collected and used by decision makers to manage health care and to guide effective and effective nursing come from several sources: administrative files, health insurance files, patient records, surveys, and other sources. Data can be used to evaluate a variety of issues related to the performance of the health care system including the delivery of nursing care, such as reimbursement, staffing in the function of patient care load, cost calculations, etc. Therefore, the data elements contained in each source serve to support the underlying function of that database.
Administrative data generally are generated as a result of patient encounters with the health care provider, including inpatient care, outpatient services, and pharmaceuticals. Data are generated by both health care professionals and facilities.
Administrative data can be used in various ways:
Utilization studies: monitor the use of health services over time; study of geographic variation in the utilization of health services; compare the use of services by age, gender, race; track referral to specialists.
Cost studies: such as, measure the cost/effectiveness of management programs; assess the effect of policy changes on the expenditure; explore differences in cost of services among different health plans.
Outcome evaluation: assess the effect of policy changes on health outcomes; evaluate differences in mortality between institutions, regions; evaluate service use profiles; etc.
Examples of applications can be found at http://www.qualitymeasures.ahrq.gov/ (Links to an external site.)
Information systems are also instrumental in supporting administrative decision-making for nursing and health care. Indeed, health care providers are faced with an array of non-clinical decisions designed to support and facilitate the delivery of quality care within budgetary margins. In addition, these decisions must be made within a certain time frame, priority must be set, decisions are made within the context of the entire organization, they are in response to identified criteria, the decision process must be explicit, and data collection is bounded by the demand of the decision under consideration.
Several decision support systems have been developed to support the health care executive and/or the nurse manager. Most decision support systems (DSS) are guided by the notion that effective management decisions are based on quantitative approaches. In health care, representative quantitative decisions models include but are not limited to forecasting, decision analysis based on information available, inventory models, linear programming, graph theory and network problems, queuing theory and waiting line problems, and simulations.
Many of the decision algorithms or models are incorporated in spreadsheets, project management software, and in databases, but also in DSS specially developed for administrative support.
An administrative DSS is an interactive, flexible, and adaptable computer-based information system for supporting decision-making for solving a management problem.
Components of a DSS include:
User interface to facilitate the communication between the user and the hardware
Model manager for accessing the available decision models
Model library including statistical, financial, graphical, and analytical calculators
Databases containing the data for querying
DBMS manages data storage and access
Report writer to format and produce outputs.
Commercial or institutional developed DSS provides assistance in the following areas:
Strategic planning and marketing
Process improvement
Financial management
Human resource management
Material management
Management of competition and markets
Management of demand for services
Provider practice management
Scheduling of personnel and facilities.
IX. References
Aungst, T. D., Clauson, K. A., Misra, S., Lewis, T. L., & Husain, I. (2014). How to identify, assess and utilize mobile medical applications in clinical practice. International Journal of Clinical Practice, 68(2), 155–162.
Hardwick, M., Pulido, P., & Adelson, W. (2007). The use of handheld technology in nursing research and practice. Orthopedic Nursing, 26(4) 251-255.
Hebda, T., Czar, P., & Mascara, C. (2005). Handbook of Informatics for Nurses & Health Care Professionals, Chapter 5. Health Care Information Systems. (3rd ed.). Upper Saddle River, NJ: Pearson Education, Inc.
Assignment
Evaluation of mHealth Applications
Find and describe the purpose of a mobile application for clinical practice of any health care providers
Name of the Mobile app:
Developer:
Main Purpose:
Evaluate the mobile application regarding its functions and usability.
For evaluating their functions, please refer to Lee’s (2013) categorization of the functions of a CDSS: assessment, problem identification, care plans, implementation, and outcome evaluation
For evaluating their usability, please refer to Brown III, Yen, Rojas, Schnall’s (2013) Health-ITUEM concepts listed in Table 2 on pp.16.
Functional Assessment of the Mobile Application Using CDSS System by Lee, S. (2013)
Criteria
Assessment
Problem identification/diagnosis
Care Plans
Implementation
Outcome evaluation
Others
Usability Assessment of the Mobile Application Using Brown III, W., Yen, P., Rojas, M., & Schnall, R. (2013).
Criteria
Error prevention
Completeness
Memorability
Information needs
Flexibility/Customizability
Learnability
Performance speed
Competency
Other outcomes

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