Informatics

• EHR (Electronic Health Records)


  An electronic version of a patient's medical history, maintained by the provider over time, and may include all key administrative clinical data relevant to that person's care under a particular provider, including demographics, progress notes, problems, medications, vital signs, past medical history, immunizations, laboratory data and radiology reports
• EHR


  • Automates access to information and has the potential to streamline the clinician's workflow
  • Has the ability to support other care-related activities directly or indirectly through various interfaces, including evidence-based decision support, quality management, and outcomes reporting
• Certification Criteria for EHR


  • Clinical Processes
  • Care coordination
  • Clinical Quality Management
  • Privacy and Security
  • Patient Engagement
  • Public Health
  • Health IT Design and Performance
  • Electronic Exchange
• Components of EHR


  • Health information and data
  • Results management
  • Order entry management
  • Decision support
  • Electronic communication and connectivity
  • Patient support
  • Administrative processes
  • Reporting and population health management
• Health Information and Data


  Comprise the patient data required to make sound clinical decisions, including demographics, medical and nursing diagnoses, medication lists, allergies, and test results. Also includes care management data regarding details of patient visits and interaction with patients, medications, consents and directives. Also contain nursing assessment and problem lists.
• Results Management


  The ability to manage results of all types electronically, including both current and historical laboratory and radiology procedure reports
• Order Entry Management


  The ability of a clinician to enter medication and other care orders, including laboratory, microbiology, pathology, radiology, nursing and supply orders; ancillary services; consultations, directly into a computer. A comprehensive EHR will also contain nursing orders.
• Decision Support


  Entails the use of computer reminders and alerts to improve the diagnosis and care of a patient, including screening for correct drug selection and dosing, screening for medication interactions with other medications, preventive health reminders such areas as vaccinations, health risk screening and detection and clinical guidelines for patient disease treatment. EHR must consistently provide the best available data, information, and knowledge in the context of the patient's needs that can be applied to the patient's healthcare goals. HCPs must be able to access the right data and information at the right time and in the proper format to facilitate their decision and care processes to optimize patient care and outcomes.
• Electronic Communication and Connectivity


  Includes the online communication among healthcare team members and their care partners and with their patients, which include email, web messaging, and an integrated health record within across settings, institutions and telemedicine. Also includes the interfaces and interoperability required to exchange health information with other providers, laboratories, pharmacies, patients and government disease registries.
• Patient Support


  Encompasses patient education and self monitoring-tools, including interactive computer-based patient education, home telemonitoring, and telehealth systems
• Administrative Processes


  Activities carried out by the electronic scheduling, billing, and claims management systems, including electronic scheduling for inpatient and outpatient visits and procedures, insurance validation, claim authorization and prior approval, identification of possible research participants, and drug recall support
• Reporting and Population Health Management


  Are the data collection tools that support public and private reporting requirements, including data represented in a standardized terminology and machine-readable format
• Advantages of EHRs


  • Increased delivery of guidelines-based care
  • Enhanced capacity to perform surveillance and monitoring for disease conditions
  • Reduction in medication errors
  • Decreased used of care
• Simple benefits of EHRs


  • No longer having to interpret poor handwriting and handwritten orders
  • Reduced turnaround time for laboratory results in an emergency department
  • Decreased time to administration of the first dose of antibiotics in an inpatient nursing unit
• Other benefits of EHRs


  • Nurses report better care outcomes and fewer concerns with care coordination and patient safety
  • Better communication among staff, especially during patient transfers, and fewer medication errors
  • Better health care by improving all aspects of patient care, including safety effectiveness, patient centeredness, communication, education, timeliness, efficiency and equity
  • Better health by encouraging healthier lifestyles in the entire population, including increased physical activity, better nutrition, avoidance of behavioral risks, and wider use of preventative care
  • Improved efficiencies and lower healthcare costs by promoting preventative medicine and improves coordination of healthcare services, as well as by reducing waste and redundant tests
  • Better clinical decision making by integrating patient information from multiple sources
• It is an important time for healthcare and technology. EHRs will remain central to shaping the future of health care. All nurses, from entry-level personnel to executives, would have a basic competency in nursing informatics, which would enable them to participate fully in shaping the future use of technology in the practice at a national level and wherever care is delivered.
• Telehealth or Telehealth Care


  Refers to a wide range of health services that are delivered by telecommunications-ready tools, such as telephone, videophone, smartphone, and computer. Umbrella term to describe all of the possible variations of healthcare services that use telecommunications.
• Telemedicine is allowed in the Philippines. The Department of Health (DOH) Administrative Order No. 2017-0035 provides guidelines for the establishment and operation of Telehealth Services in the Philippines. DOH-DILG-PHIC Joint Administrative Order No 2021-0001 titled 'Guidelines on the Implementation of Telemedicine in the Delivery of Individual-Based Health Services' (the 'Guidelines') adopts the definition of telemedicine provided by the World Health Organization (WHO).
• Driving Forces for Telehealth


  • Demographics (population characteristics/attributes)
  • Nursing and Healthcare Worker Shortages
  • Chronic Diseases and Conditions
  • Educated Consumers
  • Economics
• Clinical Uses of Telehealth


  • Transmitting images for assessment or diagnosis
  • Transmitting clinical data for assessment, diagnosis, or disease management
  • Providing disease prevention and promotion of good health
  • Using telephonic or video interactive technologies to provide health advice in emergent cases
  • Using real-time video (Teleconsultation, Telerehabilitation, Telehomecare, Telemonitoring)
• Telenursing


  The use of telecommunications and information technology to provide nursing services in health care and enhance care whenever a physical distance exists between patient and nurse or among any number of nurses. Telenurses serve as an integral part of the healthcare delivery team, no matter their location.
• Home telehealthcare


  Health and education services delivered to patients in their homes in part by telecommunication devices. Two key values: 1) Nurses can be more alert to patients' current need and address this need in a more timely manner; 2) Patients who receive telehealth interventions can receive more comprehensive management, leading to more rapid stabilization and, ideally learn how to become more competent in self-management skills.
• Tools of Home Telehealth


  • Central stations, Web servers, and Portals
  • Peripheral Biometric (Medical) Devices (e.g. vital signs monitor)
  • Telephones
  • Video cameras and Video phones
  • Personal Emergency Response Systems
  • Sensor and Activity-monitoring systems
  • Medication Management Deices
• Home Telehealth Software


  • Triage – these systems help clinicians better organize their work and arrange for appropriate interventions
  • Communications – electronic notifications protocols
  • Data Access and Information Sharing – easy access and simultaneous share and view data; real time updates
• The heart of man plans his way, but the Lord, the Sovereign God, establishes his steps.: 'Proverbs 16:9'
• Nursing Informatics


  The application of information technology to nursing
• Nursing Education


  The process of educating nurses
• Foundation of Knowledge Model


  A model that describes the foundations of nursing knowledge
• Knowledge Acquisition and Sharing


  The process of gaining and sharing knowledge
• The shift from computer literacy to information literacy and management has drawn attention to interactivity and design as the most important components of interactive web-enhanced and web-based courses in providing effective learning environment
• Types of interactions related to web-enhanced courses


  • Learner-learner
  • Learner-content
  • Learner-instructor
  • Learner-interface
• Delivery Modalities


  • Face-to-Face Delivery
  • Online Delivery/E-learning
  • Hybrid or Blended Delivery
  • Competency-Based Learning
• Tutorials


  Mimics lectures by guiding users through a series of tasks and objectives which are completed at their own pace
• Case Scenarios


  A form of problem-based learning
• Portfolios / e-Portfolios


  Useful for documenting students' learning, accomplishments and exposure to educational experiences
• Simulations


  Software is used to simulate a subject or situation resembling a real-life environment to immerse students in the experience
• Virtual Reality


  User receives multiple sensory inputs creating virtual reality for health care training
• Digital Books (eBooks)


  Affordability and accessibility are key advantages
• Webcast


  Broadcast presentation delivered by way of the web
• Webinars


  Web-based seminar using web conferencing software, which allows educators to share computer screen and files and interact with students