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Health Informatics- Module 4-Chapter 3.pptx

  1. Health Informatics BCA-2020: Semester-V
  3. Module Content  Design and Evaluation of Information Systems and Services: principles of designing information systems, strategies for Information system evaluation, Information Systems Effectiveness Measures.  Quality Improvement Strategies: quality improvement tools, factors that help to create and sustain Healthcare Informatics as a new field. quality improvement cycle: PDCA (Plan, Do, Check,Act) Cycle.  Protocols and Evidence based Healthcare: information technology tools to support best practices in health care, information technology tools that inform and empower patients.
  4. LearningObjectives  Information technology tools to support best practices in health care  Information technology tools that inform and empower patients
  5. Introduction: EBM  Medical decisions and actions should be based on the best available evidence.  Clearly, information technology has the potential to improve decision making through online medical resources, electronic clinical practice guidelines, electronic health records (EHRs) with decision support, online literature searches, digital statistical analysis and online continuing medical education (CME).  According to the Center for EvidenceBased Medicine, EBM can be defined as: “the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patient”.  Furthermore, the Institute of Medicine (IOM) states: “Patients should receive care based on the best available scientific knowledge. Care should not vary illogically from clinician to clinician or from place to place
  6. Importance of EBM  Learning EBM is like climbing a mountain to gain a better view. One might not make it to the top and find the perfect answer but individuals will undoubtedly have a better vantage point than those who choose to stay at sea level.  Reasons for studying EBM resources and tools include:  Current methods of keeping medically or educationally up-to- date do not work  Translation of research into practice is often very slow  Lack of time and the volume of published material results in information overload  The pharmaceutical industry bombards clinicians and patients every day; often with misleading or biased information  Much of what is considered the “standard of care” in every day practice has yet to be challenged and could be wrong
  7. Traditional Methods for Gaining Medical Knowledge  Continuing Medical Education (CME).TraditionalCME is desired by many clinicians but the evidence shows it to be highly ineffective and does not lead to changes in practice.  Clinical Practice Guidelines (CPGs). Unfortunately, just publishing CPGs does not in and of itself change how medicine is practiced and the quality of CPGs is often variable and inconsistent.  Expert Advice. Experts often approach a patient in a significantly different way compared to primary care clinicians because they deal with a highly selective patient population. Patients are often referred to specialists because they are not doing well and have failed treatment. For that reason, expert opinion needs to be evaluated with the knowledge that their recommendations may not be relevant to a primary care population. Expert opinion therefore should complement and not replace EBM.  Reading. It is clear that most clinicians are unable to keep up with medical journals published in their specialty. Most clinicians can only devote a few hours each week to reading.
  8. Evidence Based Health Informatics (EBHI)  EBHI is not a separate field, it represents the application of EBM tools to the field of health informatics.  While the quality of health informatics research has improved in the past decade, the overall report card for most studies is mixed, regardless of which technology is being studied.  There are at least three reasons why published research studies in health informatics have not been optimally evidence based:  Early Hype: The optimistic predictions regarding the impact of HIT on healthcare quality, safety, proficiency and cost reduction is pointed out. Many of these predictions were based on expert opinions or modeling and not high quality research.  Methodological challenges. Early research studies frequently suffered from internal validity (quality of study design and execution) and external validity (whether results are generalizable to other locations and patients) issues. Most studies reported on health information technology (HIT) are observational and retrospective in nature.  The failure to anticipate unintended consequences related to HIT adoption.
  9. Information technology tools to support best practices in health care  Healthcare InformationTechnology (IT) tools help providers and patients to manage vital health information.They also help improve the quality of care and make healthcare more cost-effective for providers and patients.  According to the Agency for Healthcare Research and Quality, health IT enables providers to manage patient care more efficiently through secure sharing and utilization of health information.The following health IT tools making health information available anywhere on a 24- hour basis.  1. Electronic Health Records  An electronic health record (EHR) system collects digital health information for patients and the larger population. Other names used for this tool include Electronic Medical Record (EMR) and Patient Health Record (PHR). Simply put, it is a digital version of a patient’s medical history.The primary health provider usually maintains the EHR. A patient’s electronic health records may include administrative and clinical data such as demographics, medications, allergies, and medical insurance cover.
  10. Information technology tools to support best practices in health care  2. ReferralTrackers  A referral tracking system is a software tool that healthcare providers use to monitor their patient referrals. It provides an effective communication channel between two medical institutions. It also helps doctors and specialists to maintain constant communication while taking care of a patient.  A referral tool enables physicians to solve many practical problems associated with medical referrals. For instance:  Physicians can use it to know the exact time their patient sees a specialist and the result of the appointment  It eliminates the need for faxing referral letters  It allows physicians to communicate with a specialist and decide if a patient’s visit will be necessary and beneficial to the patient  Using this type of tool removes many operational inefficiencies associated with patient referrals.  3. Patient Portals  The website defines a patient portal as a website designed for your personal healthcare. It is an online tool that enables patients to monitor their visits to their healthcare provider, check test results, billing, payments, and prescriptions. Some portals also allow patients to have live interactions with their physicians and book new appointments.
  11. Information technology tools to support best practices in health care  4. Remote Patient Monitoring  Remote patient monitoring (RPM) uses tech tools to track and respond to a continuous stream of patient data outside a hospital or clinic.This type of telehealth is beneficial for monitoring patients with chronic conditions like heart failure, diabetes, and hypertension. Clinicians may use it to respond promptly with an ambulance when a patient’s health data shows they are in dire need of emergency care.  5. Computerized Provider Order Entry  Computerized provider order entry (CPOE) systems are supposed to replace the traditional paper-based ordering system.They allow clinicians to write, send, and manage various treatment instructions such as laboratory tests, radiology orders, and medication requests. All these are done through a CPOE system rather than through fax, printed paper, or telephone.
  12. Information technology tools that inform and empower patients  The use of IT can lead to a fundamental redesign of home care processes based on the use and integration of electronic communication at all levels.  Many anticipate that IT platforms may lead to patient empowerment and a transition from a passive role, in which the patient is the recipient of care services, to an active role, in which the patient is informed, has choices, and is involved in the decision-making process.  Such a transition may be possible due to the active involvement of patients in the management of their disease using home monitoring devices and software, the access to information and online communities, and the use of personal health records maintained by patients themselves.
  13. Information technology tools that inform and empower patients  Information technology can be introduced in home care in a multitude of ways.The following taxonomy captures the multiple levels of IT function and functionality in the context of home care:  Active monitoring and management (requiring end-user involvement and participation)  Telehealth applications for home-based disease management (that link patients and their families to their health care providers)  Web-based communities for home care patients (that link patients and their families to health care providers, peers, and the community)  Personal health records (that enable patients to create and store their personal health information)
  14. Information technology tools that inform and empower patients  Information technology can be introduced in home care in a multitude of ways.The following taxonomy captures the multiple levels of IT function and functionality in the context of home care:  Passive monitoring and management (for which IT implementation does not require training or operation by the end-user)  Robotic applications (standalone artificial intelligence applications that support home care needs)  “Smart homes” (in which IT based on the use of sensors becomes part of the residential infrastructure)
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