What, if any relationship do you see between the information available on this webpage and regulatory, accreditation, and reimbursement issues and healthcare information system use and design? Post your ethical considerations as a message in your blog.
To start with, there's a ton of info on AHRQ's web page. We've had to explore this site in the past for other classes and I've always found it rather cumbersome and nowhere near as intuitive as some other web pages I've used. AHRQ has a resource center for health information technology. This resource center provides clinicians with information that's needed to institute and appropriately utilize health information technology. I found a lot of tools for planing, implementing, and evaluating the use of health information technology in many different clinical settings. I really found very little information on regulatory, accreditation, and reimbursement issues. While AHRQ appears to whole heartedly endorse the development and use of health information technology, they don't seem to be to be to caught up in some of the more salient issues out there. Who will oversee the use of health information technology? Who will determine whether or not a health information system is compliant with HIPAA and other health information guidelines? How will we pay for the mass adoption of health information technology by clinicians? How will CMS reimburse? How will insurance companies reimburse?
It is clear that health information technology will play a huge role in the overhaul of our current health delivery system. What is not clear is the type of role it will play. Will it help or hinder? Will it create new unanticipated issues at many levels in the system?
Monday, July 27, 2009
Monday, July 6, 2009
Module #4 Question #2
How does nursing data quality relate to decision support?
The quality of nursing data is closely related to the quality of the decision support system. The higher the quality of the data the higher the quality of the decision support system. The problem with most data used in decision support systems is that it relies heavily on quantitative sources and nursing data is not always in quantitative easily swallowed formats. Much of what we as nurses do is not measurable by quantitative means and this means that data must be collected via other methods. One such method is qualitative. How often is qualitative data included in decision support systems? After devoting a little time to searching for decison support systems that incorporate qualitative data, I came up empty handed.
Maybe the problem is not with the quality of nursing data. Maybe the problem lies with the type of data that is easiest to incorporate into todays decision support systems. I imagine that a decision support system designed to take into account the unique data collected by nurses could be quite useful and provide relevant up to date information to assist in the complex decisions nurses are faced with on a daily basis. What do you guys think?
The quality of nursing data is closely related to the quality of the decision support system. The higher the quality of the data the higher the quality of the decision support system. The problem with most data used in decision support systems is that it relies heavily on quantitative sources and nursing data is not always in quantitative easily swallowed formats. Much of what we as nurses do is not measurable by quantitative means and this means that data must be collected via other methods. One such method is qualitative. How often is qualitative data included in decision support systems? After devoting a little time to searching for decison support systems that incorporate qualitative data, I came up empty handed.
Maybe the problem is not with the quality of nursing data. Maybe the problem lies with the type of data that is easiest to incorporate into todays decision support systems. I imagine that a decision support system designed to take into account the unique data collected by nurses could be quite useful and provide relevant up to date information to assist in the complex decisions nurses are faced with on a daily basis. What do you guys think?
Module #4 Question #1
How did the readings influence your perception of your own clinical decision-making? How do we reconcile the value of nursing experience with known heuristics and biases used in human decision making?
Until I completed the readings for this module, I fancied myself to be the kind of nurse who is up to date on the latest evidence based guidelines and could easily incorporate them into my clinical decision making. Now I see that I relied upon my own clinical experience, or the clinical experience of others, to shape the majority of my decisions. It appears that I am not that different from most nurses in that I "rely heavily on experience to meet the information needs associated with decision choices under conditions of uncertainty" (Thompson, 2003). The benefits to incorporating evidence based decision support systems (DSS) into my nursing practice are pretty clear. I just need to get over my technophobic ways and embrace some of the DSS that are currently in use and think about ways that I could contribute to the development of a nursing specific DSS.
Reconciling the value of nursing experience with known heuristics and biases used in human decision making looks to be quite an undertaking. Thompson offers the following suggestions for reconciling the effects that heuristics and bias can have on human decision making: avoid making predictions in unfamilliar domains; adjust your own personal confidence estimates downwards; look for objective sources of feedback on your decisions; don't get stuck in the past, explore alternative possible outcomes that could have occured; and learn how to use base rates appropriatley in your decision making (Thompson, 2003).
Reference:
Thompson, C.(2003). Clinical experience as evidence in evidence-based practice. Journal of Advanced Nursing, 43(3), 230-7.
Until I completed the readings for this module, I fancied myself to be the kind of nurse who is up to date on the latest evidence based guidelines and could easily incorporate them into my clinical decision making. Now I see that I relied upon my own clinical experience, or the clinical experience of others, to shape the majority of my decisions. It appears that I am not that different from most nurses in that I "rely heavily on experience to meet the information needs associated with decision choices under conditions of uncertainty" (Thompson, 2003). The benefits to incorporating evidence based decision support systems (DSS) into my nursing practice are pretty clear. I just need to get over my technophobic ways and embrace some of the DSS that are currently in use and think about ways that I could contribute to the development of a nursing specific DSS.
Reconciling the value of nursing experience with known heuristics and biases used in human decision making looks to be quite an undertaking. Thompson offers the following suggestions for reconciling the effects that heuristics and bias can have on human decision making: avoid making predictions in unfamilliar domains; adjust your own personal confidence estimates downwards; look for objective sources of feedback on your decisions; don't get stuck in the past, explore alternative possible outcomes that could have occured; and learn how to use base rates appropriatley in your decision making (Thompson, 2003).
Reference:
Thompson, C.(2003). Clinical experience as evidence in evidence-based practice. Journal of Advanced Nursing, 43(3), 230-7.
Subscribe to:
Comments (Atom)
