NR 599 FINAL STUDY GUIDE MATERIAL GUARANTEED TO HELP YOU PASS  Ethical decision making o When making choices about ethical issues based on the standards of right vs wrong. o It requires a systematic framework for addressing the complex and oftencontroversial moral questions.  Bioethical standards o The study of healthcare ethics o Bioethics takes on relevant ethical problems seen by healthcare providersin relation to care  Telehealth o wide range of health services that are delivered by telecommunicationsready tools, such as telephone, videophone, and computer o is needed to help fill the nursing shortage allowing nursing to see morepatients quicker, as well as the aging population o Telecommunication technologies used to deliver health-related services orto connect patients and healthcare providers to maximize patients’ health status. o Arelatively new term in the medical/nursing vocabulary, referring to a widerange of health services that are delivered by telecommunications-ready tools such as the telephone, videophone, and computer.  Medical Applications o Software developed for medical purposes, including home medical monitoring system, medical databases for healthcareprofessionals, etc.  Medical Devices o is any device intended to be used for medical purposes  FDA Oversight for Medical Devices  Privacy o An important issue related to personal information o Restricted access of patient information or data  Confidentiality o To ensure that all personal information is protected by ensuring that limitedaccess is only given to those who are authorized to view that information.  Protecting privacy of personal information or data  Cybersecurity o the state of being protected against the criminal or unauthorized use ofelectronic data, or the measures taken to achieve this. o With the expansion of technology. Facilities are taken more precautions toprevent cyber attacks. With the move towards advancing cybersecurity is important, technology continues to grow. Ensure all systems are adequately protected and patients remain safefrom harm o NI are frequently called on to evaluate the safety and effectiveness of newdevices and software.  Computer-aided translators o is a form of language translation in which a human translator uses computer hardware to support and facilitate the translation process.  HIPPA o was established in the U.S. in 1996 to protect an individual'spersonal health care information. o Signed by Pres. Bill Clinton o Healthcare institutions are required to meet all standards andcomply with the appropriate security measures in order to safeguard patient data. o Four parts to HIPAA's Administrative Simplification  Electronic transactions and code sets standardsrequirements.  Privacy requirements.  Security requirements.  National identifier requirements.  ICD-10 Coding o An alphanumeric code used by doctors, health insurance companies, and public health agencies across the world torepresent diagnoses. o The system offers accurate and up-to-date procedure codes to improve health care cost and ensure fair reimbursement policies o The current codes specifically help healthcare providers to identify patients in need of immediate disease management andto tailor effective disease management programs.  Similarly ICD and CPT coding go together  Is a medical code set that is used to report medical,surgical, and diagnostic procedures and services toentities such as physicians, health insurance companies and accreditation organizations.  Evaluation and Management Coding o Is a medical coding process in support of medical billing o Practicing health care providers in the United States must use E/M codingto be reimbursed by Medicare, Medicaid programs, or private insurance for patient encounters.  Reimbursement Coding Is based on claims and documentation filed by providers usingmedical diagnosis and procedure codes. o Commercial payers must use standards defined by the U.S. Department of Health and Human Services (HHS) but are largelyregulated state-by-state.  Clinical Support Tools o are designed to help sift through enormous amounts of digital data to suggest next steps for treatments, alert providers to available information they may not have seen, or catch potentialproblems, such as dangerous medication interactions o Such as CDS clinical decision support, a program used byproviders. o Or various applications use by healthcare professionals to allowfor communicate between provider to provider and provider topatient o The tools are all used to benefit patient outcome  Workflow analysis o Not an optional part of clinical implementations, but rather a necessity forsafe patient care fostered by technology. o The ultimate goal of workflow analysisis not to “pave the cow path,” butrather to create a futurestate solution that maximizes the use of technology and eliminates non–value-added activities. o Although many tools and methods can be used to accomplish workflowredesign, the best method is the one that complements the organizationand supports the work of clinicians. o needs to be done as well as working in optimization (moving conditionspast their currentstate into a more effective method of performing.  WEEK FIVE READING/ KEY POINTS  Key points from the lessons and modules  Clinical Decision Support (CDS) o Generate patient specific interventions, assessments andrecommendations o CDS tools existed prior to development of EHRs o The primary goal of implementing a CDS tool is to leverage data and thescientific evidence to help guide appropriate decision making  CDS improving healthcare o Reducing clinical variation and duplicative testing o Ensuring patient safety o Avoiding complications that may result in readmissions o Create alerts about drug-drug interactions o Drug allergy contraindications  CDS challenging healthcare o Alarm fatigue o Clinical burnout o Occur with poorly implemented CDS features o Financial burden  Workflow Design o Used to describe the action or execution of a series of tasks in aprescribed sequence o Progression of steps (tasks, events, interactions) that constitute a workprocess o In a sequential workflow, each step depends on the occurrence of theprevious step; in a parallel workflow, two or more steps can occur concurrently. o Nursing informatics is uniquely positioned to engage in the analysis andredesign of processes and tasks surrounding the use of technology.  Changes in workflow, poor system design and usability issues, lack of understanding about these systems and their capabilities, user errors and systemerrors, and lack of defined protocols can all lead to process breakdowns and errors.  McGonigle Chapter 13  EHR and information systems provide POC decision support to prevent medicalerrors to save lives and money  Workflow must be considered before implementing technology or it can be moredangerous o Computerized provider order entry (CPOE) focuses on considering theworkflow  Barriersto implement technology: cost & length of time to incorporate it, frequentupgrades interrupting the workflow  American Recovery and Reinvestment Act (ARRA)- used financial incentives toimplement Meaningful Use (MU) rules and regulations o Stage 1: data capturing and sharing o Stage 2: advanced clinical processes o Stage 3: improve outcomes  Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) took over andcreated a quality payment program (QPP) to replace Medicare reporting programs