Statistics for Health Sciences & its Impact

           

 Statistics in health sciences is beneficial to health care professionals but to patients as well. Statistics in health sciences can be used to follow trends for illnesses and disease such as flu, diabetes, infant mortality, and life expectancy. The impact of the integration of medical records and statistics in health sciences allows better reporting to the Centers for Disease Control (CDC) in order to measure the health of the population. Electronic medical records are at the core of statistical reporting for the health of the population as the electronic record not only contains information from primary care, but from acute care, home care, and specialty care. With the reporting of electronic medical records, the CDC can show new cases of diagnosed diabetes among people aged 20 years or older in the United states in 2012:

	Number of new diabetes cases	Rate of new diabetes cases Per 1,000 (unadjusted)
Total
20 years or older	1.7 million	7.8
By Age
20-44	371,000	3.6
45-64	892,000	12.0
65 years or older	400,000	11.5

(Centers for Disease Control & Prevention, 2014)

With new mandates that are put in place for health care organizations through Medicare and Medicaid, there are 15 parts of data that must be collected for the first stage of meaningful use:

1.      Must use computerized physician order entry (CPOE) for >30% of unique patients with at least one medication in their medication list

2.      Drug-drug and drug-allergy interaction must be enabled

3.      E-Prescribe for >40% of the permissible prescriptions

4.      Record demographics as structured for data for >50% of all unique patients seen

5.      Maintain an up-to-date problem list of current and active diagnoses

6.      >80% of all unique patients seen have at least one entry (or an indication that the patient is not currently prescribed any medication) recorded as structured data in the medication list

7.      >80% of all unique patients seen have at least one entry (or indication that the patient has no known medication allergies) recorded as structured data in the medication allergy list

8.      >50% of all patients age 2 and above are seen with the EHR have vital signs (height, weight, and blood pressure) recorded as structured data

9.      Record >50% of patients smoking status for patients 13 years or older

10.  Report ambulatory clinical quality measure to CMS/States on all patients in EMR

11.  Implement one clinical decision support rule

12.  Provide >50% patients with an electronic copy of their own health information within 3 business days, upon request

13.  Provide >50% of patients with a clinical summary within 3 business days

14.  Must perform at least on test of electronic data exchange of key clinical information

15.  Conduct or review a security risk analysis and implement security updates as necessary and correct identified security deficiencies (MedicalRecords.com, 2014).

With data such as those listed above being monitored, disease prevention and risks can be

tracked from a very young age. Globally speaking, disease and illness can be reported to the CDC to help show where a disease may have manifested and prevent in the further spread of disease.

            Statistics in health care can also be used to track the amount of social media and networking done by health care consumers. In a survey done in 2009, statistics showed:

• ·         60 million consumers now use new media to share their health experiences online
• ·         216 US hospitals use social media
• ·         142 US hospitals have You Tube channels
• ·         132 US hospitals maintain Twitter accounts
• ·         83 US hospitals have Facebook pages
• ·         Approximately 1,200 Facebook communities advocate for cures for chronic illnesses
• ·         72% of e-patients search for medical information right before or after a doctor’s visit
• ·         93% of e-patients say the Internet has made it possible to get the medical information they need (Healthcare on Social Media News, 2009).

By using statistics for tracking the use of consumers on social media and networking,

health care professionals can track current health care trends for the population being served which is how statistics for health sciences impacts society.

            “All governmental data collection and release activities are governed by rules, regulations, and legislative authorizations” (Bernstein, & Sweeney, 2012). With rules, regulations, and legislative authorizations put in place, only data that is permitted can be collected ensuring that patient information is kept confidential. “Uses of data beyond those for disease-monitoring purposes should be ethically justified and meet some minimal standard for the data to be shared” (Bernstein & Sweeney, 2012). If information that is deemed necessary is collected, but may be questionable in the releasing of information, this should be taken into consideration before this information and data is released. “For data collection processes in which respondents have signed or signified that they consent to have their data collected, analyzed, and released, data can only be used for purposes that the respondents agreed to when consenting to provide data” (Bernstein & Sweeney, 2012).

           

References:

Bernstein, A., & Sweeney, M. (2012). Public health surveillance data: Legal, policy, ethical,        

            regulatory, and practical issues. Centers for Disease Control & Prevention. Retrieved

            from http://www.cdc.gov/mmwr/preview/mmwrhtml/su6103a7.htm

Centers for Disease Control & Prevention. (2014). National diabetes statistics report, 2014.

Retrieved from http://www.cdc.gov/diabetes/pubs/statsreport/14/national-diabetes-report-web.pdf

Healthcare on Social Media News. (2009). Statistics: Social media use by health care

            consumers. Retrieved from http://www.healthcareos.com/250/health-care-consumer-

            social-media-statistics/

Imperial County Public Health Department. Data & statistics. Retrieved from

            http://www.icphd.com/health-information-and-resources/data-%26-statistics/

MedicalRecords.com. (2014). Required data collection for meaningful use attestation. Retrieved

            from http://www.medicalrecords.com/required-data-collection-for-meaningful-use-

            attestation 

Healthcare Informatics Evolutions & Transitions Today

The evolution of health care informatics can be traced back to the 1960s. “One of the earliest efforts took place under the jurisdiction of ASTM (American Society for Testing and Materials)” (HIMSS, 2014). The first standards that were developed by ASTM included “laboratory message exchange, properties for electronic health record systems, data consent, and health information system security” (HIMSS, 2014). In 1965, “The College of American Pathologists started developing a nomenclature for pathology” (HIMSS, 2014). In 1974, UHDDS (Uniform Hospital Discharge Data Set) was developed by the Secretary of the HHS. “In 1987, Health Level Seven (HL7) began to develop a wide range of message format standards for patient registration, orders, and observations reporting and published in its first version in October of that year” (HIMSS, 2014). The Accredited Standards Committee (ASC) started to research and develop communications for interactivity of health insurance claims and other financial transactions. It is with these first steps in healthcare informatics that this area of health care has evolved into what it is today.

As the healthcare industry continues to grow, and informatics continues to evolve, new standards are being discovered daily. Standards and needs are monitored by Standards development organizations that are put in place to be very specific to the needs of the health informatics industry. “When a standards development organization recognizes a need, which may also be related to another focus area, this creates the potential for coordinated standard development” (HIMSS, 2014). The American National Standards Institute (ANSI) was the first accredited and coordinator of standardization. “In 1991, the predecessor organization to the ANSI Healthcare Informatics Standards Board (HISB) was created, initially to respond to European efforts in healthcare informatics standards” (HIMSS, 2014). It is with the development of this group that several more standards have been recognized and researched.

Current health information systems have many vendors that differ from organization to organization. With the standards that have been put in place vendors must “accommodate the variability of work flow and the availability of information in different health care settings” (HIMSS, 2014). Message standards must be flexible and allow one system to communicate with the other. It is with the implementation of electronic medical records that health informatics will continue to grow now and in the future. When an organization integrates to an electronic medical record system, not only is patient information stored easily and made readily available to health care professionals, but with electronic medical records systems, organizations have better options to report patient outcomes and data.

Telecommunications and electronic records go hand in hand with the transitions of health care informatics today. With the use of wearable health monitoring devices introduced in 2012, patient vitals can be monitored and reported back to the electronic medical record for health professionals to view while in the office or at home. In 2013, “nearly ¾ of physicians use tablets to maintain electronic health records” (Adelphi University, n.d.). The technologies that are available are a far cry from what was previously available when electronic records were first put into use in 1967 by Utah’s Latter Day Saints Hospital. It is with the evolutions and transitions in health care informatics that patients are receiving better care and health professionals are better able to monitor patient trends and diseases.  

“Electronic health records are designed to provide nationwide access to designated information compiled from data found in the medical records created by various providers regardless of whether providers are in the same healthcare system, or in a different system” (Thede, 2008). Globally speaking, the electronic medical record and the evolutions of health care informatics are supposed to be used to help patients receive the care that is needed. Society envelops this type of care as the world we live in is technologically advanced. Society wants to see these changes happen where medical information is brought to them, whereas patients do not have to seek out information for care.

References:

Adelphi University. (n.d.). A history of healthcare informatics. Retrieved from

            http://www.emrthoughts.com/2014/08/11/history-of-health-informatics-infograph/

Allied Health News. (n.d.). Careers in health informatics. Retrieved from  

            http://www.bestalliedhealthprograms.com/allied-health-news/health-informatics-careers

HIMSS. (2014). Evolution of healthcare informatics standards. Retrieved from

            http://www.himss.org/library/interoperability-standards/Evolution-of-Healthcare-

            Informatics-Standards

Thede, L., (Aug 18, 2008) “The Electronic Health Record: Will Nursing Be on Board When the

            Ship Leaves?” OJIN: The Online Journal of Issues in Nursing Vol. 13 No. 3

            Retrieved from http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/

            ANAPeriodicals/OJIN/Columns/Informatics/ElectronicHealthRecords.aspx

Telecommunications & Networking Concepts for Health Care

            As technology continually grows, the use to telecommunications and networking in health care continue to grow as well. “The use of telecommunications in health care has grown exponentially in recent years and has enhanced opportunities for patients, health care professionals and management of the health industry in general” (Gray, 2014). With the integration of electronic health records reaching many health care organization, the options for telecommunications are growing daily. When the use of telecommunications and electronic medical records, health care professionals have the options of “video consultations, remote patient data monitoring, nursing call centers and searching for or saving personal health information online” (Gray, 2014). With these options available to health professionals, this opens up greater care and benefits for patients. “Providers benefit from health care telecommunications as well, in their organization and management of information, and in electronic tools supporting clinical care” (Gray, 2014). With electronic medical records, patient information is easier for the provider to retrieve resulting in “more control over the continued management of health intervention and knowledge of patient progress” (Gray, 2014).

            When organizations convert into an electronic system, this system must be compatible with telecommunications that are available throughout the organizations. If an organization adopts new software, hardware may need updating as well in order to be compatible with telecommunications that are offered. These technologies include “videoconferencing, the internet, store-and-forward imaging, streaming media, and terrestrial wireless communications” (Institute of Medicine, 2012). With advancing technologies, it is the goal to bring telecommunications to every aspect of health care so that health care can reach places it has never reached before. Globally, telecommunications can reach areas that have little to no health care available. In doing this, thousands of patients can receive the help that is needed in order to survive. 

            “Social media sites can be a great way for health care professionals to network with colleagues and share health information” (Britt, 2014). However, there are many legal and ethical aspects that health care professionals should be aware of before making the jump into social media. “These include issues related to patient privacy, fraud and abuse, tax-exempt status, and physician licensing” (Britt, 2014). Attorney Ike Willett offers details on the legal issues that can arise:

• ·         Patient Privacy – HIPAA and state privacy laws limit health care providers’ ability to interact with patients through social media. Health care providers are prohibited from disclosing patient information without proper consent. A health care provider discloses patient information through social media without patient authorization in violation of HIPAA and/or state privacy laws can be subject in fines and other penalties.
• ·         Fraud & Abuse – Federal and state laws aimed at preventing fraud and abuse in health care prohibit health care providers from giving third parties anything of value as an inducement for the third party to generate referrals to the health care provider for services which may be reimbursable by Medicare or Medicaid.
• ·         Tax-Exempt Status – Health care providers that are exempt from taxation under Section 501(c)(3) of the Internal Revenue Code are prohibited from intervening in political campaigns and from seeking to influence legislation as a substantial part of their activities. This may extend to advertisement of sponsoring social media sites that support a political candidate or particular pieces of legislation.
• ·         Physician Licensing – Health care professionals should not provide medical advice to patients via social media. If a patient receiving the medical advice from a doctor through social media is located in a state in which the doctor is not licensed, the doctor giving the advice risks liability under state licensing laws (Britt, 2014).

           In order for health professionals to avoid ramifications and stay within the laws of the Health Insurance Portability and Accountability Act (HIPAA), “providers should not use social media to share any health information that could be linked to an individual patient, such as names, pictures, and physical descriptions, without the patient’s consent” (Britt, 2014). Health care professionals should take great care to post disclaimers on any type of social media site, blog, or web pages where information is being shared. “Healthcare organizations entering the social network need to make sure they have social media policies that specify what uses by their employees are permitted and prohibited” (Britt, 2014).

References: 

Britt, D. (2014). Healthcare professionals and social networking. South Source.  Retrieved from

            http://source.southuniversity.edu/healthcare-professionals-and-social-networking

33211.aspx

Gray, A. (2014). The advantage of telecommunication in health care. eHow. Retrieved from

            http://www.ehow.com/infor_8378675_advantages-telecommunications-health-care.html

Institute of Medicine. (2012). Telehealth. HRSA. Retrieved from

http://www.hrsa.gov/ruralhealth/about/telehealth/

Recruiting for Healthcare Jobs. (2011). Telehealth today, not tomorrow. Retrieved from

            http://recruitingforhealthcarejobs.wordpress.com/2011/12/02/telehealth-today-not-

tomorrow

Legal & Ethical Aspects of Health Information Management

  

    Legal and ethical aspects of health information management affect all areas of the health care world. With the changing over to electronic health records, both practitioners and patients tend to question what legal issues are put in place in order to maintain the privacy of their records. “The Healthcare Information and Management Systems Society (HIMSS) asserts that electronic medical records must be stored legally” (Polack, 2009). If records are not stored legally, they can be deemed invalid which can lead to the non-payment of claims from insurance companies. Questions that health care professionals should ask themselves to ensure the integrity of the medical record is kept intact are:

•   Does the system keep a record of who is accessing and writing to the record?
•  Does it contain a security protocol which is strict by not too time-consuming? Features could include an automatic time-out after a period of inactivity, and periodic changes to the alphanumeric passwords.
•  Does the system prevent access to certain critical features? For example, an employee working the front desk shouldn’t be able to edit a patient’s clinical findings.
• Does it use a secure ‘lock-out’ feature
• Does the system write time stamps on all entries, to show an audit trail? (Polack, 2009).

With these questions being asked before choosing new electronic records systems, health care professionals are putting the integrity of the medical record first, thus keeping patient information protected.

                                                                                 (Medline, 2013)                                                      

Technology is taking over the health care industry more and more every day. We can see this happening with the amount of telecommunications and networking that are used in healthcare. One can only imagine the legal and ethical aspects that are intertwined with telecommunications and networking in health care. The legal issues that are questioned with telecommunications and networking are “privacy, unauthorized activities, and intellectual property issues” (McNickle, 2012). There are five keys to legal issues and social media:

1.      Privacy. With social media, the privacy of information is questioned daily. “When thinking about social media in the workplace … if an employee has a reasonable expectation of privacy hinges on whether or not the website is password protected” (McNickle, 2012). If the website is in fact password protected, then it is considered that the employee has the expectation of privacy. “If not, then the employers may have the justification to monitor the activities of that site” (McNickle, 2012).

2.      Content Ownership. Content ownership revolves around the question of who owns the content of the website. This is where a Terms of Use page is used to show end users who owns the content of the site.

3.      Intellectual property infringement. “Copyright infringement comes into play where there are photos, videos, graphics and blogs being exchanged and posted on social media sites” (McNickle, 2012). If an employee shares confidential information on a social media site, then said employee would be held liable for their actions.

4.      Unauthorized activities. Unauthorized activities include “harassment, discrimination, defamation, disclosure of confidential information and criminal activities – which are all address in the same manner as if they happened offline” (McNickle, 2012).

5.      Regulatory compliance. Regulatory compliance is the area that has had the most scrutiny. “When looking at healthcare, HIPAA requires a patient’s identity and personal health information to be protected” (McNickle, 2012).

Ethically speaking, telecommunications and networking should only be used for the good of the organization and to keep patients knowledgeable about what is available for their health information or health needs.

References:

Chandra Pani, S, MD. (2008). Legal and ethical issues in the care of individuals with special

            Needs. Retrieved from http://specialchilddentistry.blogspot.com/2008_20_01.html

McNickle, M. (2012).  5 keys to the legal issues of social media in healthcare. Healthcare IT

            News. Retrieved from http://www.healthcareitnews.com/news/5-keys-legal-issues-social-

            media?page=0

Medline. (2013). Getting started with social media in healthcare. Retrieved from http://www.

            Leadingage.org/Getting_Started_with_Social_Media_in_Healthcare.aspx

Polack, P, (2009). Legal issues of the electronic medical record. Medical Practice Trends.

            Retrieved from http://www.medicalpracticetrends.com/2009/07/19/emr-legal-issues

Current Health Information Systems

           

 Health care information systems have been being upgraded more recently due to the need to transition to electronic medical records. “Health care information systems replace medical history paper trails with electronic data” (Weinblatt, 2014). With the need to have space for paper records, electronic records can help organizations save space and possibly expand patient rooms. With the use of electronic medical records, physicians will now have access to patient records immediately. Not only will patient records be readily available to physicians, patients can gain access to their records via patient portals and have the ability to receive e-mails from physicians about testing and diagnoses. With these tools at hand, not only is patient care being improved upon, but productivity is increased as well. In order for the transition to electronic medical records to be successful, organizations “must allow the new technology to transform its procedures and policies while being given sufficient top-down support from central management” (Weinblatt, 2014).

            When an organization makes the decision to transfer to an electronic medical record, health information systems may have to be upgraded in order to keep up with the software. One area that is always questioned is the legal aspects of health information management and the security of patient records. “Access to patient-specific health information is a complex issue governed by a variety of legal rules” (McWay, 2010). It is with these legal rules that health care providers are obligated to keep patient information protected and confidential. Each organization must have a notice of information practices readily available to patients which “dictate that the patient be notified of these uses and be given the opportunity to consent, reject, or request restriction of this information for any or all of the many uses the health record serves” (McWay, 2010). Without written consent being obtained by the patient, patient records cannot be shared, even if records are electronic.

            When examining legal aspects of health information management, there are many areas that may come into question by the person who is dealing with the patient’s health information. Ethics is considered “listening to one’s conscience or making judgments between right and wrong” (McWay, 2010). With ethics comes autonomy; beneficence and nonmaleficience; best-interest standard; fidelity; justice; rights; and veracity. In all of these areas, the ethics of self, situations, best interest of an individual, and obligation are questioned by the health care professional when making decisions about patient information and the types of health information systems that should be used within an organization.

            Telecommunications and networking concepts are extremely important concerning current health information systems. This is because without telecommunications and networking concepts, it would be impossible to electronically share information. “Among clinical care technology, telehealth includes electronic transmission of information that gives health care professionals improved working capabilities like continuing education, electronic medical records systems and research collaboration” (Gray, n.d.). With the use of telecommunications, patients are staying more connected to their primary care physicians while discovering ways to better monitor their health.

Again, telecommunications circles back to the electronic medical record and the ease of retrieving patient records. “This increased access to information and level of collaboration between patient and provider has brought about a more patient-driven health care system” (Gray, n.d.). It is because of the increased access to information and collaboration between patient and provider that patients are finally taking charge of their medical treatments.

With the rise in social media, networking is a concept that health care industries must integrate along with the adoption of new technologies and health information systems. Younger generations are more apt to use smart phones and social media, however, with networking, organizations can put out current information to patients which may help answer questions about current illnesses that are present in the community. Networking in healthcare is advertisement to help draw new patients in and show what type of facility patients will be joining. By health care organizations taking advantage of networking, this can make people curious and want to try services at the organization.

References:

Gray, A. (n.d.). The advantages of telecommunication in health care. eHow. Retrieved from

            http://www.ehow.com/info_8378675_advantages-telecommunication-health-care-html

McWay, D. C., JD, RHIA. (2010). Legal and ethical aspects of health information management

            (3^rd ed.). Clifton Park, NY: Delmar-Cengage Learning. ISBN: 9781435483309

Weinblatt, V. (2014). Health care information systems. Live Strong. Retrieved from

            http://www.livestrong.com/article/216744-health-care-information-systems/

            

The three topics for my final will be:

1. The impact of the electronic medical records integration.
2. Telecommunications & networking concepts for health care.
3. Legal & ethical aspects of health information management.

The importance of these topics are great. With the change over to electronic medical records knocking at the door of almost every health care provider, the change to electronic medical records impacts many organizations and people in the health industry, patients included. Telecommunications will continue to impact health care as communications reach further than they have before. Networking seems to be the new ways of advertisement, and with how much technology is relied upon, why should it not be? Legal and ethical aspects of health information management is one of the most important topics as health information is deemed private and should remain private and secure. 

To address these topics, research will be done in each area, using facts to back up points that are made.