Health Care

I. Technology in the healthcare industry today and its impact The state of technology in the healthcare industry is that it is developing very rapidly. 10 or 20 years ago, you wouldn’t be able to find very many computers or technology at a typical doctor’s office. Most of the stuff was done with analog equipment and manual paperwork. Now, if you go into a doctor’s office, you will find it laden with advanced technical equipment and computer technology. You may not even find a pen or pad on the doctor’s desk!

Technology has the ability to change the face of the whole healthcare delivery system and improve the quality of health and healthcare. Although there are many challenges that it represents, overcoming these challenges will lead to a more effective and better quality healthcare system in general. First of all, the use of technology in managing the healthcare system is currently in the stages of being implemented to a great extent. There is a big push to standardize medical records, for example, in an electronic format.

The government is currently offering incentives for those who convert over to and put in use some form of electronic medical records system (Versel, 2011). They are also putting into place penalties for those who do not by 2015 (U. S. Department of Health & Human Services, 2011). In terms of the actual impact on the healthcare system, this shift to electronic records will not only reduce our premiums for insurance, but also streamline and speed up healthcare delivery twofold. It also cuts administrative costs for healthcare organizations and increases space, as they will no longer have to store bulky files or paperwork.

They can replace all of that with digital records. In the long term, this transition to digital records will benefit everyone involved in the healthcare industry; however, in the short term there will be increased costs for all of us. The reason why is because there will be associated costs in developing and buying the systems to house the medical records. Not only that, but the training associated with getting everyone up to speed on how to use the new medical records system is an effort that will take both time and money.

There will likely be some resistance to the change, but overall, this is a development in technology in the healthcare industry that stands to benefit all parties involved once it gets up to speed. Another way that technology is making an impact on the healthcare industry is in the treatment of patients. Complex microsurgeries and drug administration are a thing of the past. Now, a lot of the new facilities have specialized information systems and technology that utilize robots to administer medication and perform surgeries with a much higher level of accuracy than humans could do (Feder, 2008).

Not only that, but technology and information systems are improving the treatment and diagnosis of patients for various diseases. We use technology to analyze blood and tissue samples, and also to take a look at internal parts of the body that normally would have required invasive surgery to diagnose and treat. This is clearly a move in the right direction for the healthcare industry in that the quality of care will improve without teaching human resources how to improve. We simply have to teach the human resources how to use the equipment and analyze the results.

Unfortunately, not every facility has the latest and greatest technology. The drawback to this improvement technology has brought is that not all facilities will be able to afford the new equipment straight away. There are even places in other countries that really need the equipment the most, but don’t have the ability or the resources to afford them. Often at times, patients will need to be transported to other facilities to get the treatment that they need, and end up worsening in condition or dying along the way.

The technology that drives the healthcare industry does have the power to save lives, however, it will take some time before the rest of the world is up to speed. II. Challenges in implementing technology In addition to the improvements technology is making in the healthcare industry, technology in general also poses some major challenges. For one thing, it does have a major impact on the delivery of healthcare services and their experience. For example, one of the positive points for many people in going to the doctor is the non-clinical aspect of talking and having an open forum in getting diagnosis and treatment.

With the implementation of technology, however, there is an increasing concern that visits will become “less personal” and more about the diagnosis and treatment than the actual experience. According to an article in the McKinsey Quarterly, commercially insured patients tend to focus on the non-clinical aspects of a visit rather than the clinical (Grote, Newman, & Sutaria, 2007). However, a lot of the patients on Medicare and those that are uninsured tend to care more about the cost of delivery rather than the actual experience.

Based on this, there is a concern that the shift towards more technological means will alienate one group of patients whereas they will welcome another. The shift to technological means will certainly mean a decreased cost in delivery. That is for certain. However, the shift to technological solutions won’t necessarily mean a decrease in the quality of the visit. More doctors will continue to use technology to drive their treatment methods, but overall it is up to the doctor to make a connection with the patient as the customer relations part of the job.

In fact, I feel it will be more about customer relations than the actual treatment once technology has been fully developed. Doctors will spend less time writing down and crunching numbers on the computer and focus more on interacting with the patient and utilizing technology to drive a diagnosis and treatment. Technology will also make diagnosis more transparent as medical imaging devices will make things more visible to both the patient and the doctor. Overall, the shift to technological means will certainly bring on challenges in implementation.

Doctors will at first have a hard time in getting up to speed on the new technologies and balancing that with the way they are used to doing things, and integrating it into their daily visits. However, as time goes on this will be less and less of an issue once doctors and patients accept new ways of treatment and technology in general. III. Technology in the development of medicine Technology has always had a place in the development of medicinal treatments and medical devices. Clinical trials are conducted all around the world with he promise of new and better treatments that will cure illnesses and increase lifep and quality of life. The use of technology in clinical trials is helping to not only get safer and better drugs to the market faster, but also to ensure that there are no problems long term. It used to be that clinical trials were conducted on paper, but now technology is used to ensure both quality of data entry and also the monitoring of subjects in a trial. Technology is also used to develop tests and experiments more efficiently than they were ever done on paper.

The shift to technological means is definitely one of the mainstays in the development of medicine, and is a welcome addition that presents few challenges aside from the training of resources. In terms of development, technology has also helped to make processes more efficiently and easily to allow newer drugs to be developed at a lower cost than older traditional methods of conducting trials (ICON, 2011). Budgeting and analysis can be used to efficiently allocate supplies and funds, and the actual trial data can be run through information systems in order to analyze the data from a bird’s eye view and make decisions on its development.

The impact of this is likely to be decreased costs for the consumer for drugs and medical products. IV. Recommended plans for the adoption of technology in healthcare organizations As mentioned above, there are likely to be some growing pains in the adoption of technology in the healthcare industry. Doctors will likely have a hard time with the shift to more technological means, and their staff will also likely suffer the same hardships. Ensuring a proper plan to implement a technological solution in a healthcare organization is therefore essential, and ensuring a smooth transition so that the customer is not affected in the process.

Therefore, the following are my recommendations for a smooth transition: 1. Identify the technological solution to implement, and assess what modules of the business this will impact. 2. Notify the staff of what will be implemented, and create a training plan to bring everyone up to speed in advance of the implementation so that no one is taken by surprise. 3. Develop a plan to ensure smooth integration into the organization, so that delivery is not compromised. This may include implementing it in part so that the new technology is used alongside the old process that was used to perform the same function. . Develop a timeline for the actual implementation to be complete. This is so that the employees do not continue to follow old methods as a crutch for not getting used to the new technology, and so they know when the new process will be followed. The above 4 items will be absolutely critical in ensuring a smooth transition for any healthcare organization to technological means. The reason why these steps will aid technology implementation is because it ensures that there is enough time to train resources and integrate the technology into the organization.

The reason why many organizations have a problem integrating technology is an ineffective change management plan. By introducing it slowly and getting all the required resources up to speed, there should not be an issue in change management. V. Final Thoughts Overall, technology is continuing to make an impact on the healthcare industry in a big way. Right now, there is increasing shift towards using technology to speed up services delivery and management of services.

As the world becomes more technologically advanced, there will be an ever-increasing shift towards technological means. The key to implementing technology in any healthcare organization is a change management plan that gets everyone up to speed before the actual technology is implemented, and the communication of this change to all stakeholders involved. Once the change is communicated, steps will need to be taken to ensure training of resources and integration of the technology in the business practices. In terms of using technology in the healthcare industry, technology will lways continue to impact healthcare in development of products and delivery of services. Technology is always going to be used to develop the Healthcare organizations need to focus on change management and integration of technology rather than just implementation. Works Cited U. S. Department of Health & Human Services. (2011, April 20). CMS EHR Meaningful Use Overview. Retrieved June 6, 2011, from U. S. Department of Health & Human Services Web Page: https://www. cms. gov/EHRIncentivePrograms/30_Meaningful_Use. asp Versel, N. 2011, May 31). Physicians Get Meaningful Use Payment Checks. Retrieved June 6, 2011, from InformationWeek Healthcare: http://www. informationweek. com/news/healthcare/EMR/229700213 Feder, B. J. (2008, May 4). Prepping Robots to Perform Surgery. New York Times . Grote, K. D. , Newman, J. R. , & Sutaria, S. S. (2007, November). A Better Hospital Experience. The McKinsey Quarterly , 1-10. ICON. (2011, May 1). Technology in Clinical Trials. Retrieved June 20, 2011, from Kris Gustafson: http://krisagustafson. com/gpage1. html

HEALTH CARE SYSTEM

• an organized plan of health services (Miller-Keane, 1987)

HEALTH CARE DELIVERY

• rendering health care services to the people (Williams-Tungpalan, 1981).

HEALTH CARE DELIVERY SYSTEM (Williams-Tungpalan, 1981)

• the network of health facilities and personnel which carries out the task of rendering health care to the people.

PHILIPPINE HEALTH CARE SYSTEM

• is a complex set of organizations interacting to provide an array of health services (Dizon, 1977).

COMPONENTS OF THE HEALTH DELIVERY SYSTEM

The Department of Health Mandate: The Department of Health shall be responsible for the following: formulation and development of national health policies, guidelines, standards and manual of operations for health services and programs; issuance of rules and regulations, licenses and accreditations; promulgation of national health standards, goals, priorities and indicators; development of special health programs and projects and advocacy for legislation on health policies and programs.

The primary function of the Department of Health is the promotion, protection, preservation or restoration of the health of the people through the provision and delivery of health services and through the regulation and encouragement of providers of health goods and services (E. O. No. 119, Sec. 3). Vision: Health as a right. Health for All Filipinos by the year 2000 and Health in the Hands of the People by the year 2020.

Mission: The mission of the DOH, in partnership with the people to ensure equity, quality and access to health care:

• by making services available
• by arousing community awareness
• by mobilizing resources
• by promoting the means to better health

LEVELS OF HEALTH CARE FACILITIES

1. PRIMARY LEVEL OF HEALTH CARE FACILITIES

• are the rural health units, their sub-centers, chest clinics, malaria eradication units, and schistosomiasis control units operated by the DOH; puericulture centers operated by League of Puericulture Centers; tuberculosis clinics and hospitals of the Philippine Tuberculosis Society;
• private clinics, clinics operated by the Philippine Medical Association; clinics operated by large industrial firms for their employees; community hospitals and health centers operated by the Philippine Medicare Care Commission and other health facilities operated by voluntary religious and civic groups (Williams-Tungpalan, 1981).

2. SECONDARY LEVEL OF HEALTH CARE FACILITIES

• are the smaller, non-departmentalized hospitals including emergency and regional hospitals.
• Services offered to patients with symptomatic stages of disease, which require moderately specialized knowledge and technical resources for adequate treatment.

3. TERTIARY LEVEL OF HEALTH CARE FACILITIES

• are the highly technological and sophisticated services offered by medical centers and large hospitals. These are the specialized national hospitals. Services rendered at this level are for clients afflicted with diseases which seriously threaten their health and which require highly technical and specialized knowledge, facilities and personnel to treat effectively (Williams-Tungpalan, 1981)

FACTORS ON THE VARIOUS CATEGORIES OF HEALTH WORKERS AMONG COUNTRIES AND COMMUNITIES

1. available health manpower resources
2. local health needs and problems
3. political and financial feasibility

THREE LEVELS OF PRIMARY HEALTH CARE WORKERS A.

VILLAGE OR GRASSROOT HEALTH WORKERS

• first contacts of the community and initial links of health care.
• Provide simple curative and preventive health care measures promoting healthy environment.
• Participate in activities geared towards the improvement of the socio-economic level of the community like food production program.
• Community health worker, volunteers or traditional birth attendants.

B. INTERMEDIATE LEVEL HEALTH WORKERS

• represent the first source of professional health care attends to health problems beyond the competence of village workers
• provide support to front-line health workers in terms of supervision, training, supplies, and services.
• Medical practitioners, nurses and midwives.

C. FIRST LINE HOSPITAL PERSONNEL

• provide back up health services for cases that require hospitalization
• establish close contact with intermediate level health workers or village health workers.
• Physicians with specialty, nurses, dentist, pharmacists, other health professionals.

TWO-WAY REFERRAL SYSTEM (Niace, et. al. 8th edition 1995)

A two-way referral system need to be established between each level of health facility e. g. barangay health workers refer cases to the rural health team, who in turn refer more serious cases to either the district hospital, then to the provincial, regional or the whole health care system. Public P Barangay Health OHealth Worker Nurse 2nd 3rd P H F H F U E A E A L Barangay RHU A C A C A Health Midwife Physician L I L I T Stations T L T L I H I H I O T T N RHS Sanitary Y Y

Midwife Inspector MULTISECTORAL APPROACH TO HEALTH (NLGNI, 8th edition, 1995)

The level of health of a community is largely the result of a combination of factors. Other health-related Systems (government/ private Ways of CommunityHealth Care The Health System People (Cultural) Environment (Social, Economic, physical, Etc. Health, therefore, cannot work in isolation. Neither can one sector or discipline claim monopoly to the solution of community health problems. Health has now become a multisectoral concern.

For instance, it is unrealistic to expect a malnourished child to substantially gain in weight unless the family’s poverty is alleviated…… In other words, improvement of social and economic conditions need to be attended to first or tackled hand in hand with health problems. 1. Intersectoral Linkages – Primary Health Care forms an integral part of the health system and the over-all social and economic development of the community.

As such, it is necessary to unify health efforts within the health organization itself and with other sectors concerned. It implies the integration of health plans with the plan for the total community development. Sectors most closely related to health include those concerned with: a. Agricultural b. Education c. Public works d. Local governments e. Social Welfare f. Population Control g. Private Sectors

The agricultural sector can contribute much to the social and economic upliftment of the people……. Demonstration to mothers of better techniques and procedures for food preparation and preservation can preserve the nutritive value of local foods. Through joint efforts, agricultural technology that produces side effects unsafe to health (for instance, insecticide poisoning) can be minimized or prevented.

The school has long been recognized as an effective venue for transmission of basic knowledge to the community. Every pupil or student can be tapped for primary health care activities such as sanitation and food production activities….. Construction of safe water supply facilities and better roads can be jointly undertaken by the community with public works. Community organization (e. g. establishing a barangay network for health) can be worked through the local government or community structure.

Likewise, better housing through social welfare agencies, promotion of responsible parenthood through family planning services and increased employment through the private sectors can be joint undertakings for health……We have to recognize that oftentimes health actions undertaken outside the health sector can have health effects much greater than those possible within it. 2. Intrasectoral Linkages – In the health sector, the acceptance of primary health care necessitates the restructuring of the health system to broaden health coverage and make health service available to all.

There is now a widely accepted pyramidal organization that provides levels of services starting with primary health and progressing to specialty care. Primary health care is the hub of the health system.

A PYRAMIDAL HEALTH STRUCTURE

• Tertiary National Health
• Health Care Services
• Regional Health Services
• Secondary Health District
• Health Services
• Care Rural (Local Hospital) Services
• Rural Health Units
• Primary Barangay Health Stations
• Health Care

THE NATIONAL HEALTH PLAN (Niace, et. al 8th edition 1995)

The National Health Plan is the blue print which is followed by the Department of Health. It defines the country’s health problems, policy thrusts, strategies, and targets.

POLICY THRUSTS AND STRATEGIES

There are policy thrusts and strategies which are commonly important. These are:

1. Information, education, and communication programs will be implemented to raise the awareness of the public, including policymakers, program planners and decision-makers;
2. An update of the legislative agenda for health, nutrition and family planning (HNFP), and stronger advocacy for pending HNFP –related legislation will be pursued;
3. Integration of efforts in the health, nutrition and family planning sector to maximize resources in the delivery of services through the establishment of coordinative mechanisms at both the national and local levels;
4. The partnership between the public and the private sectors will be strengthen and institutionalized to effectively utilize and monitor private resources for the sector;
5. Enhancement of the status and role of women as program beneficiaries and program implementers will be pursued to enable them to substantially participate in the development process.

Expected Lifetime Costs of Significant “Aging Shocks” for a 65-Year-Old Today Population Needing Long-term Care If we also look at another issue as to why long-term care could be a large burden is the rapid inflation in expenditures for long-term care in recent years. Medicare and Medicaid expenditures on nursing home care were $9 billion in 1980, more than doubling to $25 billion by 1990, and doubling again to $54 billion by 1999. Likewise, Medicare and Medicaid expenditures on home health care increased from less than $1 billion in 1980 to $5 billion in 1990 and to $16. billion in 1999, down from a high of $17 billion in 1996 (Health Care Financing Administration 2000; Heffler et al. 2001). With this we can also see that out of pocket expenses have not been lowered at all either. Also there is a concern about long-term care costs that comes from a report by Curran, McLanahan, and Knab (in review) it suggest that children who experience divorce may be less willing or able to care for their aging parents.

Their data indicate that the probability of an elderly person perceiving an availability of emotional support from his or her children is reduced from 71 percent for those who marry once and remain married to 56 percent for those who many and divorce. Which would make these elderly Baby Boomers more apt to have to depend on Social Security or some sort of governmental supplement? {draw:frame} There remain some substantial challenges to getting ready to meet the long-term care needs of Baby Boomers.

Basically there are four areas of concerns that need to be focused on: Creating a finance system for long-term care that works Building a viable and affordable community-based delivery system Investing in healthy aging in order to achieve lower disability rates, and Recharging the concept of family and the value of seniors in American culture. There are four sources of payments currently finance long-term care services for the elderly: Medicare, Medicaid, private insurance, and out-of-pocket payments.

The federal Medicare program pays for approximately 24 percent of all long-term care costs (Congressional Budget Office 1999). In principle, Medicare does not cover custodial long-term care, but rehabilitation care. The federal/state Medicaid program is probably the most important player in the long-term care financing system. Medicare may if you will, be considered as a back up to the Medicaid program. Basically what Medicare does is help pay for the eldest and more serious conditions in the elderly who are in a situation that they have little to no money.

An COHO generally refers to a company that provides support services to its offices correlated companies regionally and globally. SQ. What do you mean by health economics? Discuss the role of economists in healthcare industry. SQ. Discuss the importance of financial information in Healthcare Organizations.  Importance of financial information in Healthcare Organizations: Managing the finances of any health care business nowadays is like driving a car with foggy windows. The industry has been changing in big ways since long before the Affordable Care Act took effect. Medicare’s coding yester for billing and the advent of electronic medical records are examples of these changes. Financial management in health care requires exceptional skill. SQ. Explain different methods of evaluation of healthcare services.

Health Care Evaluation: Study design for assessing effectiveness, efficiency and acceptability of services including measures of structure, process, service quality, and outcome of health care. Steps in designing an evaluation Firstly it is important to decide which dimensions are to be evaluated? – inputs, process, outputs, outcomes, efficiency etc. Objectives for the evaluation itself should be set (remember SMART) – SQ. Define cost accounting. Explain the various categories of costs.

Cost Accounting: A method of accounting in which all costs incurred in carrying out an activity or accomplishing a purpose are collected, classified, and recorded. This data is then summarized and analyzed to arrive at a selling price, or to determine where savings are possible. SQ. What is financial reporting? Explain the need for financial reporting.  Finance Economics and Planning in Healthcare By Subjects ND the public (if the company is publicly traded) about how the company is performing over a specific period of time.

Financial reports are usually issued on a quarterly and annual basis. This is different from management reporting, which is financial information that is disclosed to those inside the company to be used to make decisions within the company. Financial reports are included in a public company’s annual report. Financial reporting includes the following: The external financial statements (balance sheet, income statement, statement of cash flows, and statement of stockholders’ equity).

Running Head: ETHICAL HEALTHCARE Ethical Healthcare Issues Paper Wanda Douglas Health Law and Ethics/HCS 545 October 17, 2011 Nancy Moody Ethical Healthcare Issues Paper In today’s health care industry providing quality patient care and avoiding harm are the foundations of ethical practices. However, many health care professionals are not meeting the guidelines or expectations of the American College of Healthcare Executives (ACHE) or obeying the organizations code of ethics policies, especially with the use of electronic medical records (EMR).

Many patients fear that their personal health information (PHI) will be disclosed by hackers or unauthorized users. According to Carel (2010) “ethical concerns shroud the proposal in skepticism, most notably privacy. At the most fundamental level, issues arise about the sheer number of people who will have ready access to the health information of a vast patient population, as well as about unauthorized access via hacking. ” This paper will apply the four principles of ethics to EMR system. EMR History Pickerton (2005), “In the 1960s, a physician named Lawrence L.

Weed first described the concept of computerized or medical records. Weed described a system to automate and recognize patient medical records to enhance their utilization and thereby lead to improved patient care” (para 1). The advantages of EMR system includes shared information integrated information, improvement of quality care, and adaptation of regulatory changes. Even though EMR systems have many advantages, EMR systems also have some disadvantages too. Some disadvantages of EMR systems are security, and confidential, which can raise ethical issues. In order to help identify and vercome ethical issues with EMR systems, health care professionals can use the four principles of ethics to help identify where ethical issues are compromised. The four principles of ethics are autonomy, beneficence, nonmaleficence, and justice. Autonomy According to Mercuri (2010) “autonomy means allowing individuals make their own choices and develop their own lives in the context of a particular society and in dialogue with that society; negatively, autonomy means that one human person, precisely as a human person, does not have authority and should not have power over another human person” (para 2).

Autonomy has an effect with ethics concerning EMR systems because health care organizations should have an EMR system that should maintain respect for patient autonomy. Respect for patient autonomy should have health care organizations to make decisions concerning user access of the records. Access of Records Before a health care organization implements an EMR system, they should have a security system in place, which includes “access control” component.

Access control within an EMR system is controlled by distinct user roles and access levels, the enforcement of strong login passwords, severe user verification/authorization and user inactivity locks. Health care of professionals regardless of their level, each have specific permissions for accessing data. Even though the organization have the right security system in place to prevent unauthorized users from access patient records, autonomous patients will expect to have access to his or her records with ease.

Access their record will ensure that their information is correct and safe. Beneficence According to Kennedy (2004) “beneficence is acting to prevent evil or harm, to protect and defend the rights of others to do or promote good” (p. 501). Beneficence has an effect with ethics when it comes to EMR systems because health care professionals can help to improve the health of individual patients by using patient records to help with medical research. EMR systems contain an enormous amount of raw data, which can innovate public health and biomedical research.

This research will not only do good to help the health of individual patients, but also to the health of society (Mercuri, 2010). As a result, as new EMR systems are designed, patients should be given the ability to release information from their EMRs to researchers and scientists. Nonmaleficence Not only does beneficence have an effect with ethics concerning EMR systems, but also nonmaleficence. According to Taber’s Cyclopedic Medical Dictionary “The principle of not doing something that causes harm.

Hippocrates felt this was the underpinning of all medical practice. He advised his students, primum non nocere (“first, do no harm”)” (“Nonmaleficence,” 2010). Nonmaleficence has an effect with ethics concerning EMR systems because it is the employee’s responsibilities to report any negligence or fraud of patient medical records. However, if an employee doesn’t report negligence or fraud it will cause harm to the organization and to the patient. Reporting negligence will make the organization aware of the problem and help them find a solution.

Employees can help prevent negligence or fraud notifying management when a problem is discovered. Employees can also help prevent negligence or fraud by making sure that their system access information is secure. In addition, employees can also help prevent negligence or fraud by making sure that they are creating accurate records. If the employees follow these policies of EMR security systems, they will ensure that the patient medical records are secure and safe from harm. Justice Not only does nonmaleficence have an effect with ethics when it comes to EMR systems, but also justice.

According to Mercuri (2010) “justice is commonly defined as fairness. With respect to health care, justice refers to society’s duty to provide its members with access to an adequate level of health care that fulfills basic needs” (para 5). Justice has an effect with ethics concerning EMR systems because EMRs are most helpful when the system is easy to use, fully integrated, and easily searchable. EMR systems have the potential to assist health care organizations by providing higher quality care to the users and to the patients.

In addition, EMR systems also assist health care organizations by having a system that is more unbiased through advanced effectiveness. Conclusion Even though there are still some ethical issues with EMR systems, health care professionals are moving in the right direction by being more aware. Health care professional want to do the right thing by following the organizations code of ethics, but sometimes they are not always clear on how they should handle certain EMR systems situations properly.

In order for health care professionals to handle certain EMR systems situations properly, they can use the ACHE as a reference. Using ACHE as a reference ensures that they are meeting ACHE standards. Health care professionals can also apply the four principles of ethics to determine a resolution. Applying the four principles of ethics ensures that they are following the proper protocols and guidelines and leaves considerable room for judgment in certain cases. Reference Carel, D. (2010, October). The Ethics of Electronic Health Records. Yale Journal of Medicine Law, VII (1), 8-9. Kennedy, W. (2004). Beneficence and autonomy in nursing: a moral dilemma. British Journal of Perioperative Nursing, 14(11), 500-506. Retrieved from EBSCOhost. Mercuri, J. (2010). The Ethics of Electronic Health Record. Retrieved from http://www. clinical correlations. org/? p=2211 Nonmaleficence. 2010. Taber’s Cyclopedic Medical Dictionary, 21st ed, Retrieved from EBSCO host. Pickerton, K. (2005). History of Electronic Medical Records. Retrieved from http://ezinearticles . com/? History-Of-Electronic-Medical-Records&id=254240

The History Behind Nursing Informatics Nursing informatics (NI) has become a vital part of healthcare delivery and has become a defining factor in the selection, execution, and assessment of technology that supports safe, exceptional quality and patient-centered care. Nursing has become so uniform. The data in patient records has become a valuable resource and has improved assessments and overall patient care.

Before the launch of nursing informatics throughout the second half of the 20th century there were not any real standards for language. The use of data restricted the function and effectiveness of any early informatics applications. Nurses began developing standardized language systems during the turn of the century. International collaborations involving different medical disciplines have led to the improvement of standards and have opened the door for strong and reliable information tools. Nurses have the ability to change and improve healthcare.

They have the potential to change outcomes with the use of informatics. The use of this technology does require change; a change in the person, the institute, and the systems. Nurses are developing and applying informatics to find new knowledge and are improving the quality of care given on a global level (Edwards, H. 2011). Nurses have identified three important factors in nursing informatics: basic computer skills, informatics knowledge and information literacy (Thede, L. 2012). In the beginning there was Florence Nightingale.

Not only did Nurse Nightingale pioneer the nursing profession she also started the first informatics in nursing. She stated ‘In an attempt to arrive at the truth, I have applied everywhere for information, but scarcely an instance have I been able to find hospital records fit for any purpose of comparison. If they could be obtained, they would enable us to decide many other questions besides the one alluded to? …if wisely used, these improved statistics would tell us more of the relative value of particular operations and modes of treatment than we have any means of obtaining at present.

They would enable us, besides, to ascertain the influence of the hospital … upon the general course of operations and diseases passing through its wards; and the truth thus ascertained would enable us to save life and suffering, and to improve the treatment and management of the sick … . ” (Florence Nightingale. Ozbolt, J. G. , Saba, V. K. 2008). Nurse Nightingale began nursing informatics by introducing three health sciences into nursing: health services research, evidenced-based practice and informatics (Ozbolt, J. G. , Saba, V. K. (2008).

She requested that clinical records be analyzed to assess and improve care and outcomes (Ozbolt, J. G. , Saba, V. K. (2008). She noticed the need for change before there really was a need for change. Her efforts brought about nursing informatics and the nursing profession became more modernized. Nearly 100 years later a woman by the name of Harriet Werley started to encourage the use and growth of informatics in the nursing profession (Murphy, J. 2010). In the late 1950’s she was the first nurse to participate in research in a hospital (Ozbolt, J. G. , Saba, V. K. 2008). She was asked to provide consultation for IBM on the possible use of computers in healthcare (Ozbolt, J. G. , Saba, V. K. 2008). Nurse Werley saw the benefits of computers used to store patient information and to improve patient care (Ozbolt, J. G. , Saba, V. K. 2008). She devised a minimum data set to be collected from every patient Ozbolt, J. G. , Saba, V. K. 2008). In the 1970’s nursing informatics really began to bloom. The first records of the use of computers in the nursing field started to appear in professional and scholarly literature (Murphy, J. 2010).

Nursing care plans began to focus on reducing the amount of documentation and keeping it as accurate and as detailed as possible (Ozbolt, J. G. , Saba, V. K. 2008). Another system focused on patient scheduling in a rehabilitation setting (Ozbolt, J. G. , Saba, V. K. 2008). Nurses at a California hosptial assisted in developing the first comprehensive hospital information system and helped integrat the system for nursing care planning, documentation, and feedback (Ozbolt, J. G. , Saba, V. K. 2008). They developed the standard care plans that are used throughout the world today (Ozbolt, J. G. Saba, V. K. 2008). Another big achievement of this decade was the introduction of the first commercial electronic medical record (Thede, L. 2012). This new system was patient-oriented and was implemented throughout the hospital (Thede, L. 2012). Nursing informatics really gained momentum in the 1980’s. The first national conference on computer technology and nursing was held (Ozbolt, J. G. , Saba, V. K. 2008). Scholarships and the first educational courses on Nursing Informatics were introduced into the nursing programs at Boston College, University of New York and University of Utah (Ozbolt, J.

G. , Saba, V. K. 2008). The growing record of accomplishment allowed nurses to move into managerial roles (Edwards, H. 2011). By the mid ‘80’s, nearly three decades after Nurse Werley pushed for minimum data sets, was the idea finally embraced by nurse professionals (Ozbolt, J. G. , Saba, V. K. 2008). Four specific elements of the minimum data set became a standard for nursing care: nursing diagnosis, nursing intervention, nursing outcome and the intensity of the care provided (Ozbolt, J. G. , Saba, V. K. 2008). Beginning in the 1990’s a real change was noticed.

The technological advances that had been made were astonishing (Ozbolt, J. G. , Saba, V. K. 2008). A new technology called the internet had been introduced allowing for worldwide communication of healthcare information (Ozbolt, J. G. , Saba, V. K. 2008). In 1994 the American Nurses Association published the first versions of the “Scope of Nursing Informatics Practice” and the “Standards of Nursing Informatics Practice”. In 1995, the American Nurses Credentialing Center started the basic certification in nursing informatics as an area of specialty practice (Ozbolt, J. G. Saba, V. K. 2008). Also in 1994, the American Nurses Association (ANA) published the first definition of nursing informatics: “Nursing Informatics is the specialty that integrates nursing science, computer science, and information science in identifying, collecting, processing, and managing data and information to support nursing practice, administration, education, research, and the expansion of nursing knowledge. ” (Murphy, J. 2010). The International Classification of Nursing Practices was initiated by three nurses throughout the world (Ozbolt, J. G. , Saba, V. K. 2008).

The 1990’s were a big decade for the advancement of nursing informatics. The first journal pertaining to informatics in nursing was initiated and it was online. The Online Journal of Nursing Informatics hit the wires in 1996. This online publication focused, and still focuses on publishing peer-review articles, scientific papers, review articles, practice-based articles and data bases related to nursing informatics (McGonigle, D. , Seymour, R. , Englebardt, S. , Allen, M. , Chang, B. 2001).

This journal is currently published with the amazing staff of one (McGonigle, D. , Seymour, R. Englebardt, S. , Allen, M. , Chang, B. 2001). In the 2000’s and today nursing has the tools and the terminology, which had taken years of development with the collaboration of numerous nursing professionals globally (Ozbolt, J. G. , Saba, V. K. 2008). A standardized language had been developed and nursing terminology and data standards were implemented mainstream (Ozbolt, J. G. , Saba, V. K. 2008). In 2004 nursing informatics had blown up. Education had accelerated and nursing informatics had become a staple in healthcare. Knowledge discovery methods were the key in discovering risks in health.

Nurses knew that the discovery of knowledge brings the responsibility of that knowledge and with this information nursing care is the best it has ever been (Murphy, J. 2010). In 2001 the definition of nursing informatics was expanded by the ANA. They described it as: A specialty that integrates nursing science, computer science, and information science to manage and communicate data, information, and knowledge in nursing practice. NI facilitates the integration of data, information, and knowledge 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 IT (Murphy, J. 2010). And in 2008, the current definition of nursing informatics was published. It was essentially the same as the first published definition in 1994, however, now includes the additional concept of wisdom. It reads “NI is a specialty that integrates nursing science, computer science, and information science to manage and communicate data, information, knowledge, and wisdom in nursing practice. ” (Murphy, J. 2010).

Additionally, the ANA published three editions of Nursing Informatics Scope and Standards of Practice (ANA. 2008). We as nurses must remember that change is always a difficult thing to embrace. By studying information in an informatics prospective discover how to deliver care and support decisions more effectively and safely, with better outcomes for all constituencies. Informatics tools can support the translation of knowledge into practice, but changing the behavior of people, organizations, and systems requires collaboration across a range of disciplines.

Nursing and healthcare will always be ever-changing. Change and collaborations for implementing change are fundamental in the education of nurses today. Today nurses are able to access new information and resources easier and faster than ever. Nurses are constantly being challenged to amalgamate new resources on a cognitive, psychomotor and executive level. Nurses of the future can learn technological skills and expand their knowledge and wisdom and can utilize the data.

They are encouraging the changes to take place for the nursing practice and healthcare systems by learning, implementing and teaching. Change and evolution through informatics will only improve healthcare and will save more lives. Nursing informatics has become a well established specialty within the nursing field. Solid fundamentals have been laid out over the past 25 years and NI has become an essential part of healthcare delivery despite the many barriers yet to be overcome. It is influenced by environmental, political, economic and professional forces.

The change that nurses are bringing are being influenced by new up-and-coming concepts of health and illness, advancements in the field of medical science, the patterns of diseases, demographics and an increasing ability to meet the needs of disease management and prevention as well as the needs of the patients and their families through the use of technology, knowledge and wisdom. As the specialty of nursing informatics continues to evolve new knowledge and technology will be available making the role of the nurse much more important and powerful and making the care and outcomes of each person served improved.

It is how the nurse participates in saving a life; one step at a time.

References

Edwards, H. (2011). Nursing informatics: past, present and future. Retrieved from www. theconference. ca/nursing-informatics. Murphy, J. (2010). Nursing informatics: the intersection of nursing, computer, and information sciences. Nursing Economics, vol. 28, Iss. 3, 204-7, May/June 2010. Anthony J. Jannetti, Inc. Pitman, USA. Retrieved from http://ezproxy. ccu. edu/login? url=http://search. proquest. com/docview/577364695? accountid=10200. Ozbolt, J. G. , Saba, V. K. (2008). A brief history of nursing informatics in the United States of America.

Mosby’s Nursing Consult. Vol. 56, Iss. 5, September 2008. American Nurses Association. (2008). Retrieved from: http://www. nursingworld. org/HomepageCategory/NursingInsider/Archive_1/2008NI/Jan08NI/RevisedNursingInformaticsPracticeScopeandStandardsofPractice. html. Thede, L. , (January 23, 2012) “Informatics: Where Is It? ” OJIN: The Online Journal of Issues in Nursing Vol. 17 No. 1. McGonigle, D. , Seymour, R. , Englebardt, S. , Allen, M. , Chang, B. (March 1, 2001) “The Online Journal of Nursing Informatics (OJNI)” Online Journal of Issues in Nursing. Vol. 6 No. 2. CIS312A, Healthcare Informatics

Pearl Ross Role or Function or Health Care Manager University of Phoenix January 26, 2012 A growing business needs a good manager to accomplish the same goal. The health care is a business and behind every good business is a good manager. A health care manager role is leadership and management. “A manager at any level in the health care spends significant amounts of time and place high value on communication, problem solving and decision making, collaboration with other disciplines, people development, and cost containment” (Purnell, 1999).

The manager goal is to get the employer to complete a specific goal effective and efficient. There are four cycles or step a manager goes about an obtaining this goal: organizing, planning, leading, and controlling. The most important role or function of a health care manager is leadership. “Leadership in Health Services provides example of best practice in this dynamic field, disseminating practical, relevant and timely information” (Emerald, 2011). First-class leadership is vital because the complexity of the healthcare system requires the qualities of a good leader who can link the world of management to the world of medical/clinical practice, while understanding people’s needs and accommodating and developing the broad array of health services needed by them” (Al-Haddad, 2003). Although there is nothing written or cut in stone on the behavior or qualification a manager should have in leadership; some organization believe a manager leadership should either be task-orient or relationship orient, depending on the situation.

It would benefit the company if a manager combined the two behaviors. A manager or leader should be a motivator and trustworthy. A manager in the health care field recognize a health care worker is a competent, professional and leader who have the ability to share the vision, plan and decision making of a health care system. Hence, taking this course, Health Care Management will help me in obtaining the skills, knowledge, and technique to become a full, well rounded individual. This course along will not help me become an employable administrator, but it is a steppingstone.

This course will give me the tools I need to further my career by using the steps of manager: planning, organizing, leading, and controlling. Reference Al-Haddad, M. K. (2003). Leadership in Health care Management. Bahrain Medical Bullten, Vol 25,No1 , 1-3. Emerald. (2011). Leadership and Health care service. Retrieved January 25, 2012, from Emeral Insight: www. emeraldinsight. com/info/journals/lhs/lhs/Jsp Purnell, L. (1999, April). Health care manages’ and administrators’ roles, funtions, and responsibilties. Retrieved January 25, 2012, from pubmed: www. ncbi. nlm. nih. gov/pubmed/10363017