The Exchange of Data
Data is essential in every field and aspect of life, and the healthcare industry is no exception. Data can be regarded as facts related to certain objects in consideration. For example, data relating to a patient may include their age, gender, weight, height, marital, and disease diagnosis, among others. Health data relate to the health of an entire population or individual patients. This information is usually gathered in accessible formats using technological tools, including health information systems. It can be shared with stakeholders, including insurance companies, government agencies, and other health care providers. The collected data is usually gathered into datasets compiled into databases. The Exchange of Data Essay
A dataset is different from a database. A dataset can be defined as a structured collection of data that is associated with a unique body of work. On the other hand, a database is an organized compilation of data that is stored as multiple datasets. Therefore, multiple datasets are combined to create a database. The information in a database is stored in such a way that it can be accessed, updated, and manipulated electronically using a computer or other devices. In the field of nursing, databases play a significant role in that they provide reliable and up-to-date evidence-based information that can be used to inform practice. The data can also be accessed quicker, resulting in timely care delivery. Health information exchange becomes easier when the processed or unprocessed data is stored in databases, thus, supporting effective multidisciplinary delivery of health care services. Types of HIE include directed exchange, query-based exchange, and consumer-mediated exchange.
Health Information Exchange (HIE) allows nurses and other health care providers, as well as patients, to access and securely share data electronically, thus improving the speed, safety, quality, and cost of care. Datasets can be customized and allow nurses to easily find and use third-party information such as clinical EHR, claims data, imaging, and genomics in the cloud. Clinical EHR datasets that are shared in the database, such as Medical Information Mart for Intensive Care III (MIMIC-III), include laboratory test results, vital sign measurements at the bedsides, demographics, caregiver notes, medications, procedures mortality, and imaging reports (Johnson et al., 2016). All systems that send and receive data on HIE adhere to a data standard to ensure correct formatting.
Interview Questions
- What types of data are transferred from your workplace to the public health department? How does it relate to electronic clinical quality measures (eCQM)?
- How are data shared in syndromic surveillance, disasters, and epidemics?
- What is the current state of health information exchanges (HIE)? What are the strengths and weaknesses of these organizations?
- What are some of the issues in sharing information regarding the monitoring of infectious diseases with other agencies?
- What are some of the current issues in public health, bioinformatics, and biomedical research, and what is the role of the nurse informaticist in relation to these issues?
- What are some of the hindrances faced while gathering and sharing genetic and genomics data? What measures do you take to navigate the issues?
Additional Questions
- What administrative procedures usually need streamlining while extracting and sharing health data?
- Which features should an effective health information system contain?
- What are some of the large clinical datasets that you have had experience working with before? What challenges and lessons did you take from these?
References
Johnson, A. E., Pollard, T. J., Shen, L., Li-wei, H. L., Feng, M., Ghassemi, M., … & Mark, R. G. (2016). MIMIC-III, a freely accessible critical care database. Scientific data, 3, 160035. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4878278/
Newman, D. (2022). What Is A Health Information Exchange (HIE) / Healthcare Data Exchange? Healthcare It Skills, https://healthcareitskills.com/what-is-a-health-information-exchange/
Interview Guidelines Handout: Module 2 Assessment
The interview you conduct for this assessment is similar to an informational interview. Requesting and conducting an informational interview is a way to engage in mentorship with peers and leaders in your field or gain firsthand knowledge from real-world experience in a particular area. The Exchange of Data Essay
Here are parameters and guidance for conducting an interview.
Make Contact
It may seem daunting to reach out to a peer or a leader to ask for an interview. However, engaged professionals often are happy to share their experiences. The key is to be polite and respectful of your contact’s time. To find possible contacts, inquire with former or current colleagues, alumni or alumni organizations, or professional organizations. If you don’t know someone in public health informatics, for example, members of your personal network may.Use professional channels to make contact, such as e-mail or telephone.
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Preparation
One of the best ways to be respectful of your interview subject’s time is to be prepared. Have your questions prepared ahead of time and well understood by you. That does not mean you cannot improvise with a follow-up question if the conversation follows an interesting path, but it is important to have an established framework in place in order to stay on topic. In fact, a solid framework is what helps you recognize when a new path is worth pursuing or actually off-topic.
Other preparation tips include: dress professionally, target arriving 10–15 minutes early, and use courteous and professional language.
For this Assessment, your online classroom contains questions that you are required to ask. In addition, you are required to generate three of your own questions. For the purposes of your assessment, record your three original questions here to submit with your completed assessment:
Three Original Questions for Public Health Nurse Informaticist
Conduct the Interview
Agree upon a duration for the interview, and then be sure to respect that. You will lead the interview, but ideally your interview subject will do most of the talking. Use your pre-written questions as guideposts to keep on track and on time—a new question is a way to respectfully redirect if you have strayed too far from the topic or goal of the interview.
You are allowed to record the interview, and recording may allow you to more actively listen. You can then refer back to the interview to extract the most salient portions of the conversation for your later analysis. (Tip: Jot down the time stamp from your recording device during especially salient parts—this will help you locate them more quickly later.) Taking written notes is also acceptable.
You must ask permission to record the interview subject before recording. After pressing record, state the date, time, name of the interview subject, your name, and briefly state the purpose of the interview.
Do not upload your interview recording to social media or any other website that would qualify as distributing this interview publicly. E-mail, Online Meeting Software, or Phone Interviews
If a public health nurse informaticist is not accessible in your area, you may conduct an e-mail or phone interview. For e-mail interviews, place your questions in the body of the e-mail and request that answers be typed in the body of the return e-mail. This provides a time and date stamp.
For online meeting software interviews that have a record option, be sure to follow the same permission and uploading guidance noted above.
For phone meetings, record the date and time that the call begins in your notes. If you have access to a recording mechanism for phone calls, be sure to follow the same permission and uploading guidance noted above.
Proof of Interview
If you conducted an e-mail interview, submit a copy of that e-mail with your assessment submission. If you conducted an in-person or phone interview, provide one of the following as proof of conducting the interview: Ask your interview subject to send you an e-mail confirmation that attests to having participated in the interview, and then submit a copy of that e-mail with your assessment submission. Or, print these guidelines and ask your interview subject to sign this form below. The Exchange of Data Essay
Dual Nature of Informatics Systems Program Transcript
GAIL E. LATIMER: In the electronic health record is all the information that you need regarding the patient. It’s information from your colleagues, the other nurses. There’s informations from other clinicians, pharmacists, respiratory therapy, physicians. There’s results within the electronic health record. And those results can be current. They can be current abnormal. Or they can be from 10 years ago. And then the nurse has cared for the patient. And I always say they touch. They feel. They smell. They’ve interacted with the patient. They’ve interacted with the family. So they know their impression of the patient. And then within that electronic health record and pushed to the nurse should be the evidence-based content. So that nurse at that point of care brings all of the data together using their critical thinking skills and then makes a decision on what’s right to do for that patient next. And so when I think about the most critical role of the nurse informatician, it is to be able to show and demonstrate and role model to the clinician bringing all those pieces together so that the clinician at the point of care isn’t just taking and doing tasks. They must be processing and critically thinking on the information from their colleagues, the evidence-based practice that should be pushed to them through the electronic health record, and their own findings in taking care of that patient. That’s to me the most critical role that they can play.
PATRICIA S. BUTTON: I think that ultimately the greatest area of influence is achieving the goal of having systems that, not only capture data at the individual patient level and can inform that patient’s and family’s care, but also collecting data about groups of patients, which we really talk about is evaluative research. So that it’s really action-oriented research to create this environment, this infrastructure, that will allow us to do that kind of research. That said achieving that, actually having systems, not just within one organization but across organizations, that allow us to collect data that is structured, that is coded in the same way so we can say, when we do this pain intervention in California with this group of patients and we do the same pain intervention in New York state, we can compare and contrast the impact of that. But we can only do that if we have this underlying infrastructure of coding structured data, the ability to capture the data analytics. So I see, in addition to all the steps that we kind of need to keep going through to get to that point, I think that is the goal. And I will certainly say for me that’s what’s kept me at this for as many years as I’ve been involved in it. And I think we are getting closer. The Exchange of Data Essay
GAIL E. LATIMER: You now have a repository of information about the community that you serve. And that’s very, very important. Because you should be able to use business intelligent tools. Another label that might be more in the past is clinical decision support. And it’s important that you have an operational definition of both of these. Because they can mean different things in different settings. And so what you want to do is you want to data mine the repository. So you want to know the number of teenage pregnancies in the community. You want to know teenage diabetes rates. You want to know the number of children in our schools that have asthma. And so that’s population health, which is a very, very important component of health so that we’re no longer in a world of illness. We’re in a world of health. And you should have a clear understanding of the disease processes and the healthy state of your community. And so the nurse informatician could be mining the data and with that data be able to provide that to the health system and the community for wellness programs, for possibly school nurses who would want to know asthmatics children that are in our schools working with the family. And that could reduce readmissions in the asthmatic children. So data mining is where health care is today and will be tomorrow. Because in utilizing the content within an electronic health record, we are better able to predict disease. And we want to prevent disease.
ROY L. SIMPSON: I think one of the things that a nurse informatician has the power to do is influence. Because most nurse informatician roles will not be line responsibility over hundreds of people. It’s probably going to be line responsibility over other nurse informaticians or clinicians. But the influence they have comes from the power that they have in the data. If they can make the data as clear, reliable, and valid on entry, then, when they retrieve that data into their reporting structures, it’s going to give it much more credibility. And so the power that they have is in the data they present. Presentation of data can have many different alternatives. But we need to recognize that that power of that presentation becomes very key and that when you’re presenting data you’ll want to be as factual as you can. And you want to be as supportive to the people who are reading the reports that they get the information out of it that they need in order to make the outcomes the best that they can.
The Exchange of Data
The theme of previous weeks about how to manage, understand, and make useful the many input and outputs of data also applies to the exchange of data. Nurse informaticists interact with and are sometimes responsible for health information exchanges (HIE).
The concept behind HIEs dates to the end of the 20th century, although often they were used for utilitarian purposes such as to drive down costs or track insurance. Their integration into useful, national networks with the goals of efficiency, coordination, and patient-centered care is more recent. The Health Information Technology for Economic and Clinical Health (HITECH) Act laid the foundation for larger-scale sharing across the nation through better reporting and infrastructure (McBride & Tietze, 2019, p. 251). The Exchange of Data Essay
This week, you explore a fundamental aspect of this data exchange—the difference between datasets and databases.
Although a seemingly basic question, the difference between a dataset and a database has important implications for how data is applied in practice—how it is viewed, extracted, and importantly for the nurse informaticist, how it is exchanged. In this Discussion, you examine this difference.
This Discussion has two components. The first component prompts you to consider different types of datasets or databases within professional practice.
The second component aligns with the Assignment in this module, where you will interview a professional nurse informaticist. In this component, you post-draft questions in the Discussion for feedback from your colleagues.
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To Prepare
- Review the Resources and consider the differences between datasets and databases.
- Reflect on the types of data obtained and how they are used in sharing across health information systems.
- Review the Module 2 Assignment.
- Review the requirements of the Assignment and the guidelines for developing interview questions.
Resource:
McBride, S., & Tietze, M. (2019). Nursing informatics for the advanced practice nurse: Patient safety, quality, outcomes, and interprofessionalism (2nd ed.). New York, NY: Springer Publishing.
Chapter 11, “Electronic Health Records and Health Information Exchanges Providing Value and Results for Patients, Providers, and Healthcare Systems” (pp. 248–271)
Chapter 13, “Public Health Data to Support Healthy Communities in Health Assessment Planning” (pp. 296–331)
And the transcript file. Dual Nature of Informatics Systems Program Transcript.wk4 Included the module 2 assignment as it says review it and may help creating the paper, ill hire you again for the module 2 assignment.
Module 2 Assignment (Introduction): Public Health Nurse Informaticist Interview
In this course, you have seen the term practice used often, as in nursing practice or evidence-based practice. You may have been referring to or thinking about your own nursing practice—past, present, or future—during your reading or writing. Whether you have experience with nursing informatics, are aware of it in your workplace, or hope to pursue it in the future, the ability to see informatics in practice provides valuable insight into this exciting area. Whatever your exposure to informatics, you now have the opportunity to learn more about informatics related to nursing and public health and then to reflect on your own understanding of informatics. The Exchange of Data Essay
This week, focus on finding an interview subject, arranging for an interview, and conducting the interview in order to complete Part 1 and the Module 2 Interview Guidelines handout. The Module 2 Interview Guidelines handout contains important information about how to arrange an interview, tips for conducting the interview, and other requirements related to the interview itself.
- Review the Module 2 Interview Guidelines handout.
- Identify a public health nurse informaticist to interview. If you are unable to find a nurse informaticist in a public health department in your area, you may conduct a phone or an e-mail interview, per the Module 2 Interview Guidelines handout. Contact your Instructor for further guidance if needed.
- Reflect on the interview subject’s area of expertise when choosing the subject.
- You are required to ask the following questions:
- What types of data are transferred from your workplace to the public health department? How does it relate to electronic clinical quality measures (eCQM)?
- How are data shared in syndromic surveillance, disasters, and epidemics?
- What is the current state of health information exchanges (HIE)? What are the strengths and weaknesses of these organizations?
- What are some of the issues in sharing information regarding the monitoring of infectious diseases with other agencies?
- What are some of the current issues in public health, bioinformatics, and biomedical research, and what is the role of the nurse informaticist in relation to these issues?
- You are also required to generate three questions of your own. To do so, reflect on the following:
- Based on the interview subject’s expertise, what questions could expand your knowledge base regarding data and how it is shared?
- What tools are used by the expert in their field to obtain research information, including bioinformatics, genetics, and genomics?
- Set up an interview date or time. Consult the Module 2 Interview Guidelines handout for guidance. In the Module 2 Interview Guidelines handout, you will find a form for the interview subject to sign as proof for the interview occurring.
- Tip:You are allowed to interview the same person for both the Module 2 Assignment and the Module 4 Assignment. If you plan to interview the same person twice, request permission for both interviews at the same time. Even though you may choose to conduct two separate interviews, having them both scheduled at the same time helps with time management for both you and the interview subject
Part 1: Interview Guidelines Handout With Original Questions
- For Part 1 of the Assignment, you complete the Module 2 Interview Guidelines handout. These must include:
- Thethree original interview questions you wrote to ask your interview subject. Your original questions should address how the interview subject’s position relates to public health and informatics.
- The signed statement from the interview subject (or other proof as noted in the handout).
- If you have not done so already, find an interview subject, arrange for an interview, and conduct the interview in order to complete Part 1 and theModule 2 Interview Guidelines