Question

DISCUSSION QUESTIONS providers and public health organizations. These man dates have expanded over time. Describe how you design the technical infrastructure to support this expan sion so that new data-sharing criteria are easily incorpo- rated into the system. Vendors often design "closed" infrastructures to lock cus Describe the role of the informatician in designing and implementing the EHR technical infrastructure as out- lined by the component model discussed in the chapter . How does a data dictionary influence the design and In what dircumstances might a clinical infrastructure 4. How do incentive programs such as Meaningful Use implementation of an EHR? How does the data dictio- nary enhance and restrict the EHR tomers into their products. What would be positive and based on either third-party service providers or mobile applications be desirable? What cautions would we place on these technologies in the same circumstances? negative aspects, from the healthcare organization's viewpoint, of having such an infrastructure? 9. As opposed to the closed infrastructure of most vendor affect, both positively and negatively, technical infra- structures in healthcare settings? Assume that you are leading a group developing a CDS system for your organization. Choose a particular clinical environment and set of clinical problems you want to address and describe the types of interfaces you would need with other components in the cinical infrastructure in order to be successful. What would be potential areas of concern for an EHR that heavily used third-party services to supply critical clinical functionality, such as decision support or medical reference links? systems, open source systems may allow multiple groups to contribute to the underlying system code and architecture. Describe the positive and negative aspects of this approach for the healthcare organization Contrast this with the SMART or SMART on FHIR approach. The Infobutton standard for access to knowledge resources is receiving growing interest from health IT vendors are made available through this standard, how might this change the nature of EHR applications, CDS systems, and local knowledge development and storage? and users. If more medical knowledge resources CDS, Clinical decisión support: EHR, electronic health record, FHIR Meaningfal Use criteria mandate that healthcare organi-Fast zations be able to share data with other healthcare Medical Appications, Reusable Technolog e Interoperability Resources, SMART, Substitutable

Answer 1

1. The role of informatician in designing and implementing the EHR are :-

- they are people who knows about the needs of the consumers

- helps to develop a consumer friendly software

- provides training about the different modules to the consumers

- solves technical and other software issues

2. Data dictionary is a set of information describing the contents, format, and structure of a database and the relationship between its elements, used to control access to and manipulation of the database. Data dictionary influence the design and implementation of EHR as one of its function is to design and format the database or software . It enhances and restricts EHR by providing login IDs to control access and cause modification in routine format of using to avoid it's unnecessary usage.

3. We should use clinical infrastructure based on either third party service providers or mobile applications when there is any urgent need that functioning is important or it will cause some adverse effects. Try to use these services very less and rely on our own software to carry out functions because it may lead to breech of patient's information outside our organisation and utilisation of the same for research purposes .

4. Classes or programs on 'Meaningful Use' of the technical infrastructure of healthcare settings has positive and negative effects. Some of the positive effects are :-

- improves function

- less wastage of time

- more time is utilised for patient care

- easy task completion

- advanced health care services

Negative effects are :-

- more money is needed

- more time is needed to learn and for training

- separate staff for carrying out informatic functions

- some people may not be ready to change their way of working manually.