HIM 4401 Healthcare Information Technology Systems

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Hardware

"Touchable"
Examples:
Hard Drive
Monitor
Mouse
Keyboard
Printer
Modem
Scanned
Storage Devices

CPU

Central Processing Unit

Cache

Temporary Memory

RAM

Random Access Memory
Long Term Memory

The personal computer is a......

Microcomputer

These are examples of storage devices....

Flash Drives
CD's
DVD's
Blue-Ray disc

Input Devices

Used to enter data into a computer

These are examples of Input Devices

Keyboard
Touch Screen
Scanner
Microphone
Optical Character Recognition

Three main hardware parts of a computer

CPU (central processing unit)
Memory
Storage Devices

Ports

Commincation Device
Enables Computer to "talk" to peripheral devices

Output Devices

Used to transmit data to users

These are examples of output devices

Monitor
Printer
Speakers
Projectors
Scanners
Optical Disc

Monitor resolution is measured in......

Dots Per Inch

Optical Disk

Used with document imaging systems
Uses a format known as "write once read many" (WORM)
Allows multiple user access at the same time
Allows for variius levels of security
Data cannot be altered,lost once in the system
This is a output device

Operating System

Instructions that direct the computer in its operation, regulate the hardware, and allow several programs to run simultaneously.

These are examples of Operating Systems

Windows XP
Vista
Mac Os
UNIX

Application Programs (software)

Enables user to perform specific types of work
Can work with text, numbers, graphs, images

These are examples of application programs (software)

Microsoft Office
Software developed internally by an organizations IT staff
Enterprise Software-used throughout an organization/facility

Programming Languages

Language encoded into a computer that tells it what to do and how to operate.
Communication between user and computer
Allows computers to enteract with each other

These are examples of Programming Languages

COBOL
FORTRAN
BASIC
JAVA

Bit

Basic unit of storage whithin a computer

Byte

a string of 8 numbers

These are 2 types of networks

LAN (local area network)
WAN (wide area network)

Local Area Network (LAN)

connect PC's within a local area and to a host server

Wide Area Network (WAN)

connect PC's in a large geographical area
not geographically located near each other

Networks

enable communication among linked PC's
Connect PC's to a central server (hub computer)
Can link internally and externally

These are internet connections used within networks......

Ethernet
Wireless
Fiberoptic
Modem
Wireless Cards

These are types of LAN networks

Bus Network
Star Network
Token Ring Network

Bus Network

Computers "lines up" on a single cable
Dependent upon the device before it

Star Network

Most common type of LAN network
All computers connected to a hub (star)
Data flows to hub, then passed on to each computer

Token Ring Network

A ring of computers
Data flows around the ring until reaches destination computer.

Interfaces

Allow computers to connect with a network
Allow networks to connect with one another
Allows transmission of data from one system to another

These are 2 types of network security

Firewalls
Routers

Firewalls

control access from the internet to a LAN

Router

route data between networks

Internet

Networks and computers linked together
enable data/information sharing around the world

Intranet

Private network
Firewall security restricts unauthorized users

Extranet

Allows authorized users to access private network

Which of the following types of data storage devices has the largest storage capacity?

Blu-Ray

Within the hardware of the personal computer, temporary memory is known as?

Cache

If you wanted to convert some old Kodak photos into digital data so that you could insert them into a PowerPoint presentation, you would first use a .....

scanner

A common programming language used with the Internet is?

HTML

The quality of the resolution of computer monitors is dependent on the number of pixels or......

dots per inch

Within a LAN the security device used to control access from the internet is known as....

a firewall

Which of the following data storage measurements has the largest memory size?

terabyte

Networks

enable communication among linked PC's

Optical Character Recognition

A common input device, commonly known as barcoding, used in HIM departments which enables staff to be more efficient and accurate

Operating System

The PC software that instructs the computer in its operations and regulates the hardware

Star Network

The most common type of LAN network in which data flows to a hub, and then is passed on to each computer linked in the network

Hard Drive

This is the brain of the computer

Cache Memory

Temporary memory
used when computer needs to borrow memory temporarily
used when speed is needed by the computer

RAM

long term memory

DRG Grouper

computer software program that assigns appropriate DRG's according to the info provided for each episode of care

Peripherals

Anything that is added to the computer

Graphical User Interface

used to present images or data to the user

This is also known as "barcoding"

Optical Character Recognition

What are the main parts to the personal computer?

CPU
memory
storage

ROM

memory programmed onto a chip at the factory and cannot be changed
Read Only Memory
purchased at a predetermined amount

System Files

small disk files that contain software codes that are instructions for the computer
are the 1st files a computer reads when "booting up"

RAM

temporary memory need by the computer at startup and backup
can be volatile or dynamic

WAP

wireless application protocol

Routers

provide firewall security for networks and route data between networks using IP addresses

Hub

device where all computers on a network connect

Peer to Peer Network

when a network does not use a hub

Ethernet Connection

a network that sends data from node to another in packets

Modem

bridge between digital and analog signals
converts digital data on and off

Clinical Information Systems

collect and maintain information related to patient care
data is patient identifiable
lab
radiology
nursing
pharmacy
patient monitoring

Computer Provider Order Entry

Designed for orders to be entered by a healthcare professional
Alerts and reminders built into the system

Picture Archival Communication System

radiological images stored digitally
PACS

Teleradiology

ability for images to be viewed from any location by the radiologist

Lab Information System

collects, stores and maintains lab tests and their respective results
blood chemistry
microbiology
blood banks
pathology
virology

Nursing Information System

assist in planning/monitoring patient care
documents nursing care provided
provides nursing protocols
provides access to reference guides
enables documentation at the point of care
assists in management of nursing department

Patient Monitoring System

capture data from monitoring systems
blood pressure
oxygen saturation
fetal monitoring

Telehealth

communication about health information between patient and care provider

HIPAA requires accounting of disclosures to be available to the patient for how long?

6 years

Encoder

used by coders to select the appropriate code for diagnosises and procedures

What are the 2 types of encoders?

Rules Based
Automated codebook encoder

Rules Based Encoder

require the user to type in the name a portion of the dx or procedure
Ex. 3M

Administrative Information Systems

Computer systems used to manage the business side of healthcare
Financial or Administrative in nature

These are the major administrative information systems

Financial information systems
Human Resources information systems
Decision Support Systems
The Master Patient Index
Patient Registration Systems
Practice Management Systems
Materials Management Information Systems
Facilities Management Systems

These are functions related to the Financial Information Systems

Patient Accounting
Accts Receivable
Accts Payable
Investment management
Contract Management
Payroll

Revenue Cycle

management of the accounts receivable and the accounts payable on a daily basis by the faciity

Chargemaster

automates the coding process for routine procedures

General Ledger

records credits and debits to the various accounts managed by the financial information system

Decision Support System

takes data collected by the healthcare facility, turns them into information and uses the info to make decisions about the healthcare facility
DSS

Executive Information Systems

a type of DSS that is designed to be used by top level healthcare administrators
lots of graphs and charts are generally used
facilitates quick decision making

Master Patient Index

info in MPI collected by registration personnel
info collected flows to other hospital systems
permanently maintained
key to locating a patients health record in a paper based environment
uses soundex capabilities

These are errors that can occur during patient registration and impact MPI integrity.

Overlays, 2 people with same medical record number
Duplicate Medical Record Numbers,2 medical record numbers for same person

What are the 3 types of Algorithms used in a MPI system to prevent duplication of patient records and medical record numbers?

Deterministic
Rules-Based
Probabilistic

Deterministic Algorithm

look for exact matches

Rules-Based Algorithm

"fuzzy logic"
uses a weight based system to rank potential matches

Probabilistic Algorithm

can identify transpositions/name changes
This is the most sophisticated type of Algorithm

Patient Registration ADT

Admission,Discharge,Transfer

Practice Management

used by physician office groups
Scheduling,patient accounting, patient collections, claims submission,appointment scheduling, human resources are all built into one system

Materials Management Systems

manage equipment and supplies for facility

Facilities Management

supports the management of the building

The system that would print out advanced directives, consents and notice of privacy practices is the?

Registration System

Updates to the chargemaster ultimately feed into the.......

financial system

The following is a function of the chart locator system....

Productivity Reporting

Electronic Data Management System

EDMS
An electronic system which manages documents in order to improve business processes

COLD Technology

Computer output to laser disk

COLD Technology

Transfer of data straight from the computer into imaging system

Legacy Systems

transcription system
lab system
radiology system

Data Retrieval Tools

Tools used to identify and extract data from a database

SQL

structured query language
data retrieval tool
allow user to create tables,delete tables and show how something is viewed
standard language for RELATIONAL DATABASES

QBE

query by example
data manipulation language
uses GUI to query the database

BOOLEAN search

uses boolean operators to control and refine search results
"and" "or" "not"

These are types of Boolean operators....

"and" "or" "not"

Normalization

breaking data elements into level of detail desired by the facility

Primary Data

Data directly from the source ex. medical record

Secondary Data

data taken from a primary source and abstracted into another database or registry
ex. cancer registries, mpi, disease index

Aggregate Data

non patient identifiable data
ex. research data

ORYX

examines healthcare organizations internal performance over time and then compares the organizations internal performance with that of others
Developed and maintained by the Joint Commission

Automated Forms Processing

allows user to type data directly into computer eliminating the need to manually complete a paper form and then scan it into computer

Optical Character Recognition

OCR
encoding text from analog paper into bit mapped images and translating the images and translating the images into a form that is computer readable

What is the difference between a document imaging system and an EHR?

A Document imaging system does not assist in documentation like a EHR does.

Document Imaging

process of scanning a document into the computer and creating a picture of the document

These are some advantages of a document imaging system.

Space saving
multiple user access
autofaxing
users can access anytime, anywhere
enhances patient record security

Backscanning

Scanning past medical records so that there is an existing database of patient information

Target Sheets

pages that are blank except for a barcode that will tell the scanner and ultimately the computer the content of the pages that follow

WORM technology

prevents user from altering what is stored
write once read many

Jukebox

holds and retrieves the individual disks just as a music jukebox does

Scanner are rated on.....

pages per minute

Document imaging eliminates which function?

Assembly

This controls the specific data elements collected?

Data Sets

Workflow Technology

software that allows the facility to incorporate procedures and processes into the system based on criteria established by the organization

The 1st stage in the scanning process is?

Document preparation

This type of backup backups everything on the hard drive

Full Backup

This type of backup backups only copies that have changed since the last backup

Incremental Backup

Ad Hoc Reporting

reports needed only once

Routine Reports

reports that are needed repeatedly

Indexing

Comparing scanned documents to the paper documents to ensure the quality of the scanned image is good and the documents are under the correct pt name and document type

COLD feed

transfer of data from the computer directly into the document imaging system

NCVHS

National Committee on Vital Health Statistics
advisory committee to the DHHS

What is the role of the NCVHS in regard to the EHR?

to recommend guidelines applicable to the EHR such as standards, data sets, and terminologies

Standards development organizations

SDOs
the efforts of 2 organizations
ANSI (american national standards institute)
WEDI (workgroup for electronic data interchange)

ANSI

american national standards institute
voluntary organization that accredits groups in the private sector for data standards

WEDI

workgroup for electronic data interchange
identifies ways to increase the use of electronic billing to reduce admin costs

HL7

Health Level 7
Communicates Clinical Data
Messaging Format Language

These 2 organizations serve to ensure that data elements and data sets are defined and equal so that info can be transmitted.

WEDI
ANSI

ASC X12

Communicates financial data
Messaging format language

Data Set

list of recommended data elements with uniform definitions
ensures consistency of data collected
ensures consistency of definitions of data elements
supports electronic data collection and exchange

These are data entry methods used to support data integrity.

required fields
edit checks
help screens
automatic save feature
online reference link
hot spots
streamlining repetitive data

Database

large collection of data in a standardized format which allows for data retrieval as meaningful information

Database Management System

used to manipulate and control data stored in the database
DBMS

Primary Key

Unique identifier used in a healthcare data base
ex. health record number
used in a relational database

Foreign Key

when the primary key of one table is included in another table
when this happens the nd key is called the foreign key

Name the major types of databases.

Relational database
Hierarchical database
Network database
Object-oriented database

Relational Database

has at least 2 tables
data stored on rows and columns
a field can be designated as a "primary key"
each row is a record
each column represents a single piece of data

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