M1: Assignment 1 Assignment 1 (6 Questions) **Pay attention to the Assignment Grading Rubric found in the Assignment Resources folder in Getting Started section.** Answer the following assigned questions based on the topics from Chapter 4 from your (Health Information Management : Concepts, Principles, and Practice) book. 1) Why is the healthcare industry perceived as being less proactive than other industries in the area of computerized information systems? How can this perception be changed? 2) How are the concepts of EDI, e-commerce, and e-health interrelated? 3) What is driving the increased use of computerized care protocols in healthcare? 4) What is public key infrastructure, and why is it receiving so much attention within the healthcare industry? 5) Why is strategic planning for information systems important to organizations in today’s healthcare environment? What risks are associated with not having an IS plan? 6) What is the relationship between strategic information systems planning and the systems development life cycle? Please pay attention to the Assignment Grading Rubric: • • Note: Regarding Assignment 1, please incorporate “1 or more” external sources for every question answered for full points. (You may use your 2nd book as an external source) Minimum 1000 words applies to the total minimum number of words for all the six questions answered within the assignment. Not necessarily minimum 1000 words per question answered within assignment. Turnitin Requirements: • • • • • For each assignment, your similarity score must meet a threshold of no more than 20%. Assignments with greater than 20% similarity must be revised and resubmitted to Turnitin until the 20% threshold is achieved. For resubmissions, it may take up to 24 hours for a new similarity score. It is your responsibility to allow enough time to receive a Turnitin similarity score report. Assignments with more than 20% threshold will receive a zero. Copyright @ 2013. AHIMA Press. All rights reserved. May not be reproduced in any form without permission from the publisher, except fair uses permitted under U.S. or applicable copyright law. chapter 4 Health Information Systems: Supporting Technologies and Systems Development Ryan H. Sandefer, MA, CPHIT, and Patricia B. Seidl, RHIA Learning Objectives Understand the field of informatics as it is being applied in healthcare ●● Identify the major issues associated with computerizing health data and information ●● Learn the types of computer applications and technologies being used to support the delivery of healthcare and the management of health data and information ●● Identify the barriers and limitations associated with computerized health data and information ●● Develop a working knowledge of the emerging technologies that support the creation and maintenance of electronic health record (EHR) systems ●● Prepare for assuming a leadership role in the development of improved healthcare information systems, integrated patient information systems, and decision support tools ●● Understand the importance of strategic information systems planning to healthcare organizations ●● Describe the purpose and major activities within each phase of the systems development life cycle: analysis, design, implementation, and maintenance and evaluation ●● Identify the resources needed to effectively manage information systems within healthcare organizations ●● Know the roles and responsibilities of information system professionals ●● Identify the health information manager’s role in planning, selecting, and implementing healthcare information systems ●● Key Terms Analog Analysis phase Application systems analyst Applied healthcare informatics Audit trail Autocoding Automated forms-processing (e-forms) technology Bar-coding technology Bit-mapped data Chief information officer (CIO) Chief information security officer (CISO) Chief information technology officer (CITO) Chief medical informatics officer (CMIO) Clinical care plan Clinical data repository Clinical information system (CIS) Clinical messaging system 81 05_AB103311_ch04.indd EBSCO : eBook Business Collection Trial – printed on 3/6/2018 1:52 PM via LOUISIANA STATE UNIV AT SHREVEPORT AN: 667492 ; LaTour, Kathleen M., American Health Information Management Association, Eichenwald, Shirley, Oachs, Pamela K..; 81 Health Information Management : Concepts, Principles, and Practice Account: s3563253.main.ehost 12/21/12 7:19 PM Copyright @ 2013. AHIMA Press. All rights reserved. May not be reproduced in any form without permission from the publisher, except fair uses permitted under U.S. or applicable copyright law. 82 Chapter 4 Clinical systems analyst Clinical workstation Clinician/physician web portal Cloud computing Computer-assisted coding Computer output laser disk/enterprise report management (COLD/ERM) technology Continuous speech input Data repository Data type Data warehouse Data warehousing Database administrator Decision support system (DSS) Design phase Diagnostic image data Digital Digital signature management technology Discrete data Document Document image data Document imaging technology Document management technology e-commerce e-health Electronic data interchange (EDI) Electronic document/content management (ED/CM) system Electronic records management technology Encryption Enterprise master patient index (EMPI) Executive information system (EIS) Extensible Markup Language (XML) Extranet Firewall Free-text data Geographic information system (GIS) Gesture recognition technology Health 2.0 Healthcare informatics HyperText Markup Language (HTML) Identity management Implementation phase Informatics Information management Information science Information system (IS) Intelligent character recognition (ICR) technology Intelligent document recognition (IDR) technology Interoperability Interoperate Intranet Maintenance and evaluation phase Management information system (MIS) Mark sense technology Master patient index (MPI) Master planning or steering committee Medical informatics Metadata Motion or streaming video/frame data Multimedia Natural language processing technology Network administrator Neural network Object-oriented database Online/real-time analytical processing (OLAP) Online/real-time transaction processing (OLTP) Open source technology Optical character recognition (OCR) technology Patient/member web portals Personal digital assistant (PDA) Personal health record (PHR) Physiological signal processing system Pixel Point-of-care information system Programmer Protocol Public key infrastructure (PKI) Radio frequency identification (RFID) Raster image Real audio data Request for information (RFI) Request for proposal (RFP) Secure messaging system Software engineer Speech recognition technology Strategic IS planning Structured data Systems analyst Systems development life cycle (SDLC) Text mining Unstructured data Vector graphic (signal tracing) data Web content management system Web portal Web service Web 2.0 Web 3.0 Webmaster/web developer Wireless technology Workflow technology EBSCO : eBook Business Collection Trial – printed on 3/6/2018 1:52 PM via LOUISIANA STATE UNIV AT SHREVEPORT AN: 667492 ; LaTour, Kathleen M., American Health Information Management Association, Eichenwald, Shirley, Oachs, Pamela K..; 05_AB103311_ch04.indd 82 Health Information Management : Concepts, Principles, and Practice Account: s3563253.main.ehost 12/21/12 7:19 PM Copyright @ 2013. AHIMA Press. All rights reserved. May not be reproduced in any form without permission from the publisher, except fair uses permitted under U.S. or applicable copyright law. Health Information Systems: Supporting Technologies and Systems Development Healthcare organizations are under increased pressure to control costs and improve efficiency. At the same time, they are experiencing increased demands to ensure patient safety, reduce medical errors, improve the quality of care, promote access, and ensure compliance with privacy and security regulations. Many healthcare organizations are looking to informatics to help them respond to these pressures and provide high-quality services in a more cost-effective manner. The use of computer technology to manage data and information means that well-trained and skilled individuals with knowledge about both healthcare and computerized information technologies are needed to manage (design, develop, select, and maintain) health data and information systems. It also means that healthcare organizations must prioritize the computer technologies and information systems (IS) to deploy in their institution. This chapter introduces the field of informatics as it is currently being applied in the healthcare industry. Also, it describes the current and emerging technologies used to support the delivery of healthcare and the management and communication of patient information. It discusses strategic information systems planning, the systems development life cycle (SDLC), information resource management, and the role of the health information managers in planning, selecting, and implementing healthcare information systems. The Field of Informatics Informatics is the science of information management. It uses computers to manage data and information and support decision-making activities. In short, informatics can be summarized by the following statement: “A person working in partnership with an information resource is ‘better’ than a person unassisted” (Friedman 2009, 169). The management of data and information includes the generation, collection, organization, validation, analysis, storage, and integration of data, as well as the dissemination, communication, presentation, utilization, transmission, and safeguarding of information. The healthcare industry is information intensive. One needs to spend only a day with a healthcare provider or clinician to realize that the largest percentage of healthcare professional activities relates to managing massive amounts of data and information. This includes obtaining and documenting information about patients, consulting with colleagues, staying abreast of the current literature, determining strategies for patient care, interpreting laboratory data and test results, and conducting research. Healthcare informatics is the field of information science concerned with the management of all aspects of health data and information through the application of computers and computer technologies. The State of Healthcare Informatics Historically, the healthcare industry has not valued informatics to the same degree that other industries have. 05_AB103311_ch04.indd 83 The healthcare industry has been perceived as slow to both understand computerized information management and to incorporate it effectively into the work environment. Perhaps this is because the data and information requirements of the healthcare industry are more demanding than those of other industries in a number of areas. These areas include implications of violations of privacy, support for personal values, responsibility for public health, complexity of the knowledge base and terminology, perception of high risk and pressure to make critical decisions rapidly, poorly defined outcomes, and support for the diffusion of power (Stead and Lorenzi 1999, 343). The use of information technologies to improve the healthcare delivery system gained attention in the early 1990s through the early 2000s through the publication of several reports from the Institute of Medicine that highlighted patient safety concerns and discussed how health information technologies can be used to improve care delivery. Momentum was gained with the establishment of the Office of the National Coordinator for Health Information Technology (ONC) in 2004. In 2008, ONC published the Federal Health Information Technology Strategic Plan, which defined a number of goals, objectives, and strategies that bring together all federal efforts in health IT in a coordinated fashion. The purpose of the plan is to guide the advancement of health IT throughout the federal government through 2012. More recently the Health Information Technology for Economic and Clinical Health (HITECH) provision of the American Recovery and Reinvestment Act of 2009 (ARRA) authorized the Centers for Medicare and Medicaid Services (CMS) to provide reimbursement incentives for eligible professionals and hospitals who are successful in becoming “meaningful users” of certified electronic health record (EHR) technology. Examples of healthcare informatics successes are steadily growing. Charge collection and billing, automated laboratory testing and reporting, clinical documentation, computerized provider order entry (CPOE), patient and provider scheduling, diagnostic imaging, and secondary data use make up a distinguished list of healthcare informatics successes, proving what is doable and supporting further investment. Today’s task for informatics is to design, develop, and implement computer information systems that enable healthcare organizations to accomplish visions for providing the highest-quality care in the most effective way. Applied healthcare informatics emphasizes the use of the computer-based applications in delivering and documenting healthcare services (AMIA 2005). Therefore, applied healthcare informatics is the application of information technology to functions and activities that are closely aligned with the domains of practice associated with the health information management (HIM) profession. EBSCO : eBook Business Collection Trial – printed on 3/6/2018 1:52 PM via LOUISIANA STATE UNIV AT SHREVEPORT AN: 667492 ; LaTour, Kathleen M., American Health Information Management Association, Eichenwald, Shirley, Oachs, Pamela K..; 83 Health Information Management : Concepts, Principles, and Practice Account: s3563253.main.ehost 12/21/12 7:19 PM 84 Chapter 4 Check Your Understanding 4.1 Instructions: Answer the following questions on a separate piece of paper. Copyright @ 2013. AHIMA Press. All rights reserved. May not be reproduced in any form without permission from the publisher, except fair uses permitted under U.S. or applicable copyright law. 1. How are the disciplines of information management and informatics related? How are they different? 2. Why are data and information so crucial to a healthcare professional’s daily work? 3. Why is the healthcare industry perceived as being less proactive than other industries in the area of computerized information systems? How can this perception be changed? Current and Emerging Information Technologies in Healthcare To examine the information resources and systems that enable healthcare organizations to accomplish their visions in the most effective way, HIM professionals must possess fundamental knowledge of the components of computer-based information systems. This includes possessing knowledge of system hardware, software, and service components; communication and networking components; the Internet and its derived technologies; and system architectures. For the purposes of this chapter, it is assumed that students have acquired this basic knowledge through other, generic computer system courses and related textbooks. Next, it is appropriate that HIM professionals review some of the current and emerging information technologies used to specifically support the delivery of healthcare as well as the management and communication of health data and information within the healthcare setting. To do this, five categories of current and emerging technologies in healthcare are discussed in this chapter: Supporting capture of various types of data and formats ●● Supporting efficient access to, and flow of, data and information ●● Supporting managerial and clinical decision making ●● Supporting diagnosis, treatment, and care of patients ●● Supporting security of data and information ●● Technologies Supporting the Capture of Different Types of Data and Formats The information technologies currently in use for healthcare applications, as well as the new technologies being developed, support the capture of many different data types and formats that are all used to support the clinical services and administrative functions performed in every healthcare setting. Clinical Data Repository An EHR system consists of not one or even two or more products. Rather, it is a concept that consists of a host of integrated, component information systems and technologies. The clinical data repository is a component of the EHR that captures data. The automated files that make up the EHR system’s component information systems and technologies consist of different data types, and the data in the files consist of different data formats. Some data formats are structured and some are unstructured. For example, the data elements in a patient’s automated laboratory order, result, or demographic or financial information system are coded and alphanumeric. Their fields are predefined and limited. In other words, the type of data is discrete, and the format of these data is structured. Consequently, when a healthcare professional searches a database for one or more coded, discrete data elements based on the search parameters, the search engine can easily find, retrieve, and manipulate the element. However, the format of the data contained in a patient’s transcribed radiology or pathology result, history and physical (H&P), or clinical note system using wordprocessing technology is unstructured. Free-text data, as opposed to discrete, structured data, are generated by word processors, and their fields are not predefined and limited. Consequently, data embedded in unstructured text are not easily retrieved by the search engine. (See the section on speech recognition technology and natural language processing later in this chapter). Diagnostic image data, such as a digital chest x-ray or a computed tomography (CT) scan stored in a diagnostic image management system, represent a different type of data called bit-mapped data. However, the format of bit-mapped data also is unstructured. Saving each bit of the original image creates the image file. In other words, the image is a raster image, the smallest unit of which is a picture element or pixel. Together, hundreds of pixels simulate the image. Some diagnostic image data are based on analog, photographic films, such as an analog chest x-ray. These analog films must be digitally scanned, using film digitizers, to digitize the data. Other diagnostic image data are based on digital modalities, such as computed radiography (CR), CT, magnetic resonance (MR), or nuclear medicine. Document image data are yet another type of data that are bit mapped and the format of which is unstructured. These data are based on analog paper documents or on analog photographic film documents. Most often, analog paper-based documents contain handwritten notes, marks, or signatures. However, such documents can include preprinted documents (such as forms), photocopies of original documents, or computer-generated documents available only in hard copy. Analog photographic film-based documents (that is, photographs) are processed using an analog camera EBSCO : eBook Business Collection Trial – printed on 3/6/2018 1:52 PM via LOUISIANA STATE UNIV AT SHREVEPORT AN: 667492 ; LaTour, Kathleen M., American Health Information Management Association, Eichenwald, Shirley, Oachs, Pamela K..; 05_AB103311_ch04.indd 84 Health Information Management : Concepts, Principles, and Practice Account: s3563253.main.ehost 12/21/12 7:19 PM Copyright @ 2013. AHIMA Press. All rights reserved. May not be reproduced in any form without permission from the publisher, except fair uses permitted under U.S. or applicable copyright law. Health Information Systems: Supporting Tech…
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