Reflection 1 Mod 4 HCIN 543 Integrity Rule
Objective: Demonstrate skills in a programming language such as SQL
In DBMS, constraints are a very important feature in a relational model. They are useful because they allow a designer to specify the semantics or behavior characteristics of data in the database. Constraints are the rules that force DBMS(s) to check that data satisfies the semantics. These constraints adhere to integrity rules. The rules act as liaison and are needed to inform the DBMS about certain constraints in the real world. The rule may specific to a given database. Others are generally applied to any and all database. An example of specific rule is that some fields must greater than zero. While an example of a two general rules apply to primary keys and foreign keys. There are rules guiding foreign keys, enterprise controls, business rule as well as cardinality and connectivity. There are also rule for domain integrity, entity integrity, and referential integrity. These rules, when properly set up, control such functions as insert, update and delete.
Referential integrity in a relational database is essential in relationship design, creation of forms and queries. However it is now known that database setup without referential integrity will likely perform better and be easier to administer. If referential constraints is not defined into the database DDL, then application developers will have to code similar logic into all of their application programs. And, in most cases, the application logic will be less efficient than the built-in DBMS logic. Furthermore, simply failing to code the referential constraints in the DDL does not mean that the relationships cease to exist. It just means that the database system will not enforce them, so the data will wind up with integrity problems. In terms of administering backup and recovery jobs, the same advice applies. If referential constraints were not coded into the database, then the DBMS will permit improper things such as backing up related tables on different schedules. That means data integrity issues can arise during recovery using the backups without applying log records. So, it is a good physical database design practice to implement referential integrity using database constraints.
Reflection 2 Mod 4_ HCIN 540 Impact of Electronic Health Record
Objective: Demonstrate skill in information technology (IT) system documentation
There has been a national debate about the impact of electronic health records (EHR(s)) and their effects on optimizing the patient experience. This is primarily due to the fact that existing data is not sufficient to sway the statistics either way. However, the effort to improve the quality of care delivered has led to increased implementation of electronic health records (EHR(s)) by healthcare systems throughout the nation. The positive benefits of EHR(s) include facilitation of healthcare, consolidation of information, reduction of medical errors, availability of easily transferable medical records, as well as their impact on healthcare spending. These well documented records have been emphasized as reasons for adoption of EHR(s) by the Patient Protection and Affordable Care Act.
The implementation has encountered some resistance regarding its impact on the patient experience.
As EHR implementation is increasing nationally, there is limited literature on the consequences of this technology. Barriers reported during EHR implementation include the limitations of standardization, attitudinal and organizational constraints, behavior of individuals, and resistance to change. Additionally, poor EHR system design and improper use can cause errors that jeopardize the integrity of the information inputted, leading to inaccuracies that endanger patient safety or decrease the quality of care.
Another limitation of EHR(s) has been the reported negative impact on patient‐centered care by decreasing communication during the hospital visit. Although the EHR has enhanced internal provider communication, it has been reported that there is lack of focus on the patient sitting in front of the provider. Due to perceived physician distraction during the visit, patients report decreased satisfaction when physicians spend a considerable period of time during the visit at the computer. Furthermore, the average hospital length of stay has been increased due to the use of EHR(s).
Besides, there is a gap in implementation between small and large health care organizations and the key to bridging this gap is adequate professional training. Availability of well-trained Healthcare Informatics professionals will go a long way to affect the policy implementation. These professionals will oversee the design and implementation of a record keeping and database management system that is relevant and consistent throughout the industry. It will also guide the industry through the right choice of architecture and software that will make for system integration and disaster recovery and mitigation during down times. With the database and architecture in place, the professional will further provide a much needed input on the type of security infrastructure that will be adequate for the organization.
With this in place, the stage will be set for the industry to harness the physician‐patient interaction that has become an area of increasing focus in an effort to optimize the patient experience. Positive patient‐provider communication will increase satisfaction, decrease the likelihood of medical malpractice lawsuits, and improve clinical outcomes. Finally, studies show that the EHR has a positive return on investment from savings in drug expenditures, radiology tests, and billing errors. It has also been shown that following a full HER Implementation, the industry will see a robust growth, a more efficient health care delivery system and better outcome for patients and health care professionals.
Reflection 3 Mod 4_Product/Service Description and Selection of EHR
Objective: This reflection demonstrates the use of Electronic Health Records (EHR)
Electronic health records (EHR) systems are no longer luxuries. Healthcare providers that want to provide a modern standard of care to their patients, not to mention avoiding government penalties, have no choice but to implement a Meaningful Use-certified EHR system. There may be complaints about clunky implementation processes and unreliable systems, but with the right EHR system, healthcare providers can offer more efficient, quality care and build a complete, communicable patient profile that follows them through all points of care. Finding the right system is no easy task. Whether you're switching to a new EHR or implementing one for the first time, it can be a daunting selection. The systems are complex and multifaceted, making it hard to fully understand one before making a choice. However, there are ways to make an informed decision about the best EHR, given the size and complexity of the practice.
This program exposed me to various EHR Systems while looking for the best choice for Heartland Health Family Health Clinic. This quest explored the advantages of electronic health records against the back drop of the functionality of each EHR system that was evaluated. While the benefits of a well-functioning EHR system are clear, implementing and adapting to an EHR system can be challenging for everyone. EHR(s) don't just impact physicians, but every facet of the practice. This is especially true when a practice management system or revenue cycle management integrates with the system. Everyone in the practice should be familiar with the implementation goals and long-term strategy. It is also important to fully explore all options before making any decisions. At the end of it all, Amazing Charts ended up being my electronic health records of choice.
Objective: Demonstrate skills in a programming language such as SQL
In DBMS, constraints are a very important feature in a relational model. They are useful because they allow a designer to specify the semantics or behavior characteristics of data in the database. Constraints are the rules that force DBMS(s) to check that data satisfies the semantics. These constraints adhere to integrity rules. The rules act as liaison and are needed to inform the DBMS about certain constraints in the real world. The rule may specific to a given database. Others are generally applied to any and all database. An example of specific rule is that some fields must greater than zero. While an example of a two general rules apply to primary keys and foreign keys. There are rules guiding foreign keys, enterprise controls, business rule as well as cardinality and connectivity. There are also rule for domain integrity, entity integrity, and referential integrity. These rules, when properly set up, control such functions as insert, update and delete.
Referential integrity in a relational database is essential in relationship design, creation of forms and queries. However it is now known that database setup without referential integrity will likely perform better and be easier to administer. If referential constraints is not defined into the database DDL, then application developers will have to code similar logic into all of their application programs. And, in most cases, the application logic will be less efficient than the built-in DBMS logic. Furthermore, simply failing to code the referential constraints in the DDL does not mean that the relationships cease to exist. It just means that the database system will not enforce them, so the data will wind up with integrity problems. In terms of administering backup and recovery jobs, the same advice applies. If referential constraints were not coded into the database, then the DBMS will permit improper things such as backing up related tables on different schedules. That means data integrity issues can arise during recovery using the backups without applying log records. So, it is a good physical database design practice to implement referential integrity using database constraints.
Reflection 2 Mod 4_ HCIN 540 Impact of Electronic Health Record
Objective: Demonstrate skill in information technology (IT) system documentation
There has been a national debate about the impact of electronic health records (EHR(s)) and their effects on optimizing the patient experience. This is primarily due to the fact that existing data is not sufficient to sway the statistics either way. However, the effort to improve the quality of care delivered has led to increased implementation of electronic health records (EHR(s)) by healthcare systems throughout the nation. The positive benefits of EHR(s) include facilitation of healthcare, consolidation of information, reduction of medical errors, availability of easily transferable medical records, as well as their impact on healthcare spending. These well documented records have been emphasized as reasons for adoption of EHR(s) by the Patient Protection and Affordable Care Act.
The implementation has encountered some resistance regarding its impact on the patient experience.
As EHR implementation is increasing nationally, there is limited literature on the consequences of this technology. Barriers reported during EHR implementation include the limitations of standardization, attitudinal and organizational constraints, behavior of individuals, and resistance to change. Additionally, poor EHR system design and improper use can cause errors that jeopardize the integrity of the information inputted, leading to inaccuracies that endanger patient safety or decrease the quality of care.
Another limitation of EHR(s) has been the reported negative impact on patient‐centered care by decreasing communication during the hospital visit. Although the EHR has enhanced internal provider communication, it has been reported that there is lack of focus on the patient sitting in front of the provider. Due to perceived physician distraction during the visit, patients report decreased satisfaction when physicians spend a considerable period of time during the visit at the computer. Furthermore, the average hospital length of stay has been increased due to the use of EHR(s).
Besides, there is a gap in implementation between small and large health care organizations and the key to bridging this gap is adequate professional training. Availability of well-trained Healthcare Informatics professionals will go a long way to affect the policy implementation. These professionals will oversee the design and implementation of a record keeping and database management system that is relevant and consistent throughout the industry. It will also guide the industry through the right choice of architecture and software that will make for system integration and disaster recovery and mitigation during down times. With the database and architecture in place, the professional will further provide a much needed input on the type of security infrastructure that will be adequate for the organization.
With this in place, the stage will be set for the industry to harness the physician‐patient interaction that has become an area of increasing focus in an effort to optimize the patient experience. Positive patient‐provider communication will increase satisfaction, decrease the likelihood of medical malpractice lawsuits, and improve clinical outcomes. Finally, studies show that the EHR has a positive return on investment from savings in drug expenditures, radiology tests, and billing errors. It has also been shown that following a full HER Implementation, the industry will see a robust growth, a more efficient health care delivery system and better outcome for patients and health care professionals.
Reflection 3 Mod 4_Product/Service Description and Selection of EHR
Objective: This reflection demonstrates the use of Electronic Health Records (EHR)
Electronic health records (EHR) systems are no longer luxuries. Healthcare providers that want to provide a modern standard of care to their patients, not to mention avoiding government penalties, have no choice but to implement a Meaningful Use-certified EHR system. There may be complaints about clunky implementation processes and unreliable systems, but with the right EHR system, healthcare providers can offer more efficient, quality care and build a complete, communicable patient profile that follows them through all points of care. Finding the right system is no easy task. Whether you're switching to a new EHR or implementing one for the first time, it can be a daunting selection. The systems are complex and multifaceted, making it hard to fully understand one before making a choice. However, there are ways to make an informed decision about the best EHR, given the size and complexity of the practice.
This program exposed me to various EHR Systems while looking for the best choice for Heartland Health Family Health Clinic. This quest explored the advantages of electronic health records against the back drop of the functionality of each EHR system that was evaluated. While the benefits of a well-functioning EHR system are clear, implementing and adapting to an EHR system can be challenging for everyone. EHR(s) don't just impact physicians, but every facet of the practice. This is especially true when a practice management system or revenue cycle management integrates with the system. Everyone in the practice should be familiar with the implementation goals and long-term strategy. It is also important to fully explore all options before making any decisions. At the end of it all, Amazing Charts ended up being my electronic health records of choice.
| artifact_1_mod_4_hcin_543_intergrity_rule.docx |
| artifact_2_mod_4_hcin_540_impact_of_electroni_health_records.docx |
| artifact_3_mod_4_selection_of_ehr.docx |
| artifact_4_mod_4__hcin_556_amazing_charts_elevator_pitch.docx |
