XYZ Medical Center has asked you to develop

XYZ Medical Center has asked you to develop an educational offering for a group of administrative leaders.  You have been asked to speak about the clinical and administrative use of mobile health devices and other digital health technology and Issues and challenges related to data collection, storage, analysis, security, and retrieval of health information.  Summarize the key points of the topics provided here that you would like to make to this group of administrators.

 The Discussion Board Rubric is attached.

Annotated Bibliography Worksheet

A. Bibliographical Information

B. Summary of Article

C. Evaluation of Article

D. Reflection on Application to Practice or Implementation

Annotated Bibliography Rubric

50 Pts

Written Criteria	Exemplary 10 Points	Developing 7 Points	Needs Improvement 4 Points	Faculty Comments
Bibliographical Information	Bibliographical information is accurately stated and formatted.	Bibliographical information contains 2-3 errors.	Bibliographical information contains more than 3 errors.
Summary of Article	Article is concisely summarized in one paragraph with no more than one error	Article is more than one paragraph with one error	Article exceeds one paragraph and has more than 2 errors.
Evaluation of Article	Article is evaluated in light of its purpose and credibility	Evaluation is loosely based on evidence but well organized	Evaluation does not relate to purpose of article and is not evidence-based.
Reflection on Application to Practice	Reflection contains reference to application to current of future practice merits or lack of merit.	Reflection is vague and only loosely related to current or future practice.	Reflection does not connect merit or lack of merit to practice.
Grammar, Syntax, APA Format	APA format, grammar, spelling, and/or punctuation are accurate, or with zero to three errors.	Four to six errors in APA format, grammar, spelling, and syntax noted.	Paper contains greater than six errors in APA format, grammar, spelling, and/or punctuation or repeatedly makes the same errors after faculty feedback.

Health IT and EHRs: Principles and Practice, Sixth Edition

Chapter 11: Information Technology

© 2017 American Health Information Management Association

© 2017 American Health Information Management Association

System Architecture

The technical building blocks that support the operation and use of a computer system

Hardware architecture supports

Input/output

Processing

Storage

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Input/Output (I/O) Devices
Also known as human-computer interfaces or workstations, because they are the connection between a human and the computing power of the application in the computer
Input/output devices:
Personal computers
Workstations
Desktops
Laptops or notebooks
Tablets
PDAs
Smartphones
Keyboards
Display screens
Navigational devices
Optical character recognition (OCR)
Document scanners
Barcodes
RFID
Voice or speech input
Printers

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I/O Considerations
Source of power
Cabled to electrical outlet or battery
Network connectivity
Wired versus wireless connectivity
Portability
Consider size, weight, heat
Computers on wheels
Wireless on wheels (WOW)
Workstations on wheels (WOW)
Screen (real estate)
Size and resolution
Navigational devices
Consider ease of use and loss concerns

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Data Storage
Secondary storage devices (drives)
Secondary to primary storage in the computer’s processors
Storage media
Magnetic tape
Magnetic disks
Optical disks
Flash drives/USB drives
Storage configuration: RAID
Storage architecture
Direct-attached storage
Storage area network
Network-attached storage
Hybrid
Content-addressable storage
Storage management – planning and organizing how data are stored

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Processing Capability
CPU (processor)
KB, MB, GB, TB, and beyond
MHz, GHz
ALU/registers
ROM
Booting
RAM
Caching

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Computer Categories
Supercomputer
Mainframe computer
Personal computer
Mobile devices: notebooks, laptops, tablets, smart phones
Network computers (thin clients)

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Communications and Network Architecture

Firewall
Two or more computers communicating makes a network
Client/server architecture:

Service-oriented architecture, including web services architecture
Cloud computing; virtualization

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Network Configuration
LAN
WAN
WLAN
VPN
Network Topology
Physical
Logical

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Network Components
Network Operating System
Windows, Unix, or other
Network Interface
NIC, LAN Adapters, wireless access card
Transmission Medium
Hardwire cable, infrared light, radio frequencies
Other devices
Hub
Bridge
Router switch
Gateway
Multiplexor
Modems

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Network Protocols
Rules of the road
OSI Model:
Seven layers
TCP/IP
FTP
HTTP

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Physical Plant
Data center: location that affords special protection (back-up and disaster recovery) for mission-critical equipment
HVAC
UPS
Console monitoring
Caged server racks
Back-up generators

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Software that Supports Health IT
Operating System (O/S)
Platform
Application software
Makes applications perform their functions
Source code
Application software (programs) written in a language computers can convert to electrical pulses. Provides instructions for processing.
Developer of software owns it, and generally licenses it to others, but others cannot alter the software.
Note: Configuration of software during implementation is enabled by the source code allowing for customization. Configuration does not alter the underlying source code.
Open-source software is freely distributed to others who may change it, but there may be a fee associated with acquiring it
Free software is software for which no charge is made for its use. It may or may not be open-source software

© 2017 American Health Information Management Association
Usability
Usability refers to factors that make a product easy to use, although ease of use is often subjective and subject to change as users become comfortable with computers and products.
HIMSS identifies Usability Factors (see chapter 7)
NIST defines usability as the extent to which a product can be used by specified users to achieve specified goals with effectiveness, efficiency, and satisfaction in a specified context of use
Usability frustrations with EHRs led the AMA to identify solutions for making them usable.

© 2017 American Health Information Management Association
Data Quality
Usability must ensure that the data collected, used, and shared are quality data.

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Data Retrieval Strategies
Usability and data quality are critical to data retrieval, as they must support clinician thinking:
Scan data rapidly to obtain a quick overview and understanding of a new patient
Retrieve data to refamiliarize themselves with a former patient’s history
Search data for specific facts relative to a current patient
Review a range of data to solve a problem relative to a current patient
Clinical decision support as an external memory tool has been one of the most challenging aspects of data retrieval to design in a usable and accurate manner

© 2017 American Health Information Management Association
System Constraints on CDS

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Other Functional Considerations
Screen density
Size of device
Search capability
Navigational support and content positioning
Consistency of design and flexibility
Graphics
Color and icons

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Documentation Strategies
Documentation strategies
Free text
Copy and paste
Data reuse
Pick lists or pull-down menus
Defaults
Template-based entry
Macros
NLP

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SAFER Systems for Patient Safety
ONC Health IT Safety Program
Safety Assurance Factors for EHR Resilience
Guides for EHRs and other health IT

© 2017 American Health Information Management Association