When nursing professionals work with information and generate information and knowledge as a product they can be described as quizlet?

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May be used to refer to the application of information science and technology to acquire, process, organize, interpret, store, use, and communicate medical data in all of its forms in medical education, practice, and research, patient care, and health management; the term may also refer more broadly to the application of informatics to all of the healthcare disciplines as well as the practice of medicine.

Use of information and computer technology to support all aspects of nursing practice, including direct delivery of care, administration, education, and research.

Nursing informatics is a specialty that integrates nursing science, computer science, and information science to manage and communicate data, information, knowledge and wisdom into nursing practice. Nursing informatics facilitates the integration of data, information, knowledge and wisdom to support patients, nurses, and other providers in their decision making in all roles and settings. this support is accomplished through the use of information structures, information processes, and information technology.

an RN with experience but no formal education in the area.
-proficiency with informatics applications to support all areas of nursing practice including quality improvement activities, research, project management, system design, development, analysis, implementation, support, maintenance, and evaluation
-fiscal management
-integration of multidisciplinary language/standards of practice
-skills in critical thinking, data management and processing, decision making, and system development, and computer skills
-identification and provision of data for decision making

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may be broadly defined as the use of information and computer technology to support all aspects of nursing practice, including direct delivery of care, administration, education, and research. The definition of nursing informatics is evolving as advances occur in nursing practice and technology; there have been many different definitions throughout the years as the discipline has evolved.
Nursing informatics is a specialty that integrates nursing science, computer science, and information science to manage and communicate data, information, knowledge and wisdom into nursing practice.
Nursing informatics facilitates the integration of data, information, knowledge and wisdom to support patients, nurses, and other providers in their decision making in all roles and settings.
This support is accomplished through the use of information structures, information processes, and information technology.

is the synthesis of information derived from several sources to produce a single concept or idea.
based on a logical process of analysis and provides order to thoughts and ideas and decreases uncertainty.
dynamic and derives meaning from its context.
Validation of information provides knowledge that can be used again. Historically, nursing has acquired knowledge through tradition, authority, borrowed theory, trial and error, personal experience, role modeling, reasoning, and research.
Current demands for safer, cost-effective, quality care require evidence of the best practices supported by research.

Traditionally, client data and information have been handwritten in an unstructured format on paper and placed in multiple versions of the patient record at hospitals, clinics, physician offices, and long-term and home health agencies.
This process makes the location, abstraction, and comparison of information slow and difficult, limiting the creation of knowledge.
Increasing demands for improvements in healthcare delivery call for the use of IT as a means to automate and share information for quality measurement and improvement, research, and education.
Technology exists to move from paper-based to computer-based records. It is essential that nurses collaborate with technical personnel to plan what information to include, the source of the information, and how it will be used.
Nurses must be active participants in the design of automated documentation to ensure that information is recorded appropriately and in a format that can be accessed and useful to all healthcare providers.
Nurses also have a responsibility to safeguard the security and privacy of client information via education, policy, and technical means.

American Association of Colleges of Nursing.
organization that provides a voice for baccalaureate and higher degree nsg ed programs in US.
provide curriculum elements and a framework for baccalaureate and higher degree nsg programs.
established informatics as curriculum element for baccalaureate, master's, and doctoral programs.
Baccalaureate: expected to provide skills needed to manage info and apply to pt care technology.
MSN: expected to use pt care technologies to deliver and enhance care, use communication technologies to integrate and coordinate care, analyze data to improve pt outcomes, manage info for evidence based care and pt ed, use and facilitate electronic health records (EHRs) to improve pt care.
Advanced practice grad should be able to answer questions that arise in practice, use new knowledge to analyze the outcomes of interventions and initiate change, use technology inclusive of information systems for the purpose of storage and retrieval of data, and query databases for the purpose of using available research in practice.
DNP graduates should be active participants in the design, selection, and use of IT for the purpose of supporting patient care and healthcare systems

refers to application of informatics to all of the healthcare disciplines as well as to the practice of medicine.
focus primarily upon information technologies that involve patient care and medical decision making.
May be used to refer to the application of information science and technology to acquire, process, organize, interpret, store, use, and communicate medical data in all of its forms in medical education, practice and research, patient care, and health management; the term may also refer more broadly to the application of informatics to all of the healthcare disciplines as well as the practice of medicine.
Generally used as a broad term to include all the disciplines in the field with specific health-related areas beneath it, including nsg informatics and consumer informatics.

This individual has advanced preparation in information management and possesses the following skills (ANA 2008):
• Proficiency with informatics applications to support all areas of nursing practice including quality improvement activities, research, project management, system design, development, analysis, implementation, support, maintenance, and evaluation
• Fiscal management
• Integration of multidisciplinary language/standards of practice
• Skills in critical thinking, data management and processing, decision making, and system development, and computer skills
• Identification and provision of data for decision making

growing number of Americans favor the use of electronic records as a means to improve the quality of care and lower costs.
Most feel that the benefits of electronic records outweigh risks to privacy, but concerns over privacy remain one of the biggest obstacles related to health information exchange.
quality patient care includes the protection of patients' private health information.
This protection is mandated through the Health Insurance Portability and Accountability Act.
Individual healthcare organizations employ a variety of safeguards to protect the privacy of health information.
Despite these measures data security is a real issue in healthcare, with many hospitals reporting a lack in confidence in their ability to prevent data security breaches.
Several well-publicized breaches have occurred in recent years leading to fines, litigation, damaged reputations, credit issues, and identity theft concerns.
Some of the greatest risks have come from off-line data such as stolen or lost storage media or computers, although increased access to patient healthcare information from points both inside and outside of healthcare facilities and from mobile devices such as personal digital assistants (PDAs), laptops, and smartphones also raise the potential risk of unauthorized access to private health information.
The Growing use of e-mail and Web 2.0 applications for health education, reminders, and other patient-provider communication further increases this risk.

include the following:
• A differentiated practice.
Nursing informatics differs from other specialties within nursing because it focuses on data, information, and knowledge; the structure and use are the same; and efforts to guarantee that nursing information is represented in efforts to automate health information.
It shares an interest in the client, the environment, health, and nurses in other areas of specialty practice.
• Defined research priorities.
Target areas for research were identified and published in the early 1990s.
These centered primarily on the development of a standard language for use within nursing, which would allow nurses from different regions of a country or the world to establish that they were describing the same phenomenon and to conduct studies that could be replicated.
In more recent years, survey results identified additional areas deemed critical for research, although the development of a standard nursing language remains crucial. The development of databases for clinical information is another priority area.
• Representation by one or more organization(s).
This criterion is met because nursing informatics interests are represented by work groups within the AMIA and the IMIA, in a number of regional groups within the United States, and in national groups abroad.
• Formal educational programs.
Early leaders in nursing informatics obtained their expertise through experience as well as classes in related areas such as computer science and information science. Grant monies from the Division of Nursing of the Health Resources and Services Administration (National Advisory Council on Nurse Education and Practice 1997) were used to establish the first two graduate programs in nursing informatics at the University of Maryland in 1988 and at the University of Utah in 1990.
There are now several graduate programs as well as certificate programs and doctoral education in this area.
Some nurses still elect to enter programs in healthcare informatics and medical informatics as a means to pursue their interests.
• A credentialing process.
The American Nurses Credentialing Center (ANCC 2001) used the foundation provided by the ANA in its 1994 definition of nursing informatics and scope and standards of practice.

a. A baccalaureate or higher degree in nursing or a baccalaureate in a relevant field
b. A current, active license as a professional nurse in the United States or a legally recognized equivalent in another country
c. The equivalent of 2 years of full-time professional practice as a nurse
d. Thirty contact hours of continuing education applicable to nursing informatics within the past 3 years
e. A minimum of 2,000 hours of practice in informatics nursing in the past 3 years, or a minimum of 12 semester hours of graduate credits in nursing informatics courses with at least 1,000 hours of practice in informatics nursing within the previous 3 years, or completion of a graduate program in nursing informatics that includes at least 200 hours of faculty supervised clinical practicum.
The certification examination covers content on the theory; information management principles and database management; human factors; and the analysis, design, implementation, evaluation, support, and marketing of information systems as well as trends and issues.

large computerized database management systems that support several types of activities that may include provider order entry, result retrieval, documentation, and decision support across distributed locations.
AKA client care information systems.
ex. nursing, lab, pharm, radiology, medical information systems, ED systems, physician practice mgt systems, long term and home care information systems

designed to meet needs of one or more depts or fxns within organization.
adopt vendor based solutions with little customization to allow implementation to occur quicker.
either standalone or work w/ other systems to provide sharing and seamless functionality.
seen as the means to achieve improved productivity, safety, increase quality of care, meet regulatory and reimbursement requirements, and reduce costs across the enterprise.
IT acheived thru evidence-based care, improved work flow, and better mgt of resources.
electronic health records, clinical decision support systems, bedside med administration using + pt id, computerized provider order entry (CPOE), pt surveillance, clinical data warehouse (CDW).

provider order entry, result retrieval, documentation, and decision support across distributed locations.
documentation of nsg admission assessment, d/c instructions, nsg worklist w/ routine scheduled activities r/t to care of each client, documentation of discrete data (vs, wt, i/o), documentation of routine aspects of care (bath, positioning, blood gluc, dietary intake, wound care flowsheet), standardized care plans allow for individualization, document of nsg care in progress note format (narrative chart, chart by exception, or flowsheet chart), document of med administration,

emerged from a national gathering of leaders from nursing administration, practice, education, informatics, technology, and government, as well as other key stakeholders, who realized that nursing must transform itself as a profession to realize the benefits that electronic patient records can provide.
purpose was to create a vision for the future of nursing to provide a safer, higher-quality patient care through the use of IT. requires informatics competencies for every nurse and active involvement in advancing HIT.
called for the redesign of nursing education to keep up with rapid changes in technology, active participation by nurses in the design of informatics tools, and increased visibility by nurses in the national health IT agenda.
It organized teams to work toward the common goals; obtained additional funding; developed work plans and outcomes for each team; and identified informatics competencies for all levels of nursing personnel, including nursing assistants.

This individual has advanced preparation in information management and possesses the following skills (ANA 2008):
• Proficiency with informatics applications to support all areas of nursing practice including quality improvement activities, research, project management, system design, development, analysis, implementation, support, maintenance, and evaluation
• Fiscal management
• Integration of multidisciplinary language/standards of practice
• Skills in critical thinking, data management and processing, decision making, and system development, and computer skills
• Identification and provision of data for decision making

Healthcare reform has re-emerged as a policy imperative in recent years.
In 2004 President George W. Bush created the position of the national health information technology coordinator and called for the establishment of an EHR for every American by 2014 (Miller & West 2009).
However, it was not until President Obama signed the American Recovery and Reinvestment Act (ARRA) and the Health Information Technology for Economic and Clinical Health (HITECH) Act into law in 2009 that the Department of Health and Human Services (HHS) was given authority to establish programs to improve healthcare quality, safety, and efficiency through the use of HIT and that funds were provided to support widespread adoption of HIT (McDermott Will & Emery 2009; Walker 2010).
In 2005 WHO designated the Joint Commission and Joint Commission International as the WHO Collaborating Centre on Patient Safety Solutions.
In 2007 the International Steering Committee of the Centre approved solutions for the following:
• Look-alike, sound-alike medication names
• Patient identification
• Communication during patient handover
• Correct procedure and body site
• Electrolyte solution concentration control
• Medication accuracy
• Catheter and tubing misconnections
• Needle reuse and injection device safety
• Hand hygiene.
The latter group of patient safety issues include follow-up on critical test results, falls, hospital-acquired central-line infections, pressure ulcers, care of the rapidly deteriorating patient, patient and family involvement in care, provider apology and disclosure, and medications with names that look or sound similar. The Centre coordinates the High 5s Project, which is developing standard operating procedures to address widespread patient safety problems across the globe.

The drive for patient safety, transparency in healthcare, error reduction, increased efficiency, and additional requirements on the part of regulatory agencies will continue to shape healthcare delivery and informatics practice for many years to come. Consumers will assume a greater responsibility for their healthcare choices as they shoulder a larger portion of the costs.

concepts have unique identifiers known as codes.
codes are made up letters, numbers, or a combo of both, used to designate concepts in a computer system.
concept w/ assigned code = codified.
concept codes facilitate dev of EBP and decision support rules, report administrative and financial healthcare standards for diagnoses, procedures, drugs, quality measures.
codified data track disorders, nsg problems, allergies, procedures, and s/s.

Terminology is required to represent, communicate, exchange, manage, and report data, information, and knowledge.
It enables safe, patient-centric, high-quality healthcare that optimizes data collection for the measurement of patient outcomes. EHRs can no longer be developed or implemented without standardized terminologies.
Data exchange between EHR application systems must take place without loss of meaning.
The use of standardized nursing terminology will result in better communication to the interdisciplinary team, increase the visibility of nursing interventions, enhance data collection used to evaluate and analyze patient care outcomes, and support greater adherence to standards of care.
Further, the use of standardized nursing terminology can be used to assess nursing competency.
Healthcare facilities are required to demonstrate the competency of staff for the Joint Commission.
The nursing interventions delineated in standardized terminologies can be used as a means to assess nurse competency in the performance of these interventions

Consultants may be hired for assistance in any phase of the selection process, including recommendations for the composition of the steering and selection committee, assessing the current information system, system planning, testing, security, policy and procedure development, and implementation.
The steering committee membership must be multidisciplinary, including representation from all departments affected by the new system and incorporating the clinical, administrative, and information system divisions.
This strategy is essential for id of all pertinent issues and reduces the possibility of overlooking potential problems.
The committee should be large enough to make a good decision but small enough to be effective and efficient.

Well-designed systems can allow for improvements in patient safety, the number of errors, data entry, information displays, and information interpretation, and contribute to sound decision making.
Other overall impacts include decreases in the time to complete tasks, user disruptions, training time, software rewrites, burden on support staff, and user frustration.
Usability techniques allow informatics to identify issues with technology.
More important, usability methods address why users are having those problems. Issues can then be addressed before technology is released.
The broad goals of usability are promoting acceptance and use of systems through improved interactive systems and software, developing new kinds of applications to support specific work, and promoting job optimization with the use of information systems.
goals: effectiveness, efficiency, and satisfaction.

Interoperability=The ability of two entities, human or machine, to exchange and predictably use data or information while retaining the original meaning of that data.
The need to exchange health data continues to grow in response to the demands placed by managed care, consumers seeking improved levels of healthcare, Meaningful Use requirements, and the mandate for comparative effectiveness research. To derive the utmost benefit from data, it must have a consistent or standard meaning across institution, enterprise, and alliance boundaries, facilitating the exchange of client data.
One major step in the integration process is the development of a uniform definition of terms, or language. This is essential for the easy location and manipulation of data. Uniform languages are essential to ensure semantic interoperability within EHRs.
The Systematized Nomenclature of Medicine-Clinical Terms (SNOMED-CT) is globally recognized as a common language for electronic health applications.
Health Level 7 (HL7)=A major standard for the exchange of clinical data for integration is Health Level 7 (HL7). HL7 refers to both an organization and its standards for the exchange of clinical data. The mission statement of Health Level 7 International states that its purpose is to provide standards for interoperability "that improve care delivery, optimize workflow, reduce ambiguity and enhance knowledge transfer among all of our stakeholders" .
HL7 provides a structure that defines data and elements and specifies how the data are coded.

It is integration that allows data from many disparate information systems to be accessed from one point by the user, but it is interoperability that allows for the meaningful exchange of information that retains its meaning as it crosses from one system to another, ultimately providing a complete record for each client. When information system professionals speak of integration, interoperability is the implied outcome.

process by which the physician or another healthcare provider, such as a nurse practitioner, physician's assistant, or physical or occupational therapist, directly enters orders for client care into a hospital information system.
Its benefits include a reduction in transcription errors; a decrease in elapsed time from order to implementation; standardization and more completeness of orders; fewer medication errors; and the ability to incorporate CDS, alerts for critical lab values, and prompts when certain tests are due.
Information is drawn from separate systems such as the hospital, pharmacy, and laboratory systems with drug databases to warn prescribers of potential problems with dosages, potential drug interactions, allergies, and contraindications such as pregnancy or other health conditions.

1. Record demographic information (preferred language, gender, race ethnic background, date of birth, date/cause of death (inpatient setting only)).
2. Computerized provider order entry.
3. Clinical decision support and the ability to track compliance with rule(s).
4. Automatic, real-time drug-drug and drug-allergy interaction checks based on the medication list, allergy list.
5. Maintain an active medication list.
6. Maintain an active medication allergy list.
7. Record and retrieve vital signs (height, weight, blood pressure, BMI, growth charts for ages 2-20 years).
8. Record smoking status for patients 13 years old and older.
9. Mechanisms to protect information created or maintained by the certified EHR technology that include access control.
10. Electronically exchange key clinical information among providers and patient-authorized entities.
11. Supply patients with an electronic copy of their health information upon request.
12. Supply patients with an electronic copy of their discharge instructions upon request.
13. Report required clinical quality measures to CMS.
14. Maintain up-to-date problem lists of current and active patient diagnoses.

Optional stage 1 core measures:
1. Incorporate clinical lab test results as structured data.
2. Generate patient lists by specific conditions to use for quality improvement, reduction of disparities, research or outreach.
3. Submit electronic data to immunization registries.
4. Submit syndromic public health surveillance data electronically in accordance with applicable law.
5. Identify and provide patient-specific education resources.
6. Drug-formulary checks.
7. Support medication reconciliation.
8. Generate summary care records for transition of care/referral.
9. Electronic submission of reportable lab results.
10. Advance directives for patients 65 years old and older.

Digital version of patient data found in traditional paper records. Increasingly used to refer to a longitudinal record ideally of all healthcare encounters.
generic term for all electronic healthcare systems and recently became favored term for lifetime computerized record.
an electronic record of health-related info on an individual that conforms to nationally recognized interoperability standards and that can be created, managed, and consulted by authorized clinicians and staff across more than one health care organization.
Because of the capabilities within healthcare technology and the federally mandated initiatives that are currently taking place, the exclusive use of the EHR is truly where healthcare is headed.
• The electronic medical record (EMR) is the legal record created in hospitals and ambulatory environments and often is restricted to a single episode of care.
• The electronic health record (EHR) is a longitudinal record that includes client data, demographics, clinician notes, medications, diagnostic findings, and other essential healthcare information.
• The EMR serves as a building block for the electronic health record EHR.
• Few hospitals or physician practices have attained the advanced stages of the EMR.
• The Institute of Medicine identified 12 major components or characteristics of the CPR, which continue to provide the standard for current EHR systems with only slight refinement.
• A major driver for U.S. adoption of the EHR at this time are the "Meaningful Use" financial incentives legislated by the Health Information Technology for Economic and Clinical Health Act (HITECH) of the 2009 American Recovery and Reinvestment Act.
• The EHR offers benefits to nurses, physicians, and other healthcare providers, the healthcare enterprise, and, most importantly, the consumer.
• The HITECH has sparked new interest in EHRs and brings focus and consistency to U.S. EHR adoption efforts.
• One of the major considerations in the implementation of an EHR system at this time is the selection of a system certified as capable of supporting Meaningful Use requirements to enable eligible providers to receive financial incentives.
• Other considerations in the adoption of EHR systems include creating the perquisite infrastructure, costs associated with system purchase and support, and the integration of standardized nomenclatures to support interoperability and research. Despite its many benefits, setting realistic expectations, planning for culture change, instituting safeguards to protect patient information, and caregiver resistance are the major impediments to the development of an EHR.
• Issues that must be considered when developing the EHR include data integrity, ownership of the patient record, privacy, and electronic signature.

The criteria associated with each stage are listed here.
Stage 0: Some clinical automation exists but the laboratory, pharmacy, and radiology systems are not all operational.
Stage 1: The major ancillary clinical systems—the laboratory, pharmacy, and radiology systems—are all installed.
Stage 2: Major ancillary clinical systems send data to a clinical data repository (CDR) that allows physicians to retrieve and review results. The CDR also contains a controlled medical vocabulary and clinical decision rules engine that checks for conflict. Document imaging systems may also be linked to the CDR.
Stage 3: Basic clinical documentation (vital signs, flow sheets) is required. Nurses' notes, care plans, and/or electronic medical administration records may be present and are integrated with the CDR for at least one hospital service. Basic clinical decision support is available for error checking with order entry. Some availability is present for the retrieval and storage of diagnostic imaging. Typically this refers to the picture archiving communications systems (PACS) used for x-rays and other diagnostic images.
Stage 4: Computerized provider order entry (CPOE) and a second level of clinical decision support for evidence-based practice are added to the previous stages.
Stage 5: At least one service area has the closed loop medication administration process where barcode medication administration (BCMA), radio frequency identification (RFID), or other identification technology is in place and integrated with CPOE and the pharmacy to maximize patient safety.
Stage 6: At least one service area has full physician documentation, third-level clinical decision support for all clinicians for protocols and outcomes with variance and compliance alerts, and a full PACS system.
Stage 7: This is a paperless environment where all information is shared electronically and the EHR can produce a continuity of care document (CCD).

Lifelong tool for managing health information such as disease conditions, allergies, medications, past surgeries, and other relevant information.
one example of a consumer-centric innovation, which, by definition is subject to the review and control of consumers who view, and sometimes supply information for the record, and dictate what other entities may view their record.
Electronic personal health record (PHR) [is]: a private, secure application through which an individual may access, manage and share his or her health information.
The PHR can include information that is entered by the consumer and/or data from other sources such as pharmacies, labs, and health care providers.
The PHR may or may not include information from the electronic health record (EHR) that is maintained by the health care provider and is not synonymous with the EHR.
PHR sponsors include vendors who may or may not charge a fee, health care organizations such as hospitals, health insurance companies, or employers.
In their simplest concept, PHRs are electronic systems that allow people to record, access, and share health-related information in order to help them better manage their health and healthcare.
• The PHR continues to evolve as technology and information exchange advances.
• This record is expected to play a greater role in personal health management in the future.
• The PHR is a consumer-centric, lifetime health record. Early forms were entirely paper-based. Recent developments make the PHR available via Internet connections.
• Information in the PHR may be supplied from the individual, healthcare providers, pharmacies, third-party payers, therapists, laboratory tests, and radiology results, as well as other information deemed appropriate by the individual such as exercise routines and herbal supplements.
• The concept behind the PHR is that access and information are controlled by the consumer.
• Patients may use PHRs to better manage health conditions by entering their results for their own use as well as review by their providers.
• PHRs may also provide a means to verify and obtain authorization for treatment and to determine claim status.
• Portability, privacy, and accuracy of data populated by providers or payers constitute some of the big concerns related to PHR use.
• PHRs provide the potential to improve consumer health via the ability to generate reminders for appointments, blood tests, prescription refills, results, and wellness reminders.

The Health Information Technology for Economic and Clinical Health Act (HITECH) strengthened HIPAA security and privacy protection and provides financial incentives for the user of EHRs.
While HIPAA and HITECH have designated some technical standards as mandatory, those standards are insufficient to enable collection, management, and exchange of the mandated data.
Technical standards are needed to ensure that structured and codified terminologies, sufficiently comprehensive to capture all of healthcare, are widely available, that data can be securely and easily exchanged within and across organizations, and that a valid, safe, and reliable patient-centered community-care record can be created and maintained.
Healthcare entities, as well as their business associates, must notify individuals whose health information is breached within 60 days of that breach.
The entity also needs to notify the DHHS and local news media if more than 500 individuals are affected by a breach of information security.
If data are encrypted, notification of a breach is not required. However, an entity has to validate whether data encryption works and meets federal standards.

• The primary goals of healthcare information system security are the protection of client confidentiality and information availability and integrity.
• Privacy and confidentiality are important terms in healthcare information management. Privacy is a choice to disclose personal information, while confidentiality assumes a relationship in which private information has been shared for the purpose of health treatment.
• Information privacy is the right to choose the conditions under which information is shared and to ensure the accuracy of collected information.
• Threats to information and system security and confidentiality come from a variety of sources, including system penetration by thieves, hackers, unauthorized use, denial of service and terrorist attacks, cybercrime, errors and disasters, sabotage, viruses, and human error.
• Planning for security saves time and money and is a form of insurance against downtime, breaches in confidentiality, and lost productivity.
• Security mechanisms combine physical and logical restrictions.
• Examples include automatic sign-off, physical restriction of computer equipment, strong password protection, and firewalls.
• Ultimately, healthcare administrators are responsible for protecting client privacy and confidentiality through education, policy, and creating an ongoing awareness of security.
• One aspect of system security management includes monitoring the system for unusual record access patterns, as might be seen when a celebrity receives treatment.
• Health information on the Internet requires the same types of safeguards provided for information found in private offices and information systems.
• All chart printouts, forms, and computer files containing client information should be given the same consideration as the client record itself to safeguard confidentiality.
• More secure methods of authentication are needed as even the best passwords can be compromised.

Healthcare entities, as well as their business associates, must notify individuals whose health information is breached within 60 days of that breach.
The entity also needs to notify the DHHS and local news media if more than 500 individuals are affected by a breach of information security.
If data are encrypted, notification of a breach is not required. However, an entity has to validate whether data encryption works and meets federal standards.
Patients can now restrict some disclosures of personal health information (PHI) in certain circumstances.
These restrictions are limited in scope.
If a medical practice uses EHRs, the practice has to respond to patient requests for an accounting of all PHI disclosures up to 3 years.
The Patient Protection and Affordable Care Act (Affordable Care Act), signed into law in March 2010, brings major changes to the U.S. health system.
It guarantees access to healthcare for all Americans, creates new incentives to change clinical practice to foster better coordination and quality of care, gives practitioners more information so they can improve their clinical practice, gives patients more information to help them become more value conscious, and changes the healthcare payment system to reward value.

The Health Insurance Portability and Accountability Act (HIPAA) of 1996 created landmark legal protection for personal health information (PHI). PHI refers to individually identifiable health information such as demographic data; facts that relate to an individual's past, present, or future physical or mental health condition; provision of care; and payment for the provision of care that identifies the individual. Examples include name, address, birth date, Social Security number, allergies, claims data, lab results and other diagnostic history, prescription history, records about past visits to physicians, emergency rooms and other healthcare encounters, vaccination records, and prior in- and outpatient procedures.
Transactions are electronic exchanges involving the transfer of information between two parties for specific purposes. When a healthcare provider sends a claim for payment of services, a transaction has taken place.
HIPAA mandated the adoption of selected standard transactions for electronic data interchange (EDI) of healthcare data.
These standard transactions are claims and encounter information, payment and remittance advice, claims status, eligibility, enrollment and disenrollment, referrals and authorizations, and premium payment.

Under HIPAA, every person has the right to examine and obtain a copy of protected information.
Typically, requested copies have been in paper form.
Under ARRA, every person now has the right to have an electronic copy of an EHR and to have a copy directly transmitted to any designated entity.

The Centers for Medicare & Medicaid Services (CMS) have not formally defined telemedicine for the Medicaid program, and Medicaid does not recognize telemedicine as a distinct service. Medicaid reimbursement for telehealth services is available at the discretion of individual states as a cost-effective alternative to traditional services or as a means to improve access for rural residents.

First, there is the possibility that the client may perceive it as inferior because the consulting professional does not perform a hands-on examination. The American Nurses Association (ANA) cautions that telehealth shows great promise as long as it is used to augment, not replace, existing services. Second, professionals who practice across state lines deal with different practice provisions in each state and may be subject to malpractice lawsuits in multiple jurisdictions, raising questions about how that liability might be distributed or which state's practice standards would apply. Theoretically, clients could choose to file suit in the jurisdiction most likely to award damages. The basic question here is, where did the service occur? Third, how might liability be spread among physicians, other healthcare professionals, and technical support persons? And fourth, HIPAA legislation added new concerns to the mix. These issues remain concerns today.

The American Recovery and Reinvestment Act of 2009 provides for billions of dollars in stimulus funding for research, operations, and grants in the telemedicine, telehealth, and informatics sectors. More than 24 government agencies provide grant monies to fund telehealth, telemedicine, and health information technologies, including the U.S. Departments of Health and Human Services, Homeland Security, Defense, Veterans Affairs, Commerce, Agriculture, Energy, Justice, Interior, Education, Labor, State, and Transportation. There are also private, nonprofit, national, and global groups such as the Center of Excellence for Remote and Medically-Underserved Areas and the Acumen Fund that use entrepreneurial approaches to solve health services problems.

• Telehealth is the use of telecommunication technologies and computers to provide healthcare information and services to clients at another location.
• Telehealth is a broad term that encompasses telemedicine but includes the provision of care and the distribution of information to healthcare providers and consumers.
• Efforts to contain costs, improve the delivery of care to all segments of the population, and meet consumer demands make telehealth an attractive tool. Telehealth can help healthcare providers treat clients earlier when they are not as ill and care costs less, provide services in the local community where it is less expensive, improve follow-up care, improve client access to services, and improve the quality of the client's record.
• Telehealth applications vary greatly and include client monitoring, diagnostic evaluation, decision support and expert systems, storage and dissemination of records, and education of healthcare professionals.
• Teleconferencing and videoconferencing are tools that facilitate the delivery of telehealth services.
• Desktop videoconferencing (DTV) is an important development that enables the expansion of telehealth applications into new areas. DTV uses specially adapted personal computers to link persons at two or more sites.
• Telenursing uses telecommunications and computer technology for the delivery of nursing care and services to clients at other sites.
• Neither telemedicine nor telenursing is new. Applications include education of healthcare consumers and professionals as well as the provision of care. In addition to the use of the telephone for triage and information, clients may be monitored at home via telephone or teleconferences. Telehealth is a tool that helps healthcare providers to work more efficiently.
• Major issues associated with the practice of telehealth and telenursing include a lack of reimbursement, infrastructure, plug-and-play standards, licensure and liability issues, and concerns related to client privacy and confidentiality.
• The successful use of telehealth and telenursing is best ensured through the development and implementation of a plan that addresses current services and deficits, goals, technical requirements, compliance with standards and laws, reimbursement, and strategies to handle telecommunication breakdowns.
• Telehealth and telenursing applications are expected to become more commonplace once reimbursement and licensure barriers are removed and technical standards for the exchange of information between telehealth devices and clinical information systems are established.
• Telehealth has the capacity to revolutionize the delivery of healthcare and has already started to do so.

globally recognized controlled healthcare vocabulary that provides a common language for electronic health applications. SNOMED-CT enables a consistent way of capturing, sharing, and aggregating health data across specialties and sites of care. The use of SNOMED-CT within EHRs provides interoperable data collection that can be analyzed and used in the implementation of evidence-based practice, decision-support rules, reporting of quality measures, and administrative billing.
clinical terminology comprised of codes, concepts, and relationships used in recording and representing clinical information across the scope of healthcare. SNOMED-CT is concept-based, meaning that each concept has a distinct definition with a unique code identifier.
SNOMED-CT is used to document care by clinicians, specialists, and domains using an interdisciplinary approach.
It is used to document patient care across all sites of care and healthcare facilities (acute care, home care, hospice care, spiritual health, long-term care, and healthcare clinic visits, as well as community and public health).
The documentation of assessments, flow sheets, care plans, task lists, order sets, education plans, problem lists, allergies and allergic reactions, task lists, and medication administration records can be encoded to SNOMED-CT.

is the study of how people design, implement, and evaluate interactive computer systems in the context of users' tasks and work.
HCI blends psychology and/or cognitive science, applied work in computer science, sociology, and information science into the design, development, purchase, implementation, and evaluation of applications.
Sample HCI topics include:
• The design and use of devices such as a mouse, or patient-controlled analgesia machine
• User satisfaction with a patient portal
• Users' perceptions of the effectiveness of the design of clinical documentation integrated with medication barcoding
• The meaning of icons
• The design and evaluation of applications or systems to support groups of people
• Principles of effective Web, graphical user interface (GUI), or adaptive interface design
• Social issues in computing such as dropping an individual from your virtual group
• Functional allocation of work between humans and computers
• User modeling such as cognitive analyses of users

refers to a situation in which a relationship has been established and private information is shared.
In a healthcare environment, it is the ethical principle or legal obligation that a healthcare professional will not disclose information relating to a patient unless the patient gives consent permitting the disclosure.
Confidentiality is essential for the accurate assessment, diagnosis, and treatment of health-related problems.
Once a client discloses confidential information, control over the release of this information lies with the persons who access it.
Confidentiality is one of the core tenets of medical practice.
Yet every day, healthcare professionals face challenges to this long-standing obligation to keep all information between them and patients private.
Private information should be shared only with parties who require it for client treatment.
The ethical duty of confidentiality entails keeping information shared during the course of a professional relationship secure and secret from others.
This obligation involves making appropriate security arrangements for the storage and transmission of private information, and ensuring that the hardware, software, and networks used for storage and transmission of information is secure and that measures are implemented to prevent the interception of e-mail, instant messages (IMs), faxes, and other types of correspondence that contain private information.
Nurses are obligated by the American Nurses' Association Code of Ethics and state practice laws to protect patient privacy.
The obligation of confidentiality prohibits healthcare professionals from disclosing information about a patient's case to other interested parties and encourages them to take precautions with the information to ensure that only authorized access occurs.

Personal information is information that identifies a person or could identify a person.
Obvious examples of identifying personal information include name, address, phone number, or e-mail address but could also be photos, videos, workplace name, as well as opinions and preferences.
Such identifying information can potentially allow unauthorized access to medical records, financial records, birth records, educational records, credit records, work records, and so on.
There is a trend toward integrating privacy commissions or agencies with information technology agencies to be in a better position to coordinate laws and regulations with information technology developments and intrusion prevention measures.

When nursing professionals work with information and generate information and knowledge as a product they can be described as which of the following?

When healthcare professionals work with information and generate information and knowledge as a product they can be described as?

What is the nurse's role in dealing with information technology?

When a nurse uses information from other sources to help rethink revise and apply knowledge to a clinical situation this is known as?