Show the parties involved in information exchange in your scenario. Remember that parties are not people but applications

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Description

Identify
Interoperability Requirements in Healthcare

For each of the scenarios in the
assignment document you will:

  • Show the parties involved in information exchange in
    your scenario. Remember that parties are not people but applications
  • Show the scope: Intra-hospital, inter-hospital,
    regional
  • Clearly describe at least 3 goals for building
    interoperability among the parties in the scenario, e.g. avoid duplicated
    data entry
  • Define the information exchange “trigger event”, that
    is, the point(s) at which information is going to be exchanged, e.g. after
    the doctor issues a lab order
  • Show the contents of each information exchange, e.g.
    patient demographic data, lab order, lab result data, etc.

Assumptions:

·        
Systems do not share platform or database
engines. The only available connection between systems is a reliable
communication line in case of remote communication and a local IP network
otherwise

·        
There are no funding, timing, or tooling
restrictions. And systems are always in functioning mode (no down time).

 

Scenario 1: Get-well Hospital (GH) has implemented a new
laboratory information system (LIS) named GH_LIS. Hospital management has asked
that all patient demographic and encounter information be transmitted
automatically to the LIS. Order status from the LIS has to be transmitted to
the hospital billing system (GH_ADMIN) for further processing.

Parties

Scope

Goals

Trigger Event

Content

 

 

 

 

 

 

 

 

 

 

 

Scenario 2: George Pediatric, age 12, goes to
MyClinic for a well-child visit. The nurse reviews his immunization history in
the EHR system and notes that he is due for a Tdap vaccine. In addition,
George’s mother reports that they will be travelling to a country with a risk
of yellow fever. After consulting with the travel specialist, the nurse
administers a dose of Tdap and a dose of yellow fever vaccine. The nurse
determines that George is Native American. The nurse records the child is
eligible for vaccine funded by the Vaccines for Children (VFC) due to his being
Native American. The Tdap vaccine is eligible for VFC funded vaccine, while the
yellow fever vaccine is not. The nurse captures this in the EHR. The EHR sends
the updated immunization history, including the eligibility status to the IIS.
The IIS accepts the updated immunization history, tracking eligibility for each
immunization

Parties

Scope

Goals

Trigger Event

Content

 

 

 

 

 

 

 

 

 

 

Scenario 3:  Community
Healthcare Center (CHC) wants to send directly from incoming ambulances the
Clinical evaluation, blood gas and EKG results and interpretation for their
patients (loaded into their new Mobile Emergency Management Software – MEMAS),
to the CHC-EHR repository accessed from their 1 associated hospital and 4
satellite clinics.

Parties

Scope

Goals

Trigger Event

Content

 

 

 

 

 

 

 

 

 

 

 

For Further Discussion:

·        
What will happen to these scenarios if more applications
are added later? How to design and implement a scalable, interoperable
healthcare system?

 

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Human Factors and Socio-technical Systems: Through the user stories and depictions of user cases, activity, and sequence, consideration and respect are evident in the design and application of information systems and technology

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F5: Human Factors and Socio-technical Systems: Through the user stories and depictions of user cases, activity, and sequence, consideration and respect are evident in the design and application of information systems and technology, in this case from the perspective of workflow and exchange of health information across actors with a variety of roles – Attitudes and abilities.

(Millers – Does (part 1) , Shows how (part 2 ; class diagrams) )

F7: Integrates and applies tools (UML) from human factors to implement health informatics use  cases, activity, and sequence diagrams, that provide users with ready to use modeling examples – skills

(Millers: Does )

F4 – Health Information Science and Technology: Advantages of using different terminology and vocabulary services

HI7020 Module 1:
Introduction to Healthcare Interoperability                                    Assignments

 

 

 

To complete this assignment, you need to have a UML
editor.  You can download or run a free
UML editor from the site below:

 

http://alexdp.free.fr/violetumleditor/page.php

 

To submit your assignment, you need to export the diagram
you drew in the editor either to the clipboard or as an image file and then
insert the image into a word document for submission. (See screenshot below for
exporting instructions)

 

 

 

 

 

1.     Read
the following user story of “Hospital Discharge Message to PCP”

 

Setting 1: Hospital
or ED from where patient is discharged (sends discharge summary to PCP or Care
Team).

 

 A patient is
discharged from the hospital. Discharge instructions are given to the patient
by his nurse or care manager on day of discharge at or a short time before the
physical discharge. The instructions may be generic, patient specific, or
disease specific depending on the facility’s practices and the patient’s needs.
The patient acknowledges that he has received the instructions from the nurse
(verbally, in writing, and/or electronically). The acknowledgement triggers the
physical discharge sequence of events and patient transport out of the
facility. The discharge instructions are sent to the patient’s PCP or Care Team
(as the instructions may contain information necessary for the PCP or Care Team
to follow up with the patient before the discharge summary is available).

 

 Upon discharge, the
discharge summary is prepared within the Hospital EHR system by one of the
patient’s treating clinicians. The actual clinician is dependent on the
hospital’s workflow and may be a resident, a hospitalist, an advanced practice
nurse or the attending physician of record. Once the discharge summary is
prepared, it is ready to be reviewed by the attending physician of record
(APoR) (if it has not been prepared by the APoR).

 

 The APoR reviews the
discharge summary and, once he has approved it, the discharge summary is sent
to the PCP. The message may arrive in the PCP’s EHR system even before the
patient has left the hospital. A copy of the message may be retained in the
hospital EHR per the hospital’s policies and workflow rules.

 

 NOTE: The Discharge
Instructions described above are also part of the discharge summary. If the
discharge summary is ready at the time of physical discharge, it is the only
document necessary to be sent to the PCP or patient’s care team.

 

 Audit logs of the
exchange are retained according to the hospital’s, PCP’s, and any
intermediary’s policies, procedures, and agreements.

 

Setting 2: Patient’s
PCP or Care Team (receives discharge summary from Hospital or ED clinical
system).

 

 Discharge summary/instructions
are received into the PCP practice’s EHR system. Patient generally will be
known in the EHR system in which case an automated EHR match may occur (for
example, if the hospital and PCP systems can share a common patient
identifier). Discharge summaries/instructions that are not automatically
matched to a patient are reconciled manually, which may include the process of
creating a new patient record and registering the patient. Once the discharge
summary/instructions have become part of the PCP’s EHR system, additional
practice variable activities may occur: new tasks may be directed to a front
desk staff EHR work queue, as well as to additional staff EHR work queues as
appropriate to the practice workflows. Followup/plan of care are managed according
to established PCP workflow. For example, upon receiving notification of the
patient’s status, the care manager is now aware that the patient becomes
confused when medications are altered and calls the patient to ensure the
patient is taking the correct medications post discharge and is following the
discharge instructions.

 

 The PCP may review
and promote into the EHR the newly reconciled active medications, updated
problem lists, new procedures and other discrete data elements. The hospital
(or ED) discharge summary/instructions are retained in its entirety as a
permanent part of the patient’s record.

 

 

 

a.)   Complete
the Use Case Diagram, filling in any missing actors and use cases (5pts)

 

 

 

 

 

 

b.)   Draw
an Activity Diagram to support the events as described above  (5pts)

c.)   Draw
a Sequence Diagram to describe the messages and order of messages exchanged  (5pts)  

 

 

2.     (5pts)
In the user story described above, main information exchanged between the
Actors is the discharge summary. It contains minimal standard data set and
Discharge context relevant data set:

 

·      
Standard minimal data set: Demographic
information, active reconciled medication list (with doses and sig), allergy
list, problem list

·      
Data set relevant to the discharge
summary/discharge instructions context: reason for admission, APoR information,
follow up/plan of care (e.g., CCD/83 Plan of Care (What patient can do): Forward
looking sections (Treatment Plan), treatments, diet, activities, alerts for
conditions, future visits (may include several depending on condition)
including appointment established. Patient education and information on
medication (tied to alerts), disease process, wound care, condition based
special considerations, etc.) etc.

·      
Variable data set relevant to the
hospitalization (selected by the clinician who prepared the discharge summary):
Procedures during hospitalization, Selected medications administered during
hospitalization, Selected vital signs, Emergency contact information, Relevant
results, reports, Wound care (if applicable), etc.

 

 

Complete the Class Diagram below to describe the
characteristics of the Discharge Summary Document and show the relationship
between the Discharge Summary Document, the authoring doctor, and the patient.  You can add more classes to the diagram when
necessary.

 

 

 

 

 

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Outline the interventions (at least three) you will incorporate into your professional life to achieve this goal

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Select one essential from the Master’s Essentials document from the following website https://www.tnecampus.org/sites/default/files/docs_and_pdfs/Masters%20Essentials.pdf

 

  • Write a synopsis of the Essential that you chose
  • Formulate a goal you hope to achieve related to this essential.
  • Outline the interventions (at least three) you will incorporate into your professional life to achieve this goal

 

Respond to at least two fellow student’s post with the following:

•&νβσπ;&νβσπ;&νβσπ; Comment on the interventions mentioned by your peer. Are they similar to yours? What does the peer bring to the table?

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It is February & the height of the flu season. Mrs. Gibbs brings Tommy, age 8, to General Hospital Urgent Care Center.

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Description

DB #1 Pedi Asthma

Tommy Gibbs: Pedi Asthma Exacerbation

It is February & the height of the flu season.  Mrs. Gibbs brings Tommy, age 8, to General Hospital Urgent Care Center.  He has a history of Asthma, diagnosed at age 4.  He has no other medical problems.  He received the flu vaccine in October.  Mrs. Gibbs reports that Tommy has had a fever, cough, chills, & general malaise for 2 days. 

 

He has an albuterol inhaler that he takes to school for use if needed & 

a nebulizer machine at home.  He takes no other medications.

 

Tommy used the albuterol nebulizer several times yesterday, & then last night the nebulizer didn’t seem to help.  Mrs. Gibbs put Tommy in the shower & the steam of the shower helped.  But this morning he was short of breath, wheezing & having a hard time talking.

 

Of note both Mr. & Mrs. Gibbs are cigarette smokers.

 

Assessment today

Vital Signs:  BP 130/72, HR 142, RR 38, POX 87% RA, Temp 101.6, Weight 110 lbs (50 kg)

Physical Assessment:  Neuro A & O x3; Lungs breath sounds diminished, faint expiratory wheeze; Heart Sounds regular, tachycardic, S1,S2, no murmurs appreciated; Abd soft, nontender, non-distended, bowel sounds +; Extremities PP+, no edema.

 

The Health Care Provider asks the nurse to place Tommy on nasal 02 & titrate to POX of 92% & if needed to maintain adequate POX use non-breather mask, obtain IV access & routine labs, place on the cardiac monitor, & give an albuterol nebulizer treatment stat & solumedrol 100 mg IV stat.

 

Respond to Questions:

  1. What is the pathophysiology & may have contributed to this acute event?
  2. Explain why the treatments & medications were ordered.  How will they help Tommy? 
  3. What is the Health Care Provider trying to prevent?


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Before making a case for an evidence‐based project, it is essential to understand the culture of the organization in order to begin assessing its readiness for EBP implementation.

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PROBLEM 1

Before making a case for an
evidence‐based project, it is essential to understand the culture of the
organization in order to begin assessing its readiness for EBP implementation.
Select an appropriate organizational culture survey tool and use this
instrument to assess the organization’s readiness.

1.    
Develop an analysis of 250 words
from the results, addressing your organization’s readiness level, possible
project barriers and facilitators, as well as how to integrate clinical
inquiry.

2.    
Make sure to include the rationale
for the survey categories scores that were significantly high and low,
incorporating details and/or examples. Also explain how to integrate clinical
inquiry into the organization, providing strategies that strengthen the
organizations weaker areas.

3.    
Submit a summary of your results.
The actual survey results do not need to be included.

Prepare this assignment according to
the APA guidelines found in the APA Style Guide, located in the Student Success
Center. An abstract is not required.

This assignment uses a rubric.
Please review the rubric prior to beginning the assignment to become familiar
with the expectations for successful completion.

You are required to submit this
assignment to LopesWrite. Please refer to the directions in the Student Success
Center.

Upon receiving feedback from the
instructor, revise “Section A: Organizational Culture and Readiness
Assessment” for your final paper submission. This will be a continuous
process throughout the course for each section.

MY topic is about my hospital Montefiore medical center,
Bronx (Moses campus)

CAUTI is one of the common hospital acquired
infections nowadays. It leads to prolonged hospital stays and increased health
care costs and sometimes patient deaths. Extended use of the urinary catheter
is considered as the most common source of a catheter associated urinary tract
infections (CAUTI) . Therefore, catheters should only be used for appropriate
indications and should be removed as soon as they are no longer needed. I would
like to reduce our hospital CAUTI rate by using prevention methods/tools.

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“Technology is changing how patients manage their own healthcare needs and how nurses manage patient care.

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i need Questions 2, 3 and 4 answered with reference ( APA)  

Required Reading

This reference can be used for your group discussions and is available (full text) through Moody Medical Library:

Ball, Marion J (2011). Nursing Informatics:Where technology and caring meet. Springer London.

McGonigle, D. & Mastrian, K. G. (2018). Nursing informatics and the foundation of knowledge (4th ed.). Burlington: Jones & Bartlett Learning: Ch 14. The Electronic Health Record and Clinical Informatics p.267-287

Group Discussion Board Dialogue

“Technology is changing how patients manage their own healthcare
needs and how nurses manage patient care. Nurses need new skills to use
and contribute to the development of electronic health records, to find
and evaluate the relevance of evidence to support clinical decisions and
to use data to solve patient and system problems.” Johnson, J. (2013).
QSEN Faculty Development Workshop. New Orleans.

All large facilities with Medicare patients have registries that they
have to participate in; as an advanced practice nurse you will need to
know what these registries are and what they mean for your patients.

Please discuss the following questions within your group and post under module 3 discussion board for your designated faculty. Each student doesn’t have to answer all questions but all questions must be addressed and discussed as a group.

  1. What are the implications for nursing education as the EHR becomes
    the standard for caring for patients? Be specific, provide references
    and examples when possible.
  2. What do you see is the role of the masters prepared nurse (educator,
    nurse practitioner, clinical nurse leader – address whichever your
    specialty is) with EHRs?
  3. What are some ethical considerations related to interoperability and a shared EHR?
  4. In your specialty area, are there registries that are available
    to your institution? If so, please describe the aim(s) of the regsitry;
    if not, please select a registry from the CMS website and describe its
    aim(s).

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Identify 2 reviewable sentinel events and what you could do as a nurse to prevent the identified sentinel from

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Refer to
the website provided and complete the following assignment. Write up a 3
paragraph essay or about Y of)
question. Please keep it short and summarize it in your own
words.https:J/www.jointcommission.org/

1.
Identify 2 reviewable sentinel events and what you could do as a nurse to
prevent the identified sentinel from

2.
Identify a minimum of 7 National Patient Safety Goals. Explain why it is
important for nursc to adhere to the

3.
Identify who is The Joint Commission, what is their role, and why the hospitals
used their services?

4.
Identify and describe what are QSEN competencies. why are they important?

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Discuss various theories of health promotion, including Pender’s Health Promotion Model, the Health Belief Model, the Transtheoretical Theory, and the Theory of Reasoned Action.

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Discuss various theories of health promotion, including Pender’s Health Promotion Model, the Health Belief Model, the Transtheoretical Theory, and the Theory of Reasoned Action.


  1. Discuss at least two definitions of health.
  2. Critically analyze racial and cultural diversity in the United States.
  3. Describe the importance of air, water and food quality as a determinant of health.
  4. Describe the importance of air, water and food quality as a determinant of health.

APA FORMAT 

700 Words

2 References less than 5 years old

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Dentin bonding һаѕ Ьееn studied fог mаnу years. Dυгіng resin–dentin bonding, mineral ions аге removed tо expose tһе collagen tһгоυgһ acid etching.

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Dentin
bonding һаѕ Ьееn studied fог mаnу years. Dυгіng resin–dentin bonding, mineral
ions аге removed tо expose tһе collagen tһгоυgһ acid etching. Hybridization
occurs Ьу resin inter-diffusion іntо tһе exposed dentinal collagen layer,
combined wіtһ resin tags іntо tһе opened dentinal tubules tо form tһе bonded
interface (Nakabauashi еt al., 1991). Tһе quality оf tһе hybrid layer іѕ
essential fог long term stability оf dentin bonding (Pashley еt al., 2011;
Frassetto еt al., 2016).

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21 y/o female college student, was seen in the student health center for increasing episodes of abdominal fullness and discomfort with alternating diarrhea and constipation.

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Case study 2

21 y/o female college student, was
seen in the student health center for increasing episodes of abdominal fullness and discomfort
with alternating diarrhea and constipation. Reports being diagnosed with irritable bowel
syndrome several years ago, was told to eat more fiber, but nothing has seemed to be effective
in reducing her abdominal distress, is taking a heavy course load this semester, has to work 20
hours each week for her work-study contract, and eats mainly fast foods and drinks several coals
daily.

 

CASE STUDY 3
Mr. Begay is a 55-year old Native American man admitted with a diagnosis of
cirrhosis of the

liver.  He has been vomiting for 2 days and noticed
blood in the toilet when he vomits.  He
has

had cirrhosis for 12 years,
acknowledges that he had been drinking heavily for 20 years but has

been sober for the past 2
years.  He complains of anorexia, nausea,
and abdominal discomfort. 

On his physical examination, the
findings were thin and malnourished, has moderate ascites,

jaundice of sclera and skin, 4+
pitting edema of the lower extremities, liver and spleen are

palpable.  The laboratory values are as follows: total
bilirubin: 15mg/dl, serum ammonia 220

mcg/dl, AST 190 U/L, ALT 210 U/L.

 

 

 

CASE STUDY 4

 

75 y/o African-American male, was
admitted to the hospital emergency department with partial-

thickness burns that involved his
face, neck, and upper trunk, lacerated right leg, injuries

occurred about 24 hours earlier when
he fell out of a tree onto his burning gas grill while trying

to get his cat. Complains of
slightly hoarse voice and irritated throat, states that he tried to treat

himself because he does not have
health insurance, has been coughing up sooty sputum, and

complains of severe pain in left
hip.

Leg wound is gaping and looks
infected, temperature 101.1 F, x-rays reveal a fractured right tibia

and fractured left hip, WBCs
26,400/μl with 80% neutrophils (10% bands), and surgery is

performed to repair the left hip.

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