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| Health information literacy is a combination of |
Information literacy, Computer literacy, Application of professional knowledge |
| Information literacy is the ability to |
Identify, Locate, Evaluate and Apply pertinent information |
| Computer literacy is ability to acquire and apply a basic understanding of |
Computer hardware systems and software applications |
| 4 Steps r/t Cognitive approach to information-seeking |
1-Need is identified, 2-Creation of Needs Statement, 3-Information is retrieved using Terms, 4-Information is organized |
| Strategies are techniques used for |
Search and investigation |
| Strategies must be |
Fluid and flexible |
| Static information remains the same after |
Publication |
| Static information is often used for |
Overviews, Backgrounds, Historical perspective |
| Problems r/t Textword searching |
Lack of percision, Terms may not be r/t desired content, Mass retrieval in multiple entries, Difficulty narrowing |
| Most commonly used controlled vocab in health care |
Medical Subject Headings(MeSH) |
| Use of symbols to represent letters |
Truncation |
| Boolean operators |
Combine terms in searching |
| Most commonly used Boolean operators |
And, Or, Not |
| Require consideration r/t Evaluation |
Credibility, Bias, Accuracy, Currency, Relevance, Significance, Intended audience, Usability |
| 3 kinds of knowledge r/t Computer literacy |
Foundational concepts of how technology works, Skills using computer applications, Ability to apply knowledge and adapt to change |
| 2 types of memory essential for CPU |
ROM, RAM |
| ROM vs. RAM |
ROM cannot be changed, RAM doesn't permanently store data |
| RAM function |
Working part that can be written and read |
| Measures memory, storage capacity and file size |
Byte |
| Byte r/t Bits |
1 byte=8 bits |
| Examples r/t Optical storage |
CD-ROM, DVD |
| DVD-ROM vs. DVD-R vs. DVD-RAM |
ROM:read only, R:write once, RAM:rewritable |
| Examples r/t Input devices |
Alphanumeric/function entry, Voice entry, Image entry |
| Examples r/t Output devices |
Monitor, Printer, Speaker |
| Connectivity facilitates |
Resource sharing & communication |
| Software |
Set of instruction written in a structured programming language |
| Operating systems control |
Functioning of a computer |
| Link b/w hardware and software |
Operating system |
| Program whose source code can be downloaded for free |
Open source software |
| Reason software applications are developed |
Perform specific tasks w/particular operating system |
| WYSIWYG |
What You See Is What You Get |
| Technique used to identify and rank basic IT skills needs by nurses r/t nursing education |
Delphi Technique |
| Database |
Structure collection of individual data elements |
| Program used to manage, organize and retrieve data from a database |
Database Management System(DBMS) |
| Hierarchical database r/t Design |
Contains many levels |
| Many of older DBMS programs were developed using |
Hierarchical databases |
| Characteristics r/t Hierarchical databases |
Limitations w/large data sets, Used for one-to-one relationships, Measure qualitative data |
| Solved redundancy problems r/t hierarchical models |
Network databases |
| Characteristics r/t Network databases |
Records linked together by pointers that use a key piece of data |
| Relational databases consist of |
Several tables |
| Relational databases r/t Ease of usage |
Users need to only know name of table to locate data |
| Fields vs. Records vs. Tables |
F:vertical columns of database, R:horizontal rows of database, T:consists of all records |
| Tables r/t Records r/t Fields |
T:consist of records, R:consist of fields, F:consists of smallest entity necessary to obtain meaning |
| Label at the head of a column |
Field name |
| Querying |
Process of selecting desired records |
| Algorithim |
Set of rules to follow that are inclusive of all cases |
| Basis r/t Forms and reports |
Results of data manipulation |
| 2 Types r/t Data manipulation |
Sorting data, Querying data, Both are dependent on structure of data & entries in fields |
| Sorting |
Reordering records |
| Primary vs. Secondary vs. Tertiary sorting |
Primary is broadest and then narroms |
| Can be used to perform calculations on data in specified fields |
Query |
| Underlying logic r/t Queries |
Boolean arithmetic |
| Reduction of all decisions r/t Boolean logic |
Decisions are reduced to true or false |
| And vs. Or vs. Not r/t Boolean logic |
A:narrows search, O:broadens search, N:further define criteria and narrow search |
| Wildcard symbols |
Greater than(>), Less than(<) |
| Heart of any database |
Table |
| Table consists of |
Data organized into fields(vertical) and records(horizontal) |
| Database consisting of a single table |
Flat database |
| Relational database |
2 or more tables related by unique identifiers |
| Unique identifier synonym |
Key field |
| List of all tables in a database |
Data dictionary |
| Size of database r/t Necessity of a quickly referenced data dictionary |
As a database becomes large, imperative to maintain quickly referenced data dictionary |
| 2 Types of Decision Support Systems(DSS) in health care |
Administrative & clinical |
| Agency relationship vs. Maximally effect care vs. Optimally effect care |
A:decisions made to ensure welfare of Pt and family, M:max improvement in health regardless of cost, O:improvement in health at point w/the greatest difference b/w benefits and costs of care |
| 5 Themes that shape health care paradigm |
Mandates to measure and quantify services, Financial pressures from increased demand for services, Pressure to recruit and retain health care workers, Management of workload, Efforts to reduce variation in practice |
| Forecasting |
Knowledge about past should improve ability to estimate what will happen in future |
| Decision analysis is making the best possible decision based on |
Information available |
| 3 Steps r/t Decisions |
Consider feasible alternatives, Identify positive states of nature, Construct payoff table |
| Maximax criterion vs. Maximin criterion vs. Minimax criterion |
Maximax:choose alternative w/"best of best" payoff, Maximin:choose alternative w/"best of worst" payoff, Minimax:assess opportunity costs w/each decision |
| Criterion of realism vs. Expected value criterion |
Realism:weighted average for each alternative w/coefficients of 0 or 1, Expected:weighted average of each alternative |
| Maximum likelihood criterion vs. Criterion of rationality |
Max:decision w/highest probability and alternative w/highest payoff, Rat:all decisions are equally likely |
| Simplest inventory model |
Economic order quantity model, Balances ordering costs vs. costs of maintaining iventory to optimize ordering quantity |
| Linear programming determines |
Best consumption of resources to meet objective |
| Simulation |
Imitation of system to evaluate and improve system performance |
| Advantages vs. Disadvantages r/t Spreadsheets |
A:embedded formula/functions and optimization capabilities, D:people are unfamiliar w/advanced spreadsheet applications |
| Data manipulation language allows non-programmers to |
Perform variety of operations on data |
| Query language is usage |
Directly interact w/database and pose conditions for retrieval |
| Clinical data repository vs. Data warehouse |
C:real-time retrieval and queries, D:works retrospectively |
| Data marts are sorted by |
Specific subject of data to support a specific function |
| 4 Categories of clinical decision support facilitated by the computer |
Assist provider in making decisions, Provide alerts, Provide guidance to alter care, Support quality assurance activities |
| Electronic data interchange allows linked computers to conduct |
Business transactions |
| Geographical information system |
System capable of assembling, storing, manipulating and displaying geographically referenced material |
| Production jobs are used to perform |
Data-processing |
| System development/Project management function |
Selection & installation of new computer systems |
| IT departments r/t Shift to off-site vendors |
Systems development/Project management, Network |
| Application support function |
Assist users w/application functionality |
| Support function vs. Systems administration r/t Function |
Support:help desk, Systems:operating systems management & IS security |
| Primary leadership role r/t IS department |
Chief information officer |
| Division of time r/t Manager |
Time spent w/staff vs. Time spent w/system users |
| Supervisor performs hands-on functions with |
Staff members they supervise |
| Telecommunications operator vs. Telecommunications technician |
O:manages switchboard, T:support for equipment |
| Responsible for creating lasting impression of organization |
Telecommunications operator |
| Systems analyst role |
Bridge technology gap b/w specific application and knowledge that applies for the business function of that application |
| Consultant services are acquired by this method, Contract basis |
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| Mainframe computers vs. Mid-range computers |
Mainframe:run large health care organization's core applications & rely upon proprietary operating systems, Mid-range:run medium-smaller organization's core applications & support specialized software w/large health care organizations |
| Workstations vs. Portable computers |
W:support staff members for local & remote functions, P:document Pt information at point of care |
| Peripherals r/t Technology infrastructure |
Input & output devices |
| Primary clients r/t IS departments |
Internal staff of a health care organization |
| Variation r/t Characteristics of IS departments |
Depend upon type of organization |
| Community hospital vs. Teaching hospital r/t IS departments |
C:find solutions w/limited resources, T:find solutions w/cutting-edge technology |
| Setting in which most IS advancements occur |
Teaching hospitals |
| Inteface engine function |
Ensure messages b/w systems are communicated effictively & reliably |
| Health care systems r/t IS department formation |
Formed after merger of serveral independent organizations |
| IS support r/t Smaller health care settings |
Usually outsourced |
| Clinical decision support system(CDSS)function |
Automated decision support system that mimics human decision |
| Problem-solving/Decision-making conditions |
Stress, Cognitive overload, Uncertainty, Increasing levels of scrutiny |
| Causes development of Knowledge-based systems |
Challenges facing clinical decision-making |
| Knowledge-based system are used to enhanced |
Human abilities during health-related conditions |
| Conditions r/t CDSS acceptance resistance |
Narrowness of scope, Mistrust of clinical decisions, Inability to incorporate new discoveries, Nonportability to other systems, Lack of integration w/exitsting systems |
| Classic view vs. Knowledge-based view r/t Decision-making |
C:focus on analysis of alternatives, K:knowledge is generated every time a decision is made |
| Stuctured vs. Unstructured vs. Semistructured decision-making |
Structured:routine decisions are made using established guidelines & static rules, U:highly unique decisions are made in emergent situations in which alternatives are unknown, Semi:some background information is known |
| Common decision-making process r/t Health care |
Semistructured |
| Knowledge r/t Decision-making |
New knowledge is created OR old knowlege is altered/discarded |
| Descriptive vs. Procedural knowledge |
D:description of some kind, P:how-to/step-by-step procedure |
| Methods r/t Gaining procedural knowledge |
Observation, Learning, Experience |
| Examples r/t Descriptive knowledge |
Past, Present, Future, What if's |
| Reasoning vs. Inferencing |
R:assists in drawing a conclusion, I:drawing conclusions from evidence |
| Reasoning vs. Inferencing r/t Basis |
R:product of experience & exposure, I:based on probabilities |
| 2 Formats that assist w/standardizing interface b/w CDSS & other systems |
Arden syntax, Guideline interchange format |
| Arden syntax is a way to share |
Medical knowledge in a manner that can be utilized by a computer |
| Intelligent agents ability |
Autonomously accomplish a task |
| Indication r/t Future size of data warehouses |
Human Genome Project |
| Data mining allows understanding of patterns in |
Data |
| Process r/t Knowledge discover in large data sets |
Identify problem, Obtain data set, Preprocess the data, Apply algorithm, Interpret findings |
| Trending data is collected |
Over time |
| Backbone of most health iformation systems |
Admission, discharge and transfer(ADT) |
| Functions r/t Admission, discharge and transfer |
Collect, store & track Pt information from admission to discharge |
| Interface is exchange of information b/w |
Systems |
| Interface avoids |
Redundant data entry |
| Advantage r/t Best of breed |
Increase each system's robustness w/data entered into other systems & reported in all connected systems |
| Data integration accomplishment |
Accomplished by interfacing many information systems together |
| Clinical data repository is a single database that captures |
Information from numerous systems |
| Allows one person to find, access or enter data at the same time |
Automation |
| End user |
Person who uses components of a system |
| 4 Perspectives r/t Health care information systems |
Clinical, Enterprise, Technical, Client |
| 3 Paths r/t Input |
User enters data, Transfer of data from interfaced systems, Automatic data transfer from other systems |
| Networks allow data & files to be shared regardless of |
Location |
| Point-of-service vs. Point-of-care |
POS:device is located where information is required/collected, POC:data entered at bedside |
| System architecture ensures |
Efficient/effective access to data |
| Data archive vs. Data purging |
A:how long data is kept , P:what should be deleted |
| Core component r/t eHealth |
Electronic health record |
| Any information r/t individual which resides in an electronic system for the primary purpose of providing health care |
Electronic health record |
| Electronic health records constantly change d/t |
New technology |
| Core idea r/t Electronic health records |
Availability on demand anywhere data are needed w/sufficient detail |
| Problems r/t Paper-based records |
Only one person can access at a time, Illegible handwriting, Security/confidentiality breaches, Removed/lost sections |
| Setup standards and precedence r/t Electronic health records |
Institute of Medicine(IOM) |
| Advantages r/t Electronic health reports |
Improved quality of provided health care, More complete, Better organization, Legible information, Discrete storage |
| Downfall r/t Websites offering personal electronic health records |
Privacy |
| Functions implemented via internet |
Remote access, Access to multiple information systems, Direct Pt access |
| Standardization of terms in naming data elements allows |
Consistency, Validity |
| Every acute care hospital uses |
Uniform hospital discharge data sets as a summary of Pt's hospital experience |
| Classifications vs. Vocabularies vs. Nomenclatures |
C:grouping similar items together, V:list of standard terms w/specific definitions, N:systematic listing of the proper names of a particular area of interest |
| Privacy vs. Confidentiality |
P:Pt has right to decide what info they will disclose, C:disclosed info will not be shared w/out permission |
| Properly designed electronic health record systems r/t Security |
Can be more secure than paper systems |
| Most important element r/t Electronic health record security |
Human element |
| Consumer shift r/t Electronic health record |
Individual responsibility for health |
| 3 Dimensions of performance |
Access, Integrity, Availability |
| Access is the ability to obtain |
Data and information for specific purposes |
| Security r/t Access |
Measures organizations implement to protect information and systems |
| Integrity ensures |
The completeness and accuracy of data and information, Protection of data and information from processes that would invalidate them |
| Threats r/t Data integrity |
Accidental entry of incorrect data, Unauthorized access |
| Availability is the ability to |
Access data and information appropriate to their authorization level |
| Basis r/t Ensuring that data is reliably and readily available |
Storage capabilities, Media life expectancies |
| Definition of health record in 2010 |
Record is maintained by multiple providers and shared when necessary |
| What we can expect r/t Virtual health records |
Improvement of care, Reduction of medical errors, Reduction of administrative costs |
| Past vs. Present r/t Ownership of health information |
Past:hospital-owned material, Present:Pt has right to control use of their private health information |
| DNA & Human Genome Project r/t Pt privacy |
Provides tools to look specifically at generations of a family and predict future health conditions accurately |
| HIPAA |
Health Insurance Portability and Accountability Act of 1996 |
| HIPAA provides |
Standards and a regulatory framework, Mandate that HCP must obtain Pt consent before sharing their information |
| Application of a signature to a document by electronic means |
Electronic signature |
| Health care informatics necessities |
Knowledgeable of vulnerabilities, Develop plan for information management and protection, Integrity of data, Efficient availability processes |
