UTHSC Groups E and D

UTDKS · Apr 18, 2014

Cwoodru5, I think you started this thread bringing up valid points. The best explanation to why standards are needed in interoperability is like the example given in the book about railroads staying on track (Sewell, 2013).

Sewell and Thede (2013) also point out how when deviations from these standards happen it has a rippling effect on updating and maintaining data, integrate applications, and aggregate information between systems (pg. 357).

Reference:

Sewell, J., & Thede, L.Q. (2013) Informatics and nursing: Opportunities and challenges. (4th ed.). Philadelphia: Lippincott.

UTDGC · Apr 18, 2014

The National Alliance for Health Information Technology defines interoperability as the ability of different information technology systems and software applications to communicate, to exchange data accurately, effectively, and consistently, and to use the information that has been exchanged (NAHIT, 2006). The key concept of interoperability is sharing, not something that is new to the healthcare industry as doctors, nurses, and other healthcare administrative members have always been able to pass papers with various clinical informative data around the hospital or office, all be it with high constrictions due to the physical nature of "paper charting". With the introduction of the EMR interoperability becomes the main goal of the health care industry, however strict standards need to be met for the EMR to succeed. The "sharing" of information from one person to the next requires that all personnel dealing with confidental EMRs need to adhere to a set of standards, without these standards interoperability would compromise HIPPA.

laurinemory · Apr 18, 2014

UTGE1-LR

According to Sewell and Thede, “interoperability is not possible without standards” (p. 266). First, “interoperability” is defined as “the ability of one or more systems to pass information and to use the exchanged information” (Sewell and Thede, 2013, p. 266). Furthermore, a “standard” is “an agreement to use a given protocol, term, or other criterion that has been formally approved by a nationally or internationally recognized professional trade association or governmental body,” (Sewell & Thede, 2013, p. 266).

Establishing set standards is germane to creating a system that is interoperable. For example, a set medical terminology and medical acronyms are used in the electronic healthcare records to facilitate understanding of a patient's health across multiple systems and healthcare settings. Without consistency in those acronyms and terms, medical records would be cumbersome to understand, and patient care would suffer. According to HIMSS (Healthcare and Information Management Systems Society), if we consider the numerous healthcare professionals that are involved in a single patient's care--physicians, nurses, pharmacists, medical assistants, physical therapists, and so on--the need for standardization is clear (Why do we need interoperability standards?). It is difficult to imagine a time when diseases were not even classified in a standardized way, but it was 1900 before there was any agreement in medicine on standardizing the causes of death. Currently, the ICD (International Statistical Classification of Diseases and Related Health Problems) maintains a list of known diseases and injuries that is “described, classified, and assigned a unique code” (Sewell & Thede, 2013, p. 270). In the United States, the use of these codes is required by the Health Insurance Portability and Accountability Act (Sewell & Thede, 2013, p. 270).

As globalization continues, standardization of medical language and protocol will become increasingly important. As Sewell and Thede point out, quick access to health data concerning disease outbreaks has become increasingly important as individuals are traveling between states and nations more than ever before .

Healthcare and Information Management Systems Society. 2014. What is interoperability? Retrieved April 18, 2014 from https://www.himss.org/library/interoperability-standards/what-is

Sewell, J., & Thede, L.Q. (2013) Informatics and nursing: Opportunities and challenges.(4th ed.). Philadelphia: Lippincott.

laurinemory · Apr 18, 2014

UTGE1-LR, In response to cwoodru5:

I agree with you, that "standards keep interoperability on track". Often times, especially with patients who have an extensive medical history, the EMR is our best resource for keeping everything straight. Patients may be seeing multiple doctors who are prescribing multiple medications, so creating standards for the EMR across multiple healthcare settings is extremely important not only in terms of patient safety but also in terms of quality of care. Geriatric patients especially come to mind as I am writing this.

laurinemory · Apr 18, 2014

UTGE1-LR, In response to Mhunt17:

You brought up a really important point when you said that patients often have comorbid conditions that require more than one physician. It is really important for there to be standards to facilitate effective communication for among healthcare providers for patients who have multiple diseases and are prescribed many medications. I was thinking about all of the renal patients we have cared for on our floor at Methodist; most of them have comorbid diseases: diabetes, CHF, and so on. Not only do we have to consider each of their medical diagnoses and numerous medications, we also have to take into account their level of kidney function. It is easy to imagine a situation in which their safety could be compromised if the EMR is not regulated by a set of communication standards.

tkilpat1 · Apr 18, 2014

UTD-TK

Laurinemory, I agree with your Geriatric patient population point. Often times we see patients who have extensive medical histories. Maintaining a clear and concise format pertaining to each condition so that different caregivers can be on the same page is crucial in providing quality care to each client to the best of the healthcare team's abilities. Mapping, as defined by Sewell, consolidates all of the data about clients so that every discipline can understand exactly the plan of care (Sewell & Thede, 2013, p. 269). As healthcare evolves, so will the quality of communication between disciplines.

Sewell, J., & Thede, L.Q. (2013) Informatics and nursing: Opportunities and challenges.(4th ed.). Philadelphia: Lippincott.

maci12134 · Apr 18, 2014

Standards are essential in every aspect of life. Life everyone has mentioned, interoperability is how systems share and exchange information (Sewell, 2013) With Interoperability, can you imagine the chaos, mistrust, miscommunication, lack of efficiency, and expensive mistakes that could occur if standards where not assigned to things like the stock market, the government, international affairs, and especially the health care system.

The health care system has had many obstacles and barriers over the years. Members of the health care team could not readily access information related to topics without going to a medical library. Members of specialist teams such as neurologist, nephrologist, insurance companies, labs, and even family practitioners could not readily access their client's medical records for evaluations and further referrals. Members from rural communities had a disadvantage with communication and easy access to health professionals. "There were physical, economic, and knowledge barriers to receiving optimal healthcare services." (E-health standards)

Setting up electronic medical records allowed for open access for review of data that greatly benefits the medical staff and the client to receive quick and efficient care. The access to medical records could. With physicians, insurances, and hospitals all using different entities to provide these records, access and communication was still minimal without the help from interoperable standards. Along with the time zone example in the book, fire departments, ems, police departments, and hospitals, along with different cities, all used different f frequencies in communication. With standards, "information in common formats, encrypt or compress information, perform functions like error detection and correction, or provide common addressing or security structures." (E-health standards) Having these standards allow for reliable sharing of information communication between devices of physicians and facility which all adhere to the standards which help overcome barriers for optimal healthcare. "ICT standards enable not only e-health but the Internet, mobile systems, the traditional phone system, and systems that deliver digital music, movies, video, and images." (E-health standards) The advancement of course leaves a grave concern with privacy and security for hospitals and clients, but in my opinion the benefits greatly out weight the risk.

E-health Standards and Interoperability. ITU-T Technology Watch. (April 2012). http://www.itu.int/dms_pub/itu/oth/23/01/T23010000170001PDFE.pdf

Sewell, J. P., & Thede, L. Q. (2013). Informatics and nursing: opportunities and challenges (4th ed.). Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins.

-Megan Mallamaci

maci12134 · Apr 18, 2014

I Agree exactly what you have said. Interoperability is essential in all aspects, but is very beneficial and important in the nursing realm. We must be up to date on how to use new and old equipment to give the best care to our patients as well as keeping up to date with labs that are done, and imaging to know continuously what is going on with our patients. We also are responsible for understanding the protocols on documenting and the care of patients such as correct baths and NPO status to we do not jeopardize the health of our patients. Without correct documentation protocol, other health professionals may not be aware of the health state and critical findings of a patient.

Great post.

maci12134 · Apr 18, 2014

I definitely agree with standards of acronyms and medical terminology used. As we all have seen in class and in the hospital there are tons of meanings to certain abbreviations that could be taken in the wrong context and potentially cause grave harm to our patient. The need for a standard set is crucial, but we also have all seen old doctors and nurses set in their ways. Such as still not using gloves when drawling blood, or refusing to use a more up-to-date medication out because they have always had success with their old medications. It is hard for them to grasp the new diagnosis out there and the large amount of multiple co-morbidity that patients have now, and the need to use different strategies and communication for care.

ldye2 · Apr 18, 2014

According to The National Alliance for Health InformationTechnology, interoperability, in healthcare, is defined as "the ability ofdifferent information technology systems and software applications tocommunicate, to exchange data accurately, effectively and consistently, and touse the information that has been exchanged". The ultimate goal of informatics and the interoperability therein is toprovide information equipped, data-driven patient specific care. This goal can not be achieved withoutexpecting a certain level of standard. Specifically, those that denote theoutcomes of interoperability, as well as those that govern the healthcare teamthat will have access to the private information of patients should be included in any plan for interoperability. The standards of interoperability should bepresent in every facet of the healthcare team. There are standards that identify the benefits of it forhealth professionals, health managers, health researchers, and mostimportantly, the patients. Withoutinteroperability, necessary data and information will not be shared or may be erroneously shared and thiswould undoubtedly compromise the level of care provided to patients. Standards are key to creating a healthcare record that is patient-centered and successful in providing point of care services for clients.

Interoperability in Health Informatics Systems. 2014. Retrieved April 18, 2014 from

http://www.openclinical.org/interoperability.html

utnursejdm2014 · Apr 18, 2014

While working in the healthcare field for just a short amount of time , I realized how vital accurate communication is. Patient's today have more than one doctor working together ,so this is where the interoperability plays a major role. According to Sewell , interoperability is the ability of two or more systems to pass information and to use the exchange information ( Sewell, 2013).This is very effective in delivering accurate healthcare information and can eliminate possible medication and surgery error. These healthcare system would not be efficient without having standards. A standard is an agreement to use a given protocol, term, or other criterion that has been formally approved by a nationally or internationally recognized professional trade association or governmental body( Sewell,2013). Just imagine a nurse's job day to day without having some type of standards involving time, orders, and medications. Drugs administration times wouldn't be accurate, abbreviation usage would lead to miscommunication, and STAT orders could possible be delayed if these systems didn't exist.

Sewell, J. P., & Thede, L. Q. (2013). Electronic healthcare system issues. In Informatics and nursing: Opportunities and challenges (4th ed., p. 266). Philadelphia, PA: Wolters Kluwer Health/Lippincott Williams & Wilkins

ldye2 · Apr 18, 2014

I agree with you UTDGC. Standards should exist and function as a governing system in an effort to ensure that all healthcare professionals adhere to the expectations and privacy laws of HIPPA. However, standards should also function in a "streamlining" approach to ensure that every healthcare provider is "on the same page", literally and figuratively. Some one in an earlier post commented that not having access to the same patient information, including any updates would severely compromise the level of care provided to the patient no to mention, put the patient at risk for medical errors. Hammond (2005)states " Health data standards are key to the U.S. quest to create an aggregated, patient-centric electronic health record; to build regional health information networks; to interchange data among independent sites involved in a person's care" ( Hammond 1205). Aggregation involves a meeting of the minds and coordination of the system. For without this coordination, vital information would be lost and in turn , point-of-care services would not be successfully implemented.

Hammond, W.E.(2005). The making and adopting of health data standards. Health Affairs, 24 (5), 1205-1213. The Making And Adoption Of Health Data Standards