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DNP 805 Topic 4 DQ 2 Discuss the type of integration data from your defined patient population in Topic 4 DQ 1 would require

DNP 805 Topic 4 DQ 2 Discuss the type of integration data from your defined patient population in Topic 4 DQ 1 would require

Topic 4 DQ 2

May 5-9, 2022

Discuss the type of integration data from your defined patient population in Topic 4 DQ 1 would require. How could the EHR database facilitate this type of integration between clinical and administration systems

REPLY TO DISCUSSION

Electronic Health Record (EHR) are used in our healthcare organization and widely used to research as well. The validity of the results is dependent upon the assumptions of the healthcare system. EHR based data have challenges and some threats to validity and includes target population, availability and interpretability of clinical and non-clinical data. EHR includes socioeconomic status, race, and ethnicity that can be compared. Availability of data for fundamental markers of health are important for identifying inequities. The data has the ability to capture individuals clinical trials , data sets and measures the outcome that has potential risk factors. The EHR can be robust, informative and important to the understanding of health and disease in the population.

The Veterans Health Administration is a unique healthcare organization that provides good insight into the implementation of a population health approach to vaccine acceptance. I work at the VA and I can say that we cater to a special population in the community. The COVID-19 pandemic and vaccine hesitancy, and has been a threat in public health. Population health approach to vaccine acceptance using EHR-based tools can greatly impact vaccination rates in the healthcare system. Vaccine hesitancy—“the reluctance or refusal to vaccinate despite the availability of vaccines”—was identified as a “top 10” threat to global health in the years leading up to the COVID-19 pandemic. Vaccine hesitancy on a large scale focuses in voices of authority, engaging health care workers, scientists and strategies are addressed. The size and scope of the Veterans Health Administration, the characteristics of EHR primary focuses in health population, record of high quality preventive care and implementation of an evidenced-based framework to address vaccine hesitancy. The goal is to improve clinical and operational vaccine uptake. Steps that improve vaccine acceptance includes the identification of education for clinicians and veterans. Development of vaccine acceptance tools and application of population health approach will readily available.

References:

Centers for Disease Control and Prevention. COVID Data tracker. Available at: https://covid.cdc.gov/covid-datatracker/#vaccinations_vacc-total-admin-rate-total. Accessed September 1, 2021.

 

Ni K, Chu H, Zeng L, et al. Barriers and facilitators to data quality of electronic health records used for clinical research in China: a qualitative study. BMJ Open. 2019;9(7):e029314. doi: 10.1136/bmjopen-2019-029314. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

DNP 805 Topic 4 DQ 2 Discuss the type of integration data from your defined patient population in Topic 4 DQ 1 would require

DNP 805 Topic 4 DQ 2 Discuss the type of integration data from your defined patient population in Topic 4 DQ 1 would require

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Verheij RA, Curcin V, Delaney BC, et al. Possible sources of bias in primary care electronic health record data use and reuse. J Med Internet Res. 2018;20(5):e185. doi: 10.2196/jmir.9134. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

 

World Health Organization. Ten threats to global health in 2019. Available at: https://www.who.int/news-room/spotlight/ten-threats-to-global-health-in-2019. Accessed September 1, 2021.

REPLY

Great topic Beverly—The Covid pandemic came on quickly like a rush of a whirlwind or tornado and caused so much havoc and left in its wake a lot of devastation and then dissipated or slowly dissipating. In the wake of the Pandemic, the administration and the clinical systems had to work together to follow the center for disease rules and regulations concerning this pandemic by creating policies for their decisions and the informaticists created the electronic health records (EHR) that would be used to obtain some form of minimal history and physical before the vaccine could be given and also used to record the type of vaccine that was given so that CDC can monitor the effectiveness of the medication to determine the need for further treatment or not. Like you pointed out Beverly, the EHR was used to keep track of those who had not taken the vaccine since there was no record of them taking it. Which led to increased process of re-education. So, with the EHR, it shows the need for educating people to the need for vaccinations. In my hospital facility, there were those who also refused to take it until it was mandated and then some took it and others presented exemptions.

Reference:

Centers for Disease Control and Prevention (CDC). (2021, April 2). Monitoring COVID-19 Vaccine Effectiveness How and Why CDC Tracks How Well the Vaccines Are Working. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/effectiveness/how-they-work.html

REPLY

Thank you for providing an insightful post. The COVID-19 pandemic has tremendously impacted all healthcare systems. According to Balut et al. (2021), sufficient uptake of the vaccination is imperative to slow the spread of COVID-19, especially among the most vulnerable such as homelessness. Of the 83,523 Veterans who experience homelessness, about 45.8% were vaccinated based on the database collected by the U.S. Department of Veteran Affairs (VA). In addition, there is a strong correlation between COVID-19 vaccinations and Veterans who utilize VA healthcare and service (Balut et al., 2021). With this, I agree with you that a vaccine acceptance tool should be readily available, ly to those who are more vulnerable such as Veterans experiencing homelessness.

 

Reference

 

Balut, M. D., Chu, K., Gin, J. L., Dobalian, A., & Der-Martirosian, C. (2021). Predictors of COVID-19 vaccination among veterans experiencing homelessness. VACCINES9(11). https://doi-org.lopes.idm.oclc.org/10.3390/vaccines9111268

REPLY

The electronic health record EHR or the electronic medical record (EMR) is one of the most important sources for data analysis. It can be used today to drive decision-making in public health, identify risk factors for infectious diseases and treat them, and provide the continuity of care among various medical institutions while improving the quality of healthcare and continue to push forward medical and scientific research (Wang, 2019). Data Integration is the process of collecting a cluster of raw data from different sources and combining them into one source and it is stored and distributed to various applications from the storage place as new data. So, data mining would yield great knowledge of information needed to provide useful insights for research that would enable the compatibility of the EMR with different hospitals. It is the process of merging the systems from two different companies into one centralized data set. So, the integration and interoperability of healthcare data from different sources of information and communication technology (ICT) in a region or a country is of the utmost necessity for care and treatments in hospitals (Sreemathy, Naveen Durai, Lakshmi Priya, Deebika, Suganthi, & Aisshwarya, 2021), (Wang, 2019).

Integration is often times looked upon as easy and just inputting data into a system but it is beyond that. The systems that have targeted only the technical aspects has led to many failures because the two systems are not built the same and may have different levels, and vendor policies, so there is a need to include the social factors as well and the broader context in the integration process (Bjørnstad, & Ellingsen, 2019).

The patient population that I would like to integrate their data information would be the chronic heart failure (CHF) patients. It is a chronic debilitating disease with a very high mortality rate and severe symptom burden for a long duration. The physical symptoms of CHF are shortness of breath (SOB), Dyspnea, pain, fatigue, decreased physical activity, anxiety and depression because of the declining quality of life (QoL), (Siouta, Heylen, Aertgeerts, Clement, Janssens, Van Cleemput, & Menten, 2021). The integration data from this population would be the patient demographic which includes the age, gender, allergies, weight, admitting symptoms, prior diagnosis, history and physical with any chronic symptoms such as dyspnea, lower extremity edema, any use of oxygen, medications, laboratories, diagnostics, procedures, treatment care plans, and any tolerable physical activity. For there to be an integration between the clinical and the administrative systems, the integration process has to comply with the ethical and legal standards of the facilities and the regulators. For all the clinical and administrative systems to integrate, there are integrative systems in place like the enterprise resource planning systems, enterprise application integration, component ware, and middleware. Also, the standardization of systems is also necessary with integration and many more. The most recent being the open EHR standard 17 and international initiative to structure and standardize clinical knowledge by global consensus (Bjørnstad, & Ellingsen, 2019).

IT systems in hospitals support cooperative work. Schmidt and Simone28 argue that cooperative work interleaves distributed tasks; articulation work manages the consequences of the distributed nature of the work. Hence, information technology (IT) systems in hospitals need coordination and articulation work to function (Bjørnstad, & Ellingsen, 2019).

Improving the processes for patients and providers with the policy approaches must be evaluated to make sure that they remove unnecessary steps and complications for patients, while decreasing administrative burdens for providers. Standards and approaches must reflect how information flows through the health care system, the technical systems that are needed, and the crucial role of health information professionals play in translating across clinical and administrative domains. Also, the sharing of health information across payers and providers requires consideration of privacy policies, to ensure that only the minimum necessary information is shared, and they are not used beyond the specific transaction limited (American Health Information Management Association (AHIMA), 2020)

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