HEALTHCARE INFORMATICS Notes

HEALTHCARE INFORMATICS NOTES UNIT 1 - 3 major: labs, radiology, pharmacy - Difference between IT (servers, network, comms, etc.) - Interoperability is one major problem. o Healthcare IT: how to manage the IT, disaster recovery, set up servers o Healthcare Analytics: how you use info generated by IT to support decision making o Healthcare informatics: manage, organize data, merge IT & Analytics Health informatics = use of data to design innovations and interventions l  lower costs, higher quality, and better patient outcomes. o Information = processed data (raw facts) o Knowledge = actionable information o Wisdom = knowledge becomes part of your decision - Epic: the “Microsoft” of healthcare informatics is based off MUMPS - HL7 is the foundation of interoperability, addressing the comm between devices. - 5 domains; IT, operations, data comms, workflow (busi unit silos, best of breed environment dom, interfaces vs integration, analytics The workflow domain : each institution typically runs around 80 applications - Data definitions/use driven by business unit: e.g., pediatric patient may mean <18yo or not, transferred patient or not - Interface nation: 9 interfaces  Hospital info/Billing (double arrow = 2-way comm) <> Laboratory info/radiology/pharmacy/dietary system/ Order and charge written to patient record - HL7 Fast Healthcare Interoperability Resources (FHIR): standards introduced in 2012 and are under development. o More of a guideline - Data comms domain trends: o Mobility driven o Demand for ubiquitous connectivity. o EMR = Five 9s reliability Healthcare real-time demands o True cost(?) Capital. Operating. Depreciation. o Bring Your Own Device (BYOD) o THE CLOUD - Which function of health care 1 st utilize IT? Finance - Goals of automation in h/c: improve care quality, efficiency, administrative processes - Current challenges: o Costs – upward 45yrs, make eco < competitive, gov + priv payers implement ctrls, unsustainably high, inadequate quality

o Errors – excess preventable deaths, no solutions yet o poor quality – complex sci + tech, > chronic illness w/ acute centered system, inadequate use of IT, pmt system X reward qlty improvement o evidence-based med - infor mgmt & learning strategy that integrate clinical o expertise w/ best evidence available to make effective clinical decisions, improve pt care o org changes – market driven reform, increased competition, - Health Information Portability and Accountability Act (HIPAA): standards, required to participate in Medicare, pen for noncompliance - Medicare Prescription Drug Improvement & Modernization Act of 2k3; standards for e- prescribing - HIS initiatives: - OBAMA admin: American Recovery and Reinvestment Act of 2009 (ARRA): Title IV–Health Information Technology for Economic and Clinical Health (HITECH) Act o Stimulus/incentives of EHR adoption - Meaningful Use criteria: features, functions, reporting, interoperability capabilities shown to improve care; met to receive incentive pmts for Medicare pts UNIT 2:  What are the characteristics of the physicians, practices, and hospital systems most admire?  Internal comm, seamless comm, instant updates of patients’  What do you need to know today for your practice or healthcare system to succeed and prosper?  Employee satisfaction (physicians, nurses), patient satisfaction  affecting financial bottom line, continuous communication, utilization of technology, data governance structure, benchmarking  Class discussion: Saga of Joe Wilson 1,2) Bracelets, phone apps that noted personal medical info  The healthcare industry is information intensive, and the management of healthcare organizations is improved by strategic use of information  Information is used for:? – Quality of patient care – Financial management – Strategic planning – Operations management  Electronic medical records (EMR) – within one institution versus electronic health records (EHR) – among multiple institutions  Scope of care – Episode of care – Continuum of care: involves whole system, across different services and time, settings – Population health: e.g., outcome for a group of patients having specific conditions (diabetes)  Order entry/order management, computerized provider order entry (CPOE) – used to select which treatment to pursue  Clinical Decision Support: IMPORTANT!  HIE: Health Information Exchange (both verb and noun) o Directed Exchange o Query Based Exchange o Consumer Mediated Exchange  How does EMR impact billing? Quicker cycle!