Assignment Prompt & Instructions
**files (1)**
– ## DiscussioninstructionsINFO320.docx
**## DiscussioninstructionsINFO320.docx**
i)
**Discussion Thread: Case Study — Telehealth**
Reading the following case study and answer the discussion prompts:
Mrs. Smith is 82 years old and is diagnosed with hypertension, diabetes, and congestive heart failure. Her two children live in California, while she lives in North Carolina in a small family home on 10 acres of land in the Blue Ridge Mountains. Mrs. Smith has been in the hospital four times in the last year due to congestive heart failure. As her eyesight and mobility get worse with age, she has found it a challenge to stay on her medical plan and to do her shopping for the right foods she knows she should be eating. Mrs. Smith’s health plan, Purple Cross of North Carolina, assigned a nurse case manager to address her situation. Purple Cross provided a digital scale and a remote monitoring device that recorded Mrs. Smith’s condition every day by uploading her weight and transmitting the answers to a series of questions on a touch screen kiosk. The case manager also coordinated delivery of Meals on Wheels, providing low-sodium, diabetic-compliant dinners to Mrs. Smith on an ongoing basis. The case manager calls Mrs. Smith twice a week, taking the time to educate her about her medications, her activities, and the disease-specific elements that will keep her healthy and out of the hospital. When the case manager identifies that Mrs. Smith can no longer organize her daily medications, a digital medication dispenser will be provided that will keep her on her medication regimen. The medication dispenser will be preloaded with Mrs. Smith’s medications and will issue a subtle doorbell tone when it is time to take them. With the combination of remote and real-time (telephonic) support persons and technologies, Mrs. Smith can remain in her home and avoid further inpatient admissions.
Describe the risk and benefits of using Telehealth for Mrs. Smith. Explain other technology that can be used to assist Mrs. Smith at home. Elaborate on the financial cost savings related to Telehealth in this scenario. Describe other ways telehealth can be useful in healthcare implementation.
Elaborate on a scripture reference related to the discussion content. Write a response of 500 words in response to the assigned case study without including the reference page.
II)
**Discussion Thread: Community Systems, Decision Support, Public Health**
Discuss how the development of Clinical Decision Support (CDS) standards and statewide health information exchanges (HIEs) are essential to the national adoption of CDS. How does CDS align with the goal of rewarding "quality over quantity" in healthcare reimbursement? Based on your research and response, does this favor the adoption of CDS or argue against it?
Elaborate on a scripture reference related to the discussion content. This response should have at least 300 words and demonstrate course-related knowledge. It must include a Scripture reference and a minimum of 1 citation in current APA format.
III)
**Discussion Thread: ePatient, Social Networking, Personal Health Record**
One of the principles of an ideal PHR is data sharing; another is data ownership, control, and privacy. Consider the following questions: Do you see any potential conflicts between these two principles? How do you think these issues can be resolved in the practical use of the PHR? What are the challenges and opportunities?
Elaborate on a scripture reference related to the discussion content. This response should have at least 300 words and demonstrate course-related knowledge. It must include a Scripture reference and a minimum of 1 citation in current APA format.
IV)
**Case Study — User Experience, Standards, and Analytics**
Read the following case study and answer the discussion prompts:
A small community hospital in the Midwest has used a homegrown information system for years. The system began in the early 1970s with a financial module. Over time, additional modules were added. A limited number of departments selected a commercial system and interfaces were used to integrate these into the overall functionality of the hospital information system. Except for physicians, most in-house clinical or care-related documentation is online. However, about 15% to 20% of this documentation is done by free text and is not effectively searchable. In addition, the screens, including the drop-down and default values, were built using terms selected by the in-house development team in consultation with clinical staff; thus there is no data dictionary or specific standard language. In the last few years, the hospital has purchased two outpatient clinics (obstetrics and mental health) and a number of local doctor practices. The clinics and doctors’ offices are now being converted to the hospital administrative systems. A few of the clinical applications that are tied directly to the administrative systems such as order entry and results reporting are also being installed.
A major change is being planned. A new chief information officer (CIO) was hired last year, and she has appointed a chief medical information officer (CMIO) and a chief nursing information officer (CNIO). No other significant staff changes were made. With her team in place, one of the CIO’s first activities was to complete an inventory of all applications. Rather than continue to build, a decision was made to switch to a commercial vendor, and the hospital selected a commercial system.
Identify issues with the existing system. Provide staff with an appropriate “work-around” for using the existing system. Provide an overview of two of the standard languages used within the new system including discipline or specialty, updating frequency, and available cross-maps. Describe ways to obtain clinical staff input and specific methods to support the transition to the new system.
Elaborate on a scripture reference related to the discussion content. Elaborate on a scripture reference related to the discussion content. Write a response of 500 words in response to the assigned case study without including the reference page.
V)
**International Efforts, Innovations, Issues**
A major obstacle to the global adoption, expansion, and progress of eHealth is the lack of available healthcare workers trained in informatics and adequately prepared to work in this growing field. What unique skill set(s) are needed to work in this evolving discipline? What obstacles present themselves as informatics expands globally (i.e., education/language barriers, differences in terminology, legal issues, access to technology, and regulatory policies, etc.)? How might these challenges be overcome?
Elaborate on a scripture reference related to the discussion content. This response should have at least 300 words and demonstrate course-related knowledge. It must include a Scripture reference and a minimum of 1 citation in current APA format.
VI)
**Case Study — Selection, Implementation, Delivery**
Read the following case study and answer the discussion prompts:
A good friend of yours is director of nursing at a 220-bed community hospital. Last year the hospital merged with a much larger medical center. One of the upsides, as well as one of the challenges, resulting from this change has been the rapid introduction of new computer systems. The goal is to bring the hospital “up to speed” within 3 years. At present, the Computerized Physician Order Entry (CPOE) is being implemented. The general medical and surgical units went live last month. The ICU, pediatrics, and obstetrics units are scheduled to go live next month. The plan is to work out any kinks or problems on the general units and then go live in the specialty units. Most of the physicians, nurse practitioners, and physician assistants initially complained but are now becoming more comfortable with the computers and are beginning to integrate the CPOE process into their daily routines. Several physicians are now requesting the ability to enter orders from their offices and others are looking into this option. However, three physicians have not commented during this process but are clearly resisting. For example, after performing rounds and returning to their offices they called the unit with verbal orders. After being counseled on this behavior, they began to write the orders on scraps of paper and put these in the patient’s charts or leave them at the nurses’ station. When they were informed that these were not “legal orders,” they began smuggling in order sheets from the non-activated units. In addition, they have been coercing the staff nurses on the units to enter the orders for them. This has taken two forms. Sometimes they sign in and then ask the nurses to enter the orders. Other times they ask the nurses to put the orders in verbally and then they confirm the orders. The nurses feel caught between the hospital’s goals and the need to maintain a good working relationship with these physicians.
Identify issues that occurred during CPOE implementation, identify potential causes of such issues, and list specific recommendations, using evidence-based rational and research to resolve the identified issues prior to the next CPOE implementation.
Elaborate on a scripture reference related to the discussion content. Elaborate on a scripture reference related to the discussion content. Write a response of 500 words in response to the assigned case study without including the reference page.
**## DiscussioninstructionsINFO320.docx**
i)
**Discussion Thread: Case Study — Telehealth**
Reading the following case study and answer the discussion prompts:
Mrs. Smith is 82 years old and is diagnosed with hypertension, diabetes, and congestive heart failure. Her two children live in California, while she lives in North Carolina in a small family home on 10 acres of land in the Blue Ridge Mountains. Mrs. Smith has been in the hospital four times in the last year due to congestive heart failure. As her eyesight and mobility get worse with age, she has found it a challenge to stay on her medical plan and to do her shopping for the right foods she knows she should be eating. Mrs. Smith’s health plan, Purple Cross of North Carolina, assigned a nurse case manager to address her situation. Purple Cross provided a digital scale and a remote monitoring device that recorded Mrs. Smith’s condition every day by uploading her weight and transmitting the answers to a series of questions on a touch screen kiosk. The case manager also coordinated delivery of Meals on Wheels, providing low-sodium, diabetic-compliant dinners to Mrs. Smith on an ongoing basis. The case manager calls Mrs. Smith twice a week, taking the time to educate her about her medications, her activities, and the disease-specific elements that will keep her healthy and out of the hospital. When the case manager identifies that Mrs. Smith can no longer organize her daily medications, a digital medication dispenser will be provided that will keep her on her medication regimen. The medication dispenser will be preloaded with Mrs. Smith’s medications and will issue a subtle doorbell tone when it is time to take them. With the combination of remote and real-time (telephonic) support persons and technologies, Mrs. Smith can remain in her home and avoid further inpatient admissions.
Describe the risk and benefits of using Telehealth for Mrs. Smith. Explain other technology that can be used to assist Mrs. Smith at home. Elaborate on the financial cost savings related to Telehealth in this scenario. Describe other ways telehealth can be useful in healthcare implementation.
Elaborate on a scripture reference related to the discussion content. Write a response of 500 words in response to the assigned case study without including the reference page.
II)
**Discussion Thread: Community Systems, Decision Support, Public Health**
Discuss how the development of Clinical Decision Support (CDS) standards and statewide health information exchanges (HIEs) are essential to the national adoption of CDS. How does CDS align with the goal of rewarding "quality over quantity" in healthcare reimbursement? Based on your research and response, does this favor the adoption of CDS or argue against it?
Elaborate on a scripture reference related to the discussion content. This response should have at least 300 words and demonstrate course-related knowledge. It must include a Scripture reference and a minimum of 1 citation in current APA format.
III)
**Discussion Thread: ePatient, Social Networking, Personal Health Record**
One of the principles of an ideal PHR is data sharing; another is data ownership, control, and privacy. Consider the following questions: Do you see any potential conflicts between these two principles? How do you think these issues can be resolved in the practical use of the PHR? What are the challenges and opportunities?
Elaborate on a scripture reference related to the discussion content. This response should have at least 300 words and demonstrate course-related knowledge. It must include a Scripture reference and a minimum of 1 citation in current APA format.
IV)
**Case Study — User Experience, Standards, and Analytics**
Read the following case study and answer the discussion prompts:
A small community hospital in the Midwest has used a homegrown information system for years. The system began in the early 1970s with a financial module. Over time, additional modules were added. A limited number of departments selected a commercial system and interfaces were used to integrate these into the overall functionality of the hospital information system. Except for physicians, most in-house clinical or care-related documentation is online. However, about 15% to 20% of this documentation is done by free text and is not effectively searchable. In addition, the screens, including the drop-down and default values, were built using terms selected by the in-house development team in consultation with clinical staff; thus there is no data dictionary or specific standard language. In the last few years, the hospital has purchased two outpatient clinics (obstetrics and mental health) and a number of local doctor practices. The clinics and doctors’ offices are now being converted to the hospital administrative systems. A few of the clinical applications that are tied directly to the administrative systems such as order entry and results reporting are also being installed.
A major change is being planned. A new chief information officer (CIO) was hired last year, and she has appointed a chief medical information officer (CMIO) and a chief nursing information officer (CNIO). No other significant staff changes were made. With her team in place, one of the CIO’s first activities was to complete an inventory of all applications. Rather than continue to build, a decision was made to switch to a commercial vendor, and the hospital selected a commercial system.
Identify issues with the existing system. Provide staff with an appropriate “work-around” for using the existing system. Provide an overview of two of the standard languages used within the new system including discipline or specialty, updating frequency, and available cross-maps. Describe ways to obtain clinical staff input and specific methods to support the transition to the new system.
Elaborate on a scripture reference related to the discussion content. Elaborate on a scripture reference related to the discussion content. Write a response of 500 words in response to the assigned case study without including the reference page.
V)
**International Efforts, Innovations, Issues**
A major obstacle to the global adoption, expansion, and progress of eHealth is the lack of available healthcare workers trained in informatics and adequately prepared to work in this growing field. What unique skill set(s) are needed to work in this evolving discipline? What obstacles present themselves as informatics expands globally (i.e., education/language barriers, differences in terminology, legal issues, access to technology, and regulatory policies, etc.)? How might these challenges be overcome?
Elaborate on a scripture reference related to the discussion content. This response should have at least 300 words and demonstrate course-related knowledge. It must include a Scripture reference and a minimum of 1 citation in current APA format.
VI)
**Case Study — Selection, Implementation, Delivery**
Read the following case study and answer the discussion prompts:
A good friend of yours is director of nursing at a 220-bed community hospital. Last year the hospital merged with a much larger medical center. One of the upsides, as well as one of the challenges, resulting from this change has been the rapid introduction of new computer systems. The goal is to bring the hospital “up to speed” within 3 years. At present, the Computerized Physician Order Entry (CPOE) is being implemented. The general medical and surgical units went live last month. The ICU, pediatrics, and obstetrics units are scheduled to go live next month. The plan is to work out any kinks or problems on the general units and then go live in the specialty units. Most of the physicians, nurse practitioners, and physician assistants initially complained but are now becoming more comfortable with the computers and are beginning to integrate the CPOE process into their daily routines. Several physicians are now requesting the ability to enter orders from their offices and others are looking into this option. However, three physicians have not commented during this process but are clearly resisting. For example, after performing rounds and returning to their offices they called the unit with verbal orders. After being counseled on this behavior, they began to write the orders on scraps of paper and put these in the patient’s charts or leave them at the nurses’ station. When they were informed that these were not “legal orders,” they began smuggling in order sheets from the non-activated units. In addition, they have been coercing the staff nurses on the units to enter the orders for them. This has taken two forms. Sometimes they sign in and then ask the nurses to enter the orders. Other times they ask the nurses to put the orders in verbally and then they confirm the orders. The nurses feel caught between the hospital’s goals and the need to maintain a good working relationship with these physicians.
Identify issues that occurred during CPOE implementation, identify potential causes of such issues, and list specific recommendations, using evidence-based rational and research to resolve the identified issues prior to the next CPOE implementation.
Elaborate on a scripture reference related to the discussion content. Elaborate on a scripture reference related to the discussion content. Write a response of 500 words in response to the assigned case study without including the reference page.