City Tech OpenLab



Assignment #2: Information and Knowledge of Healthcare InformaticsAbelardo Rodriguez, RNNew York City College of Technology NUR 40170March 10, 2015 Describe the HITECH (Health Information Technology for Economic and Clinical Health) Act. (How would you explain HITECH Act to someone who has never heard of it?)The Health Information Technology for Economic and Clinical Health Act also known as the HITECH Act is a “STIMULUS” legislature passed in order to help or assist stimulate the economy from the recession the United States of America (USA) had experienced during the twenty first (21st) century. It is a sub-program of the American Recovery and Reinvestment Act (ARRA) of February 17, 2009 developed by the Health Information Technology (HIT) not only to stimulate the economy but to improve the delivery of healthcare services as well (McGonigle & Mastrian, 2015, p. 147). This legislature consists of two separate divisions- Division A and Division B. Division A focuses on the development of the implementation and the adaptation of HIT policies and standards, and provides enhanced privacy and security for patient information. Division B on the other hand provides financial support to the hospitals and healthcare professionals to implement the Electronic Health Record (EHR) technology systems that meets specific standards (McGonigle & Mastrian, 2015, p. 148). The specific purpose of the HITECH Act are as follows:improve healthcare quality by coordinating various healthcare providers of the patient, fostering appropriate medical or healthcare decisions preventing medicalerrors and focusing more on patient specific care (Konecny,L., 2015, PPT IV, Slide 38).reducing healthcare cost through prevention of inefficiencies such as duplicationsand decrease medical errors (Konecny,L., 2015, PPT IV, Slide 38).improve patient, family, and community health by promoting preventive interventions, early detections, and the management of chronic diseases (Konecny, L., 2015, PPT IV, Slide 38).protecting public through early detection and rapid response to infectious diseasesbioterrorism, and other situations (Konecny,L., 2015, PPT IV, Slide 38).facilitate clinical research (Konecny, 2015, PPT IV, Slide 38).reduction of health disparities in marginalized communities or areas (Konecny, L.,2015, PPT IV, Slide 38).enhanced security of patient information (Konecny,L., 2015, PPT IV, Slide 38).In explaining the HITECH ACT to someone who has never heard of this specific legislation, I would state that this is a law passed by the president of the United States President Barack Obama on February 17, 2009 in order to improve the American healthcare system and reduce the cost spent on it, and also includes providing security of the individual’s private health information, reducing risk behaviors to prevent future diseases though examinations and early screening, and making it available to families or individual with low incomes or on the povertylevel. What is the relationship between the HITECH Act and HIPAA (Health Insurance Portability and Accountability ACT)?The relationship between the HITECH Act and the HIPAA Act is that both entities focus on thesecurity and privacy of patient information by ensuring healthcare organizations compliance with their mandatory rules and regulations in regards to the confidentiality of the protected health information (PHI). In ensuring compliance with their Privacy and Security Rules, they mandated entities to conduct regular audits , any breaches in the privacy and security of protected health information must be remedied immediately, and through application of the HIPAA requirements directly to the business associates of covered entities. Both of these acts’ privacy and security laws, enhances the individual rights of the patient providing them with greater access and control of their public health information- which promotes autonomy enabling patient to control its users, disseminators, and disclosures of that specific health information (Konecny, L., 2015, PPT IV, Slide 44). Why is it important to establish client ownership of the health record?The importance of establishing client ownership of their healthcare records promote autonomy,allowing patient to view, annotate, challenge or contrast the content of their record. Althoughit prohibits the patient (or owner) to modify or change the content entered by the medicalprofessionals (for this is still considered as a legal document or evidence). Establishing ownership over their own records give patient a sense of control, and independence to decidewho may or may not access be allowed to access their health information and prevent any misuse. Healthcare information security is of great importance and the inappropriate use by authorized users is a growing concern. How do HIPAA and the HITECH Act address these issues?HITECH and HIPAA act addresses the issue of healthcare information security by enforcing their privacy and security rules through mandating organizational entities to conduct regular audits to assure compliance and any breaches in the privacy or security of PHI must be remediedimmediately and improvement of PHI security and privacy by applying the requirements of HIPAA directly to the business associates of covered entities (Konecny,L., 2015, PPT IV Slide 41). The privacy rule limits the use and disclosure of their information, while the security aspect requires healthcare providers to safe-guard patient health information from improper use or disclosures, maintain integrity of the information and ensuring its availability only to the authorized users (McGonigle & Mastrian, 2015, p. 157). Although HIPAA was the first legislation passed to protect patient privacy, HITECH act was also created in order to enforce information security and confidentiality. THE HIPAA and the HITECH act are almost similar, but the HITECH act entitles patient a notice of privacy practices from the healthcare personnel, and it requires authorization of the patient for the disclosure of their information before it can be released to another healthcare provider allowing the patient to identify who is authorized andunauthorized to access the information.Define cognitive informaticsCognitive informatics is a field of study made up of different disciplines such as: linguistics- thescientific study of language, neuroscience- scientific study of the nervous system, artificial intelligence- a branch of computer science that deals with writing computer programs that can creatively solve problems, and psychology- the science of mental life. It is a multidisciplinary study of cognition and information focusing on the information processing mechanisms, and theprocess and their engineering applications in computing (McGonigle & Mastrian, 2015, p. 61). It enhances the understanding of how information is acquired, processed, stored, and retrieved. How could cognitive informatics be used to create tools that would assist nurses in formulating client plans of care?Cognitive informatics can be used to create tools that would assist the nurses in formulating clients plan of care. An experienced nurse can automatically identify the problem, pull information relevant to the problem, decide a plan of action, implement the plan, and evaluate theeffectiveness of the intervention. In similarity, cognitive informatics can design decision software which models the human and natural decision making process of professionals- for oldand new nurses. These software systems can help decision makers to consider the outcome of different courses of interventions before implementing the action. The software may also containextra information that users may not be aware of and can choose the best course of action possiblewhich can lead to a better decision in an unfamiliar situations (McGonigle & Mastrian, 2015, p. 62). In the clinical setting, what artificial intelligence (AI) tools would improve the quality of client care? Include in your discussion two (2) specific AI examples. One artificial intelligence tool that would improve the quality of client care is the electronic health record. With this computer system a clinician can access patient history, medications, treatment, and allergies that can assist in reducing medical errors i.e. viewable alerts on same sound medications, patient allergies, and etc.. Another AI tool that is useful in improving quality of client care are database search engines such as PubMed, and CINAHL (Cumulative Index of Nursing and Allied Health Literature) which allows practitioners to tap into a collective knowledge of thousands to millions of information gathered from best evidence based research practices, different providers, and patient visits and enable utilization within the practice. How would you use NIC to assist nurses in your facility to define and document nursing practice? Be specific in your prepared response and provide in your discussion at least two (2)specific clinical examples.The Nursing Intervention Classification is a comprehensive, research-based, standardized classification of intervention that nurses perform useful for clinical documentation, communication of care across settings, integration of data across systems and settings, effectiveness research, productivity measurement, competency evaluation, reimbursements, and curricular deign. It also includes interventions (independent and collaborative) of nurse on behalf of patients. The interventions covers both the physiological and psychosocial, it addresses healthpromotion, illness preventions, and illness treatments. It not only address the individual patientbut the family and community as well (Bulechek, Butcher, Dochterman, & Wagner, 2013). NIC can assist nurses in defining and documenting nursing practice through the use standardized language that can lead to a better communication among nurses i.e. the North American Nursing Diagnosis (NANDA)- which uses terminologies that communicates the professional judgments nurses make every day to their patient, providing clarity and minimizing communication errors. And while an individual nurse will only come up with a limited number of interventions related to their specialty, NIC can serve as a guideline or a clinical pathway-like structure that can be implemented to clients with specific diagnosis that captures the expertise of all nurses from different specialties. What are the advantages of your facility using NIC? You must be specific and comprehensive inyour response. Include at least five (5) advantages.The advantages of my facility using NIC is through its comprehensiveness, it provides a full range of nursing interventions from general and specialty practices. The nurses in the facility will be able to follow a clinical pathway-like nursing interventions or it can serve as a guideline that can be implemented on a client with specific diagnosis and also provides alternative interventions. With the information reflecting current clinical practice and research we can be assured that the interventions are the most current information that will result in an optimal patient outcome. With its easy to use organized structure, nurses can quickly identify domains, classes, interventions, and activities. preventing delays and promoting efficiency in the patient care continuum. Another advantage of NIC is its availability of translation in several languages. Due to its availability in several languages, the information can be understood and implemented by personnel that are not fluent in the English language. And at last, with the classification using language that is clear and clinically meaningful, it somewhat promotes a standardized language or terminologies for the healthcare practitioners preventing any misconception that can avoid miscommunication of information and interventions (Bulechek, Butcher, Dochterman, & Wagner, 2013). What are the disadvantages or barriers to using NIC? Be specific and comprehensive in yourdiscussion and provide at least two (2) examples. A disadvantage or barrier that presents using the NIC is the lack of understanding of standardized nursing language by nurses and other healthcare personnel. Practitioners whoare not well versed in the medical terminologies may have a hard time identifying or communicating the correct information. In my opinion, another disadvantage of the NIC isthat it might make nurses be (too) reliant on this classification system that it will hinder thedevelopment of their critical thinking skills. For example, if a new nurse always rely on using the suggested interventions from the NIC system and he or she did not get the expected result (since no patients are the same), that nurse may not be able to implement an alternative and improved intervention.ReferencesBulechek, G.,? Butcher, H., Dochterman, J., & Wagner, C. (Eds.). (2013). Nursing interventions classification (NIC) (6th ed.). St. Louis, MO: Elsevier.Konecny, L., (2015). Perspective on Nursing Informatics. PPT Slide 38-44.h HYPERLINK "ttp://bbhosted.cuny.edu/webapps/hl-h" ttp://bbhosted.cuny.edu/webapps/hl- horizonliveb_60/com_list?action=display&course_id=_1102587_1&content_id=_18880573_1&rid=s_1102587_1_293108. Retrieved March 05, 2015.McGonigle, D. & Mastrian, K. (2015). Nursing Informatics and the Foundation of Knowledge (3rd ed.). Sudbury, MA: Jones and Bartlett Publishers. ................
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