Health care informatics is acquiring, storing, retrieving and using healthcare information to increase collaboration between patient’s healthcare providers. It links technology, communication and healthcare to improve safety and quality of care (What, n.d.). Nursing informatics is a subset of this. It collaborates nursing science, science, information science and computer science to not only manage but communicate pertinent patient data (Healthcare, 2017).
Informatics is affecting healthcare in many ways. It is increasing cost saving by tracking patient care, reducing the amount of repeat procedures that are costly and wasteful. It increases the sharing of information, resulting in more timely care. This decreases the chance of errors and reduces malpractice claims. Informatics is allowing patients to take a more active role in their healthcare through electronic access. They are able to educate themselves about their diagnosis and prognosis and keep track of their medications. It also allows them to communicate with their doctors and nurses more effectively. Since healthcare is becoming more specialized patients are likely to have several healthcare provides participating in their care. This requires and increased need for care coordination. Health informatics provides the way to more effectively keep track of the patient among multiple providers, improving outcomes.
The electronic health care record (EHR) is resulting in higher quality, safer and more coordinated team care. It assists members of the health team to increase efficiency and in turn allowing them to spend more time with patients. Many jobs that were previously manual are able to be automated saving time and money (6, n.d.). With the increase in the best evidence-based practice, the EHR has the capability of tracking disease conditions, alerting the providers in vital changes in the patient’s conditions (McGonigle, pg 255). Patient safety is another benefit. Examples include medication safety in the hospital setting. Patients are now wearing name bands that have to be scanned prior to medication administration. This alerts the nurse to a patient’s current medication list and stops the professional if the scanned medication does not meet one of the 5 rights (McGonigle, pg 270). Patient Safety needs to be a commitment among each healthcare organization. This is a way that technology can help us keep that commitment (282). Safety is not just for the patients however. The EHR allows healthcare providers to protect themselves. If patient care is questioned the records can be easily accessible to the parties involved and can be reviewed. Technology has allowed for a more real time approach to health care, with the advancement of texting emailing and instant messenger allowing order clarification and patient changes to be addressed sooner rather than later. Many of our tools that we use are interfaced with the EHR decreasing the chance of human error, such as telemetry, blood pressure cuffs and thermometers. The EHR allows for providers to answer questions quickly, chart comprehensively, and access patient information quickly and with little effort. These features allow more time to be spent with patients.
It is difficult to calculate the cost of healthcare informatics in an organization. It is much easier to find the ways it is saving organizations money. Increasing the efficiency of the staff allow more patients to be cared for. This in turn increases revenue not only with the visit itself, but ancillary services utilized like x-ray and lab. Shared information also decreases the amount of repeat procedures that are done because the insurance companies and hospitals are able to more comprehensively track when and if procedures have been done. The connectivity through electronic means also means faster communication. An example is as a clinic nurse it was common to copy paper records and mail via USPS to the specialist they were going to see. Now it is possible to fax or send electronically through portals or email. Another decrease in waste is usage of the patient portal. Patients can access their own information to keep themselves informed and share information with other providers as needed. By utilizing the patient portal patients are likely to know more about their health care and be able to asked more focused questions during visits, getting more out of their experience. In 2008 Peter R. Orszag who is the Director of the Congressional Budget Office listed the following as costs of the EHR: the fixed cost of the hardware, software, and the cost of installation, licensing fees, expenses to maintain the system and “opportunity cost” that is defined as the time the healthcare provider could have spent seeing patients but is learning how to use the EHR. He later stated that systems range from $25,000-$45,000 per provider for the initial implementation. He added the cost of maintaining the system adds $3,000-$9,000 per provider. Finally, the cost per hospital bed is approximately $4,500 (Alexander, 2015).
Balancing technology and patient care can be a challenge. Nurses must have a positive attitude for informatics to be successful in an institution. Healthcare informatics originally started in places like radiology and the laboratory. It has since moved to the clinical settings. Initially nurses were hesitant to use electronic charting because they felt it interrupted their workflow. The EHR has now become an important part of nurse’s information workflow. They are able to document and communicate the patient’s condition to organize care according to the needs of the patient. Nurses have expanded their patient teaching to other forms besides written material. Other forms of patient education include I pads and smart TV’s. Hospitals are invested in the getting patients educated because there is show to decrease re admission rates, decrease in healing time, improved mental discomfort, and increase in positive patient results (The, 2014).
Healthcare professionals are expected to have a high competency rate. The education of the nurse is not only through textbooks and reading but through simulation. Simulations allow the instructor to control the learning environment by practicing and providing feedback. Patient simulation allows the student to develop and apply knowledge and skills in a realistic situation. This teaching strategy gives the student a safe environment to experience scenarios and intervene in clinical situations in a safe supervised setting without putting a patient at risk. There are several types of patient focused simulations for the student. Screen based computer simulators are designed to model human physiology, tasks or environments. Through the computer program the student makes clinical decisions and then sees the result in action. These programs are typically web based or computerized assisted and are inexpensive. Complex task trainers use virtual reality and represent a high level of technology. It is used when teaching staff cannot see what the student is assessing because this simulator can detect pressure through sensors, however they are very expensive. Human patient simulators are interactive mannequins that provide realistic physiologic responses for example respirations, pulses, heart sounds and breath sounds. Example of name brand models are METI and SimMan. They provide a variety of age groups with realistic anatomy and functionality. These mannequins react like a live human and the instructor can adjust the patient scenario immediately if indicated. Simulators can also promote safety by teaching proper medication administration implementing the 5 rights. They can help teach how to figure medication dosages. Since a simulator can be used to provide a realistic situation in the METI simulator the patient uses a bar code system and it activates a physiologic response in real-time (Enhancing, n.d.).
Continuing education is a must for nursing professionals. There are classes such as Advanced Cardiac Life Support (ACLS) that teach specific assessment skills. These classes are usually at least two-part, one-part book work/lecture and the other part skills learning. These types of didactic classes are also utilized in refresher courses for nurses who are returning to practice. There are many advantages to patient simulation. It allows a safe environment for learning that puts no risk to patients. The students get out be active participant by getting hands on experience. Since we are a very technology driven society this way of learning appeals to the contemporary learner. They are able to visualize physiological changes and response that are at times hard to explain. The simulations can be designed to meet a variety of course objectives. (Enhancing, n.d.).
Though there are many advantages to simulators there are disadvantages associated with them. The primary being cost. Costs of simulators range from $30,000 to $200,000 depending on functionality. Other costs associated with the equipment is the physical space it takes to store and supplies and equipment needed to simulate specific scenarios. One way to curve the cost associated with simulators is to share with either other schools or local hospitals. Since simulators have multidisciplinary functionality the cost can be shared by an environment that teaches a variety of medical disciplines (Enhancing, n.d.).
Informatics is also vital in the business portion of healthcare. There are core business systems that are the framework for reimbursement of services provided. They are admission, discharge and transfer (ADT), financial systems, acuity systems and scheduling systems. The ADT is the structure that the others are built on. The information provided through the ADT is patient name, DOB, insurance information and medical records number. The financial system manages the expense and revenue portion of the medical record. The financial system helps the facility decide how or if they can afford to grow. Acuity systems track the patient types within a facility. This provides information to assist a facility in planning the expenses and resources needed to provide care. Scheduling systems organize the staff, services offered, equipment availability and allocation of patient beds. These resources are then tracked and the information can be provided to the financial departments as part of the budgeting. This can also determine if there is an increase or a decrease in specific resources needed (McGonigle, 2015).
The American Reinvestment and Recovery Act (ARRA) was put into effect in 2009. The goal of this act was to modernize the infrastructure one component of this is the “Health Information Technology for Economic and Clinical Health (HITECH) Act”. They call this implementation of meaningful use. There are five components that focus on outcomes, policy priorities in health. These five are 1) improve quality, safety and efficiency and reduce errors, 2) engage patients and families in their health, 3) improve care coordination, improve population and public health and ensure privacy and security protection of patient medical records. As each stage of meaningful is implemented the health care facilities need to be able to report that they met the objectives. This is done by auditing the information within patient medical records, in the form of reports (Meaningful, 2018).
Health informatics is a broad and wide field. It encompasses all aspects of the healthcare field. It starts when the patient enters a facility for health care. The personal data is collected and then as the patient requires interventions the informatics follow. Example are automated lab result, digital radiology, telemetry systems, nurses and physicians inputting orders. The informatics does not end once the patient is discharged because there is billing and coding. The facility then uses the information gathered to address acuity, budgeting and resource allocation. Informatics is all around us and the goal is to get the most current information and give the safest care possible.
What is Health Informatics?
It is the term that describes acquiring, storing and retrieving healthcare information. This is to increase the collaboration among a patient’s various health care providers. Informatics is the science that applies concepts, theories and practice to increase the chance of a better outcome. The job outlook is increasing and include the following careers nurse informaticists, health information management technicians, medical information officers, director of clinical informatics and clinical data analyst. The salary is between $85,000-$137,000 depending on your education and role (What n.d).
Nurse informatics is a subset that the American Nurse Association defines as “a specialty that integrates nursing, science, computer science and information science to manage and communicate data, information and knowledge in nursing practice. Health informatics is a growing field that is continually adopting new technology. This has helped increase the efficiency of healthcare and outcomes. The implications are not only for nursing but for managers as well. They must interpret information to make decisions regarding revenue and budgeting. They may also use the information for utilization of materials and resources (OJNI, 2017).
What is Health Informatics?
There are different types of health informatics. These include but are not limited to clinical informatics, bioinformatics, computational health informatics and clinical research informatics. Clinical informatics relate to the healthcare providers who give direct patient care. They analyze and evaluate clinical processes. Bioinformatics are more personalized medication, specifically gene sequencing and biostatistics. Computational health informatics is studies how computational methods relate to health care. This study uses more computational concepts rather than healthcare. Clinical research informatics uses clinical research as its base. They track various collections of data (What USF, n.d).
Nursing Informatics Career & Salary.
Nurse informatics specialist implement software, information and knowledge to better assist the nurse and other healthcare providers in utilization and documentation within software. They work in hospitals, consulting firms, universities and cooperation’s. According to the Bureau of Labor Statistics job growth is projected to rise by 26% by 2020. The reason being organizations are interested in controlling health care costs. The average is $66,000 (Nurse, n.d.).
6 Ways Health Informatics is Transforming Healthcare.
The following six ways are examples of the transforming healthcare: dramatic savings, shared knowledge, patient participation, impersonalization of care, increased coordination and improved outcomes. Waste can be curbed by quicker delivery of information, decrease in repeat procedures, increase in more timely care. Informatics allows shared knowledge by providers and patients about diseases, therapies and medications. Patient participation is allowed secondary to patient portals. This gives the patient increased access to their personal medical record. Impersonilization of care is a criticism saying providers are not “getting to know” patients but they are knowing the data of the patients only. Increased coordination speaks to patients receiving care by potentially numerous personal during a hospital stay. The informatics allows all these people to have the information they need at the same time. Improved outcomes with the EHR are resulting in higher quality and safer care. Coordinated teams are providing better diagnosis and decreasing the chance of errors. This frees up nurses and physicians because of the increase in efficiency (6 n.d.).
5 Ways Healthcare Informatics Help Nurses.
There are 5 ways informatics and technology can help nurses. Further education, either online classes for college credit or CEU’s. Increase Communication, includes texting emailing and instant messaging. This allows the nurse to report changes faster and earlier. It saves lives, the use of telemetry, automated bp cuffs lets one easily trend patient data. Protect themselves, within the EHR there are hard stops that remind nurses of critical items that need to be charted, this will help if patient care is called into question. Increase efficiency, if the software is layed out appropriate it allows the nurse to access information regarding the patient quickly. Utilizing the technology available allows nurses to take better care of patients (Five, n.d.).
The Right Balance- Technology and Patient Care.
Nurses used to believe that electronic charting was an interruption to their workflow. As technology as, evolved nurses are becoming more accustomed to it. Nurse have the abilities to access information quickly and efficiently and improve their workflow. There are barriers to electronic charting, one of those being perception and satisfaction toward technology. Nurses who have been in the field longer have doubts about information technology and are hesitant to use for fear of clicking in the wrong place and become frustrated easily. The informatics nurse helps mesh information technology and nursing by training, assist in skill building on the computer and providing support (The, 2014).
Nursing Informatics: The Future is Here.
Information technology is directly related to meaningful use. Meaningful use has core objectives that include but are not limited to: computerized provider order entry, drug-drug and drug-allergy interaction checks, maintaining active medication and allergy lists and report hospital quality assurance measure to CMS or States. Technology in the EHR allows the data to be extracted from the software in the form of a report efficiently. Nurses are essential in the success of healthcare informatics so they should be involved in the planning, design, implementation and evaluation of the software. Nurses also are most likely the ones to help patients access their patient portal especially in underserved areas so it is critical they have the training needs in informatics. Competencies identified by The Technology Guided Education Reform (TIGER) include communication technology concepts, computer use and managing files, word processing, spreadsheets, database usage, presentation and communication and web browsing (Nursing, 2018).
Enhancing Patient Safety in Nursing Education Through Patient Simulation.
Simulation training is one way the IOM To Err is Human: Building a Safer Health Care System recommended to prevent errors in the clinical setting. Though it is relatively new there are various types of simulation tools. Three specific types include part task trainers, complex task trainers and screen-based simulators. The part task trainer is static that are designed to replicate one portion of the body. These are used to teach basic skills and procedures. The complex task trainer uses virtual reality and tactile simulation. This allows the faculty to clearly see what the patient is assessing when normally it would be hard to see. Screen based simulators model the environment of patient specific tasks. The learner is then given feedback visually after the intervention. These various types of training allow the instructor to better assess the students learning and areas of weakness. The instruct can then tailor the simulation to the student’s needs (Enhancing, n.d.).
Simulation in Nursing Practice: The Impact on Patient Care.
Simulation is a technique that is met to amplify real experiences. Most simulations follow similar designs. There is typically prework, preparation learning, followed by implementation and then debriefing. The debriefing is met as reflective learning for the student, while the instructor gives additional feedback. Standard simulation terminology are as follows clinical scenarios, debriefing, facilitator, fidelity, high fidelity simulations, mid fidelity simulations, low fidelity simulations, task trainers and insitu simulation. Fidelity the terminology means the believability of the simulated experience. The definition is from the International Nursing Association for Clinical Simulation and Learning and used at the terms for standards of best practice. Simulation is best used when it is done in a variety of ways for the nursing student. Many universities and hospitals have specific simulation programs they follow for learning and orientation (Simulation, 2013).
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