HSC 360 Technology in Health Care

Medical Informatics and Information Systems in Healthcare

Anthony Lund

HSC 360

DR McGraw

13 Feb 2020

1. American Recovery and Reinvestment Act February 17, 2009 (ARRA)

2. The Health Information Technology for Economic and Clinical Health (HITECH) Act, February 17, 2009

3. Office of the National Coordinator for Health Information Technology April 27, 2004 (ONCHIT)

4. electronic health record (EHR)

5. Nationwide Health Information Network (NHIN)

6. The Health Insurance Portability and Accountability Act of 1996 (HIPAA)

7. health information technology (HIT) pg.3

1. https://www.transit.dot.gov/regulations-and-guidance/legislation/arra/american- recovery-and- reinvestment-act-arra

2. https://www.hhs.gov/hipaa/for-professionals/special-topics/hitech-act-enforcement-interim-final-rule/index.html

3.https://web.archive.org/web/20060929210210/http://www.os.dhhs.gov/healthit/executivesummary.html

4. https://www.healthit.gov/faq/what-electronic-health-record-ehr

5. https://www.nist.gov/hit/nationwide-health-information-network-nhin

6. https://www.hhs.gov/hipaa/index.html

7. https://www.healthit.gov/topic/privacy-security-and-hipaa/hipaa-basics

8. Burke, L. Information Technology for the Health Professions. [VitalSource Bookshelf]. Retrieved from https://bookshelf.vitalsource.com/#/books/9780134879420/pg3

Information Technology in Public Health

Anthony Lund

HSC 360

DR McGraw

13 March 2020

“Public health has many definitions. John M. Barry, writing on the flu pandemic of 1918–1919, states that public health “is where the largest numbers of lives are saved, usually by understanding the epidemiology of a disease—its patterns, where and how it emerges and spreads—and attacking it at its weak points. This can lead to prevention by means of public health measures like better sanitation or providing cleaner water. It can also lead to the development and widespread distribution of vaccinations.” #5 – Pg 78.

Data on infectious diseases and their patterns are imperative to public health. This used to be accomplished by monitoring a geographical area, now it is done digitally through Electronic Health Records (EHRs) and other specifically designed tracking software. Today’s computers study and model events that could potentially cause a threat to public health systems. Some of these events are diseases that could cause a public health threat such as MRSA, hospital errors, and global warming.

Computers are perfect for creating models of a disease and how it is transmitted. They can create simulations and vary multiple factors at once. They are able to use demographics and transportation methods to track and predict where a disease outbreak could appear. MIDAS (Models of Infectious Disease Agent Study) can build a model of a disease based on real time data, and Microsoft’s Excel program can easily calculate expected rates.

Today’s computers can also allow health professionals to look at genes and proteins in viruses and in the human genome, while also being able to examine the DNA for inconsistencies. Supercomputers and bioinformatics together can assist in creating effective vaccines, medications, and prevention protocols. “In 2010 a new way of sequencing DNA was found, which enabled small genetic changes to be pinpointed. This allows researchers to trace the spread of MRSA (methicillin-resistant Staphylococcus aureus) around the world and even within one hospital. This might lead to ways of controlling the spread of MRSA.” #5 - Pg 87

“Statistics and mapping of a disease progression were used to contain an epidemic for the first time in the 19th century. An early example of public health in action involves the London cholera epidemic of 1854. Dr. John Snow (one of the few scientists who hypothesized that cholera was spread through contaminated water) noticed a large cluster (500 deaths in 10 days) of cholera in one neighborhood. He plotted the cases on a map. The neighborhood got its water from one pump. Snow reasoned that this was the source of the outbreak. The pump handle was removed, and the epidemic contained.” #5 - Pg 84

In 2010, information technology was used in Haiti to track Cholera. Radio stations and cell phones were used to send out information and warnings. They were also able to track people through their cellphone movements to help make predictions on where a flare up area might occur. Through further study and analyzing DNA, it was found that the bacteria had originated in South Asia.

Through the Office of the National Coordinator for Health Information Technology (ONCHIT), information is shared between public health entities and health information systems. This allows information to be readily shared between a patient’s EHR and a telehealth facility. Another way that information is obtained and shared is through syndromic surveillance. Syndromic surveillance can monitor disease patterns in hospitals and homeless shelters, and monitor outside air incase of a bioterrorism attack.

Symptoms and lab results are entered into EHRs. Once entered, the health information technology system (HIT) will then make that information available to the local public health agency. Through this process, registries are made and maintained so that the data can be analyzed.

Satellife is another way information is being shared worldwide. This is a satellite that orbits the earth every 100 minutes, which means that 3 times a day it will pass over every point on earth. The satellite makes contact with the ground for approximately 15 minutes. Data is uploaded at about 1 page per second. Computers are able to upload to the satellite, and then download the data when it passes over the intended destination. This process is known as store and forward.

The National Electronic Disease Surveillance System (NEDSS) connects public health departments and healthcare systems with the CDC so that health concerns can be passed on immediately by using the information collected from the National Notifiable Diseases Surveillance System (NNDSS). This system enables the local, national, and international sharing of data that will allow the monitoring, control, and prevention of possible outbreaks.

The Geographical Information Systems (GIS) captures, stores, checks, and displays data concerning the spread of disease. This can allow the display of the occurrence and spread of a disease on a map so that a possible pattern can be determined.

FRED (Framework for Reconstructing Epidemiological Dynamics) and MIDAS were created by the National Institute of General Medical Sciences (NIGMS) along with EpiFire, WHONET, Global Epidemic Model, and TranStat to create, monitor, and predict infectious disease transmissions around the world.

Climate change is another factor that is closely monitored. Global warming is currently showing its effects on human health and the earth with an alarming rate. Pollution, poor land management, extreme cold spells, and heat waves are contributing to health issues in people of all ages.

Telehealth technology is advancing at an amazing pace. With today’s computers, tablets, and cellphones, a healthcare provider is only a quick click away.

The “new” clinic setting is already starting to be a thing of the past. The new “Ask A Nurse” is shown above. All an individual has to do is walk up to a booth, and a provider is ready and available 24/7. The individual can follow the onscreen instructions to properly use the on hand medical devices. These devices will allow the provider instant feedback so that they are able to give a diagnosis. The capability of obtaining bloodwork so that results can be readily available is in progress.

A major plus to telehealth is having the capability to provide an eER (shown above). Superfast internet speeds allow good quality and reliable video and audio to handle emergency situations. Doctors and nurses are available to assist by giving medical instruction or helping to document. Rural hospitals are the main focus for this technology, because in a lot of places, education and medical advancement information is as updated as a bigger medical facility.

Telehealth has many branches and is expanding daily. Some of areas are: ePharmacy, eRespitory, eSchool, eLong Term Care, eTransfer Center, eICU, eRadiology, and eNeurology.

Medical Aircraft Dispatch Centers are also equipped with telehealth capabilities so that medical crews have assistance and information while in the air.

References

1. http://www.os.dhhs.gov/healthit/executivesummary.html

2. https://www.healthit.gov/faq/what-electronic-health-record-ehr

3. https://www.nist.gov/hit/nationwide-health-information-network-nhin

4. https://www.healthit.gov/topic/privacy-security-and-hipaa/hipaa-basics

5. Burke, L. Information Technology for the Health Professions. [VitalSource Bookshelf]. Retrieved from https://bookshelf.vitalsource.com/#/books/9780134879420/

6. https://www.apha.org/policies-and-advocacy/public-health-policy-statements/policy-database/2014/07/18/09/19/preparing-for-pandemic-influenza

7. http://publications.nigms.nih.gov/com-putinglife/simsickness.htm

8. Groves, T. (1996). SatelLife: Getting Relevant Information To The Developing World. BMJ: British Medical Journal, 313(7072), 1606-1609. Retrieved March 30, 2020, from www.jstor.org/stable/29733882

Appendix

Unable to perform due to interview appointments being cancelled because of COVID-19.