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Nursing informatics and healthcare policy, privacy confidentiality and security
1. NURSING INFORMATICS AND HEALTHCARE
POLICY, PRIVACY CONFIDENTIALITY AND
SECURITY
BY : MS. JAIMIKA PATEL
PH.D. SCHOLAR
DEPARTMENT OF MENTAL HEALTH NURSING
3. INFORMATICS
INFORMATICS: French word informatique
which means computer science.
Informatics is defined as computer science
+ information science. Used in conjunction
with the name of a discipline, it denotes an
application of computer science and
information science to the management
and processing of data, information, and
knowledge in the named discipline. Thus
we have, medical informatics, nursing
informatics, pharmacy informatics and so
on.
4. HEALTH INFORMATICS
Health informatics is the practice of acquiring,
studying and managing health data and applying
medical concepts in conjunction with health
information technology systems to help clinicians
provide better healthcare.
Health informatics, sometimes known as healthcare
informatics, has grown as an evolving science with
the expansion of electronic health records (EHRs)
and health data analytics systems. It has also
grown with the establishment of health data
exchange standards, such as HL7 (health Level
7) and FHIR (Fast Health Interoperability
Resources) and clinical health terminology sets like
SNOMED CT.
5. NURSING INFORMATICS
Nursing informatics is another kind of health informatics that
encompasses nurses' interactions with health IT systems. The field has
become more important as most healthcare systems and physician
practice facilities have put their patient records online and entrusted their
nursing teams to handle transition-of-care situations in their EHRs.
A way of helping in the management and processing of nursing information
data through the use of computers. Involves research and analysis aimed
at supporting nursing education and practice. Deals specifically with the
process of gathering and acquiring nursing health care data.
Nursing informatics specialists try to accurately document transitions of
care -- for example, when a patient is going from an ambulatory setting to
a hospital setting, or from a hospital to a rehabilitation center. Often, this is
required by Medicare or private insurance reimbursement program criteria.
As with clinical informatics, nursing informatics is still growing as an
educational field in which students can receive academic certificates and
degrees.
6. DEFINITION OF NURSING INFORMATICS
Nursing informatics "is the specialty that integrates nursing science with
multiple information and analytical sciences to identify, define, manage and
communicate data, information, knowledge and wisdom in nursing
practice.
According to the American Nurses Association (ANA), nursing informatics
“integrates nursing science, computer science, and information science to
manage and communicate data, information, knowledge, and wisdom in
nursing practice.” Registered nurses who come into the field by way of on-
the-job training or continuing education are called Informatics Nurses.
Nurses who earn an MS or a PhD in nursing informatics or earn a post-MS
certificate in nursing informatics or a related field, such as biomedical or
health informatics or information management, are called Informatics
Nurse Specialists. Both are helping transform health care by providing
essential information to students, educators, clinicians, consumers,
administrators, scientists, and policymakers when and where they need it.
9. HISTORY
Nurses have worked in informatics roles for over twenty-five years, but
the phrase “nursing informatics” was not seen in the literature until 1984.
Nursing informatics has established itself as a specialty in the nursing
field.
Nurses have become proficient in utilizing and adapting complex
technology into caring nursing practice for decades, at least since the
time of Florence Nightingale in the United Kingdom and even earlier,
when Jeanne Mance (1606-1673) founded the first hospital in Montreal,
Canada in 1642.
Various forms of machinery such as ventilators and physiological
monitors were first used in intensive and critical care settings, and are
now currently used in adapted form in less acute areas, even in home
care.
10. GOALS OF NURSING INFORMATICS
GOAL
Improve the
of populations
Supporting
nursing research
Supporting life-
long learning
Managing and
delivering
education
experiences
Establishing
effective
administrative
systems
Direct provision of
care
12. APPLICATION OF NURSING INFORMATICS
APPLICATION
OF NURSING
INFORMATICS
Clinical
Practice
Administration
Education
Community
setting
Research
13. Clinical practice
Point-of-Care Systems and Clinical Information Systems
Work lists to remind staff of planned nursing interventions
Computer generated client documentation
Electronic Medical Record (EMR) and Computer- Based Patient
Record (CPR) Monitoring devices that record vital signs and other
measurements directly into the client record (electronic medical
record)
Computer - generated nursing care plans and critical pathways
Automatic billing for supplies or procedures with nursing
documentation
Reminders and prompts that appear during documentation to
ensure comprehensive charting
14. CONT…
Patient Education:
Nursing informatics can be used for symptom management and
patient education. The nurse can access the information for the patient or
teach the patient where to find appropriate and helpful information. For
example, on an oncology unit, nursing informatics can be used to teach
patients effective symptom management of the treatment modalities which
often cause pain, fatigue and poor nutritional status. Nursing informatics
can also aid in other nursing interventions of the oncology nurse, such as
analgesic administration and stress-reduction techniques.
Clinical Alert System:
The computerized clinical alert system can be used in conjunction with
the hospital pharmacy. A system design is created to alert both pharmacy
and health staff when two or more drug prescriptions are incompatible.
15. CONT…
Patient Data: Nursing informatics can also be useful in a
physician’s clinic. In a managed care environment, information
systems make administrative management more efficient. The
private practitioner, program or facility to manage every aspect of
patient care can use one data management system. In each of
these health care settings data management systems can be
applied to treatments, diagnostics, documentation, practice
management, insurance claims and referrals and protocols as well
as treatment and diagnostics results.
16. CONT…
Telehealth:
Telehealth includes the use of telephones and sophisticated image
transmission systems like ECG, faxes and remote camera imaging.
Telehealth places the ambulance personnel in touch with the Emergency
Department and it also operates to put the generalist “nurses and
doctors” at the Emergency Department in touch with specialists.
Telehealth is used to evaluate the stroke victims while they are in transit
so appropriate therapy can be initiated quickly upon arrival at the
Emergency Department. In similar fashion, a nurse practitioner in a
remote Emergency Department might be guided via telephone in the
proper procedure for inserting chest tubes so a man with a collapsed
lung could be stabilized for subsequent transport to a major hospital.
Finally, nursing informatics can be useful for interdepartmental
communication such as ordering supplies from central supply, lab work,
etc.
17. CONT…
Clinical Information:
In order for the nurse to ensure the patient is receiving the most up-to-
date care for a variety of chronic conditions, the National Institute of
Health (NIH) have an agency designed to offer such guidance. Clinical
practice guidelines can be found at
http://www.nhlbi.nih.gov/guidelines/index.htm. The practice guidelines
found at this site provide management information for asthma,
cholesterol, hypertension and obesity.
Clinical practice guidelines for the management of diabetes mellitus
and menopause can be found at
http://www.aace.com/clinguideindex.htm. Further information can be
found through the Medscape Nurses site and National Institute of
Health- http://www.nih.gov.
18. Use of computers in hospital and community
clinical implication
Use of computers
Assessment
Patient
monitoring
Improved
quality of care
Reduced
documentatio
n expenses
Improved
security
Improved
documentatio
n
Increased
efficiency
Electronic
Medical
Records
Telemedicine
19. Significance of nursing informatics
Significance of
Nursing
informatics
Facilitates
communication.
Allows
articulation of
organized
information
Leads to
credibility
20. NURSING ADMINISTRATION
Health Care Information Systems
Automated staff scheduling
E-mail for improved communication
Cost analysis and finding trends for budget purposes
Quality assurance and outcomes analysis
21. NURSING EDUCATION
Computerized record-keeping
Computerized-assisted instruction
Interactive video technology
Distance Learning-Web based courses and degree programs
Internet resources-CEUs and formal nursing courses and degree
programs
Presentation software for preparing slides and hand-outs-
PowerPoint and MS Word
Simulation
22. NURSING RESEARCH
Computerized literature searching-CINAHL, HINARI, Medline and
Web sources
The adoption of standardized language related to nursing terms-
NANDA, etc.
The ability to find trends in aggregate data, that is data derived from
large population groups-Statistical Software, SPSS.
23. COMMUNITY SETTING
The main uses of computers in community are
Gathering of epidemiological and administrative statistics.
Patient appointments- identification system.
Patient assessment and data gathering.
Monitoring.
Documentation.
Special need application.
24. BENEFITS OF COMPUTER AUTOMATION IN
HEALTH CARE
Electronic Medical Record
Improved access to the medical ward: the EMR can be accessed from several different
locations simultaneously, as well as by different levels of providers.
Decreased redundancy of data entry: for example, allergies and vital signs need only be
entered once.
Decreased time spent in documentation: automation allows direct entry from monitoring
equipment, as well as point of care data entry.
Increased time for client care: more time is available for client care because less time is
required for documentation and transcription of physician orders.
Facilitation of data collection for research: electronically stored client records provide
quick access to clinical data for a large number of clients.
Improved communication and decreased potential for error: improved legibility of clinician
documentation and orders is seen with computerized information systems.
Creation of a lifetime clinical record facilitated by information systems.
25. Other Benefits
Decision support tools as well as alerts and reminders notify the
clinician of possible concerns or omissions. An example of this, is
the documentation of patient allergies in the computer system. The
health care providers would be alerted to any discrepancies in the
patient medication orders.
Effective data management and trend finding include the ability to
provide historical or current data reports.
Extensive financial information: can be collected and analyzed for
trends. An extremely important benefit in this era of managed care
and cost cutting.
Data related to treatment such as inpatient length of stay and the
lowest level of care provider required can be used to decrease
costs.
26. BENEFITS OF NURSING INFORMATICS
Electronic Medical Records (EMR) benefits:
Improved access to the medical record. The EMR can be accessed
from several different locations simultaneously, as well as by different
levels of providers.
Decreased redundancy of data entry. For example, allergies and vital
signs need only be entered once.
Decreased time spent in documentation. Automation allows direct
entry from monitoring equipment, as well as point-of-care data entry.
Increased time for client care. More time is available for client care
because less time is required for documentation and transcription of
physician orders.
27. CONT…
Facilitation of data collection for research. Electronically stored
client records provide quick access to clinical data for a large
number of clients.
Improved communication and decreased potential for error.
Improved legibility of clinician documentation and orders is seen
with computerized information systems.
Creation of a lifetime clinical record facilitated by information
systems
28. NURSE INFORMATICIST
They may also make recommendations
as to how to improve the processes and
uses of computer programs in order to
improve patient outcomes. For this
reason, many nurse informaticists work
as consultants.
Other nurse informaticists work in an
administrative capacity, and contribute
to decision-making on medical
information technology. Some nurse
informaticists educate nurses on how to
effectively enter medical information into
a computer system, as well as train
nurses how to use new technology.
29. DECISION- SUPPORT
SOFTWARE
Decision-support tools as well as alerts
and reminders notify the clinician of
possible concerns or omissions. An
example of this, is the documentation
of patient allergies in the computer
system. The health care providers
would be alerted to any discrepancies
in the patient medication orders.
Effective data management and trend-
finding include the ability to provide
historical or current data reports.
30. CONT…
Extensive financial information can be
collected and analysed for trends. An
extremely important benefit in this era
of managed care and cost cutting.
Data related to treatment such as
inpatient length of stay and the lowest
level of care provider required can be
used to decrease costs.
31. ADVANTAGES
Database advantages
Shared data
Centralized control
Disadvantages of redundancy control
Improved data integrity
Improved data security, and database systems;
Flexible conceptual design.
More easily archived
Standardized and customized reporting
Legible
More accurate patient data, less chance of error
Document set maintained
32. DISADVANTAGES
Complex conceptual design process
Need for multiple external databases
Need to hire database-related employees
High DBMS acquisition costs
A more complex programmer environment
Potentially catastrophic program failures
A longer running time for individual applications
Highly dependent DBMS operations
Increased costs to start up, maintain, train, and upgrade Computer
literacy required-fear of computers.
Confidentiality, privacy and security difficult to guarantee.
33. TRENDS NURSING INFORMATICS:
Past Nursing Informatics
Nursing informatics was first defined as the use of computer technology
support nursing, including clinical practice, administration, education and
research.
The first generation of nursing information systems was designed to
paperwork and communication. In general, the systems accomplished
by transferring information to the computer, what nurses had done on
paper and by telephone. These systems replaced paper records, filing
cabinets and pneumatic tubes. Although this was helpful and effective in
reducing the time spent on documentation and communication it did not
address many of the fundamental issues for nurses’ use of data,
information and knowledge to guide effective care (Executive summary,
2004).
34. CONT…
Until 1948, primary care remained in the home. With the
development of Hill-Burton Act of 1948, money was provided for the
building of hospitals and promoted a catalyst for change in
healthcare. In the 1960’s, Medicare and Medicaid provided
reimbursement for services to many individual patients and the
health insurance industry grew. This provision of funding allowed
many new innovations: new drugs, advanced surgical procedures,
new technologies, equipment, and sophisticated diagnostic
procedures. All of which led to the development of medical
specialties, each treating a different part of the patient and creating
its own records for patient. (Thede, 2003).
35. CONT…
It is not unusual to find a patient being treated by several physicians
at the same time. These physicians share little information; they may
duplicate tests or prescribe medications that are not compatible with
those prescribed by another physician. The current healthcare system
relies primarily on paper records that are oriented to episodes and
providers .
During the past four decades the U.S. government has played a major
role in the development and promotion of telehealth through various
agencies. Although interest waned as funds were depleted in the
1980’s, technological advancements made it a more attractive
prospect. Federal monies and Agriculture Department’s 1991 Rural
Development Act laid the groundwork for bringing the information
superhighway to rural areas for education and telehealth purposes.
36. CONT…
The most aggressive development of telehealth consults for
Armenian earthquake victims in 1989, while more recently the
military has been working on several projects to feed medical
images from the battlefield to physicians in hospitals for improved
treatment of casualties .
37. Present Nursing Informatics
Although the history of nursing informatics extends only some
twenty years, the field is advancing rapidly as a scientific discipline
and has significant implications for patient care.
As research in nursing informatics evolves, it has become apparent
that the issues are far more complex than reducing time spent on
paper work. The high-intensity generation, management,
processing of data and knowledge are integral components of
nursing care. Informatics gives nurses the means to carry out these
aspects of care efficiently and effectively to improve outcomes for
patients.
38. CONT…
Nursing informatics impacts nurses today. Today, evolving
standards of practice increase the nurse’s accountability. The
malpractice crisis has strengthened accountability and increased
emphasis on complete and detailed nursing documentation.
Changes in reimbursement methods are affecting nursing care
delivery. Cost containment and consumerism place additional
pressures on not only the individual nurse but also the entire
nursing profession.
39. Future Nursing Informatics
Nursing informatics has arrived and the baby has started to walk. In
the process, nursing informatics has introduced new challenges and
opportunities along with new computer applications.
Nursing informatics is a growing field for advancement and offers
many potential areas for cost containment.
Nursing informatics and managed care, make telehealth an
attractive tool to save healthcare bills: Telehealth may provide
savings in the following areas: improved access to care, allowing
clients to be treated earlier and with fewer interventions.
Clients may receive treatment in their own community where
services cost less, improving quality of care and improved continuity
of care through convenient follow-up.
40. CONT…
Telehealth applications vary greatly and include client monitoring,
diagnostic evaluations, decision support systems, storage and
dissemination of records for diagnostic purposes, image
compression for efficient storage and retrieval, research, voice
recognition for dictation and education of healthcare professionals
and consumers.
Many providers expect that telehealth will revolutionize healthcare.
It promises to improve speed and accuracy of communicating with
medical providers to gather information and address concerns.
Nursing informatics and telehealth will continue to grow and
become commonplace.
41. JOURNAL
REFERENCES
Exploring the impact of health
information technology on
communication and
collaboration in acute care
nursing.
Nurses’ experiences using a
nursing information system:
early stage of technology
implementation.
The perfect role for nursing
informatics: Nursing staff
development.
42. HEALTH CARE
POLICY
To practice effectively in today’s continually
changing healthcare environment,
informatics professionals need to be aware
of existing and proposed healthcare policy.
Policy - a course of action that guides
present and future decisions.
Healthcare policy is established on local,
state, and national levels to guide the
implementation of solutions for the
populations health needs.
43. CONT…
The number of informatics
programs for nurses has
significantly increased, preparing
more informatics nurse specialists
to practice in the field, and a
number of trends and events have
placed information technology (IT),
information systems (IS), and
informatics at a center of attention
in healthcare.
44. Healthcare Policy and Nursing
Informatics as a Specialty
Nurses have contributed to the purchased, design, and
implementation of IS since the 1970s and in 1992, the American
Nurses Association (ANA) recognized NI as a specialty.
To be acknowledged as a specialty within nursing, informatics had
to:
Demonstrate a differentiated practice base
Identify the existence of educational programs in the field.
Develop a research agenda.
45. PREPARATION FOR SPECIALITY PRACTICE
To become a specialty, it was necessary for NI to show that educational
programs are available to prepare nurses to practice in the field.
The Division of Nursing (DN), Health and Humans Services Administration
(HRSA) founded two Master’s NI programs and one Doctoral program in NI at
the University of Maryland.
In 1997 an NI specialty program open at New York University and in 1998 a
specialty program was implemented at Duquesne University at Pittsburgh.
Discussion of specialization, Styles included for identifying a research focus as
one criterion for a specialty.
A final requirement for a specialty is representation by at least one organization.
Within nursing, there is organizational support in the American Organization of
Nurse Executives.
46. HEALTH CARE POLICY IMPACT ON NURSING
INFORMATICS PRACTICE
Nursing Shortage and Nursing Informatics
Nursing has experienced a number of shortages in recent history.
An older nursing workforce
A higher ratio of older associate degree graduates
The availability of more attractive career opportunities for women
Decreased interest in nursing as a career difficult work environments.
Unless something is done the shortage will rise from 6% in 2000 to 29% in
2020 or more than 800,000 nurses short of the number needed.
47. CONT…
The Bureau of Labor Statistics as Phase 2 of the AAN technology project
began, staff nurses from three hospitals in Virginia and California were asked
to identify or verify the most difficult aspects of their practice and how
technology would improve those tasks.
As the project continues, systems will be designed, implemented, and tested
to determine their effect on nurses’ work.
It is up to NI specialists to help design and implement IT systems that will
finally assists nurses in their practice and to validate the results thru
research.
48. CONT…
Schools and colleges of nursing have shortened program lengths and
instituted accelerated program for those who already hold a baccalaureate
degree in an attempt to increase nursing workforce numbers.
Nursing organizations have been actively advocating for increased federal
funding to expand programs and increase loans, scholarships, and
incentives.
In 2002 the AAN Commission on Workforce launched a multiphase project to
develop IT that will help support nurses in their day to day work.
In Phase 1, interdisciplinary, creative thinkers were assembled to determine
how technology could be used to facilitate nurses’ work.
49. CONT…
Bradley (2003) indicated that technology solutions should improve
existing care processes and outcomes, increase access thru the
use of portable handheld devices, incorporate Internet capability to
overcome distance barriers of care and improve access to
knowledge acquisition.
These authors also advocate for using bar-coding of medications,
use of speech recognition, and fine tuning the user interface of
systems to support nurses.
50. National Health Information
Infrastructure
Another national initiative that will impact NI is the National Health
Information Infrastructure (NHII).
This voluntary initiative, involving a three stage process over 10
years, is intended to improve the effectiveness, efficiency, and overall
quality of health and healthcare in the United States.
NHII calls for comprehensive knowledge-based networks that
integrate clinical, public health and personal health information to
improve decision making by having information available to
providers.
51.
52. Health Insurance Portability and Accountability
Act (HIPAA)
HIPAA was passed in 1996 and is intended to improve public
and private health programs by establishing standards to
facilitate the efficient transmission of electronic health
information.
HIPAA pre-empts state law and payer specific variations of data
standards; mandates input from private, standard setting
organizations.
HIPAA has a significant impact on informatics: IT must be
designed to comply with Title II of the act.
53. CONT…
All of the requirements of HIPAA are expected to be in placed by May 23, 2008
October 16, 2002-Electronic Healthcare Transactions and Code Sets
April 14, 2003-Privacy
October 16, 2003-Electronic Healthcare Transactions
April 14, 2003- Privacy-small health plans
July 30, 2004- Employer Identifier Standard
April 21, 2005-Security Standard
August 1. 2005- Employer Identifier Standard
April 21, 2006- Security Standards-small health plans
May 23, 2007- National Provider Identifier
May 23, 2008- National Provider Identifier.
54. CONT…
In November 2004, under HIPAA administrative simplification, CMS
expects to publish the proposed rules for a national health payer
identifier and a format for standardized claims attachments.
The privacy rule of HIPAA was published in December 2000 and
became effective in April 14, 2001
The privacy rule and other HIPAA regulations are having
tremendous impact on health informatics, including NI. For
example, under HIPAA patients must be permitted to review and
amend their medical records
Informatics nurses are responsible for understanding and helping to
implement HIPAA regulations.
55.
56. PRIVACY
Privacy, as distinct from confidentiality, is viewed as the right of the
individual client or patient to be let alone and to make decisions about how
personal information is shared. Even though the U.S. Constitution does
not specify a “right to privacy”, privacy rights with respect to individual
healthcare decisions and health information have been outlined in court
decisions, in federal and state statutes, accrediting organization guidelines
and professional codes of ethics.
The top-of-mind example is the federal HIPAA Privacy Rule, establishing
national standards for health information privacy protection and defining
“protected health information” A stated purpose of the HIPAA Privacy Rule
“…is to define and limit the circumstances in which an individual’s
protected heath information may be used or disclosed”.
57.
58. CONT…
Established pursuant to the broader Health Insurance Portability and
Accountability Act of 1996 (HIPAA), as described by the U.S.
Department of Health and Human Services (HHS), the Privacy Rule,
“strikes a balance that permits important uses of information, while
protecting the privacy of people who seek care and healing”
Individuals are provided some elements of control, such as the right to
access their own health information in most cases and the right to
request amendment of inaccurate health information. However, in that
attempt to strike a balance, the Rule provides numerous exceptions to
use and disclosure of protected health information without patient
authorization, including for treatment, payment, health organization
operations and for certain public health activities.
59. CONT…
While debate continues as to whether the HIPAA Privacy Rule has
substantially strengthened individual privacy rights, it has certainly
increased awareness of the topic of health information privacy, of
issues surrounding its protection and of the patient’s role in the
process. There is no question that health information management
professionals’ roles have been impacted by responsibilities for
HIPAA Privacy Rule compliance. In reflecting on the Privacy Rule’s
and its more recent amendments pursuant to the Health Information
Technology for Economic and Clinical Health (HITECH) Act.
60. CONT…
HIPAA has evolved during the past decade and was greatly fortified
by the 2009 HITECH Act and its HIPAA modification regulations
released in January 2013. Whatever one might think about HIPAA,
it is hard to dispute that it has had a vast impact on patients, the
healthcare industry, and many others over the last 10 years—and
will continue to shape healthcare and professionals.
61. CONFIDENTIALITY
Confidentiality in health care refers to the obligation
of professionals who have access to patient records or communication
to hold that information in confidence. Rooted in confidentiality of the
patient-provider relationship that can be traced back to the fourth
century BC and the Oath of Hippocrates, this concept is foundational to
medical professionals’ guidelines for confidentiality.
This professional obligation to keep health information confidential is
supported in professional association codes of ethics, as can be seen
in principle I of the American Health Information Management
Association Code of Ethics, “Advocate, uphold, and defend the
individual’s right to privacy and the doctrine of confidentiality in the use
and disclosure of information”.
62. CONT…
Confidentiality is recognized by law as privileged communication
between two parties in a professional relationship, such as with a patient
and a physician, a nurse or other clinical professional. As patients, we’ve
come to expect confidential communication in these relationships. While
application in legal proceedings is subject to evidentiary rules and
consideration of the public need for information, support of privileged
communication can be seen in case law.
Effective psychotherapy depends upon an atmosphere of confidence and
trust in which the patient is willing to make a frank and complete
disclosure…The psychotherapist privilege serves the public interest by
facilitating the provision of appropriate treatment for individuals suffering
the effects of a mental or emotional problem.
63. CONT…
When considering sensitive health information requiring special
layers of confidentiality, such as with mental health treatment, state
statutes provide guidance for health information management
professionals. for example, the Mental Health and Developmental
Disabilities Confidentiality Act offers detailed requirements for
access, use and disclosure of confidential patient information
including for legal proceedings.
64. SECURITY
Security refers directly to protection, and specifically to the means used to
protect the privacy of health information and support professionals in holding that
information in confidence. The concept of security has long applied to health
records in paper form; locked file cabinets are a simple example. As use of
electronic health record systems grew, and transmission of health data to
support billing became the norm, the need for regulatory guidelines specific to
electronic health information became more apparent. The HIPAA Security Rule
provided the first national standards for protection of health
information. Addressing technical and administrative safeguards, the HIPAA
Security Rule’s stated goal is to protect individually identifiable information
in electronic form—a subset of information covered by the Privacy Rule—while
allowing healthcare providers appropriate access to information and flexibility in
adoption of technology. Again, that notion of balance appears in the
law: necessary access by healthcare providers vs. protection of individuals’
health information.
65.
66. CONT…
Breaches to confidentiality now face more serious penalties given
modifications to both the HIPAA Privacy and Security Rules
following publication of final rule provisions of the HITECH
Act. “The new rule will help protect patient privacy and safeguard
patients’ health information in an ever expanding digital age”.
67. CONT…
A response to the challenge is information governance, described
as the strategic management of enterprise-wide information
including policies and procedures related to health information
confidentiality, privacy and security; this includes the role of
stewardship . Health information managers are uniquely qualified to
serve as health information stewards, with an appreciation of the
various interests in that information, and knowledge of the laws and
guidelines speaking to confidentiality privacy and security. The role
of the steward encompasses not only ensuring the accuracy and
completeness of the record, but also protecting its privacy and
security .
68. CONT…
All who work with health information— health informatics and health
information management professionals, clinicians, researchers,
business administrators and others— have a responsibility to
respect that information. And as patients, we have privacy rights
with regard to our own health information and an expectation that
our information be held in confidence and protected. As citizens,
our public interest in health information may prevail, such as in
situations involving public health or crime. Balancing the various
interests in health information and upholding its confidentiality,
privacy and security present ongoing and important challenges
within the healthcare and legal systems, and career opportunities
for health information management professionals.
73. Change Management Info
graphic
Formed within the HIMSS CNO-CNIO
Vendor Roundtable, the info graphic
was created with a purpose to realize
the value of the health IT investment,
achieve benefits and sustainable
transformation required for an
organizational change management
approach, as well as ongoing
organization/vendor relationships for
continued innovation for leaders across
the healthcare spectrum.
74. CNIO Job Description
As the Chief Nursing Informatics
Officer (CNIO) role varies within
healthcare organizations, it is essential
to have a standardized job description
that can be referenced for needed
competencies regardless of specific job
title. This document provides
recommendations for a C-Suite level
CNIO job description including
qualifications and Experience, Key
Responsibilities, and Reporting
Structure.
75. The TIGER Initiative
TIGER (Technology Informatics
Guiding Education Reform) is a
grassroots initiative focused on
education reform, fostering inter-
professional community development
and global workforce development. The
spirit of TIGER is to maximize the
integration of technology and
informatics into seamless practice,
education and research resource
development.
76. CONCLUSION
At present, nursing informatics is an emerging field of study. National
nursing organizations support the need for nurses to become computer
literate and versed in the dynamics of nursing informatics. We are at a
transition period. Becoming educated in nursing informatics is, for the most
party, a self-directed and independent endeavor. Programs that offer basic
and further education in nursing informatics are beginning to spring up
around the globe, but many more are needed to provide easy access for
motivated nurses.
Managing electronic health information presents unique challenges for
regulatory compliance, for ethical considerations and ultimately for quality
of care. As electronic health record system “meaningful use” expands, and
more data are collected, such as from mobile health devices, that
challenge for healthcare organizations expands.
77. REFERENCES
Indian Nursing Council
https://www.indiannursingcouncil.org
Health informatics - Wikipedia
https://en.wikipedia.org › wiki › Health_informatics
Nursing informatics - Wikipedia
https://en.wikipedia.org › title=Nursing_informatics
Alliance for Nursing Informatics
http://www.allianceni.org
Confidentiality, privacy and security of health information
Patient Confidentiality and Privacy in Healthcare I UIC Online
78. REFERENCES
CPHIMS http://himss.org/ASP/certificationHome.asp
HIMSS Nursing Informatics Community
www.himss.org
AlL aBoUT nUrSiNg InFoRmAtIcS: NURSING INFORMATICS and
HEALTHCARE POLICY (karlrufosumatra.blogspot.com)
HIPAA - Health Information Privacy - HHS.gov
https://www.hhs.gov › hipaa
Informatics in Nursing: Impact and Importance | UIC Online
https://healthinformatics.uic.edu
