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29 Cards in this Set

  • Front
  • Back

Biomedical Informatics

The interdisciplinary field that studies and pursues the the effective use of biomedical data, information and knowledge for scientific inquiry, problem solving, decision making, motivated by efforts to improve human health. BMI investigates and supports reasoning, modeling, simulation, experimentation and translation across the spectrum from molecules to individuals to populations from biological to social systems bridging basic science and clinical research and practice and the healthcare enterprise Kulikowski - JAMIA

Friedman Definition of Informations Tower of Achievement

Base: Model formation followed by system development then system implementation and finally study of effectiveness

The following are examples of what



COSTAR, HELP, TMR, Regenstreif, ElCamino

Older versions of EHR's


COSTAR - Mass Gen; HELP - Utah


TMR - Duke; EL Camino - Califorioa


Regenstreif - Indiana

Metcalfe's Law

Value of telecommunications network is proportional to the square of the number of connected users (n): n(n-1)/2. The more user, the more valauble the netwrok

Moore's Law

Number of transistors on an integrated circuit doubles every two years. Processing speed and memory double every two years. It seems to hold true for processing speed, memory storage, pixels on camera etc- it describes driving force of technological and social change

Greek Oracle Problems

Information system that assume user knows nothing - just ask question and computer gives answer (e.g. Internist1)

Curly Braces Problem

Problem with Arden Syntax and the portability of CDS rules from one institution to another - the info enclosed in the curly braces of code {...} was unique to the institution

Arden Syntax

The HL7 International Arden Syntax for Medical Logic Modules (MLMs) is an ANSI-approved American National Standard language for encoding medical knowledge and representing and sharing that knowledge among personnel, information systems and institutions. The Arden Syntax for Medical Logic Modules (MLMs) assists physicians in decisions and alerts based on logic encoded into health knowledge bases called MLMs, each of which contains sufficient knowledge to make a single decision. With an appropriate computer program (known as an event monitor), MLMs run automatically, generating advice where and when it is needed. For example, one MLM warns physicians when a patient develops new or worsening kidney failure. Arden Syntax is an open standard for representing CLINICAL knowledge, to be used by individual clinicians, institutions, and vendors to develop clinical rules (rules that directly impact patient care) using a standard format and language. It is also suited for writing business rules that directly interface with clinical data.

UN Article 12 Human Right Declaration

* No one shall be subjected to arbitrary interference with his privacy, family, home or correspondence, nor to attacks upon his honour and reputation. Everyone has the right to the protection of the law against such interference or attacks.

European Concil on Human Rights

1. Everyone has the right to respect for his private and family life, his home and his correspondence.
2. There shall be no interference by a public authority with the exercise of this right except such as is in accordance with the law and is necessary in a democratic society in the interests of national security, public safety or the economic well-being of the country, for the prevention of disorder or crime, for the protection of health or morals, or for the protection of the rights and freedoms of others

Code of Fair Information Practice

No secrete data


Person must be able to find out what is in dat about them and how it is used


Person can prevent info from being used for other purposes


Person must be able to amend record


Thoses using data must be sure it is accurate and secure


Us GOv 1973


Belomont Report and common rule

Safety and security of research subjects



Respect, Beneficence (do not harm and maximize benefits) and Justice


Belmont 1979


Common rule adopted by 1991 by 15 US depart.

ISO

International Standards Organization


ANSI serves as secretary

Security

Measures that organizations implement to protect information and systems. It includes efforts not only to maintain condfidencitlity but also to ensure integrity and availability of information and the information system,

Confidenitality

Right of an individual to control how information is shared or released

Privacy

Individuals desire to limit disclosure of personal information

HITECH (part of ARRA)

American Recover and Reinvestment Act


Division A - Title XIII and Division B Title IV


Together these are what make up HITECH

Model and Context for Security and Privacy


From IOM (For the Record)

Threat Assessment


Asset List


Policy


Education


Technical Measures

Model and Context for Security and Privacy



Technical Measures

1. Access Control 2. Individ authentification


3. Audit Trails


4. Physical security and database recovery


5. Protect Remote access points


6. Protect external electronic communications


7. Software discipline


8. System Assessment

Model and Context for Security and Privacy


Organizational Measures

-ASecurity and confidenitality practices and committess


- Information Security officers


-Educations and training programs


- Sanctions


- Improved authorization forms


- Patient access to audit logs

HASH Fucntions

Computer Funtion that Maps data of abitrary lenght to data of fixed lenghth - the returned value is called a HASH value - used for data integrity - can tell if a file has been opened (?)

Changes to HIPAA with ARRA

Expanded BA agreements


Data restrictions


Limited Data sets, restricte disclosure, marketing,reporting security breeches, accounting and disclosures, chri

Authentication and Authorization

Non-repudication - clear that if they say the didn't write something you can show they can



Audit Trails, document version hx/lifecycle

Health Information Managmnet Committee

Medical Record committee


- policies - chart completion, who can enter in record, guide operations of medical records


- release of medical records policy


- Coding


- security

Health Information Credentials and Certifciation

Security Certification


Privacy Certification


Health Information Credentials:


RHIA - Registered Health Informatin Administator


RHIT - Regist Health Inform Technician

Translational Research

Accelerating research results from lab to clinical setting


T1 - test what works - efficacy research


T2 - who beneiftis from promising care - outcomes, comparative health, health services


T3 - how to deleiver high quality care

Health Finianceing - how much we spend etc

20% of GDP by 2016 (17.6% in 2010)


$8952 per person annually


Total spending 2.6 trillion (20% medicare 15% medicaid, (39% public) 33% Private

Broad goals of ACA

Regulate coverage - no pre-exisitng, create high risk pool


Coverage expansion - mandates indiviual and employer, plus medicaid expansion


Bend Cost Curve - incentives for higher quality cost effective cares

PCORI

Pt centered Outcomes Researh - public-private to support outcomes based research