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