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63 Cards in this Set
- Front
- Back
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Attributes
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Properties or characteristics of data elements, such as their names (whether they are alphabetic, numeric, and so on), that are included in a relational database
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Cybernetics
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A theory of control systems based on communication (transfer of information) between components of systems with respect to their environment
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Closed system
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A system that operates in a self-contained environment without input from other systems or the environment
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Data quality
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The reliability and effectiveness of data for its intended uses in operations, decision making, and planning
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Electronic systems
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Systems that are aided by computer devices
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Human systems
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Systems that are organized relationships among people
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Information systems theory
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The explanation that information is generated by data that are processed in predictable ways that contribute value
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Inputs
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Data entered into an information system (for example, the patient's vital signs entered by a nurse or monitoring device, the admitting clerk's interview of the patient to obtain demographic information)
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Interoperability
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The ability of different information systems and software applications to communicate and exchange data
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Knowledge
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The information, understanding, and experience that give individuals the patient care data for clinical decision support and the power to make informed decisions
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Manual systems
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Systems that entail humans performing certain processes
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Objects
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The basic component in an object-oriented database that includes both data and their relationships within a single structure
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Open system
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A system that permits other parties to produce products that interoperate with it
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Outputs
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The outcomes of inputs into a system (for example, an output of the entry of a medication order is the receipt of the order by the pharmacy information system)
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Processes
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A systematic series of actions taken to create a product or perform a service
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Systems development life cycle
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A model used to represent the ongoing process of developing (or purchasing) information systems
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Templates
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A preset format for documenting data in a computer application so that the user is reminded of what data to capture and in what format
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What kind of system is a healthcare delivery system?
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human system
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FOSS
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free and open source system
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Why have providers been slow to adopt EHR?
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cost, complexity, and need for a fully develped infrastructure
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Basic Information Theory
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Describes the flow of data from a source to its ultimate destination.
In general, data are input into a system for the purpose of being processed and then output as useful information. |
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Transmitter
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Often a clinician, although it may be a monitoring device or auto-analyzer. The clinician records a description of an observation, the response, or summary of the the two.
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Channel
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Processing raw data into useful information.
In the manual world it would be the paper-based medical record. |
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Goal of an EHR
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Patient Safety, Quality of Care, Productivity Improvement, and so on...
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Receiver
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Documentation that direct output of the process.
In the case of an EHR, it has much enhanced utility beyond documentation, including expanded communication capabilities and knowledge generation. |
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Goal of the System
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Ultimate Destination of the Information Flow
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Data
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Dates, Numbers, Images, Letters and Words that represent basic facts and observations about People, Processes, Measurements, and Conditions
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Information
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Factual data that have been collected, combined, analyzed, interpreted, and/or converted into a form that can be used for specific purpose
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Knowledge
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Information, understanding, and experience that give individuals the power to make informed decisions.
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Examples of unstructured data
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Narrative notes, Print files, Video and voice files, Scanned images of documents, Pictures
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Examples of structured data
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Data entered into templates, Coded data, Bar codes, Radio frequency identification
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Information system (IS)
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considered a set of components that work together to achieve a common purpose
- consists of inputs, processes, outputs, boundaries and goals - EHR is an example of an IS |
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Mechanical Systems
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Systems developed by humans but can operate without human intervention
Ex. heating and cooling systems |
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Human Systems
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Are organized relationships among people
Ex. political system, healthcare delivery system Healthcare system - boundaries = health care services; inputs = individuals seeking health care services; processes = providers, payers (those that delivery services); outputs = cures/improvements in illness/injury |
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Man-machine Systems
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Any form of supportive operations that assist humans in the performance of their work (can be manual or electronic)
ex. EHR system - humans enter data into computer to be stored/retrieved later to support patient care |
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Manual Systems
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Those that entail humans performing certain processes (paper filing system)
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Electronic Systems
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Aided by computing devices (EHR system)
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Deterministic system
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parts function according to a predictable relationship
ex. alarm clock set to go off at a certain time |
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All the relationships among the parts cannot be defined in advanced
ex. human systems - how long will we live? how tall will we be? why am I always hungry |
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Closed system
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All parts operate together without external influences
Input >Process> Output - ex. fan - many vendors want to have closed systems so they can keep specifics proprietary and also so it forces customers to buy all the components from them |
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Open system
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Environment impacts parts
- ex. furnace - works based on what the temperature in the room is - vendors who apply open-systems build software that confirm to readily available standards - this is encouraged with EHRs |
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FOSS and FLOSS
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FOSS: free and open-source systems
FLOSS: free, libre, and open-source systems |
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Interoperability
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The ability of one IS to exchange data with another
- closed systems lack interoperability |
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What are some reasons why interoperability has lacked in many EHR/IS?
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1. Providers were adopting information systems slowly, needing to prove their value.2. If a single proprietary vendor were interested in having internal systems communicate with each other, it could often provide almost everything it needed for its basic operations.
3. Providers have been slow to adopt EHRs because of their cost, complexity, and need for a fully developed infrastructure. 4. Providers want to ensure the confidentiality of their patients' health information. Where sophisticated access and audit controls meant added cost and effort, even when they were available in products. 5. Providers often viewed the collection of health information about their patients as proprietary |
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Describe the flow of data in the EHR setting
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1. Information Source (observation about a pt)
2. Transmitter (clinician, monitoring device) 3. Channel (medical record) 4. Receiver (documentation - the output of the process) 5. Destination (sign of disease, the goals of EHR (improved quality care) |
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How can you overcome errors during data capture?
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Templates are designed for data entry & often have predefined parameters that are checked as data are entered
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Data quality
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Relates to the Accuracy, Completeness, Timeliness, Precision, Currency, Granularity, Relevancy, Definition, Accessibility, and Consistency of the input
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Unstructured Data
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Textual objects and images that can be stored in a computer, but not processed by a computer.Ex. Narrative notes, Print files, Video and voice files, Scanned images, Pictures
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Structured Data
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Discrete facts and figures that can be encoded and processed by a computer
Ex. Data entered into templates, Coded data, Bar codes, Radio frequency identification |
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Name the general components of an information system
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1. Devices to capture data in multiple formats that are converted into a machine-processable state
2. Instructions to index, store, calculate, compare and perform other functions on data 3. Devices to display original data at another time/place and present results of calculations, comparisons and other functions |
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What is missing from ISs that clinicians worry about?
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1. incapable of heuristic (?) thought - "gut instinct"
2. require changes to their instructions in order to continue to be useful in the face of external change (things that were not anticipated at the time of design) |
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IS characteristics: people
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People are the key reason for IS existence - and also how they exist. ISs have been characterized as man-machine systems because people design them and people use them
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IS characteristics: policy
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refers to directives or principles on which people perform their work or other activities of their lives.
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IS characteristics: process
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is the manner in which a task is performed.
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IS characteristics: relationships
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Relationships between objects and attributes help an IS achieve its purpose. Objects are the component part of the system; attributes are the properties of those objects that describe what they do and how they work.
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IS characteristics: unity of purpose
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causes the collective parts of an IS to have integrity
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IS characteristics: feedback mechanisms
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Provide information about environmental factors that interact with the functioning of a system
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Cybernetics
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a theory of control in which systems accept input, process it and produce output relative to sensors that monitor against standards and hence control processing and inputs to ensure best possible result
- if sensor data and standards vary, control processes are instituted |
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SDLC
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Systems Development Life Cycle
- steps necessary to develop, or at least plan for implementing, an EHR system. |
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List the Traditional SDLC Methodology steps (linear approach - waterfall methodology)
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1. Feasibility: the planning step. The existing manual system is evaluated and deficiencies are identified.
2. Analysis: new system requirements are define. Deficiencies are addressed with specific proposals for improvement. 3. Design: The proposed system is designed and plans are laid out concerning the physical construction, hardware, operating systems, programming, communications, and security issues. 4. Implement: The new system is developed and components and programs are obtained and installed. 5. Test: The system is put to use in various ways, possibly phased in. 6. Maintain: When the new system is up and running for awhile, it should be exhaustively evaluated and maintenance must be kept up to date. |
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Why does the traditional SDLC not always work for EHR systems?
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Greater focus needed on implementation rather than development
- most EHR systems are systems of systems, therefore you need more of a spiral type of model where steps are repeated for each component implemented. |
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Phases of SDLC for EHR Project Management
(spiral-type model) |
1-Initiation
2-Planning 3-Acquisition or design & development 4-Implementation 5-Operations Maintenance 6-Disposition/disposal |
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Information Theory
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Input:
-Information source - observation -Transmitter - description Process: -Channel - medical record -Receiver - documentation (also output) Output: -Destination - sign of disease |
