Index

 

 

 

Page numbers followed by f and t indicate figures and tables, respectively.

A

Abuse, 265–267
Acceptance meeting, project, 123
Accountable Care Organizations (ACOs), 3
Actionable information, conceptual framework, 322–323
Actions, for plan members’ health, see Plan members’ health
Activation function, defined, 339
Activities, project closeout, 123–125
acceptance meeting, 123
contract review, 123–124
knowledge transfer, 124–125
outcomes assessment, 123–124
Activities, project execution and monitoring and controlling phases, 112–121
budget management, 117–118
communication planning, 112–113
issue management, 118–119
project documents, updating, 121
project life cycle checkpoints, 120
quality management, 117
risk management, 113–114
schedule management, 114–115
scope management, 116–117
update meetings, conducting, 119–120
vendor contracts, management of, 120–121
work results, documentation, 116
Activities, project initiation phase, 86–92
business need/opportunity, defining, 87
business objectives and benefits, 87–88
cost-benefit, 89–90, 92
key stakeholders, 88–89
risk management, 92
schedule management, 90–92
sponsor/leader, 86–87
strategic mission and vision, 88
Activities, project planning phase, 94–109
charter, developing, 96
communication planning, 108–109
constraints and assumptions, 97–98
cost estimate and budget, 104–106
human resource requirements, 102–103
issue management, 107–108
milestones, establishing, 101–102
objectives, defining, 96–97
other resource requirements, 104
procurement and sourcing strategy, 98–99
project managers, 94–96
project plan, developing, 109
quality management plan, 106–107
risk management, 106
schedule/work plan, developing, 99–101
scope
defining, 96
management, 108
ADE, see Adverse drug event (ADE)
Ad hoc decision support, 360
Ad hoc reports, 255, 256
Advanced data analytics, 31–32, 32f
Advance Practice Institute, 206
Adverse drug event (ADE) alert system, clinical, 210–214
approach, 211–213
background, 210–211
results, 213–214
Advertising spend, revenue curve vs., 287–288, 287f
Affordable Care Act (ACA), 2, 14, 26–27
Age distribution chart, 297, 297f
Alerting systems, healthcare
analytical capabilities, level, 256
clinical ADE, see Adverse drug event (ADE) alert system
data mining, 333–336
overview, 333–334
text mining, examples, 345–348
Alignment, with strategic mission and vision, 88
Amazon Web Services (AWS), 241
American College of Clinical Engineering (ACCE), 235
American Medical Informatics Association (AMIA), 62
American Nurses Credentialing Center (ANCC) certification, 134
American Recovery and Reinvestment Act (ARRA), 22, 49–50, 63
Analysis
of clinical processes and workflow, 154–155
paralysis, 252–254
statistical, level of analytical capabilities, 257
TAKMI, 361–362
traffic, 299
variable distribution, 297, 298f
Analytics, health, 251–273
advanced and predictive data, 31–32, 32f
applications, 243–247
big data on, 336–337
business vs. clinical, 259–261, 259f
EOCs and ETGs, 291–293
graphics, 295–303
types, 296–300, 296f, 297f, 298f, 299f, 300f, 301f, 302f
value of data, 301, 302–303
healthcare costs, lowering, 260, 265–269
health outcomes, improving, 260, 269–272
information creation through, see Information creation
levels, 255–259
ad hoc reports, 256
alerting, 256
forecasting, 257
optimization, 258
predictive modeling, 258
query drilldown, 256
standard reports, 256
statistical analysis, 257
maturity and objectives, 254
multivariate, knowledge discovery through, 323–325, 326f
organizational performance, improving, 260, 261–264, 262t, 264t
overview, 251–252
paralysis, 252–254
Six Sigma, 290–291
workflow, of provider organizations, 244–245
ANNs (artificial neural networks), 336, 337, 339–341, 340f, 344
Antidotarium Florentine, 220
Apache Agora, 365
Application(s)
analytic, 243–247
data mining, 288, 359–361
departmental clinical support, 157–158
Derby database, 365
informatics, 192–193, 200–215
OLAP, 279
workflow, 193–194
Applications, of healthcare informatics, 200–215
overview, 200
Trinity Health, case study, 200–215
clinical ADE alert system, 210–214
I2S2 intranet, 204–210
overview, 200–201
physician-led informatics, 201–204
Areas, for healthcare efficiencies, 12–21
clinical and operational activities, quality improvement, 18–20
compliance issues, 16–18
CRM, 20–21
financial activities, 13–16
Areas, of health professional needs, 186–195
clinician and patient deficits in knowledge and skills, 190–192
computerized reminder systems, 194
CPOE system, 192–193
information overload, 187–190
producing new knowledge from data, 195
time pressures, 192
workflow applications, 193–194
Area under receiver operating characteristic curve (AUC), 341–342, 341t, 342f, 344, 345t
ARRA (American Recovery and Reinvestment Act), 22, 49–50, 63
Artificial neural networks (ANNs), 336, 337, 339–341, 340f, 344
Assessment(s)
for clinical documentation, 134–135, 135t
of data mining models, 341–342
AUC, 341–342, 341t, 342f, 344, 345t
KS statistics, 341
outcomes, 123–124
practices, 61–62
Assumptions, project, 97–98
AUC (area under receiver operating characteristic curve), 341–342, 341t, 342f, 344, 345t
Authentication login and performance, computer, 157
Average length of stay (ALOS), 202, 203–204, 204f

B

Bar charts, 296, 296f, 297
Bar code, for medication, 191
Barcoding for medication administration (BCMA), 139
Benefits
of EMR, 152
project initiation phase, 85
business, identifying, 87–88
cost-benefit, determining, 89–90, 92
Bernard, Claude, 220
Big data
analytic framework, 282–283
on data analytics, 336–337
data mining and, 238–239, 240f
defined, 233
example of, 241
real-time mining and, 289–290
research funds and, 240–241
Blog(s)
cancer, with UIMA, 362–366
health-related, 363–364
postings, 365
Blue Cross insurance provider, 267
Blue Shield insurance provider, 267
Bluetooth wireless communications, 233–234
Body sensor networks (BNSs), 234–235, 234f
Brenner, Jeffrey, 319–321
Bubble chart, 299, 299f
Budget
EMR project, 168–169
project management, phases
execution and monitoring and controlling, 117–118
initiation phase, 89–90, 92
planning phase, 104–106
Business
analytics, clinical vs., 259–261, 259f
need/opportunity, defining, 87
objectives and benefits, identifying, 87–88
Business case, 93
Business intelligence, 277–286, 305–317
dashboards, 284–285, 285f
data mining, 316–317
dynamic reporting through OLAP, 280, 281–284, 282f
in EMRs, strategy and Six Sigma, 310–316
evaluation, 310–311
reviewing workflow, 311–316, 314f, 316f
overview, 305–306, 308–310, 309f
“patient treatment” intelligence, 307–308
pivot tables, 279–280, 280t, 281t
reports, 277–279, 279f
robust, dashboard views and, 286
sources of efficiency gains, 307
success, secrets to, 306–308
system, functionalities, 12

C

Canadian Institutes of Health Research (CIHR), 183–184
Canadian Medical Associations, 191
Cancer blogs, with UIMA, 362–366
blog postings, 365
phases and milestones, 365–366
Capabilities, analytical, 254
levels, 255–259
ad hoc reports, 256
alerting, 256
forecasting, 257
optimization, 258
predictive modeling, 258
query drilldown, 256
standard reports, 256
statistical analysis, 257
Care
coordination of
community of health and wellness, 26, 32–35, 38
improvement, MU and, 66–67, 72
management programs, 321
preventive, 47, 219, 335
primary, 32–33, 46–47
quality and cost of, 320–321
redesigning, 61–62
Caregivers, deficits in knowledge and skills, 190–192
Care maps, defined, 186
Case studies
of DSSs, 337–345
data mining, models, 338–345
description of data, 337–338
objective, 337
Trinity Health, 200–215
clinical ADE alert system, 210–214
I2S2 intranet, 204–210
overview, 200–201
physician-led informatics, 201–204
Centers for Medicare and Medicaid Services (CMS), 3, 27–28, 50, 52–53, 64–65, 66, 68, 70
Certification Final Rules, 51
Certified electronic health record technology (CEHRT), 51–56, 63, 66, 70
Certified Medical Education (CME) credit, 175
Certified Professional in Healthcare Information and Management Systems (CPHIMS), 134
Challenges
capitated contracts, 15
CEHRT, 51–53
clinicians, 186–195
computerized reminder systems, 194
CPOE system, 192–193
deficits in knowledge and skills, 190–192
information overload, 187–190
producing new knowledge from data, 195
time pressures, 192
workflow applications, 193–194
community health, 32–35, 34f
compliance, 17
knowledge translation, 195–196
rural healthcare, 33–35, 34f
Change control, long-term user support and, 178–179
Charter, project, 96
Checkpoints, project life cycle
execution and monitoring and controlling phases, 120
planning phase, 101–102
Chief financial officer (CFO), 128, 133, 136, 212
Chief information officer (CIO), 128, 129, 133, 136, 144, 169
Chief medical informatics officer (CMIO), 128, 151, 165–166, 169
Chief medical officer (CMO), 128, 133, 169
Chief nursing officer (CNO), 128, 132, 133, 137, 144
CIS, see Clinical information system (CIS)
Classification and regression tree (CART), 338, 344
Clinical access, to computer workstations, 156–157
Clinical activities, quality improvement in, 18–20
Clinical ADE alert system, see Adverse drug event (ADE) alert system
Clinical analytics, business vs., 259–261, 259f
Clinical compliance, 16–18
Clinical decision intelligence (CDI), 362
Clinical decision support system (CDSS), 139, 189, 321
Clinical information system (CIS), nursing in, 127–145
overview, 127–128
phases of implementation, 132–145
design phase, 137–143, 140f, 141f, 142f
go-live, 143–144
system optimization, 144–145, 146f
system selection, 133–136, 135t, 136f
roles, 128–132
CSAs, 130–131
educator, 131–132
executive sponsor, 129
project director, 129–130
superusers, 132
team leader, 130
Clinical Leadership Council, 207
Clinical practice guidelines, defined, 186
Clinical processes, analysis and documentation, 154–155
Clinical systems analysts (CSAs), 130–131, 132, 137, 138, 139
Clinicians
behavior change of, 185
challenges, 186–195
computerized reminder systems, 194
CPOE system, 192–193
deficits in knowledge and skills, 190–192
information overload, 187–190
producing new knowledge from data, 195
time pressures, 192
workflow applications, 193–194
defined, 182
Closeout, project, 122–126
activities, 123–125
acceptance meeting, 123
contract review, 123–124
knowledge transfer, 124–125
outcomes assessment, 124
deliverables, 125–126
overview, 122–123
Clustering technique, 357
CMS (Centers for Medicare and Medicaid Services), 3, 27–28, 50, 52–53, 64–65, 66, 68, 70
Cognitive systems, 237–238
Cognitive systems, in healthcare, 293–295
Colorectal cancer (CRC)
data mining models for, 343–345, 343f, 345t
postsurgery for, 337–338
survival of, 337
Commonwealth Fund, 47
Communication planning, project
execution and monitoring and controlling phases, 112–113
planning phase, 108–109
Communication(s)
devices, 36
expectations, EMR and, 164–165
Community, data-driven, 32–35, 34f
Community hospitals, 200
Compliance, clinical, 16–18
Computed axial tomography (CAT), 228
Computed tomography (CT), 228–229, 230, 230f, 300, 302f
Computer-based training modules (CBT), 173
Computerized physician/provider order entry (CPOE)
with CDSS, 139
EMR and
departmental clinical support applications, 157–158
medical errors, reducing, 153
overview, 150, 151
physicians on computer in advance, 158–159
products, 169
informatics application, 192–193
KLAS data, 161
for medication, 64
modification of order details, 170–171
orderables, construction of, 169
order sets design and construction, 171–172
physician pilot for, 176–177
synonyms, 170
time-saving features, 192–193
Computerized reminder systems, 194
Computer login efficiency and performance, 157
Computers, for clinical care, 156–157
Computer tutoring, 190
Congressional Budget Office (CBO) report, 49
Connection weights, defined, 340
Constraints, project, 97–98
Content management software, 205
Continuing education, 191
Contract(s)
closure, 123–124
cost reimbursement, 99
fixed-price/lump-sum, 99
management systems, 15–16
unit price, 99
vendor, management of, 120–121
Convergence, improving health outcomes, 270
Coordination of care
community of health and wellness, 26, 32–35, 38
improvement, MU and, 66–67, 72
Cost management, project
execution and monitoring and controlling phases, 117–118
initiation phase, 89–90, 92
planning phase, 104–106
Cost reimbursement contract, 99
Cost(s), healthcare
of care, 320, 321
current and predicted, 322
EMR, 152–153
high-cost plan members, 323–324
HIT, use, 48–49
I2S2, 205
lacking health insurance, 47
lowering, 260, 265–269
PPS deployment and, 201–202
of projects, 83–84
reducing, 28, 49
rising, 270
WHO statistics, 46–47
CPOE, see Computerized physician/provider order entry (CPOE)
Critical access hospital (CAH), 52, 53
Crossing Quality Chasm, 48, 57, 127
Customer relationship management (CRM)
characteristics, 201
in healthcare, 20–21
with physicians, 201–204

D

Dashboard design, effectiveness of, 284–286, 285f
Data
analytics, advanced and predictive, 31–32, 32f
description of, 337–338
electronic healthcare, see Electronic health data
exchanges, complexities, 2
interoperability
for medical practitioners, 223–224, 224t
standards for, 223–225, 224t
medical, see Medical data
producing new knowledge from, 195
resources, enhancing, 305–317; see also Business intelligence
structured and unstructured, 246–247, 290
valuation, analytics and, 286–290, 301, 302–303
Data acquisition, medical, 225–233
EKG, EEG, 226, 227f
imaging informatics, 230, 231–233, 232f
pulse oximetry, 227
scanners, 227–230
CT, 228–229, 230, 230f
DICOM, 230, 231f
MRI, 227, 228–229, 228f
PET, 229, 229f, 230f
sensors, 225–226, 226f
Data-driven community, of health, 32–35, 34f
Data mining, 333–348, 353–366
advertising spend vs. revenue curve, 287–288, 287f
applications, 288, 359–361
big data, on data analytics, 336–337
business intelligence and, 316–317
cancer blogs with UIMA, 362–366
blog postings, 365
phases and milestones, 365–366
case study of DSSs, 337–345
description of data, 337–338
objective, 337
defined, 238, 355
discovery techniques, 357–358
examples, 361–362
in healthcare, 238–239, 240f
healthcare alerting systems, 333–336
informatics through management theory, 11–12
large data sets, 240–243, 243f
mining and scoring, 359
models, 338–345
ANNs, 339–341, 340f, 344
assessment of, 341–342, 341t, 342f
for colorectal cancer, 343–345, 343f, 345t
decision trees, 338–339, 344
logistic regression, 338
overview, 353–355
pattern-discovering algorithms, 356
predictive techniques, 358
as process, 356–359
real-time mining and big data, 289–290
source of information, 288
structured and unstructured data, 290
text mining, examples, 345–348
value of, 355–356
value of data and, 286–290
Data privacy, issue, 22
Data requirements, I2S2 content in, 207
Decision support systems (DSSs)
case study of, 337–345
data mining, models, 338–345
description of data, 337–338
objective, 337
functionalities, 12
Decision trees, 336, 338–339, 344
Deep vein thrombosis (DVT), 309
Defense Advanced Research Projects Agency (DARPA), 240, 241
Deliverables, project phases
closeout, 125–126
execution and monitoring and controlling, 122
initiation, 93
planning, 109–110
Departmental clinical support applications, 157–158
Deployment, of departmental clinical support applications, 157–158
Derby database application, 365
Design phase, 137–143, 140f, 141f, 142f
Diabetes, wireless medical sensors and, 35–36
Diagnosis
coding, 14
patient, structured and unstructured data for, 246–247
Diagnosis-Related Groups (DRGs), 244, 292, 309
Digital Imaging and Communications in Medicine (DICOM), 230, 231f
Director, project, 129–130, 131, 133, 134, 136, 137, 141, 142, 143, 144
Discharge planning, 346–347
Discovery techniques, data mining, 357–358
DMAIC methodology, Six Sigma, 291, 311–312
Documentation
clinical
assessment for, 134–135, 135t
processes and workflow, 154–155
post-discharge chart, making, 158–159
project
knowledge transfer, 124–125
updating, 121
work results, 116
provider notes, 172
workflow, 138–139
Downtime procedures, 157
Dynamic reporting through OLAP, 280, 281–284, 282f

E

Earth Cube, 241
Eclipse, 364, 365
Education
continuing, 191
CSA and, 131, 139
in design phase, 142–143
individualized educational programs, 190
I2S2 content in, 208–209
issues, 143–144
medical staff and hospital staff, 173–175
patient, 65–66, 71–72
Educators, 131–132, 142–143, 174, 175
Edwin Smith Papyrus, 219–220
Efficiencies, healthcare, 8
areas for, 12–21
clinical and operational activities, 18–20
compliance issues, 16–18
CRM, 20–21
financial activities, 13–16
gains, sources of, 307
improvement, 63–65, 303–304
Electrocardiogram (EKG), 226, 227f
Electronic health data, IT and, 25–38
advanced and predictive data analytics, 31–32, 32f
data-driven community of health, 32–35, 34f
mobile health, 35–38, 37f
overview, 25–28
role, 28–31, 29f
Electronic health records (EHRs)
attitudes regarding use of IT and stages, 59–60, 59f
CEHRT, 51–56, 63, 66, 70
CIS, see Clinical information system (CIS)
foundational requirement, 58–59, 58f
functionalities, MU and, 65, 66, 67, 68, 69
growing utilization of devices, 18
information overload and, 188–189
laggards, 60–61
MU and, see Meaningful Use (MU)
physicians, participation, 57–58, 59
for quality measures to CMS, 64–65, 66, 68
reminder systems within, 194
text mining techniques, 348
time-saving features, 192
widespread implementation of, 49
Electronic medical records (EMRs), 150–179
advantages, 163–164
business intelligence in, 310–316
evaluation, 310–311
reviewing workflow, 311–316, 314f, 316f
CPOE and
departmental clinical support applications, 157–158
KLAS data, 161
medical errors, reducing, 153
overview, 150, 151
physicians on computer in advance, 158–159
disadvantages, 164
medical error reduction proposition, 153–154
methodology for adoption, 155
overview, 150–152
perceptions, costs, and outcomes, 152–153
preplanning for, 154–155
prerequisites, 156–158
clinical access to computer workstations, 156–157
computer authentication login and performance, 157
departmental clinical support applications in advance of CPOE, 157–158
downtime procedures, 157
products, 169–179
building physician favorite folders, 175–176
change control and long-term user support, 178–179
CME credit, 175
CPOE, 169
education, 173–175
go-live, 177–178
modification of order details, 170–171
order sets design and construction, 171–172
physician pilot for CPOE, 176–177
provider notes, 172
refining, usability testing, 172–173
synonyms, 170
recommendations, 179–180
transformation, 151, 155, 158–169
communicating expectations, 164–165
engaging physicians in process, 165
patient care pathways for orders, development of, 159–160
physician leadership, 165–168
physicians, 160–161
physicians on computer in advance of CPOE and documentation, 158–159
project organization, management, and budget, 168–169
rationale for EMR implementation, 162–163
recommended steps, 162–165
on workflow, 163–164
Eligible hospital (EH), 52, 53
Eligible professionals (EPs), 51–54, 63, 70
EMRs, see Electronic medical records (EMRs)
Engagement, measuring member, 325
Environment, project management, 81–82, 82f
Episodes of care (EOCs), analytics of, 291–293
Episode treatment groups (ETGs), analytics of, 291–293
Error(s), medical
detection, HIT and, 191
reduction proposition, 153–154
Execution and monitoring and controlling, project, 111–122
activities, 112–121
budget management, 117–118
communication planning, 112–113
issue management, 118–119
project documents, updating, 121
project life cycle checkpoints, 120
quality management, 117
risk management, 113–114
schedule management, 114–115
scope management, 116–117
update meetings, conducting, 119–120
vendor contracts, management of, 120–121
work results, documentation, 116
deliverables, 122
overview, 111–112
Executive sponsor, 129, 130, 131, 133, 137, 139, 143, 144
Executive steering committee, 120, 128–129, 133, 137, 144, 145
Expenditures, see Cost(s)
Expert systems, medical data and, 237–238, 237f

F

Facebook, 346
Fair Market Value site, 208
Families, engagement, 65–66, 71–72
Favorite folders, physician(s) 175–176
Federal Advisory Committee Act (FACA), 50
Federal Communications Commission (FCC), 233, 235
Federally Qualified Health Clinics (FQHCs), 33
Final acceptance meeting, 123
Final contract review, 123–124
Financial activities, healthcare efficiencies, 13–16
Fitbit®, 36
Fixed-price/lump-sum contract, 99
Forecasting, level of analytical capabilities, 257
Fraud, analytical, 265–267

G

Game changers, 49–56
Gantt charts, 80
Genomic mapping, of large data sets, 239, 240f
Geovisualization, 300
Go-live period, 143–144, 177–178
Go-live support staff, 177–178
Governance, I2S2 content in, 206–207
Graphics, in analytics, 295–303
types, 296–300, 296f, 297f, 298f, 299f, 300f, 301f, 302f
value of data, 301, 302–303
Grievances, 21
Guidelines and education, I2S2 content in, 208–209
Guide to Project Management Body of Knowledge (PMBOK®Guide), 82–83

H

Health, data-driven community of, 32–35, 34f
Health analytics, see Analytics
Health and Human Services Department (HHS), 221, 223
Healthcare
business intelligence in, see Business intelligence
data mining in, see Data mining
efficiencies, areas for, 12–21; see also Areas, for healthcare efficiencies
electronic data, see Electronic health data
informatics, application of, see Applications, of healthcare informatics
IT and informatics, see Information technology (IT)
knowledge translation in, see Knowledge translation
processes, management of, 8–9
productivity, efficiency and uniqueness, 8
project management, see Project management
quality time in, see Quality time
in rural setting, 33–35, 34f
text mining in, see Text mining
Health disparities, reducing, 63–65
Health informatics, defined, 9
Health Information and Management Systems Society (HIMSS), 62, 224t, 234, 235
Health information exchanges (HIEs)
formation of, 28
purpose, 30
role, 30
Health information technology (HIT)
errors, detection, 191
knowledge translation and, 184
of MU, see Meaningful Use (MU)
Health Information Technology for Economic and Clinical Health (HITECH) Act, 6, 26, 49–50, 56, 63, 70
Health Insurance Portability and Accountably Act (HIPAA), 22, 26, 223, 223f
Health IT Committee, 50
Health IT Standards Committee, 50
Health Level Seven (HL7), 223, 224, 234
Health outcomes, improving, 260, 269–272
Health professional needs, areas of health informatics and, 186–195
clinician and patient deficits in knowledge and skills, 190–192
computerized reminder systems, 194
CPOE system, 192–193
information overload, 187–190
producing new knowledge from data, 195
time pressures, 192
workflow applications, 193–194
Health status, defined, 324
Heat maps, 299–300, 300f, 301f
HITECH (Health Information Technology for Economic and Clinical Health) Act, 6, 26, 49–50, 56, 63, 70
Hospital consumer assessment of healthcare providers and systems (HCAHPS) score, 20
Hospital readmission, defined, 346
Hot spotting, 246, 319–320, 325
Human resource, requirements, 102–103

I

IBM, 8, 293, 294, 354, 361
Imaging informatics, 230, 231–233, 232f
Implementation
EHRs, 49
EMR
physician, engagement, 165
rationale for, 162–163
ITs, 9–11
Implementation, CIS
nursing in, see Clinical information system (CIS)
phases, 132–145
design phase, 137–143, 140f, 141f, 142f
go-live, 143–144
system optimization, 144–145, 146f
system selection, 133–136, 135t, 136f
Influenza, 194, 346
Informatics, health; see also Information technology (IT)
application of, see Applications, of healthcare informatics
areas of health professional needs, 186–195
clinician and patient deficits in knowledge and skills, 190–192
computerized reminder systems, 194
CPOE system, 192–193
information overload, 187–190
producing new knowledge from data, 195
time pressures, 192
workflow applications, 193–194
defined, 9
imaging, 230, 231–233, 232f
nurse specialist, 133–134
through management theory, 9–12
business intelligence and decision support systems, 12
project and knowledge management, 9–11
Six Sigma and data mining, 11–12
Information
actionable, conceptual framework, 322–323
care management, 321–322
overload, 187–190
source of, 288
Information creation, through analytics, 276–304
business intelligence, 277–286
dashboards, 284–285, 285f
dynamic reporting through OLAP, 280, 281–284, 282f
pivot tables, 279–280, 280t, 281t
reports, 277–279, 279f
robust, dashboard views and, 286
cognitive systems, 293–295
data mining and value of data, 286–290
advertising spend vs. revenue curve, 287–288, 287f
applications, 288
real-time mining and big data, 289–290
source of information, 288
structured and unstructured data, 290
efficiency and productivity, 303–304
EOCs and ETGs, 291–293
graphics, 295–303
types, 296–300, 296f, 297f, 298f, 299f, 300f, 301f, 302f
value of data, 301, 302–303
overview, 276–277
Six Sigma analytics, 290–291
Information technology (IT), 1–22
areas, for healthcare efficiencies, 12–21
compliance issues, 16–18
CRM, 20–21
financial activities, 13–16
quality improvement in clinical and operational activities, 18–20
attitudes regarding use of IT and stages of EHR, 59–60, 59f
data privacy, 22
electronic health data and, see Electronic health data
healthcare processes, management of, 8–9
historical perspective, 3–7, 4f, 4t, 5f
informatics through management theory, 9–12
business intelligence and decision support systems, 12
project and knowledge management, 9–11
Six Sigma and data mining, 11–12
overview, 1–3
productivity, efficiency and uniqueness, 8
strategies, MU and, 62–69; see also Meaningful Use (MU), of HIT
system selection, 133–136, 135t, 136f
transformation, in healthcare, 305
Initiation, project, 84–93
activities, 86–92
business need/opportunity, 87
business objectives and benefits, 87–88
cost-benefit, 89–90, 92
key stakeholders, 88–89
risk management, 92
schedule estimates, 90–92
sponsor/leader, 86–87
strategic mission and vision, 88
deliverables, 93
overview, 84–85
Institute for Healthcare Improvement (IHI) website, 62
Institute of Health Policy and Management, 193
Institute of Medicine (IOM), 48–49, 50, 127, 191
Insurance, health, 47–48, 267, 356
Integrated Information Shared Services (I2S2) intranet, 204–210
approach, 205–209, 206f
results, 209–210
role, 201
Intelligence, business, see Business intelligence
Interactive decision support, 360
International Statistical Classification of Diseases (ICD)
ICD- 9 and ICD-10 coding, 14, 17–18
standard, by WHO, 224–225
Internet, evolution, 6
Interoperability of CEHRT 51
data
for medical practitioners, 223–224, 224t
standards for, 223–225, 224t
healthcare system, 33–35, 34f
of system sharing of medical images, 230
Introduction to Study of Experimental Medicine, 220
ISO/IEEE 11073, 235
Issue management, project
execution and monitoring and controlling phases, 118–119
planning phase, 107–108
IT, see Information technology (IT)

J

Jenkins, Will, Dr., 46

K

Keeping Patients Safe, 127
Key performance indicators (KPIs), 263, 285, 286
Knowledge discovery techniques, 323–325, 326f
Knowledge management, 9–11
Knowledge transfer, 124–125
Knowledge translation, 181–196
areas of health professional needs, health informatics, 186–195
clinician and patient deficits in knowledge and skills, 190–192
computerized reminder systems, 194
CPOE system, 192–193
information overload, 187–190
producing new knowledge from data, 195
time pressures, 192
workflow applications, 193–194
challenges, 195–196
CIHR on, 183–184
HIT and, 184
overview, 181–184
strategies for improving, 185–186
Kolmogorov-Smirnov (KS) statistics, 341, 344, 345t
Kotter, John, 44–45
Kryder’s law, for data storage, 218
K -space formalism, 228

L

Laggards, 60–61
Leader(s)
project
establishing, 86
role and responsibilities, 86–87
team, 130
Leadership, physician, 165–168
Lifestyle factors, rheumatoid arthritis and, 270–271
Line charts, 297, 298f
Logistic regression models, 338
Long-term user support, change control and, 178–179
Lymphatic drainage patterns, visualization of, 300, 301f

M

MACRA (Medicare Access and CHIP Reauthorization Act), 52, 55, 56, 70, 73
Magnetic resonance imaging (MRI), 227, 228–229, 228f
Make-or-buy analysis, 98
Managed Care Plans (MCPs), 320
Management
contract, 15–16
customer relationship, 20–21
EMR project, 168–169
of healthcare processes, 8–9
project, see Project management
theory, informatics through, 9–12
business intelligence and decision support systems, 12
project and knowledge management, 9–11
Six Sigma and data mining, 11–12
Map visuals, 299–300, 300f
Maturity, analytical, 254
Mayo Clinic, 347, 354
M.D. Anderson Cancer Centers, 294
Meaningful Use (MU), of HIT, 43–73
consequences, 72–73
developing plan, 56–61
of EHRs, 26, 50–61
EMR adoption and, 151, 161
goals for, 44, 50–56
incentive program, 50–56
IT strategies and, 62–69
care coordination, improvement, 66–67, 72
health disparities, reducing, 63–65
patient and family engagement, 65–66, 71–72
population and public health, improvement, 67–68, 72
privacy and security protections, 68–69
quality, safety and efficiency, improvement, 63–65
objectives, 71
overview, 6–7
Stage 2, 51, 52–53, 63, 65–69
Stage 3, 52, 53–54, 70–71
Medicaid, 17, 50, 54, 55, 320
Medical data, mining of, 218–247
analytic applications, 243–247
data acquisition, 225–233
EKG, EEG, 226, 227f
imaging informatics, 230, 231–233, 232f
pulse oximetry, 227
scanners, 227–230
sensors, 225–226, 226f
data mining and big data, 238–239, 240f
expert systems, 237–238, 237f
future directions, 240–243, 243f
genomic mapping of large data sets, 239, 240f
modern medicine, evolution of, 219–221, 222f
other evolving mining, 243–247
risk stratification, 245–246
structured and unstructured data, 246–247
workflow analytics of provider organizations, 244–245
overview, 218–219
standards, 221, 223–225, 223f, 224t
wireless medical devices, 233–236
bluetooth wireless communications, 233–234
BNS, 234–235, 234f
integrated data capture modeling for, 235–236, 236f
protected spectrum, 235
Medical error reduction proposition, 153–154
Medical informatics, defined, 9
Medical service exam (MSE), 313, 314, 314f
Medicare, 17, 21, 28, 47, 50, 55
Medicare Access and CHIP Reauthorization Act (MACRA), 52, 55, 56, 70, 73
Medicare Shared Savings Program Accountable Care Organizations (MSSP ACO), 28
Medline, 187
Meetings, conducting
final acceptance, 123
update, 119–120
Memorial Sloan Kettering, 294
Merit-based incentive payment system (MIPS), 52, 55, 70
Methodology
for adoption of EMR, 155
project management, 82–83
Milestones, establishing, 101–102
Mining technique, 359
Mobile health, 35–38, 37f
Models, data mining, 338–345
ANNs, 339–341, 340f, 344
assessment of, 341–342
AUC, 341–342, 341t, 342f, 344, 345t
KS statistics, 341
for colorectal cancer, 343–345, 343f, 345t
decision trees, 338–339, 344
logistic regression, 338
Modern medicine, evolution of, 219–221, 222f
Modification, of order details, 170–171
MU, see Meaningful Use (MU)
Multivariate analytics, knowledge discovery through, 323–325, 326f

N

Nance, John, 45–46
National Coordinator for Health IT, 50
National Electrical Manufacturers Association (NEMA), 230
National Institute of Standards, 221, 223
National Institutes of Health (NIH), 240–243, 243f
National Science Foundation (NSF), 240–243, 243f
“Never event” prohibitions, 19
New knowledge from data, producing, 195
New Yorker, 319, 320–321
Niazkhani, Zahra, 193
Nightingale, Florence, 220–221
Nodes
defined, 339
input, hidden, and output, 339–340
transformations, 344
Notes on Nursing, 220–221
Nurses
in change management, 138
CIS implementation, 128; see also Clinical information system (CIS)
in CSA role, 138
education, 132
evaluation and medical history review, 313
informatics nurse specialist, 133–134
on informatics staff, 151–152
manager of cardiac unit, 256, 257
patient-centered workflow, 193
in selection process, 135–136
as superuser, 135
Nursing, in implementation of CIS, see also Clinical information system (CIS)

O

Objectives
analytical, 254
DSSs, 337
MU of HIT, 71
physician-led informatics, 203t
project
defining, 96–97
initiation phase, 87–88
Office of National Coordinator (ONC), 50
Online analytical processing (OLAP)
application of, 279
dynamic reporting through, 280, 281–284, 282f
Open Clinical, 189
Operational activities, quality improvement in, 18–20
Optimization
level of analytical capabilities, 258
phase, CIS implementation, 144–145, 146f
Orderables
construction of, 169
synonyms, 170
Order details, modification of, 170–171
Order entry formats, defined, 169
Order sets
common uses for, 171
defined, 171
design and construction, 171–172
Organizational performance, improving, 260, 261–264, 262t, 264t
Outcomes
for ALOS, 203
assessment, 123–124
EMR, 152–153
health, improving, 260, 269–272
improvement, application of healthcare informatics, see Applications, of healthcare informatics
treatment, structured and unstructured data for, 246–247

P

Paralysis, analysis, 252–254
Pasteur, Louis, 181–182
Patient care pathways for orders, development of, 159–160
Patient-Centered Medical Homes (PCMHs), 3
Patient Protection and Affordable Care Act (PPACA), 26
Patient(s)
deficits in knowledge and skills, 190–192
diagnosis, structured and unstructured data for, 246–247
health information, access, 65–66, 71–72
satisfaction, 20–21, 281, 282, 283, 311
treatment intelligence, 307–308
Patient Safety and Potential Error and Event Reporting (PEERs) site, 207
“Pay for performance” programs, 19
Payments, Medicare, 28
Perceptions, EMR, 152–153
Performance, organizational, 260, 261–264, 262t, 264t
Personal health information, privacy and security protections for, 68–69
Phase entrance criteria, 101–102
Phase exit criteria, 101
Phases, of CIS implementation, 132–145
design phase, 137–143, 140f, 141f, 142f
go-live, 143–144
system optimization, 144–145, 146f
system selection, 133–136, 135t, 136f
Phases, project life cycle, 84–126
closeout, 122–126
activities, 123–125
deliverables, 125–126
overview, 122–123
execution and monitoring and controlling, 111–122
activities, 112–121
deliverables, 122
overview, 111–112
initiation, 84–93
activities, 86–92
deliverables, 93
overview, 84–85
planning, 93–110
activities, 94–109
deliverables, 109–110
overview, 93–94
Physician-led informatics, case study, 201–204
approach, 202
objectives of, 203t
results, 202, 203–204, 204f
Physician Practice Management site, 208
Physician Profiling System (PPS), 201
Physician(s)
CPOE, see Computerized physician/provider order entry (CPOE)
CRM with, 201–204
engaging, in EMR design and implementation processes, 165
favorite folders, building, 175–176
leadership, 165–168
participation, EHRs and, 57–58, 59
physician-driven project, 161
pilot for CPOE, 176–177
resistance, 160–161
transformation, 160–161
Picture archiving and communication system (PACS), 230, 231
Pie charts, 296, 296f
Pilot, for CPOE, 176–177
Pivot tables, 279–280, 280t, 281t
Plan, developing
MU of HITs, 56–61
project, 109
Plan members’ health, action for, 319–326
actionable information, conceptual framework, 322–323
knowledge discovery through multivariate analytics, 323–325, 326f
overview, 319–321
Planning, project, 93–110
activities, 94–109
charter, developing, 96
communication planning, 108–109
constraints and assumptions, 97–98
cost estimate and budget, 104–106
human resource requirements, 102–103
issue management, 107–108
milestones, establishing, 101–102
objectives, defining, 96–97
other resource requirements, 104
procurement and sourcing strategy, 98–99
project managers, 94–96
project plan, developing, 109
quality management plan, 106–107
risk management, 106
schedule/work plan, developing, 99–101
scope, defining, 96
scope management, 108
deliverables, 109–110
overview, 93–94
PMBOK® Guide (Guide to Project Management Body of Knowledge), 82–83
PMO (project management office), 83–84
Point-of-care information systems, 187–188
Point of care (POC) technology, 139
Population analytics, 299
Population and public health, improvement, 67–68, 72
Positron emission tomography (PET), 229, 229f, 230f
Postings, blog, 365
Practices, clinical office, 61–62
Predictive data analytics, 31–32, 32f
Predictive modeling, level of analytical capabilities, 258
Predictive techniques, data mining, 358
Premier, 29
Preplanning, for EMR, 154–155
Prerequisites, EMR, 156–158
clinical access to computer workstations, 156–157
computer authentication login and performance, 157
departmental clinical support applications in advance of CPOE, 157–158
downtime procedures, 157
Preventive care, 47, 219, 335
PricewaterhouseCoopers, 46
Primary care, 32–33, 46–47
Privacy
data, 22
protection for personal health information, 68–69
Procurement strategy, determining, 98–99
Productivity, of healthcare, 8, 303–304
Products, EMR, 169–179
building physician favorite folders, 175–176
change control and long-term user support, 178–179
CME credit, 175
CPOE, 169
education, 173–175
go-live, 177–178
modification of order details, 170–171
order sets design and construction, 171–172
physician pilot for CPOE, 176–177
provider notes, 172
refining, usability testing, 172–173
synonyms, 170
Product scope, defined, 96
Program evaluation and review technique (PERT) diagrams, 80–81
Project communication planning, 108–109
Project constraints and assumptions, identifying, 97–98
Project director, 129–130, 131, 133, 134, 136, 137, 141, 142, 143, 144
Project documents, updating, 121
Project management, for healthcare, 80–126
definition, 80–81
environment, 81–82, 82f
implementations of ITs, 9–11
life cycle phases, 84–126
closeout, 122–126
execution and monitoring and controlling, 111–122
initiation, 84–93
planning, 93–110
methodology, 82–83
office (PMO), 83–84
overview, 80
Project manager
assigning, 94–96
role and responsibilities, 95, 100, 102–103
skills, 95
Project organization, EMR, 168–169
Project plan
deliverables, 109–110
developing, 109
Project report, final, 125–126
Project scope
defined, 96
management, 108, 116–117
Project status reports, 122
Provider notes, 172
Pruning, 339
Pulse oximetry, 227

Q

Quality, of care, 320–321
Quality improvement
in clinical and operational activities, 18–20
IT strategies and MU, 63–65
Quality management, project
execution and monitoring and controlling phases, 117
planning phase, 106–107
Quality time, in healthcare, 43–73
assessing and redesigning, 61–62
developing plan, 56–61
drivers of change, 48–49
game changers, 49–56
MU of HIT, see Meaningful Use (MU), of HIT
overview, 43–48
Query drilldown, 256

R

Rationale, for EMR implementation, 162–163
Real-time mining, big data and, 289–290
Receiver operating characteristic (ROC) curve, 341–342, 341t, 342f, 343f, 344
Redesigning, practice, 61–62
Refining, EMR products, 172–173
Reforms, healthcare, 25–28
Reminder systems, computerized, 194
Reports, business, 277–279, 279f
Request for information (RFI) document, 133, 134
Request for proposal (RFP) document, 133, 134
Resistance, physician, 160–161
Resources
data, enhancing, 305–317; see also Business intelligence
requirements
human, 102–103
other, 104
Responsibilities
CSAs, 130–131
educator, 131–132
executive sponsors, 137
project director, 129–130
project manager, 95, 100, 102–103
project sponsor/leader, 86–87
Result(s)
clinical ADE alert system, 213–214
I2S2 intranet, 209–210
from physicians’ involvement, 202, 203–204, 204f
Revenue curve, advertising spend vs., 287–288, 287f
Rheumatoid arthritis, lifestyle factors and, 270–271
Risk, stratification, 245–246
Risk management, project
execution and monitoring and controlling phases, 113–114
initiation phase, 92
planning phase, 106
ROC (receiver operating characteristic) curve, 341–342, 341t, 342f, 343f, 344
Role(s)
electronic health data and IT, 28–31, 29f
HIEs, 30
nursing, in CIS implementation, 128–132
CSAs, 130–131
educator, 131–132
executive sponsor, 129
project director, 129–130
superusers, 132
team leader, 130
project manager, 95, 100, 102–103
project sponsor/leader, 86–87
Rules engines, 265–266
Rural healthcare challenges, 33–35, 34f

S

Safety, improvement, 63–65
application of healthcare informatics, see Applications, of healthcare informatics
SAS Enterprise Miner 6. 1, 337, 338, 343, 343f, 344
Satisfaction
patient, 20–21, 281, 282, 283, 311
staff, 145
Savings, use of HITs and, 49
Scanners, medical, 227–230
CT, 228–229, 230, 230f
DICOM, 230, 231f
MRI, 227, 228–229, 228f
PET, 229, 229f, 230f
Scatterplots, 297, 298f
Schedule management, project execution and monitoring and controlling phases, 114–115
initiation phase, 90–92
planning phase, 99–101
Scientific advancement, improving health outcomes, 270
Scope management, project
defined, 96
execution and monitoring and controlling phases, 116–117
project planning phase, 108
Scoring technique, 359, 361
Security, protection for personal health information, 68–69
Sensors, medical, 225–226, 226f
Six Sigma
analytics, 290–291
analyzing data resources, 11–12
business intelligence in EMRs, 310–316
evaluation, 310–311
reviewing workflow, 311–316, 314f, 316f
DMAIC project methodology, 291, 311–312
Skills, clinician and patient deficits in, 190–192
Smart Health and Wellbeing (SHB) program, 241–242
Sourcing strategy, determining, 98–99
Special interest working group (SIG), 234
Sponsored Provider Network site, 208
Sponsor(s)
executive, 129, 130, 131, 133, 137, 139, 143, 144
meetings, 120
project
establishing, 86
role and responsibilities, 86–87
Staff/staffing
clinical support, 151, 154, 162
go-live support, 177–178
medical
building physician favorite folders, 176
education, 173–175
guidelines and education, 208
leadership, 166–168
preparing, for EMR, 158–159
transformation of, 162
nurses, in selection process, 135–136
resources, optimizing, 17, 102–103
satisfaction, 145
Stakeholders
defined, 88
key, identifying and engaging, 88–89
Standard(s)
medical data, 221, 223–225, 223f, 224t
reports, 256
State-of-the-art voice recognition software, 172
Statistical analysis, level of analytical capabilities, 257
Status meeting, 119–120
Strategy
business intelligence and, 310–316; see also Business intelligence
mission and vision, alignment with, 88
Stratification, risk, 245–246
Streaming mining, 289
Strokes, 190
Structured data
analytics of, 290
for patient diagnosis and treatment outcomes, 246–247
Success, measure of, 306–308
Superusers, 60, 132, 137, 138, 139, 141, 142, 144
Survey Readiness link, 208–209
Swine flu, 334, 346
Synonyms, 170
Systemized Nomenclature of Medicine (SNOMED), 225
System selection, CIS implementation, 133–136, 135t, 136f

T

Team leader, 130
Telemedicine technologies, 242
Testing, usability, 172–173
Text Analysis and Knowledge Mining (TAKMI), 361–362
Text mining healthcare alerting systems; see also Data mining
examples, 345–348
overview, 333–334
The Joint Commission (TJC), 133
Time-saving features, 192
Time series line charts, 297, 298f
Time stamps, 244
To Err Is Human, 48, 127
Traffic analysis, 299
Transformation, in healthcare
EHR system-enabled care, 58–59, 58f
EMR and, 151, 155, 158–169
communicating expectations, 164–165
engaging physicians in process, 165
patient care pathways for orders, development of, 159–160
physician, 160–161
physician leadership, 165–168
physicians on computer in advance of CPOE and documentation, 158–159
project organization, management, and budget, 168–169
rationale for EMR implementation, 162–163
successful, recommended steps, 162–165
on workflow, 163–164
healthcare providers, 13–14
HIT-enabled care, 53, 56, 58
of input data, 344
IT transformation, 305
nodes, 344
Treatment outcomes
patients, 307–308
structured and unstructured data for, 246–247
Trinity Health, case study, 200–215
clinical ADE alert system, 210–214
approach, 211–213
background, 210–211
results, 213–214
I2S2 intranet, 204–210
approach, 205–209, 206f
results, 209–210
overview, 200–201
physician-led informatics, 201–204
approach, 202
objectives of, 203t
results, 202, 203–204, 204f
Twitter, 346

U

Uniqueness, of healthcare, 8
Unit price contract, 99
Unstructured data
analytics of, 290
for patient diagnosis and treatment outcomes, 246–247
Unstructured Information Management Architecture (UIMA), cancer blogs with, 362–366 see also Cancer blogs
Updated planning documents, 122
Update meetings, conducting, 120
U.S. Department of Health and Human Services, 22, 32, 55, 70, 223
U.S. Healthcare Affordable Care Act, 346
Usability testing, 172–173
Utilization collaborative team (UCT), 203, 204f

V

Valuation
data, 286–290, 301, 302–303
data mining, 355–356
Variable distribution analysis, 297, 298f
Vendor contracts, management of, 120–121
Veratect, 334
Vioxx, 354
Voice recognition software, 172

W

Watson, 8, 293, 294
Web content management (WCM) system, 205
Web crawlers, 362
Welltok, 294
Why Hospitals Should Fly, 45–46
Wibree, 235
Wireless medical devices, 233–236
bluetooth wireless communications, 233–234
BNS, 234–235, 234f
integrated data capture modeling for, 235–236, 236f
protected spectrum, 235
Wireless medical sensors, 35–36
Work breakdown structure (WBS), developing, 99–101
Workflow
analytics of provider organizations, 244–245
applications, 193–194
documentation, 138–139, 154–155
EMR on, 163–164
reviewing, business intelligence and Six Sigma, 311–316, 314f, 316f
Work plan, see Schedule management
Work results, documentation, 116
Workspace, requirements, 104
Workstations, computer clinical access to, 156–157
World Health Organization (WHO), 46, 224–225, 334

X

XDATA program, 241
..................Content has been hidden....................

You can't read the all page of ebook, please click here login for view all page.
Reset