Handbook of Informatics for Nurses and Health Care Professionals

by Hebda, Toni Lee; Czar, Patricia; Mascara, Cynthia M.

• ISBN13: 9780131512627
• ISBN10: 0131512625
• Edition: 3rd
• Format: Paperback
• Copyright: 2005-01-01
• Publisher: Prentice Hall

Summary

Handbook of Informatics for Nurses & Health Care Professionals is an introduction to the computer technology used by nurses & other health care professionals. Offering an overview of informatics, as well as practical information for day-to-day use. Book jacket.

Author Biography

Cynthia Mascara is a Principal Consultant with Siemens Medical Solutions-Health Services and previously served in nursing services and administration at the University of Pittsburgh Medical Center.

Table of Contents

PREFACE	xv
ACKNOWLEDGMENTS	xix
MEDIA CONTRIBUTORS	xxi
REVIEWERS	xxiii
ABOUT THE AUTHORS	xxv
SECTION ONE General Computer Information	1	(116)
CHAPTER 1 Informatics in the Health Care Professions	3	(33)
Data, Information, and Knowledge	4	(3)
The Nurse as Knowledge Worker	7	(1)
The Significance of Good Information Management	8	(1)
The Definition and Evolution of Informatics	8	(4)
Informatics Competencies for Nurses	12	(3)
Applications of Nursing Informatics	15	(1)
Nursing Practice	15	(1)
Nursing Administration	15	(1)
Nursing Education	16	(1)
Nursing Research	16	(1)
The Current Status of Health Care Delivery	16	(5)
Patient Safety	17	(1)
The Nursing Shortage	18	(1)
Pressure to Implement Information Technology	18	(1)
Consumer Demands for Quality and Cost-Effective Care	19	(1)
Research	20	(1)
Managed Care	20	(1)
Benefits of Nursing Informatics for Other Health Care Professionals	21	(2)
Nursing Informatics as a Specialty Area of Practice	23	(4)
The Role of the Informatics Nurse	27	(1)
The Future of Nursing Informatics	28	(1)
Case Study Exercise	29	(1)
Summary	29	(1)
References	30	(6)
CHAPTER 2 Hardware, Software, and the Roles of Support Personnel	36	(28)
Hardware	37	(1)
Input Devices	37	(1)
Central Processing Unit	38	(1)
Secondary Storage	38	(1)
Output Devices	38	(1)
Computer Categories	38	(4)
Peripheral Hardware Items	42	(3)
Networks	45	(1)
How Computers Work	46	(2)
Selection Criteria	48	(3)
User Needs	49	(1)
Physical Constraints	49	(2)
Mobile and Wireless Computing	51	(2)
Software	53	(3)
Operating Systems	54	(1)
Application Software	55	(1)
Utility Programs	55	(1)
Roles of Support Personnel	56	(4)
Superuser	56	(1)
Call Desk and Help Desk Personnel	56	(1)
Microcomputer or PC Specialist	56	(1)
Analyst	57	(1)
Clinical Liaison	57	(1)
Programmer	57	(1)
Network Administrator	57	(1)
Trainer	58	(1)
Security Officer	58	(1)
Chief Information Officer	58	(1)
Webmaster	58	(1)
Chief Privacy Officer	59	(1)
Chief E-health Officer	59	(1)
Compliance Officer	59	(1)
Disaster Planning and Recovery Officer	59	(1)
Interface Engineer	60	(1)
Case Study Exercises	60	(1)
Summary	61	(1)
References	61	(3)
CHAPTER 3 Ensuring the Quality of Information	64	(16)
Data Integrity	65	(2)
Ensuring Correct Data Collection and Entry	65	(2)
Data Management	67	(6)
Data Storage	68	(3)
Outsourcing Data Management and Storage	71	(1)
Data Retrieval	71	(1)
Data Exchange	72	(1)
Characteristics of Quality Information	73	(2)
Data Mining	75	(1)
Data Cleansing	76	(1)
Case Study Exercises	77	(1)
Summary	77	(1)
References	78	(2)
CHAPTER 4 Electronic Communication and the Internet	80	(37)
The Internet	82	(23)
E-mail	83	(4)
File Transfer	87	(1)
The World Wide Web	87	(6)
Browsers	93	(1)
Search Tools	93	(2)
Listservs	95	(1)
News Groups	95	(1)
Bulletin Board Systems	96	(1)
Access to Health Care Information and Services	96	(1)
Professional Information Sharing	97	(3)
Online Publications and Journals	100	(1)
Marketing Services	101	(1)
E-health	102	(3)
Concerns Related to the Use of the Internet	105	(3)
Firewalls	105	(1)
Web Security	105	(1)
Organizational Policy	106	(1)
Overload	107	(1)
Viral Contamination	108	(1)
Intranets and Extranets	108	(2)
Case Study Exercises	110	(1)
Summary	110	(1)
References	111	(6)
SECTION TWO Health Care Information Systems	117	(206)
CHAPTER 5 Health Care Information Systems	119	(23)
Clinical Information Systems	120	(16)
Nursing Information Systems	120	(6)
Clinician Information Systems	126	(1)
Monitoring Systems	126	(1)
Order Entry Systems	126	(2)
Laboratory Systems	128	(2)
Radiology Systems	130	(1)
Pharmacy Systems	131	(4)
Other Clinical Systems	135	(1)
Administrative Systems	136	(1)
Registration Systems	136	(1)
Scheduling Systems	137	(1)
Decision Support and Expert Systems	137	(1)
Case Study Exercises	138	(1)
Summary	139	(1)
References	139	(3)
CHAPTER 6 Strategic Planning	142	(16)
The Mission	143	(1)
Goals and Objectives	144	(1)
Developing Strategies	145	(1)
Strategic Planning for Information Systems	146	(2)
Steps of the Strategic Planning Process	148	(7)
Identification of Goals and Scope	149	(1)
Scanning the External and Internal Environments	149	(1)
Data Analysis	150	(1)
Identification of Potential Solutions	150	(1)
Selecting a Course of Action	151	(3)
Implementation	154	(1)
Ongoing Evaluation and Feedback	154	(1)
Case Study Exercises	155	(1)
Summary	156	(1)
References	157	(1)
CHAPTER 7 Selecting a Health Care Information System	158	(18)
Needs Assessment	159	(9)
The Steering Committee	161	(1)
Consultants	162	(1)
Developing a Common Vision	162	(1)
Understanding the Current System	163	(1)
Determining System Requirements	163	(5)
System Selection	168	(6)
Additional Sources of Information	168	(1)
Request for Information	169	(1)
Request for Proposal	170	(4)
Case Study Exercises	174	(1)
Summary	174	(1)
References	175	(1)
CHAPTER 8 System Implementation and Maintenance	176	(15)
System Implementation	177	(9)
Develop an Implementation Committee	177	(1)
Install the System	177	(4)
Analyze Hardware Requirements	181	(1)
Develop Procedures and Documentation	182	(1)
Testing	183	(1)
Provide Training	183	(1)
Go-Live Planning	183	(1)
Common Implementation Pitfalls	184	(2)
Maintenance	186	(2)
User Feedback and Support	186	(1)
System Maintenance	186	(2)
Technical Maintenance	188	(1)
The Information System's Life Cycle	188	(1)
Case Study Exercises	188	(1)
Summary	189	(1)
References	190	(1)
CHAPTER 9 Information Systems Training	191	(18)
Identification of Training Needs	193	(11)
User Needs	193	(1)
Training Class Content	194	(2)
Class Schedules	196	(1)
Hardware and Software Requirements	197	(1)
Training Costs	197	(1)
Training Center	198	(1)
Training Approaches	198	(2)
Proficiency Testing	200	(4)
Additional Training Considerations	204	(1)
Training Students	204	(1)
Case Study Exercises	205	(1)
Summary	206	(1)
References	207	(2)
CHAPTER 10 Information Security and Confidentiality	209	(28)
Privacy, Confidentiality, and Security	210	(1)
Information System Security	211	(5)
Security Risks	212	(4)
Security Mechanisms	216	(4)
Physical Security	216	(1)
Passwords and Other Means of Authentication	217	(2)
Firewalls	219	(1)
Application Security	219	(1)
Antivirus Software	220	(1)
Spyware Detection Software	220	(1)
Administrative and Personnel Issues	220	(7)
Levels of Access	272
User Authentication	222	(1)
Personnel Issues	223	(1)
System Security Management	224	(2)
Audit Trails	226	(1)
Handling and Disposal of Confidential Information	227	(4)
Computer Printouts	227	(1)
Faxes	228	(1)
Electronic Files	228	(2)
E-mail and the Internet	230	(1)
Web-Based Applications for Health Care	230	(1)
Electronic Storage	231	(1)
Case Study Exercises	231	(1)
Summary	232	(1)
References	233	(4)
CHAPTER 11 System Integration	237	(14)
Interfaces	238	(3)
Integration Issues	241	(1)
The Need for Integration Standards	241	(4)
Data Dictionary	242	(1)
Master Patient Index	242	(1)
Uniform Language	243	(1)
Data Exchange Standards	244	(1)
Benefits of Integration	245	(1)
Integration Implications for Nursing	246	(1)
Emerging Integration Solutions	247	(1)
Case Study Exercises	247	(1)
Summary	248	(1)
References	249	(2)
CHAPTER 12 The Electronic Health Record	251	(17)
Definitions	252	(2)
Historical Developments	254	(2)
Benefits of the EHR	256	(2)
General Benefits	257	(1)
Nursing Benefits	257	(1)
Physician Benefits	258	(1)
Health Care Enterprise Benefits	258	(1)
Current Status of the EHR	258	(4)
Considerations When Implementing the EHR	258	(2)
Data Integrity	260	(1)
Ownership of the Patient Record	261	(1)
Privacy and Confidentiality	261	(1)
Electronic Signature	262	(1)
Smart Cards	262	(1)
CHINs	263	(1)
Considerations for the Future	264	(1)
Case Study Exercises	265	(1)
Summary	266	(1)
References	266	(2)
CHAPTER 13 Regulatory and Accreditation Issues	268	(24)
Privacy and Confidentiality Legislation	269	(9)
The Health Insurance Portability and Accountability Act	272	(5)
Other Privacy Legislation	277	(1)
Accreditation and Reimbursement Issues	278	(3)
Joint Commission for Accreditation of Healthcare Organizations	278	(1)
Commission on Accreditation of Rehabilitation Facilities	279	(1)
Reimbursement Issues	280	(1)
HIPAA Electronic Data Interchange (EDI) and Transactions Rule	281	(1)
Quality Initiatives	281	(1)
Special Facility Issues	282	(3)
Geriatric and Long-Term Facilities	282	(2)
Psychiatric Facilities	284	(1)
Case Study Exercises	285	(1)
Summary	286	(1)
References	287	(5)
CHAPTER 14 Contingency Planning and Disaster Recovery	292	(31)
What Is Contingency Planning?	293	(1)
Steps of the Contingency Planning Process	294	(5)
Advantages of Contingency Planning	299	(1)
Disasters versus System Failure	300	(2)
Environmental Disasters	300	(1)
Human Error	300	(1)
Sabotage, Cybercrime, Terrorism, and Bioterrorism	301	(1)
System or Equipment Failure	302	(1)
Continuity and Recovery Options	302	(4)
Backup and Storage	303	(3)
Manual versus Automated Alternatives	306	(7)
Salvaging Damaged Records	309	(3)
Restarting Systems	312	(1)
Planning Pitfalls	313	(1)
Using Post-Disaster Feedback to Improve Planning	314	(2)
Legal and Accreditation Requirements	316	(1)
Case Study Exercises	317	(1)
Summary	318	(1)
References	319	(4)
SECTION THREE Specialty Applications	323	(82)
CHAPTER 15 Using the Computer to Support Health Care Education	325	(30)
Instructional Applications of Computer Technology	326	(15)
Computer-Assisted Instruction	327	(2)
Competency-Based Training	329	(1)
Multimedia	329	(2)
Teleconferencing	331	(1)
Distance Education	331	(4)
Web-Based Instruction (WBI)	335	(4)
E-learning 33S
Computer Labs	339	(2)
Audiences for Computer-Enhanced Education	341	(5)
Formal Nursing Education	341	(3)
Continuing Education	344	(1)
Client Education	345	(1)
Issues Related to Computer-Enhanced Education	346	(1)
Educational Opportunities in Nursing Informatics	347	(1)
Case Study Exercises	347	(1)
Summary	348	(2)
References	350	(5)
CHAPTER 16 Telehealth	355	(28)
Terms Related to Telehealth	356	(2)
Teleconferencing	358	(1)
Videoconferencing	358	(1)
Desktop Videoconferencing	358	(1)
Historical Background	358	(2)
Driving Forces	360	(1)
Applications	361	(6)
Online Databases and Tools	362	(2)
Education	364	(1)
Continuing Education	364	(1)
Home Health Care	364	(1)
Disease Management	365	(2)
Legal and Privacy Issues	367	(3)
HIPAA, Referral, and Payment	367	(1)
Support Personnel	368	(1)
Liability	368	(1)
Licensure Issues	369	(1)
Confidentiality/Privacy	370	(1)
Other Telehealth Issues	370	(1)
Establishing a Telehealth Link	371	(5)
Formulating a Telehealth Plan	371	(1)
Building the Supporting Framework	372	(1)
Human Factors	373	(1)
Equipment	374	(1)
Telehealth Costs	374	(1)
Technology Issues	374	(2)
Telenursing	376	(1)
Future Development	376	(1)
Case Study Exercises	377	(1)
Summary	378	(1)
References	379	(4)
CHAPTER 17 Research	383	(22)
Using Computers to Support Research	384	(10)
Identification of Research Topics	384	(1)
Literature Searches	384	(2)
Data Collection Tools	386	(3)
Data Analysis	389	(3)
Data Presentation: Graphics	392	(1)
Online Access to Databases	392	(2)
Impediments to Health Care Research	394	(5)
Unified Language Efforts	395	(1)
Multi-institutional Research	396	(1)
Research in Real Time	396	(1)
Collaborative Research	396	(3)
Dissemination of Research Findings	399	(1)
The Implications of HIPAA for Health Care Research	399	(1)
Students Using Computers for Research	400	(1)
Case Study Exercises	401	(1)
Summary	402	(1)
References	402	(3)
APPENDIX A: INTERNET PRIMER	405	(8)
APPENDIX B: CAREER RESOURCES ON THE INTERNET	413	(4)
APPENDIX C: CASE STUDY EXERCISES-SUGGESTED RESPONSES	417	(20)
GLOSSARY	437	(16)
INDEX	453

Excerpts

The original idea for this book came from the realization that there were few comprehensive sources available with practical information about computer applications and information systems in health care. From its inception this book was envisioned as a guide for nurses and other health care professionals who need to learn how to adapt and use computer applications in the workplace. As the outline developed, it became apparent that this book could also serve as an informatics text for students in the health care professions. This third edition contains updates and revisions to reflect changes that have occurred in the rapidly evolving technology of health. Each of the authors has a long-standing interest and involvement in nursing informatics, having worked in the field; been active in informatics groups, and presented nationally and internationally. ORGANIZATION The book is divided into three sections. The first section, General Computer Information, reviews information common to all information systems. It assumes no prior knowledge or experience with computers. Chapter 1 introduces the reader to the role of informatics in contemporary health care. Chapter 2 reviews basic information and terminology related to computer hardware and software. The section on the roles of various support personnel has been expanded, with content added on wireless and mobile computing. Chapter 3 emphasizes the importance of maintaining data integrity and suggests some practical steps to ensure current, accurate data in health care information systems. The fourth chapter addresses basic Internet use to support health care. The discussion on search tools has been expanded and content has been added on the evaluation of Web sites. Additional information on Internet use and resources are found in the appendices at the end of the book. The second section, Health Care Information Systems, covers information and issues related to the use of computers and information systems in health care. This section bridges the gap between the theory and practice of nursing informatics. Chapter 5 covers basic information on health care information systems, including decision support and expert systems. Chapters 6 through 14 discuss all aspects of selecting, implementing, and operating these systems. Chapters 6 through 9 discuss the processes of overall and system strategic planning, system selection, implementation, and training. Chapter 8 contains additional information on testing, system evaluation, and strategies to implement system changes after system installation. Other pertinent topics are addressed in the remaining chapters. Chapter 10 discusses information security and confidentiality; Chapter 11, system integration; and Chapter 12, the Electronic Health Record. Chapter 13, Regulatory and Accreditation Issues, has been updated to reflect the implications of the Health Insurance Portability and Accountability Act (HIPAA) and in particular the impact on nursing informatics and health care professionals. Chapter 14 covers contingency planning and disaster recovery. Section III covers three specialty applications of computers in health care. Chapter 15 discusses ways that computers can support health care education. It contains content on Web-based education as well as the use of wireless and handheld computers in education. Chapter 16, Telehealth, discusses the applications and issues associated with this area of practice. Chapter 17 looks at ways that computers are being used in nursing and health care research. The major themes of privacy, confidentiality, and information security are woven throughout the book. Three appendices are included at the end of the book. The first two provide detailed information on getting up and running on the Internet and using the Internet to perform a job search. The third appendix provides suggested answers to the case studies that are found at the end of every chapter. FEATURES E