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 TechnologyA 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 SystemsImproved quality and safetyOutcomes managementEvidence based practice

“The complexity of modern healthcare has now exceeded the limitations of the unaided human mind.” Eddy, DM (1990)

Clinical Information SystemsThe bedside chart and beyond

Support clinical outcomes and quality assurance

•Collect aggregate data•Use coded terminology•Clinical analyticsBuilt in clinical decision making support

systemsClinical pathways

CIS Quality MeasuresClinical 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".

http://en.wikipedia.org/wiki/Clinical_decision_support_system

•Alerting• Interpretation•Assisting•Diagnosing•Managing

CIS Quality MeasuresClinical 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 MeasuresClinical 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 MeasuresEvidence 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 CareIHI:•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.

http://www.ihi.org/IHI/Topics/PatientCenteredCare/PatientCenteredCareGeneral/

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 providersDimick, Chris. "First Steps to Patient-Centered Care: Meaningful Use Focuses Industry on Baby Steps." Journal of AHIMA 82, no.2 (February 2011): 20-24.

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 Future of Healthcare Technology

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