Clinical Informatics: From Dirt Roads to Superhighways Patricia Korolog Mulberger, MSN, RN-BC
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1 Clinical Informatics: From Dirt Roads to Superhighways Patricia Korolog Mulberger, MSN, RN-BC
2 Objectives Journey Roles Whose Driving Trends
3 Domains of Clinical Informatics
4 The Reality of Clinical Informatics Multidisciplinary Medicine Nursing Public Health Pharmacy Radiology Other Relevant Fields Information Management Computer Science Cognitive Science Science of Terminologies & Taxonomies Heuristics Library Sciences Archival Science Mathematics
5 Very Early Origins Hippocrates Medical record should accurately reflect Course of disease Probable cause of disease I believe that it is an excellent thing for a physician to practice forecasting. He will carry out the treatment best if he knows beforehand from the present symptoms what will take place later ates.htm
6 First Informatics Nurse 8#q=florence%20nightingale%20polar%20area%20diagrams
7 Mid 1600 s Mechanical Calculator 1830 s Automated mechanical computer Late 19 th Century Census Early IBM 1940 Binary Code 1943 WWII
8 1946 ENIAC st computer used in clinical practice 1956 Mobile Telephone 1959 Robert Ledley 1961 Dept of Medical Methods Research
9 More Driving Forces 1969 EHR Software ATARI IBM Personal Computer WWW NwHIN
10 Human Genome Project 2009 ARRA NOW Need Grows for clinical informaticists
11 My Journey
12 Paths To Clinical Informatics Career
13 Nursing Formal/Academic Undergraduate Level Informatics Nurse (IN) RN w/ interest/experience in informatics field Mostly on the job learning Graduate Level Informatics Nurse Specialist (INS) Post Graduate Focus PhD or DNP Academic (PhD) Faculty Applied Practice (DNP)
14 Credentialing ANA Nursing Informatics is a nursing specialty (1992) Scope and Standards of Practice st Edition nd Edition American Nursing Credentialing Center Nursing Informatics HIMSS Certified Professional in Healthcare Information and Management Systems American Board of Imaging Informatics Certified Imaging Informatics Professional
15 American Healthcare Informatics Professional Organizations
16 The Promises
17
18 Trends Emphasis on change in delivery models Providing care outside of hospital setting More cost efficient Clinically relevant Outcome based Patient Engagement Population Health Bioinformatics Genomics
19 Trends Rise of Analytics Opportunities to participate, create, and shape tomorrow s healthcare Population Health Community Health PBM (Pharmacy Benefit Manager) companies Wellness care Quality/performance measure
20 NowTrending.HHS.gov
21 Individual Apps Monitoring, Tracking and Trending Connecting Digital Coaching Disease oriented cookbooks Body Measurements. HR, RR, Steps, Stairs, Calories
22 Past Challenges Meet Future Trends
23 New Healthcare Data Sources RFID Streaming Device Data Physiological Monitors Ventilators Wearables Social Media Geographic Information System (GIS) Data Open Data Internet of Things (IoT)
24 FHIR The Public API for Healthcare? FHIR = Fast Health Interoperability Resource Builds on previous HL7 data structures to describe data formats and elements More powerful & less complex than HL7 V3 Easier to implement Uses web-based http application programming interface Huff, S., McCallie, D HIMSS 2015
25 FHIR The Public API for Healthcare? FHIR Resources Well-defined, simple snippets of data that capture core clinical entities Build on top of existing HL7 data types Resources are the objects in a network of URI reference linkswe Huff, S., McCallie, D HIMSS 2015
26 SMART Platform Open Specification for Apps Substitutable Medical Apps Kohane/Mandl NEJM (2009) A SMART App is a Web App HTML5 + JavaScript Remote or embedded in EHR URL passes context & FHIR li nk EHR Data Access via FHIR Huff, S., McCallie, D HIMSS 2015
27 Who is driving the train!
28 New Drivers Cognitive and Behavioral Psychology User Experience Human & Computer Interaction Devices Wearables Patients & Family
29 Now on the Team AND ALL OF YOU
30 Contact Information Patricia Korolog Mulberger (406)
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