N222Y Health Information Technology Module: Improving Quality in Healthcare and Patient Centered Care Looking to the Future of Health IT

Computers and Technology Impact on Healthcare Review- what is Health IT What is Informatics? What is an informatics nurse? IOM- Core Competencies American Recovery and Reinvestment Act of 2009 Why should nurses care? Impact on bedside care What does the nurse need to know?

Healthcare Technology A time of rapid change Electronic Health Record (EHR) Personal Health Record (PHR) Components of health information systems: ▫ Clinical systems ▫ Administrative systems ▫ Computerized Provider Order Entry ▫ Clinical Decision Support Systems ▫ Equipment

Clinical Information Systems Improved quality and safety Outcomes management Evidence based practice “The complexity of modern healthcare has now exceeded the limitations of the unaided human mind.” Eddy, DM (1990)

Clinical Information Systems The bedside chart and beyond Support clinical outcomes and quality assurance Collect aggregate data Use coded terminology Clinical analytics Built in clinical decision making support systems Clinical pathways

CIS Quality Measures Clinical Decision Support Systems: A working definition has been proposed by Dr. Robert Hayward of the Centre for Health Evidence: "Clinical Decision Support systems link health observations with health knowledge to influence health choices by clinicians for improved health care". Alerting Interpretation Assisting Diagnosing Managing

CIS Quality Measures Clinical Pathways Interdisciplinary in focus- include nursing, medicine, nutrition, physical therapy, etc Guide care of patients with common diagnosis Based on national care standards and EBP Used for high volume, high cost diagnoses and procedures Examples: Patients with CHF ▫ Open heart surgery patients ▫ Knee replacement recovery

CIS Quality Measures Clinical Outcomes Management Data driven- means collection of consistent data ▫ Core measure tracking Collects and facilitates the tracking of quality indicators ▫ NDNQI Changes to care can be integrated into the EHR

CIS Quality Measures Evidence Based Practice Practice is embedded in CIS systems ▫ Prompts, required fields ▫ References accessible (hotlinks, etc) The “Learning Health Care System” ▫ IOM Report ▫ Patients Like Me

Health Information Technology and Patient Centered Care

Patient Centered Care IHI: Care that is truly patient-centered considers patients’ cultural traditions, their personal preferences and values, their family situations, and their lifestyles. It makes the patient and their loved ones an integral part of the care team who collaborate with health care professionals in making clinical decisions. Patient-centered care puts responsibility for important aspects of self-care and monitoring in patients’ hands — along with the tools and support they need to carry out that responsibility.

Patient Centered Technology gives patients the ability to communicate effectively and immediately with their providers provides patients access to information that is important and useful for them, when they need it allows providers to look holistically at an individual and treat them through the coordination of other providers Dimick, Chris. "First Steps to Patient-Centered Care: Meaningful Use Focuses Industry on Baby Steps." Journal of AHIMA 82, no.2 (February 2011):

Patient Centered Technologies Communication tools Personal Health Records Self management of health Tools to find care, evaluate care and comparison “shop” Personalized health

The Future Of Health Care Technology Emerging Technologies Disruptive Technologies Big Data Mobile Health

The Nurse Role Proficient user of technology Understands the purpose of the technology and its role in healthcare and its effect on nursing workflow Uses it correctly, securely and ethically Uses it to improve patient outcomes and safety Familiar with the value of nursing data, how it’s captured and analyzed Able to use resources for clinical decision making Understands the limitations and risks of healthcare information technology Recognizes the need for nurse involvement in the development of health IT systems

Led by Bellevue College, the Health eWorkforce Consortium was formed to elevate Health Information Technology workforce development locally and nationally and provide career paths into this promising field for veterans and others. The nine-college consortium includes Bellevue College, Bellingham Technical College, Clark College, Clover Park Technical College, Northern Virginia Community College, Pierce College, Renton Technical College, Spokane Community College, and Whatcom Community College. The Health Information and Management Systems Society (HIMSS) is also a primary partner. This workforce solution is 100% funded by an $11.7m grant awarded by the U.S. Department of Labor's Employment and Training Administration. The solution was created by the grantee and does not necessarily reflect the official position of the U.S. Department of Labor. The Department of Labor makes no guarantees, warranties, or assurances of any kind, express or implied, with respect to such information, including any information on linked sites and including, but not limited to, accuracy of the information or its completeness, timeliness, usefulness, adequacy, continued availability or ownership. This work is licensed under a Creative Commons Attribution 4.0 International License. Exceptions: 1) Materials identified as copyrighted or derived from another source. 2) Materials extracted from the Office of the National Coordinator (ONC) Health Information Technology Workforce Curriculum, which carries a more limited CC-BY SA license.CC-BY SA license