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Health information literacy is a combination ofInformation literacy, Computer literacy, Application of professional knowledge
Information literacy is the ability toIdentify, Locate, Evaluate and Apply pertinent information
Computer literacy is ability to acquire and apply a basic understanding ofComputer hardware systems and software applications
4 Steps r/t Cognitive approach to information-seeking1-Need is identified, 2-Creation of Needs Statement, 3-Information is retrieved using Terms, 4-Information is organized
Strategies are techniques used forSearch and investigation
Strategies must beFluid and flexible
Static information remains the same afterPublication
Static information is often used forOverviews, Backgrounds, Historical perspective
Problems r/t Textword searchingLack of percision, Terms may not be r/t desired content, Mass retrieval in multiple entries, Difficulty narrowing
Most commonly used controlled vocab in health careMedical Subject Headings(MeSH)
Use of symbols to represent lettersTruncation
Boolean operatorsCombine terms in searching
Most commonly used Boolean operatorsAnd, Or, Not
Require consideration r/t EvaluationCredibility, Bias, Accuracy, Currency, Relevance, Significance, Intended audience, Usability
3 kinds of knowledge r/t Computer literacyFoundational concepts of how technology works, Skills using computer applications, Ability to apply knowledge and adapt to change
2 types of memory essential for CPUROM, RAM
ROM vs. RAMROM cannot be changed, RAM doesn't permanently store data
RAM functionWorking part that can be written and read
Measures memory, storage capacity and file sizeByte
Byte r/t Bits1 byte=8 bits
Examples r/t Optical storageCD-ROM, DVD
DVD-ROM vs. DVD-R vs. DVD-RAMROM:read only, R:write once, RAM:rewritable
Examples r/t Input devicesAlphanumeric/function entry, Voice entry, Image entry
Examples r/t Output devicesMonitor, Printer, Speaker
Connectivity facilitatesResource sharing & communication
SoftwareSet of instruction written in a structured programming language
Operating systems controlFunctioning of a computer
Link b/w hardware and softwareOperating system
Program whose source code can be downloaded for freeOpen source software
Reason software applications are developedPerform specific tasks w/particular operating system
WYSIWYGWhat You See Is What You Get
Technique used to identify and rank basic IT skills needs by nurses r/t nursing educationDelphi Technique
DatabaseStructure collection of individual data elements
Program used to manage, organize and retrieve data from a databaseDatabase Management System(DBMS)
Hierarchical database r/t DesignContains many levels
Many of older DBMS programs were developed usingHierarchical databases
Characteristics r/t Hierarchical databasesLimitations w/large data sets, Used for one-to-one relationships, Measure qualitative data
Solved redundancy problems r/t hierarchical modelsNetwork databases
Characteristics r/t Network databasesRecords linked together by pointers that use a key piece of data
Relational databases consist ofSeveral tables
Relational databases r/t Ease of usageUsers need to only know name of table to locate data
Fields vs. Records vs. TablesF:vertical columns of database, R:horizontal rows of database, T:consists of all records
Tables r/t Records r/t FieldsT:consist of records, R:consist of fields, F:consists of smallest entity necessary to obtain meaning
Label at the head of a columnField name
QueryingProcess of selecting desired records
AlgorithimSet of rules to follow that are inclusive of all cases
Basis r/t Forms and reportsResults of data manipulation
2 Types r/t Data manipulationSorting data, Querying data, Both are dependent on structure of data & entries in fields
SortingReordering records
Primary vs. Secondary vs. Tertiary sortingPrimary is broadest and then narroms
Can be used to perform calculations on data in specified fieldsQuery
Underlying logic r/t QueriesBoolean arithmetic
Reduction of all decisions r/t Boolean logicDecisions are reduced to true or false
And vs. Or vs. Not r/t Boolean logicA:narrows search, O:broadens search, N:further define criteria and narrow search
Wildcard symbolsGreater than(>), Less than(<)
Heart of any databaseTable
Table consists ofData organized into fields(vertical) and records(horizontal)
Database consisting of a single tableFlat database
Relational database2 or more tables related by unique identifiers
Unique identifier synonymKey field
List of all tables in a databaseData dictionary
Size of database r/t Necessity of a quickly referenced data dictionaryAs a database becomes large, imperative to maintain quickly referenced data dictionary
2 Types of Decision Support Systems(DSS) in health careAdministrative & clinical
Agency relationship vs. Maximally effect care vs. Optimally effect careA: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 paradigmMandates 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
ForecastingKnowledge about past should improve ability to estimate what will happen in future
Decision analysis is making the best possible decision based onInformation available
3 Steps r/t DecisionsConsider feasible alternatives, Identify positive states of nature, Construct payoff table
Maximax criterion vs. Maximin criterion vs. Minimax criterionMaximax: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 criterionRealism:weighted average for each alternative w/coefficients of 0 or 1, Expected:weighted average of each alternative
Maximum likelihood criterion vs. Criterion of rationalityMax:decision w/highest probability and alternative w/highest payoff, Rat:all decisions are equally likely
Simplest inventory modelEconomic order quantity model, Balances ordering costs vs. costs of maintaining iventory to optimize ordering quantity
Linear programming determinesBest consumption of resources to meet objective
SimulationImitation of system to evaluate and improve system performance
Advantages vs. Disadvantages r/t SpreadsheetsA:embedded formula/functions and optimization capabilities, D:people are unfamiliar w/advanced spreadsheet applications
Data manipulation language allows non-programmers toPerform variety of operations on data
Query language is usageDirectly interact w/database and pose conditions for retrieval
Clinical data repository vs. Data warehouseC:real-time retrieval and queries, D:works retrospectively
Data marts are sorted bySpecific subject of data to support a specific function
4 Categories of clinical decision support facilitated by the computerAssist provider in making decisions, Provide alerts, Provide guidance to alter care, Support quality assurance activities
Electronic data interchange allows linked computers to conductBusiness transactions
Geographical information systemSystem capable of assembling, storing, manipulating and displaying geographically referenced material
Production jobs are used to performData-processing
System development/Project management functionSelection & installation of new computer systems
IT departments r/t Shift to off-site vendorsSystems development/Project management, Network
Application support functionAssist users w/application functionality
Support function vs. Systems administration r/t FunctionSupport:help desk, Systems:operating systems management & IS security
Primary leadership role r/t IS departmentChief information officer
Division of time r/t ManagerTime spent w/staff vs. Time spent w/system users
Supervisor performs hands-on functions withStaff members they supervise
Telecommunications operator vs. Telecommunications technicianO:manages switchboard, T:support for equipment
Responsible for creating lasting impression of organizationTelecommunications operator
Systems analyst roleBridge 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(blank)
Mainframe computers vs. Mid-range computersMainframe: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 computersW:support staff members for local & remote functions, P:document Pt information at point of care
Peripherals r/t Technology infrastructureInput & output devices
Primary clients r/t IS departmentsInternal staff of a health care organization
Variation r/t Characteristics of IS departmentsDepend upon type of organization
Community hospital vs. Teaching hospital r/t IS departmentsC:find solutions w/limited resources, T:find solutions w/cutting-edge technology
Setting in which most IS advancements occurTeaching hospitals
Inteface engine functionEnsure messages b/w systems are communicated effictively & reliably
Health care systems r/t IS department formationFormed after merger of serveral independent organizations
IS support r/t Smaller health care settingsUsually outsourced
Clinical decision support system(CDSS)functionAutomated decision support system that mimics human decision
Problem-solving/Decision-making conditionsStress, Cognitive overload, Uncertainty, Increasing levels of scrutiny
Causes development of Knowledge-based systemsChallenges facing clinical decision-making
Knowledge-based system are used to enhancedHuman abilities during health-related conditions
Conditions r/t CDSS acceptance resistanceNarrowness 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-makingC:focus on analysis of alternatives, K:knowledge is generated every time a decision is made
Stuctured vs. Unstructured vs. Semistructured decision-makingStructured: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 careSemistructured
Knowledge r/t Decision-makingNew knowledge is created OR old knowlege is altered/discarded
Descriptive vs. Procedural knowledgeD:description of some kind, P:how-to/step-by-step procedure
Methods r/t Gaining procedural knowledgeObservation, Learning, Experience
Examples r/t Descriptive knowledgePast, Present, Future, What if's
Reasoning vs. InferencingR:assists in drawing a conclusion, I:drawing conclusions from evidence
Reasoning vs. Inferencing r/t BasisR:product of experience & exposure, I:based on probabilities
2 Formats that assist w/standardizing interface b/w CDSS & other systemsArden syntax, Guideline interchange format
Arden syntax is a way to shareMedical knowledge in a manner that can be utilized by a computer
Intelligent agents abilityAutonomously accomplish a task
Indication r/t Future size of data warehousesHuman Genome Project
Data mining allows understanding of patterns inData
Process r/t Knowledge discover in large data setsIdentify problem, Obtain data set, Preprocess the data, Apply algorithm, Interpret findings
Trending data is collectedOver time
Backbone of most health iformation systemsAdmission, discharge and transfer(ADT)
Functions r/t Admission, discharge and transferCollect, store & track Pt information from admission to discharge
Interface is exchange of information b/wSystems
Interface avoidsRedundant data entry
Advantage r/t Best of breedIncrease each system's robustness w/data entered into other systems & reported in all connected systems
Data integration accomplishmentAccomplished by interfacing many information systems together
Clinical data repository is a single database that capturesInformation from numerous systems
Allows one person to find, access or enter data at the same timeAutomation
End userPerson who uses components of a system
4 Perspectives r/t Health care information systemsClinical, Enterprise, Technical, Client
3 Paths r/t InputUser enters data, Transfer of data from interfaced systems, Automatic data transfer from other systems
Networks allow data & files to be shared regardless ofLocation
Point-of-service vs. Point-of-carePOS:device is located where information is required/collected, POC:data entered at bedside
System architecture ensuresEfficient/effective access to data
Data archive vs. Data purgingA:how long data is kept , P:what should be deleted
Core component r/t eHealthElectronic health record
Any information r/t individual which resides in an electronic system for the primary purpose of providing health careElectronic health record
Electronic health records constantly change d/tNew technology
Core idea r/t Electronic health recordsAvailability on demand anywhere data are needed w/sufficient detail
Problems r/t Paper-based recordsOnly one person can access at a time, Illegible handwriting, Security/confidentiality breaches, Removed/lost sections
Setup standards and precedence r/t Electronic health recordsInstitute of Medicine(IOM)
Advantages r/t Electronic health reportsImproved quality of provided health care, More complete, Better organization, Legible information, Discrete storage
Downfall r/t Websites offering personal electronic health recordsPrivacy
Functions implemented via internetRemote access, Access to multiple information systems, Direct Pt access
Standardization of terms in naming data elements allowsConsistency, Validity
Every acute care hospital usesUniform hospital discharge data sets as a summary of Pt's hospital experience
Classifications vs. Vocabularies vs. NomenclaturesC: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. ConfidentialityP: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 SecurityCan be more secure than paper systems
Most important element r/t Electronic health record securityHuman element
Consumer shift r/t Electronic health recordIndividual responsibility for health
3 Dimensions of performanceAccess, Integrity, Availability
Access is the ability to obtainData and information for specific purposes
Security r/t AccessMeasures organizations implement to protect information and systems
Integrity ensuresThe completeness and accuracy of data and information, Protection of data and information from processes that would invalidate them
Threats r/t Data integrityAccidental entry of incorrect data, Unauthorized access
Availability is the ability toAccess data and information appropriate to their authorization level
Basis r/t Ensuring that data is reliably and readily availableStorage capabilities, Media life expectancies
Definition of health record in 2010Record is maintained by multiple providers and shared when necessary
What we can expect r/t Virtual health recordsImprovement of care, Reduction of medical errors, Reduction of administrative costs
Past vs. Present r/t Ownership of health informationPast:hospital-owned material, Present:Pt has right to control use of their private health information
DNA & Human Genome Project r/t Pt privacyProvides tools to look specifically at generations of a family and predict future health conditions accurately
HIPAAHealth Insurance Portability and Accountability Act of 1996
HIPAA providesStandards and a regulatory framework, Mandate that HCP must obtain Pt consent before sharing their information
Application of a signature to a document by electronic meansElectronic signature
Health care informatics necessitiesKnowledgeable of vulnerabilities, Develop plan for information management and protection, Integrity of data, Efficient availability processes