Informatics for Healthcare Professionals

Rating:
Summary: An Analysis of Informatics for Healthcare Professionals
Review: AN ANALYSIS OF

INFORMATICS FOR HEALTHCARE PROFESSIONALS

Informatics for Healthcare Professionals, written by Kathleen M. Young of Western Michigan University, serves as a textbook for healthcare professionals participating in informatics courses.

VALUE OF INFORMATION
The author contributes valuable points regarding the value of information in the field of healthcare. Information is derived from processed data. Information becomes knowledge and that knowledge is then utilized to make appropriate healthcare decisions. Healthcare professionals who can appropriately manage and process information will be the most successful in affecting patient outcomes.
Information is not unique to healthcare and patient outcomes. Society, teaching/learning, and government are all affected by obtaining information, especially through the use of technology. Society has begun to change the way it communicates information by utilizing voice mail, e-mail, the World Wide Web, etc. that were not utilized in the past. Teaching and learning, such as that conducted in the Emory University Career MPH Program, are now conducting classes via distance learning tools. Technology has been utilized to further political agendas and propaganda, as well as provide an avenue for information in countries that seek to restrict information from its citizens.
Young goes further to discuss the five rights of information. For information to be considered valuable, it must be the right information, given to the right person at the right time and right place. The right amount of information must also be given. Once information is considered valuable within healthcare, it drives reimbursement, quality assurance, accreditation processes, etc. However, the key importance of information in healthcare is to expand medical knowledge.
Medical knowledge is primarily gained by evaluating information learned through research. Several types of research are employed to contribute to information, thereby increasing the body of medical knowledge. Applied research is aimed at solving specific problems. Clinical research examines outcomes related to services rendered. Administrative research focuses on all aspects of quality, accessibility and the appraisal of healthcare and its delivery. Finally, educational research investigates the effectiveness of various curricula. The trend in today's society is to translate the information gained through research into knowledge to improve clinical outcomes. Today, research knowledge is used to develop evidence-based guidelines for medical treatment, with the goal of reducing practice variability, thereby improving clinical outcomes and reducing costs.

ORGANIZATION AND STORAGE OF INFORMATION
According to the author, information is organized and stored by various mechanisms. Databases are one of the most common methods of storage, which now have the ability to store text, voice and even images. In healthcare, some popular databases are MEDLINE, CINAHL and HEDIS. The Agency for Healthcare Research and Quality (AHRQ) is also becoming a popular database, due to its collection of evidence-based guidelines. Data repositories store multiple databases and contain tools for extraction and manipulation of data. Data warehouses are also used to store a large accumulation of data and contains selected data elements. Usually, a data warehouse serves as an enterprise-wide solution for decision support.
The future of data storage in the healthcare arena will be the electronic health record, more commonly known as the electronic medical record (EMR). Although the paper chart is still the most widely used method for data organization and storage, EMRs are the future in healthcare. EMRs provide electronic storage of patient demographic information, clinical information, test and lab results, workflow management and references to clinical information. Evidence-based guidelines are also easily integrated into EMRs, which are available for clinical decision-making throughout the patient visit. Information within an EMR system is generally stored on a centralized database server, which can be accessed by all client computer systems. Shared data is available to all users of the system at various security levels. The ideal future, according to the author, is to develop an electronic health record that is accessible worldwide by the use of a patient identifier.

EXCHANGE OF INFORMATION IN THE WORKPLACE
Information is exchanged in the workplace through several mechanisms. E-mail is the most common exchange of information within the workplace today. Listservs, voice mail, the World Wide Web, chat rooms and USENETS are other common forms of information exchange. Of course, paper charts, post-it notes and memos still have there place, but are less frequent than in the past.
The future, according to Young, will lead to a more advanced method of information exchange, which is telehealth. Telehealth utilizes mechanisms, such as video conferencing, that allow healthcare professionals to participate in healthcare delivery from remote locations. This technology will also be valuable for distance learning, consultations and bringing medical expertise to health professional shortage areas. The use of telehealth will greatly advance healthcare, although it will be costly.

KNOWLEDGE MANAGEMENT IN PUBLIC HEALTH
Young's publication has important implications to the field of public health. Most importantly, public health professionals need to carefully process information to contribute to medical knowledge. Medical knowledge gathered through research or other means, will lead to the development of evidence-based guidelines. Public health professionals must embrace evidence-based guidelines, which will lead to improved patient outcomes, thereby improving the health of the population. Public health professionals must also begin to both develop and share databases across agencies, as well as across states. The sharing of databases and information can be effective in decision support in the field of public health. Furthermore, the sharing of information allows for public health professionals from all disciplines to provide valuable input. This ensures that information will lead to valuable knowledge, which will be instrumental in protecting the health of the population.

CONCLUSION
In conclusion, I would like to state that this textbook was insightful, well written and organized. I thought that the content was critical for healthcare professionals to understand the importance of and need for processing information, the utilization of technology in healthcare, basic technical terminology and principals that serve as the infrastructure for technology and the future of technology in healthcare. I plan on incorporating this textbook into our continuous quality improvement series for medical students, residents and faculty training programs. I would recommend Young's publication to healthcare professionals of all specialties.

Rating:
Summary: The Journey of Informatics!
Review: Having read Informatics for Healthcare Professionals, overall, I am moved to put forth efforts to improve gathering, organizing, storing and disseminating health information. I am particularly inspired by Young’s vision of universal access to both medical information and patient records, which would facilitate continuous health maintenance and care for all people, regardless of world location or medical history. In this paper, I will discuss Young’s points regarding information and knowledge, as well as how she affects my career.
Once accurately gathered and stored, disseminated health information is extraordinarily valuable. One primary value of disseminated health information is improving patient outcomes. A provider, having access to the most current, evidence-based literature will better manage a patient’s condition, for example treating tonsillitis with antibiotics or other home remedies, than if she based decisions on personal inclination, which may be to recommend an unnecessary tonsillectomy. Similarly, a well human being in his 20’s, having access to information about basic health promotion, for example blood pressure controlling diets, will manage his health more efficiently than if he waited to hear it from a physician at age 50, after necessary triple bypass surgery. From a different perspective, changing how we achieve information, for example measuring blood glucose through an external, non-invasive biosensor rather than sticking the patient, would improve quality, convenience and therefore compliance of healthy lifestyles. Patient outcomes of improved dissemination of current, accurate health information also include reducing the number of emergency room visits. Finally, with improved informatics, especially accuracy of information, providers can reduce human suffering and length of hospital stay due to medication errors.
Another primary value of improved health information is increasing time efficiency when documenting patient encounters. Young wrote that 38% of time with each patient is spent charting. In my experience, her percentage is low, but in either case, too much of the time allotted for patient care is spent on paperwork, rather than with the patient. In addition, paper charts decrease time efficiency because only one person can read or contribute to a paper chart at a time. Just as electronic journals have expedited learning among providers, implementing electronic patient records will increase efficiency of time, energy and ultimately improve patient care while reducing costs.
Not only do I believe that having access to information should be a human right, but, as Young stated, information needs to occur as the right information, for the right people, at the right time and place and in the right amount. Moreover, information can have asymmetrical or symmetrical shapes. An example of asymmetrically shaped information is a physician knowing side effects of an antibiotic such as Erythromycin but failing to tell the patient. When the patient feels noxious or develops photosensitivity, she may think the cause is one other than the antibiotic. In contrast, symmetrically shaped information is free flowing: bi-directional, thorough and honest. Ultimately, universal, symmetrical information facilitates true democracy and social justice.
Young implied that increased access to accurate information encourages (healthy) competition among health care providers. This may be true, and I also believe that providers who are determined to implement strategies based on evidence-centered information expedite evolution of efficient health and healthcare standards. These standards shape the provider culture, in essence promoting increased accuracy when interacting with patients.
Shared knowledge, or advancing knowledge across populations, promotes research findings, links education and practice, enhances practice with research based practice and determines resource consumption. Information from databases such as the World Wide Web, and database warehouses can be extracted to share knowledge. Knowledge gives power and equality. Utilizing data warehouses speeds dissemination of knowledge extracted from patient records, treatment procedures or institutional management decisions. Integrating telehealth into patient care facilitates efficient sharing knowledge among providers.
Young compared paper and electronic storage of patient information in depth. Advantages to paper storage are as follows: familiarity, including how to use, how much it costs, and how to handle legally; its portability; the fact that there are no overhead costs; and its versatility – many types of information exist in one chart: provider notes, graphs, pictures, electrocardiograms, laboratory reports, etc. Disadvantages of paper storage include the following: charts are misplaced or lost, incomplete, illegible, and can physically degrade over time; only one person can use a given chart at a time; it is difficult to store large amounts of paper data compared to electronic data; continued quality improvement becomes laborious as informaticians are forced to wade through thick, disorganized charts; there are no programmed warning signals, so information is not automatically flagged and is vulnerable to error; patients have to re-tell information to providers because providers can’t find old charts or it is too time-consuming to find charts; and information is generally fragmented and scattered. All of the aforementioned hinder provision of optimal health maintenance or care and result in consumption of costly time and energy.
In contrast, electronic health records have many advantages: required storage space is smaller than for paper, charts are accessible to many people simultaneously, information retrieval is instantaneous, programmed warning signals flag abnormal labs and reminders for preventive screening such as “time for a colonoscopy,” administrative duties are efficient and clear cut, and patients do not have to repeat telling past medical information because providers can easily access this information prior to patient interaction. Disadvantages of electronic health records include high startup costs, a steep learning curve to operate the system, confidentiality, privacy and security issues, hardware is either nonportable or wireless (portable) but breakable, data entry could be flawed and users may develop ergomatic issues.
According to Young, not one hospital has fully implemented an electronic health record system. Why? In addition to the disadvantages of electronic health records listed above, barriers to universal implementation include the lack of a common vision, the lack of standardized terminology, system architecture and indexing. Of these, overhead costs and security are perhaps the greatest barriers to implementation of electronic health records.
In order to improve information flow – assessing which information is important to acquire, accurately gathering, storing and disseminating information – change must occur. Be it a patient, EKG technician, physician or medical records official, many factors are involved in the art of change, successfully implementing change. As Young suggested, psychological factors, technological preparation, time, energy, capacities, pace of change and adequate communication are all-important factors to consider when planning change.
Changing medical records from paper to electronic is just one component of informatics that we, as health professionals, need to change in order to optimally collect and manipulate health information. Young indicated that barriers to change, for example applying evidence-based medicine rather than personal inclinations, are lack of prioritization, time, access, education and modeling. Furthermore, even if a common vision for informatics existed and health professionals prioritized improving information systems, gave time, acquired necessary education, modeling and access to change, human flaw factors may undermine improvements. Finite abilities, inhibitory environments, false perceptions, cognition, response execution, lack of attention and aging limit us humans. While, as Young quoted James Conway, “people don’t make errors because they want to or because they’re bad people,” errors do occur. Errors can be rule based (design flaw) or knowledge based (operator error) and they result from shortcomings of perception, memory and cognition. To diminish errors, Young wrote that beginning with the analysis stage of implementing new systems, designers must accommodate for limits of human performance, while exploiting our strengths. Changes must be learnable, efficient, easily memorized, and satisfying to users (...)

Rating:
Summary: The Journey of Informatics!
Review: Having read Informatics for Healthcare Professionals, overall, I am moved to put forth efforts to improve gathering, organizing, storing and disseminating health information. I am particularly inspired by Young’s vision of universal access to both medical information and patient records, which would facilitate continuous health maintenance and care for all people, regardless of world location or medical history. In this paper, I will discuss Young’s points regarding information and knowledge, as well as how she affects my career.
Once accurately gathered and stored, disseminated health information is extraordinarily valuable. One primary value of disseminated health information is improving patient outcomes. A provider, having access to the most current, evidence-based literature will better manage a patient’s condition, for example treating tonsillitis with antibiotics or other home remedies, than if she based decisions on personal inclination, which may be to recommend an unnecessary tonsillectomy. Similarly, a well human being in his 20’s, having access to information about basic health promotion, for example blood pressure controlling diets, will manage his health more efficiently than if he waited to hear it from a physician at age 50, after necessary triple bypass surgery. From a different perspective, changing how we achieve information, for example measuring blood glucose through an external, non-invasive biosensor rather than sticking the patient, would improve quality, convenience and therefore compliance of healthy lifestyles. Patient outcomes of improved dissemination of current, accurate health information also include reducing the number of emergency room visits. Finally, with improved informatics, especially accuracy of information, providers can reduce human suffering and length of hospital stay due to medication errors.
Another primary value of improved health information is increasing time efficiency when documenting patient encounters. Young wrote that 38% of time with each patient is spent charting. In my experience, her percentage is low, but in either case, too much of the time allotted for patient care is spent on paperwork, rather than with the patient. In addition, paper charts decrease time efficiency because only one person can read or contribute to a paper chart at a time. Just as electronic journals have expedited learning among providers, implementing electronic patient records will increase efficiency of time, energy and ultimately improve patient care while reducing costs.
Not only do I believe that having access to information should be a human right, but, as Young stated, information needs to occur as the right information, for the right people, at the right time and place and in the right amount. Moreover, information can have asymmetrical or symmetrical shapes. An example of asymmetrically shaped information is a physician knowing side effects of an antibiotic such as Erythromycin but failing to tell the patient. When the patient feels noxious or develops photosensitivity, she may think the cause is one other than the antibiotic. In contrast, symmetrically shaped information is free flowing: bi-directional, thorough and honest. Ultimately, universal, symmetrical information facilitates true democracy and social justice.
Young implied that increased access to accurate information encourages (healthy) competition among health care providers. This may be true, and I also believe that providers who are determined to implement strategies based on evidence-centered information expedite evolution of efficient health and healthcare standards. These standards shape the provider culture, in essence promoting increased accuracy when interacting with patients.
Shared knowledge, or advancing knowledge across populations, promotes research findings, links education and practice, enhances practice with research based practice and determines resource consumption. Information from databases such as the World Wide Web, and database warehouses can be extracted to share knowledge. Knowledge gives power and equality. Utilizing data warehouses speeds dissemination of knowledge extracted from patient records, treatment procedures or institutional management decisions. Integrating telehealth into patient care facilitates efficient sharing knowledge among providers.
Young compared paper and electronic storage of patient information in depth. Advantages to paper storage are as follows: familiarity, including how to use, how much it costs, and how to handle legally; its portability; the fact that there are no overhead costs; and its versatility – many types of information exist in one chart: provider notes, graphs, pictures, electrocardiograms, laboratory reports, etc. Disadvantages of paper storage include the following: charts are misplaced or lost, incomplete, illegible, and can physically degrade over time; only one person can use a given chart at a time; it is difficult to store large amounts of paper data compared to electronic data; continued quality improvement becomes laborious as informaticians are forced to wade through thick, disorganized charts; there are no programmed warning signals, so information is not automatically flagged and is vulnerable to error; patients have to re-tell information to providers because providers can’t find old charts or it is too time-consuming to find charts; and information is generally fragmented and scattered. All of the aforementioned hinder provision of optimal health maintenance or care and result in consumption of costly time and energy.
In contrast, electronic health records have many advantages: required storage space is smaller than for paper, charts are accessible to many people simultaneously, information retrieval is instantaneous, programmed warning signals flag abnormal labs and reminders for preventive screening such as “time for a colonoscopy,” administrative duties are efficient and clear cut, and patients do not have to repeat telling past medical information because providers can easily access this information prior to patient interaction. Disadvantages of electronic health records include high startup costs, a steep learning curve to operate the system, confidentiality, privacy and security issues, hardware is either nonportable or wireless (portable) but breakable, data entry could be flawed and users may develop ergomatic issues.
According to Young, not one hospital has fully implemented an electronic health record system. Why? In addition to the disadvantages of electronic health records listed above, barriers to universal implementation include the lack of a common vision, the lack of standardized terminology, system architecture and indexing. Of these, overhead costs and security are perhaps the greatest barriers to implementation of electronic health records.
In order to improve information flow – assessing which information is important to acquire, accurately gathering, storing and disseminating information – change must occur. Be it a patient, EKG technician, physician or medical records official, many factors are involved in the art of change, successfully implementing change. As Young suggested, psychological factors, technological preparation, time, energy, capacities, pace of change and adequate communication are all-important factors to consider when planning change.
Changing medical records from paper to electronic is just one component of informatics that we, as health professionals, need to change in order to optimally collect and manipulate health information. Young indicated that barriers to change, for example applying evidence-based medicine rather than personal inclinations, are lack of prioritization, time, access, education and modeling. Furthermore, even if a common vision for informatics existed and health professionals prioritized improving information systems, gave time, acquired necessary education, modeling and access to change, human flaw factors may undermine improvements. Finite abilities, inhibitory environments, false perceptions, cognition, response execution, lack of attention and aging limit us humans. While, as Young quoted James Conway, “people don’t make errors because they want to or because they’re bad people,” errors do occur. Errors can be rule based (design flaw) or knowledge based (operator error) and they result from shortcomings of perception, memory and cognition. To diminish errors, Young wrote that beginning with the analysis stage of implementing new systems, designers must accommodate for limits of human performance, while exploiting our strengths. Changes must be learnable, efficient, easily memorized, and satisfying to users (...)

Rating:
Summary: In-depth review of Informatics for Healthcare Professionals
Review: The book entitled Informatics for Healthcare Professionals by Kathleen M. Young, tackles the informatics of healthcare as a new specialty and disseminates the complex world of managing and processing information to support decision making in medical practice. An investigation of Medical Informatics for Healthcare Professionals reveals the circular continuum of data--to information--to knowledge as not only important, but also discusses the value, organization, storage, and exchange of information in a context that is easy to read and understand, even for the novice informatics student.

Perhaps one of the greatest strengths of Young's book is her in-depth analysis of the evidence-based practice model, its benefits and weaknesses. The author describes the evidence-based medicine paradigm from beginning to end, giving the reader a comprehensive overview of how the decision-making structure of medical care has changed from the early 1980's to the year 2000. Young makes her opinion known that there is a vast crevasse between the benefits of the evidence-based model and the problems in a healthcare industry not so willing to embrace the notion of just how well information technology can benefit the entire healthcare spectrum.

A powerful section of Young's book addresses the human side of informatics, or "human factors." The author focuses on the design, implementation, and process of information systems and how medical devices developed without the application of "human factors" incorporated into their structure, could lead to injuries and even death.

Three of the most helpful sections for any healthcare professional designing, implementing and maintaining health information systems in Young's book are how to develop a pattern of change among healthcare professionals for facilitating acceptance, the information systems cycle, and information for managing health. Particularly valuable was the order in which information systems are developed. The reader is enticed into the actual process of information systems development from the initial idea, through the design phase, to development, and finally to implementation and rollout. The objectives of each phase are succinctly stated. The only variable missing was the same lengthy analysis as to why projects fail.

Young stresses the importance of how healthcare professionals should own the information process to produce optimum outcomes. Incorporating up-to-date information technology into healthcare systems, she says, can only improve continuity of care, ensure efficient exchange of information, and reduce costs.

Public Health professionals can glean a great deal of structural information in Young's book regarding the order of project development for information systems. As an overview, the book is a basic introduction to informatics and provides insight for further investigation into the obviously more complex data collection systems of the healthcare industry.

Young's book continuously reinforces how significant it will be for new healthcare professionals to utilize the current system of information to their advantage and build it into evidence-based practice for future generations.

All in all, a very good foundation book for understanding Informatics as it pertains to the healthcare industry.