-
Name 4 things that describes the relationship of NQS and PPACA
- ENSURE TRANSPARANCY
- INCREASE EFFICIENCY
- ENGAGE CONSUMERS
- PROVIDE DATA TO EFFECTIVELY MANAGE CARE COST AND QUALITY
-
Name the 2 sets of regulatory standards of HITECH
- STANDARD 1: DEFINES MU OF EHR
- STANDARD 2: SPECIFIES HOW EHRS ARE DEVELOPED AND CERTIFIED TO MEET MU CRITERIA
-
RELATIONSHIP OF CENTERS OF MEDICARE/MEDICAID MU W/ HITECH
IMPLEMENTED AN HER INCENTIVE PROGRAM TO ENCOURAGE PROVIDERS AND HOSPITALS TO ADOPT AND IMPLEMENT CERTIFIED TECHNOLOGY
-
5 DOMANS OF MEASUREMENT ACA
- PATIENT/CAREGIVER EXPERIENCE
- CARE COORDINATION
- PATIENT SAFETY
- PREVENTATIVE HEALTH
- AT RISK POPULATION/FRAIL ELDERLY HEALTH
-
3 PHASES OF MU IDENTIFIED BY HITECH
- PHASE 1: IMPLEMENT A CERTIFIED EHRS MEETING BASIC REQUIREMENTS
- PHASE 2: CONSUMER ENGAGEMENT AND INCREASES THE CAPTURE AND EXCHANGE OF DATA
- PHASE 3: CAPTURE AND EXCHANGE MORE STRUCTURED DATA, SUPPORT POPULATION HEALTH MANAGEMENT, MEASURE OUTCOMES, AND MAINTAIN PATIENT-CENTERED CARE
-
SIMILARITIES AND DIFFERENCES BETWEEN MEDICARE AND MEDICAID MU CRITERIA
- Medicaid: 63,750 (NPs fall here), 8.7 billion
- Medicare: 44,000 (NOT NP), 17.2 billion
- BOTH: hospitals
-
CRITERIA FOR VENDORS UNDER HITECH, 2 components
- 1: PROVIDING EHR DEVELOP PRODUCTS IN ACCORDANCE WITH THE CRITERIA THAT HAVE BEEN LAID OUT IN THE STATUTORY RULE-MAKING PROCESS AS “CERTIFIED” PRODUCTS
- 2. REQUIRES THAT PROVIDERS EFFECTVELY USE THESE SYSTEMS IN A MEANINGFUL WAY MEASURED BY DETAILED METRICS THAT DETERMINES THAT THE PROVIDER MEETS MU CRITERIA
-
ROLE OF PATIENT ENGAGEMENT WITH HITECH AND MU
CONSUMER EMPHASIS AS A PARTNER IN THE HEALTH CARE DELIVERY PROCESS
-
IOM expectations: 6 AREAS FOR IMPROVEMENT FOR HEALTH CARE SYSTEMS
- EFFECTIVENESS
- SAFETY
- PT-CENTEREDNESS
- TIMELINESS
- EFFICIENCY
- EQUITABILITY
-
DOMAINS OF NURSING EDUCATION FOR HEALTHCARE INFORMATICS (NEHI) FRAMEWORK
- POINT-OF-CARE TECHNOLOGY
- DATA MANAGEMENT AND ANALYTICS
- PATIENT-SAFETY/QUALITY AND POPULATION HEALTH
-
USE OF NEHI FRAMEWORK TO ORGANIZE THE STUDY OF NURSING INFORMATICS (3 DOMAINS WHICH ADDRESS THE MAJOR ROLE OF APN WITHIN INFORMATION TECHNOLOGY ENVIRONMENT)
- PATIENT SAFETY/QUALITY
- DATA MANAGEMENT AND ANALYTICS
- POINT OF CARE TECHNOLOGY
-
PROVIDER ORGANIZATIONS TAKE ON RESPONSIBILITY OF PT POPULATIONS FOR WHICH THEY PROVIDE CARE AT A FIXED RATE PER PERSON
ACCOUNTABLE CARE ORGANIZATIONS (ACO)
-
FEDERAL ORGANIZATIONS RESPONSIBLE FOR OVERSEEING THE MEDICARE AND MEDICAID PROGRAMS
CENTERS FOR MEDICARE/MEDICAID (CMS)
-
REFLECTS APPLIED INFO MANAGEMENT TOOLS SUCH AS BUSINESS INTELLIGENCE TOOLS AND THE STATISTICAL SOFTWARE PROGRAMS TO TRANSFORM DATA AND INFO INTO IMPROVED HEALTHCARE DELIVERY
ELECTRONIC HEALTH RECORD (EHR)
-
THE USE OF COMPUTER TECHNOLOGY TO MANAGE HEALTH INFO
HEALTH INFORMATION TECHNOLOGY (HIT)
-
LEGISLATION PASSED AS PART OF THE AMERICAN RECOVERY AND REINVESTMENT ACT (ARRA) WHICH IDENTIFIES TWO SETS OF STANDARDS ESTABLISHED AS REGULATORY REQUIREMENTS TO HELP PROVIDERS MEET MU OF EHRS AND TO ASSURE EHRS ACORSS THE NATION MEET AN ADEQUATE STANDRAD FOR PERFORMANCE
HEALTH INFORMATION TECHNOLOGY FOR ECONOMIC AND CLINICAL HEALTH (HITECH)
-
PROCESS IMPLEMENTED IN A SERIES OF PHASES TO DEMONSTRATE UTILIZATION OF EHRS AND THE IMPACT ON HEALTH
Meaningful use (MU)
-
MODEL OF CARE DESIGNED TO ENHANCE ADVANCED PRACTICE CARE DELIVERY
NURSING EDUCATION FOR HEALTHCARE INFORMATICS (NEHI)
-
SPECIALTY THAT INTEGRATES NURSING SCIENCE WITH MULTIPLE INFO AND ANALYTICAL SCIENCES TO IDENTIFY, DEFINE, MANAGE, AND COMMUNICATE DATA, INFORMATION, KNOWLEDGE, AND WISDOM IN NURSING PRACTICE
NURSING INFORMATICS (NI)
-
DEMONSTRATION OF THE PATIENT AS BEING A PARTNER IN HEALTHCARE
PATIENT ENGAGEMENT
-
LEGISLATION THAT FOCUSES ON PROVIDING ALL AMERICANS WITH ACCESS TO QUALITY AND AFFORABLE HEALTH CARE
PATIENT PROTECTION AND AFFORDABLE CARE ACT (PPACA)
-
ACHIEVEMENTS OF METRICS TO ENSURE CARE PROVIDED IS WITHIN IDENTIFIED STANDARDS OF CARE
PATIENT QUALITY
-
ACHIEVEMENT OF METRICS TO ENSURE CARE PROVIDED IS WITHIN IDENTIFIED SAFETY STANDARDS OF CARE; A DOMAIN OF THE NEHI FRAMEWORK
PATIENT SAFETY
-
REFLECTS THE USE OF TECHNOLOGY IN PATIENT CARE DELIVERY; A DOMAIN OF THE NEHI FRAMEWORK
POINT-OF-CARE TECHNOLOGY
-
REFLECTS QUALITY IMPROVEMENT TOOLS APPLIED TO INDIVIDUALS AND HEALTH INCENTIVES
POPULATION HEALTH
-
nurse educated beyond the bachelor’s degree level
APRN
-
health care professional who serve as clinical and counseling psychologists, mental health and substance abuse social workers, mental health counselors, substance abuse counselors, psychiatrists, and marriage and family therapists
Behavioral health professional
-
have prescriptive authority and provide care to women during pregnancy and birth, as well as primary care health services to women from adolescence beyond menopause
Certified nurse midwife (CNM)
-
nurses who order, conduct, and interpret diagnostic and laboratory tests; prescribe both pharm/non-pharmacologic agents; establish and coordinate interprofessional plans of care; and teach and counsel on health promotion and risk reduction of
disease
Certified nurse practitioner (CNP)
-
prepared at the masters or doctoral level as expert clinicians in a specialized area of nursing practice
Clinical nurse specialist (CNS)
-
are the primary anesthesia providers in rural
America and other medically underserved areas; practice in a variety of settings
Certified registered nurse anesthetist (CRNA)
-
use of the computer to order medical tests
Computer-based provider order entry (CPOE):
-
plans and conducts food service to assist in the promotion of health and control of disease
Dietician
-
documents that identify and direct inclusion of essential content within all nursing curricula
Education standards
-
professional who plans, directs, and coordinates medical and health services
Health care administration professional
-
professional who focuses on health information technology
HIT professional:
-
the identification, definition, management, and communication of data, information, knowledge, and wisdom.
Informatics nurse specialist:
-
behaviors that highlight interprofessional
teamwork and reliance on technology solutions to enhance patient–clinician communications, planning, and decision making.
Institute of medicine (IOM) core competencies:
-
national education associations of
schools of the health professions focused on creation of core competencies for interprofessional collaborative practice to guide curricula development at all health professions schools
Interprofessional Education Collaborative (IPEC®):
-
group of healthcare professionals responsible for the provision of
patient care
Interprofessional team
-
process implemented in a series of phases to demonstrate utilization of EHRs and the impact on health
Meaningful use (MU):
-
reflects the U.S. goal for improving health care of the
population and is reported to Congress each year
National prevention strategy:
-
aims and priorities to improve health care of the population
National quality strategy:
-
model of care designed to enhance advanced practice care delivery
Nursing Education for Healthcare Informatics (NEHI)
-
plans and conducts nutritional programs to assist in the promotion of health and
control of disease
nutritionist
-
assesses, plans, organizes, and participates in rehabilitation programs
that help build or restore vocational, homemaking, and daily living skills, as well as general
independence, to persons with disabilities or developmental delays
Occupational therapist:
-
dispense drugs prescribed by physicians and other clinicians with prescriptive
authority and have become important information resources for patients about medications and their use
Pharmacist:
-
assesses, plans, organizes, and participates in rehabilitative programs that
improve mobility, relieve pain, increase strength, and improve or correct disabling conditions resulting from disease or injury
Physical therapist:
-
healthcare provider who works with a physician to provide patient care
Physician assistant
-
a project that generated quality and safety
competencies and accompanying educational materials for pre-licensure nursing students and the faculty teaching such content
Quality and Safety Education for Nurses (QSEN):
-
identifies behaviors and actions permissible based upon education and licensure
Scope of practice:
-
standards designed to advance the science of simulation, share best
practices, and provide evidence-based guidelines for implementation and training
Simulation standards:
-
actions and behaviors expected to be performed when functioning within a particular nursing role
Standards of practice
-
a grass roots collaborative
effort that established specific recommendations for schools of nursing to prepare nursing
students and practicing nurses to fully engage in digital health care
Technology Informatics Guiding Education Reform (TIGER):
-
Aim of NQS
- better care
- affordable care
- healthy populations and communities
-
what is the cornerstone of meaningful use
patient engagement
-
3 components for reformation of healthcare delivery
- technology for lowering cost
- Assurance of patient safety and quality technology driven environment
- Nursing's diverse role as HIT advances
-
What can inadvertently cause patient harm in regards to patient safety and quality in technology-driven environment
rapid deployment of technology in healthcare environment
-
What should be used as a guide to implement safe HIT systems for better care
Dept of Health and Human services book
-
Since the enactment of ACA, who is expected to fill the gaps as providers due to the increased need for primary care providers
ARNPs
-
Interprofessional teamwork and Institute of Medicine (IOM) 4 core competencies
- utilize informatics
- Employ EBP
- Provide Pt-centered care
- Apply quality improvement
-
5 organizations that support Educational Standards for preparing nurses to function within the HIT environment
-
In regards to MU and HITECH what limits the impact of interprofessional teams
Language that focuses on the physician reimbursement through the medicare/medicaid incentive structure
-
Informatics Competencies for interprofessional teams describe:
integration of knowledge, skills, abilities, and judgement
-
What is the gold standard for preparing nurses to function within the HIT environment
NEHI model
-
Evidence for interdisciplinary teams supported by which 4 organizations
-
Name the stages of theory development
- Observe phenomena
- Explain phenomena
- Model developed
- Model is tested and refined
-
Name two different levels of theories
-
Name 3 purposes of Mid Range theory level
- treat propositions within the theory
- Aid in the building of enlightment
- used to narratively describe complex processes
-
What does the ISTA model address
Various types of social, technical, and contextual interactions with HIT that can result in unintended consequences
-
What other informatics-based theories have nursing informatics used for sources of knowledge
- information science
- cognitive science
- computer science
- various information/knowledge attributes
- technology interface characteristics
-
What is quality improvement
Blend of different theorists and approaches that include 6 core areas. Not a single definition.
-
Name 6 core areas of Quality improvement
- safety and patient centeredness of care
- effectiveness
- timeliness
- efficiency
- equitability of services
-
What is to be the primary socio-technical lens of discussion for use within QI activities
ANT
-
What does ANT represent
- Actors
- Networks
- Translations
-
What is a black box network
Feature of ANT that stabilizes allowing all actors within the network to function as one rather than separate entities
-
what is the building block of science
Epistemology
-
Is quality improvement used as an approach or a tool
either
-
What is a Plan-Do-Study-Act model (PDSA)
Model that is an approach to conceptualize quality improvement
-
What can be used to operationalize quality improvement activities
ANT
-
What framework identifies three overriding dimensions of health care evaluation: structure, process, outcomes
Donabedian's
-
the nature of knowledge and what we can actually understand and “know”
Epistemology:
-
a body of knowledge including facts and theories generated by the use of controlled
rigorous and precise methods within a delimited area of concern
Science
-
an attempt to describe, explain, or predict some phenomenon of interest; develops in
stages
theory
-
refers to a system that contains both social and technical elements
Socio-technical
-
process where an actor performs an action within a large network of actors who form, align, and stimulate action through a process called translation
Actor-Network Theory
-
a process that is preplanned, executed, and evaluated in a logical,
stepwise fashion
Quality Improvement:
-
the use of science to create a device to solve a problem
Technology
-
an approach to conceptualize quality improvement
Plan-Do-Study-Act Model:
-
framework to evaluate health care that includes
structure, process, and outcome
Donebedian Health Outcomes Model:
-
What system appreciates the importance of humans and technology as well as acknowledge all things have the potential to interact and generate action
Socio-technical systems
-
Describe ANT and black box network
- Actor: human or nonhuman entities that perform action
- Network: group of actors
- Translation: process of stimulating action
- Black box network: stabilized action network
-
what does ANT focus on
how actors interact with each other and the environment
-
What programs and plans were designed to achieve the goal of not just building an EHR, but actually implementing them?
- ONC
- HITECH
- REC
- HIE in the states
- NwHIN Direct
- supporting/creating Beacon communities
- SHARP grants
- Certification exams at colleges
-
What two additional initiatives were created by PPACA to encourage EHR sharing between states
NQS (priority areas for quality)and ACOs (payer reform)
-
What supported the implementation of electronic health records and health care data
sharing
HITECH
-
what was created to development standards within the health information technology
Office of the National Coordinator for Health Information Technology (ONC)
-
The HITECH Act included funding provisions for
6 major initiatives
-
What defined the EHR incentive program
MU
-
what programs designed to get small practices to adopt and meaningfully use
REC
-
Where is Health information exchanges built
between each state
-
providers or groups of providers agree to assume some
level of risk with regard to the treatment of a large cohort of individuals
Accountable Care Organizations
-
provided grants to communities to help them connect the use of health
information technology to improvements in community health outcomes as demonstrated by
standardized quality measures
Beacon Project
-
created a national standard of functionalities that providers and
hospitals could reference to ensure that their EHR was capable of supporting meaningful use
EHR Certification Program
-
a five-year program of increasing complexity to encourage providers
and hospitals to adopt and meaningfully use electronic health records
EHR Incentive Program
-
identifies aims and priorities which are intended to serve as a
framework for each of the different health-related agencies within the HHS
National Quality Strategy
-
a program to provide technical assistance to
primary care providers in small and safety-net practices to facilitate selection, adoption, and use
of electronic health records
Regional Extension Center (REC) Program
-
a program for States to build a nation-wide technological infrastructure
that supports the secure exchange of clinical content between relevant care providers
State HIE Program
-
projects awarded to four
university centers to spur technological innovation regarding the development of EHR
technology
Strategic Health IT Advanced Research Projects (SHARP)
-
HITECH ACT included funding for what 6 major initiatives
- EHR incentive program
- EHR Certification program
- State HIE program
- Regional extension center (REC) program
- Beacon Community program
- Workplace development (community college curriculum & university based training)
- Strategic Health IT Advanced Research Projects (SHARP)
-
Who ran out of money for the EHR implementation programs
Office of national coordinator for health information technology (ONC)
-
What was the framework for promoting EHR adoption
EHR incentive program
-
Creation of HIE for expanding HIT created what 3 designs
- central data repository model
- Federated model using local repositories
- Hybrid model with elements of both types
-
What year were changes made for EHRs to become certified must be capable of Nationwide Health Information Network Direct (NwHIN direct) or Direct
2011
-
3 part aim of Beacon communities
- improve population health
- test innovative approaches
- Build health IT infrastructure
-
What program has guides that provide info about community challenges with HIT implementation and how to overcome obstacles
Beacon
-
3 specific organizational milestones of Regional Expansion Center Programs
- Enrollment with REC
- Go live on an EHR
- Provide achieved MU
-
4 critical areas of EHR funcitonality designed by SHARP grants for universities and research institutions
- Sharp S: privacy and security
- Sharp C: Physician cognition and decision-making
- Sharp A: health application design
- Sharp N: use of EHR data
-
What grant was awarded to support medical devices
MD SHARP
-
Interlocking programs 3 most critical programs
- EHR incentive
- REC program
- State HIE program
-
what guides the development of health policy and implementation
NQS
-
process of integrating patient's goals and concerns with medical evidence to achieve high-quality medical decisions
shared decision making
-
4 approaches to empower people
–Provide with tools and information to make healthy choices
–Promote positive social interactions and support healthy decision making
–Engage and empower people and communities to plan and implement prevention policies and programs.
–Improve education and employment opportunities
-
Approaches to empower people in health care:
–Confirm understanding of health promotion and disease prevention
–Involve consumers in planning, developing, implementing, disseminating, and evaluating health and safety information
–Use alternative communication methods and tools to support more traditional written and oral communication.
–Refer to adult education and English-language instruction programs enhance understanding of health promotion and disease prevention messages
-
Approaches to pt involvement
–Interprofessional education/collaborative
–Support patient activation
-
Models to pt involvement
–Family Health Model
–Betty Neuman Model of health
–Family systems theory (FST)
–Patient- and family-centered care
-
Create a learning health care system with the characteristics of: (4 things)
- Science and Informatics
- Patient clinician partnerships
- Incentives
- Culture
-
what law involves computing power will double every 2 years
Moore's
-
What is a bit
standard unit of measure in computers
-
what is a bascia whole unit of info used to form the written codes assigned to retrievable computer data archives known as "the memory"
Byte
-
processing speeds, memory requirements, interface equipment, operating system requirements, and software to run the clinical software
hardware
-
system, application, programming tools
software
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