Health Informatics Assignment Week 4 to 6

Question Week 4

  1. What are some of the assumptions of the distributed cognition framework? What implications does this approach have for the evaluation of electronic medical record systems?
  2. Explain the difference between the effects of technology and the effects with technology. How can each of these effects contribute to improving patient safety and reducing medical errors?


    When contemplating the facilitating role of technology while giving individual performance, the implications of technologies as well as the impact of technology, Salomon et al. (1991) makes a significant distinction. The former relates to the performance improvements seen by customers when they are fitted with the technology. New technologies contributes a lot to patient-centered treatment in promoting social media platforms, text messages and email contact amongst providers and patients. This also tends to increase access to data along with web - based health records which could also enhance treatment accessibility or even self-monitoring. A systematic review45 analyzed the therapeutic potential of PDMS as well as concluded that, by reducing the dependence on recordkeeping, these programs improved the time spent on specialist care. Furthermore, PDMS programs minimized problems (medical errors, accidents with ventilators, intravenous injuries and other accidents). This included (1) computerized physician order entry (CPOE, a program in which a physician inserts a drug order directly into some kind of software program developed to prevent inconsistencies) and (2) barcode scanners of drugs to assure that the right patient in the hospital receives the appropriate dosage of the right medication at just the right time. Technology 's effects pertain to everlasting changes in general intellectual capabilities (deep understanding and abilities) as a result of the interactions with an innovation. This impact is clearly revealed within the framework of an EMR system 's lasting consequences. This is discussed more extensively in a recent section of AI on disbursed and participatory cognitive ability in medication. Variability use of methodologies is confirmation of the technological moderating mechanism. This phase of the research was expanded by Patel et al. (2000) to investigate the cognitive implications with using the same EHR device in a diabetes clinic. The findings showed the most data available to the diagnosing assumptions was contained throughout the EHRs. The analysis revealed more necessary information to the psychiatric suppositions was encompassed in the EHRs. Additionally, the integrated model and content were directly correlated to the particular classification of the specific setting. The paper-based documents tend to help maintain the dignity of the patient's evolutionary passage of decades, although this is especially omitted from EHR. Technology has assisted in enhancement of patient-centered care as it has led to the encouragement of patients for several objectives like continuous improvement and customer preferences, it is necessary to enable patients to become more proactive in their treatment. Technology continues to contribute to patient-centered treatment by promoting social media platforms, text messages and email contact between doctors and consumers. This also enhances access to the information including certain medical records online, which might enhance self-monitoring and convenience of the patient.

  3. Explain the significance of the representational effect. What considerations need tobe taken into account in developing representations for different populations of users and for different tasks?
  4. The use of electronic medical records (EMR) has been shown to differentially affectclinical reasoning relative to paper charts. Briefly characterize the effects they have on reasoning, including those that persist after the clinician ceases to use the system. Speculate about the potential impact of EMRs on patient care.
  5. A large urban hospital is planning to implement a provider order entry system. Youhave been asked to advise them on system usability and to study the cognitive effects of the system on performance. Discuss the issues involved and suggests some of the steps you would take to study system usability.
  6. What steps are involved in the process of translating internal representations (mental models) into natural and computer-representable languages and expressing them in a guideline format?
  7. The development of expertise has been characterized as a “non-monotonic”process. Explain the nature of this development process using some of the findings in relation to a) diagnostic reasoning and b) memory for clinical information.

Question Week 5

Questions for Discussion

  1. Why do computer systems use magnetic disks to store data and programs rather than keeping the latter in main memory where they could be accessed much more quickly?
  2. What are four considerations in deciding whether to keep data in active versus archival storage?
  3. Explain how an operating system insulates users from hardware changes.


    Operating systems interact with hardware on the gadget. The operating system sits between the application areas that you must be running and the equipment, by using drivers as that of the functionality between the two. If an application requires to display anything, for instance, it passes the function over to the operating system. This project focuses with the CPU to build a description of the image processing systems as well as to assure that each work gets done. Choosing the right software and hardware is key to a computer system consists. Nonetheless, amid such distinctions, most machines are using the same basic structures for storing and processing information and for communicating to the outside environment. The resemblances between machineries vastly outweigh the distinctions upon its conceptual level. It delegates the CPU to different tasks, monitors other application running in the computer, monitors contact between hardware components, regulates data transmission between input devices to output devices, and manages file storage information such as data file formation, opening, reading, writing and closing. When a memory document that isn't in storage space is retrieved, the CPU opens up space for it by moving a little-used document to storage device and taking in the required page from memory. This map was produced dynamically by the hardware on certain machines and still causes substantial delays, so complete use of memory space should be restricted to a process that makes the device to operate efficiently. When checked, programs and data processed onto external disks are transferred into main memory; the hardware automatically uploads the conceptual addresses to physical addresses. When checked, programs and data processed onto external disks are transferred into main memory; the hardware automatically uploads the conceptual addresses to physical addresses.

  4. Discuss the advantages and disadvantages of individual workstations linked in a LAN versus shared access to mainframe computers.


    Installing a local area network (LAN) enables local data connectivity through engaging the telecommunications company or network access service for connectivity purposes in an office, a school, or a campus. That very system is committed to involving various computer nodes at full speed to promote the resource sharing amongst different people, like data, software as well as equipment. Users operating at individual workstations could access data and programs through system database server: computers committed both for public and private storage of local information. Applications could interpret things globally and save the findings to the mail server over the network, or give flexibility to a quick, shared printer. The advantages of LANs can be pointed out as: Sharing of resources; virtual systems and data control; simple link of the machinery from various suppliers’ LANs are primarily used only for exchanging the network. Many users will share costly hardware, such as laser printers and CD/ ROM players, while they are connected to a network. When a LAN is open, the need for a union catalog could be removed although each regional library would provide its own catalogs on premises and have links to several other catalogs across the system. Required to check information of indebted lenders may be easily detected as LAN connects data on the distribution to a computer. LANs can be used for academic purposes throughout the bookstore as well. Another feature of LANs that might offer an advanced product for potential library users involves online communication that uses multiple remote machines connected to a network to hold a briefing without any of the physical assembling of members at one location. The main areas where LANs can be implemented throughout libraries are housekeeping implementations, education programs, sharing resources and office management. The library headquarters could've been derived from different those certain offices, such as personal, financial and public assistance sections and so on. LAN 's drawbacks are the significant cost of configuration. The initial design expenses of upgrading LAN are strong whereas a server needs special software. Communications systems, such as an ethernet cable, switches, hubs, routers, and cables are indeed costly. LANs aren't intended for long distance and time. A need for fair opportunities on computer network like Ethernet and token ring restricts a LAN 's capacity.

  5. Define the terms data independence and database schema.How do database management systems facilitate data independence?
  6. Why have so many different computer languages been developed?
  7. How can you prevent inappropriate access to electronic medical record information?How can you detect that such inappropriate access might have occurred?

Questions Week 6

Questions for Discussion

  1. Reread the hypothetical case in Section 6.2.1.
    1. What are three primary benefits of the clinical system? What are three primary disadvantages?
    2. Do you think that the benefits of the system outweigh the disadvantages? Are there adequate noncomputer-based solutions to the problems with which the system was designed to help? If so, what are they?
    3. How would you change the system in your institution or in one you have read about? Among the topics you might address are the effects of the system on hospital routine, computer reliability, and terminal availability and the adequacy of user training programs.
  2. Describe an outpatient clinic’s billing system in terms of inputs, outputs, and processes. Sketch a simple data-flow diagram that represents your model of the system.
  3. Discuss the inherent tension between protecting the confidentiality of patient records and providing health professionals with rapid and convenient access to clinical information. What level of system security do you think provides an appropriate balance between these conflicting goals?


    Confidentiality with patients is among medicine's very essential pillars. Safeguarding a patient's private information is not only a question of personal fortitude, it's necessary to preserve the essential relationship of trust seen between physician as well as the client. This can impact the traditional roles of health care staff as well as the current relationships amongst groups of people, such as doctors and nurses, nurse training, and care providers alike. Significant moral and statutory concerns that emerge involve the confidentiality of patient records, computers' proper role in clinical practice. (notably in medical decision-making), and even the accountability of designers and consumers to ensure that the system is functioning properly. With both the widespread adoption of EHRs, significant challenges need to be resolved in patient personal privacy: legislative gaps, dearth of confidence in the system and level of clinical influence over one’s electronic information. Seeking federal laws, like HIPAA and the HITECH Act serve t0o protect the protected health information. Through encoding the information in a manner which could only be decrypted through approved systems or consumers with access code, EHRs might make it much easier to pass health information (like testing results or symptoms to clinicians via healthcare providers or health information to recommendations). The confidential information concept is really about confidentiality, and honoring the needs and desires of the patient. Confidential information is maintaining a trust between both the client as well as the practitioner that is an essential part of successful exercise in treatment. A health care professional, social care worker or advanced care worker could have to breach confidentiality when they are supposed to be hurting yourself or someone and that they're intending or commit a criminal offence. Some other practical implementation of computing technology was computer-based patient-monitoring programs which collected physiological data directly from patients. The calculations can't be done automatically for such computationally intensive programs, whereas the machines accumulate and analyze millions of different interpretations. The most popular compromise position seems to be to allocate each user a security profile, and often a balance (a cryptocard with a second password that frequently changes) or biometric identifier (including a fingerprint scan for the user). Component access to data could then be managed for specific customers or user groups.

    Ensure that the Privacy Policy applies to associates.

    Ensure that all sensitive information is kept within secure networks.

    Integrate IT protection measures focused on best practices.

    Make sure the workers are adequately educated on Cyber Security Protocols for Healthcare.

    Don't Drop Changes Tech.

    Command Access to Consumer safeguarded Information.

    Don't use the Single Password for all of it.

    Keep protected passwords in a safe place.

  4. Discuss three barriers to technology transfer among health care institutions.


    Technology can build gaps amongst doctors and patients: Providers have been seen in previous years to keep medical records, while paper charts have been stored in their workplaces. With EMRs, clinicians question the established order, and demonstrate their right to have and control their individual medical information. There are recommended programmers who deal with technology with a simplified guidance.

    Technology would take a lot of time from doctors: With already hectic schedules, it is important for doctors to optimize the available time. This is proposed that developers should concentrate on creating macro- as well as smart-list technology approaches to help shorten the duration that practitioners organize information into another EMR. The system is also seen as individualistic by doctors. Information will have been just as important for distribution as the human component, throughout the increasing health system. So rather than finding and trying to address a problem, entrepreneurs frequently find out about a technological advance but instead figuring out how to do it. Conversely, investors are recommended to make consumption of an already current infrastructure and is inexpensive. Though patients, doctors, and clinics are keen on emerging innovations, so nobody needs to be someone who can compensate for it. Underneath the payment fee-for - service framework, organizations would be less likely to embrace strategies that minimize expenses, or decrease medical appointments.

  5. Explain the difference between outcome and process measures of system performance. Identify two outcome and two process parameters that you might use to evaluate the performance of a clinical consultation system that assists physicians in diagnosing disease. Describe an experiment that you could perform to evaluate the effect of the system on one of these parameters. What potential difficulties can you foresee in conducting your experiment? What can you do to compensate for these difficulties?
  6. In what three ways is the use of a clinical consultation system similar to the use of human consultants or static sources of health information such as textbooks? In what three ways is it different?