Community Health Nursing 1 - Lecture

STUDENT ACTIVITY SHEET BS NURSING / SECOND YEAR

Session # 22

LESSON TITLE: New Technologies Related to Public and Materials:

Health Electronic Information
Pen, paper, index card, book, and class List

LEARNING OUTCOMES:
Reference:
Upon completion of this lesson, the nursing student can:
1. Use appropriate technology to support the delivery of care Famorca, Z. U., Nies, M. A., & McEwen, M.
to individuals and families; and, (2013). Nursing Care of the Community. Elsevier
2. Describe the existing implementation of ICT for public Gezondheidszorg.
health.

LESSON PREVIEW/REVIEW (5 minutes)

Instruction: Discuss the aims of OSH? Explain briefly.
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MAIN LESSON (30 minutes)

iClinic System supports the functions of a clinic, i.e., barangay health station, rural health unit, or other health care facility
that is devoted to providing primary health care service of patient.
 Provides a systematic way to manage patient records and generates standardized reporting requirements both at the
local and national level.

Integrated Hospital Operations and Management Information System (IHOMIS) is a windows based computerized
hospital information system for government hospitals.

eHealth Vision By 2020

 Will enable widespread access to health care services, health information, and securely share and exchange patients ’
information in support to a safer, quality health care, more equitable and responsive health system for all the Filipino
people by transforming the way information is used to plan, manage, deliver and monitor health services.

Technology Improved Public Health by Means of:

 Better equipment has allowed doctors to provide more comprehensive care.
 Better treatments have increased the quality of life of a number of different people suffering from long-term illnesses.
 Better medicine has completely wiped out the fear of some life-threatening illnesses of the past.

Public Health Changing Electronic Records Data Registries

Electronic health records (EHRs) can improve public and population health outcomes. By efficiently collecting data in a
form that can be shared across multiple health care organizations and leveraged for quality improvement and prevention
activities, HER scan: Improve public health reporting and surveillance.

Using E-Health in the Community:

 Universal health care and ICT (known as Kalusugan Pangkalahatan)
 To attain efficiency by using IT in all aspects of health care.
 Electronic medical records (EMRs)
 Are basically comprehensive patient records that are stored and accessed from a computer or server.

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 Telemedicine
 To provide clinical support
 To overcome geographical barriers, connecting users who are not on the same physical location
 It involves the use of various types of ICT.
 Its goal to improve health outcomes.
 eLearning
 Essential in health promotion and maintenance, can be facilitated by ICT.

Benefits on using iClinic Systems

1. Efficiency Gains
 Enhanced health workforce productivity in retrieving patient information, record keeping, administration and
referrals
2. Improved Quality of Care
 Reduced instances of medically avoidable adverse events
 Improved ability to monitor compliance to medications and other treatment regimes
3. Improved Operations Planning and Management
 Improved access to quality data to inform healthcare service and workforce planning and development.
4. Improved Health Monitoring & Reporting
 Track patients’ data over time
 Monitor how patients measure up to certain parameters like vital signs (e.g. blood pressure readings, respiratory
rate readings), vaccinations, and others
 Identify patients who are scheduled for visits
 Improved ability to support surveillance and management of public health interventions
 Improved ability to report and analyze health outcomes
5. Innovation & Growth
 Use of health data standards comply or conform to national requirements
 Complies to DOH health data reporting requirements (e.g., FHSIS, disease registries and surveillance, inventory)
 PhilHealth reporting requirements (TSeKAP)
 Other government agency reporting collaboration
 Increased opportunity for continuing innovations

System Features
 Field Health Services Program (e.g., Maternal Care, Family Planning, Child Care, Dental Care, Tuberculosis,
Filariasis, Malaria, Leprosy, Environmental Health, Natality, Morbidity, Mortality)
 Unified Disease Registries (Cancer, Diabetes, Stroke, COPD, Injuries and others
 Watching Over Mother Babies (WOMB)
 Pantawid Pamilyang Pilipino Program of the DSWD
 Philippine Health Information Exchange
 PhilHealth Systems (e.g., Membership Verification, Philhealth Membership Registration for new Members,
Tsekap Benefits)
 Maternal and Neonatal Death Reporting System

Integrated Clinic Information System (iClinic System) as a tool to efficiently and effectively monitor patient cases in the
Rural Health Units (RHU) or Health Centers (HC). It systematically collects, processes, stores and presents information in
support of RHU functions.

iClinic System has two system status:

 Online Status:
 It is highly recommended to use the online status. The online status stores the data directly to the DOH Central
Office Server, therefore providing real-time information as data is being entered.
 Data is always readily and available to authorized iClinic system users anytime and anywhere they have internet
access
 Offline Status:
 This status is designed for facilities that have limited access or no access at all to an internet connection.
 It has the same features and functions with the online status.
 Since the off-line status stores data locally, additional system tools were added in automating the data
synchronization, extraction, uploading, and back up which should be religiously and strictly done on a regular
basis.

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Objective of the System:
The primary objective of iClinic System is to efficiently and effectively support the function of a clinic or health facility.
Specifically, the system aims to:
 Systematically collect, process, store and present information in support of the function
 Improve patients service in a time-efficient and cost-effective manner
 Enforce standards on inputs, processes and outputs on data collection, analysis, report generation and feedback.

This User’s Manual contains step-by-step on how to:

 Access the Online System
 Install the Offline version
 Navigate Around the System This manual will guide you in accomplishing a task completely and effectively giving
direct instructions and useful illustrations.

Use iClinic System built-in tools to:

 Enter/edit information; Useful tools are built-in in most fields to assist in data entry and to enforce standards in inputs.
 Search for information
 Open a record for viewing
 Generates reports
 Synchronize, Extract, Upload, and Back-up your data
 Get system updates
 Access the Philippine Health Information Exchange (PHIE) Lite,

System Features
 Ease of use;
 Hybrid software that can be run in an online and offline environment;
 Compliant to National Health Data standards for system interoperability with DOH, PHIC and other government
agency’s reporting requirements
 Ability to track or monitor inventories received dispensed or distributed by the health facility;
 Includes SMS notification for patient’s schedule of next visit;
 Provides dashboard for visualization, management if reports at all levels for decision making and evidence -based
health planning; and
 Free installation and maintenance cost of the software.

The iClinicSys contains the following modules:

1. Log-in/Log-out
2. Patient Demographics
3. Consultation/Individual Treatment Record
4. Medical History
5. Laboratory and Radiologic Request and Result
6. Electronic Health Record.
7. Schedule of Next Visit with SMS
8. References – ICD-10, DOH Standard Geographic Codes, DOH Health Facility Codes
9. Referral System
10. Integrated Tuberculosis Information System (ITIS)
11. Maternal and Neonatal Death reporting System (MNDRS)
12. PHIC or PhilHealth verification member status through web-service
13. PHIC or PhilHealth Primary Care Module thru PHIE Lite
14. DSWD verification of Pantawid Pamilyang Pilipino Program (4Ps) through web-service
15. FHSIS Reports
16. System Administration

Deployment The system will be implemented in all Rural Health Units (RHUs) or Health Centers (HCs) nationwide. The
Provincial Health Offices (PHOs), City Health Offices (CHOs) and Center for Health Development (CHDs) offices will have
access to the system online to conduct data monitoring and validation submitted by the RHUs or HCs.

Different types of Health Information System:

 Electronic Medical Record (EMR) and Electronic Health Record (EHR)
 Practice Management Software-Master Patient Index (MPI)
 Patient Portals.

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 Remote Patient Monitoring (RPM)
 Clinical Decision Support (CDS)

Effective use of communication and technology by health care and public health professionals can bring about an age of
patient- and public-centered health information and services. IT tools and effective health communication processes,
potential to:
 Improve health care quality and safety
 Increase the efficiency of health care and public health service delivery
 Improve the public health information infrastructure
 Support care in the community and at home
 Facilitate clinical and consumer decision-making
 Build health skills and knowledge

With the advent of information and communication technologies, health data and information can now be shared by one
healthcare provider with another through electronic transmission. Further, the use of internationally recognized standards,
and transmission and validation protocols that ensure client privacy and data protection have made the exchange feasible
in a secure manner.

Philippine Health Information Exchange serves the following purposes:

 Ease the unification and integration of health data and processes across different health facilities employing disparate
electronic medical record systems
 Promote interoperability by providing means for communication and coordination of electronic health data among the
various health domains (i.e., disparate clinic information systems, and applications) without loss of semantics
 Increase accountability for the proper management of health information
 Harmonize and optimize eHealth processes and workflows
 Serve as reference in the development of integrated information systems
 Promote the implementation and use of interoperability standards.

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The guiding principles in the development of Philippines eHealth Strategic Framework are as follows:
 Client-focus or person-centered information
 Collaboration and/or partnerships with different stakeholders
 Users’ Involvement
 Strategic approach in phases to achieve the eHealth vision so as to gain more focus, judiciously and efficiently use
resources
 Harmonization and Independence to guide alignment of eHealth activities at the national level without controlling
health care providers to implement local eHealth solutions
 Recognize the presence of entities that have already started eHealth so as not to constraint their continuing
advancement and gain their support
 Availability of human resource to implement the eHealth agenda in the country and promote transparency and public
accountability
 Compliance to laws and regulations
 Optimize use of resources so as not to duplicate time, effort and investments

Roles of community health nurses in eHealth

 Make more informed decisions
 An identification that is unique for each health care provider.

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 Access to quality and reliable health information.
 Access to an integrated/single view of the patients’ health information at the point of care.
 Access to health information like clinical decision support tools, medications, clinical knowledge, skills development
and others.
 Collaborate or coordinate with other health care providers, and interact with health consumers.
 Securely share and exchange health information across different geographical locations and all parts of the health
sector, as governed by information sharing and exchange protocols.
 Provide electronic consultations or telehealth services.
 There are online test/examination ordering system and results reporting, referrals, and prescriptions.
 Health providers can experience high speed broadband connectivity.
 Data and records manager
 Change agent
 Educator
 Tele presenter
 Researcher

CHECK FOR UNDERSTANDING (20 minutes)

You will answer and rationalize this by yourself. This will be recorded as your quiz. One (1) point will be given to correct
answer and another one (1) point for the correct ratio. Superimpositions or erasures in you answer/ratio is not allowed.
You are given 20 minutes for this activity:

Multiple Choice

1. A nurse who organizes and establishes a political action committee (PAC) in their local community to address issues
relating to the accessibility and affordability of healthcare resources in the community is serving in which capacity and role
of the registered nurse?
A. Client advocate
B. Collaborator
C. Politician
D. Entrepreneur
ANSWER: ________
RATIO:__________________________________________________________________________________________
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2. Which of these statements related to information technology is accurate?

A. Social networks and cell phone cameras pose low risk in terms of information technology security and confidentiality.
B. The security of technological data and information in healthcare environments is most often violated by those who work
there.
C. The security of technological data and information in healthcare environments is most often violated by computer
hackers.
D. Computer data deletion destroys all evidence of the data.
ANSWER: ________
RATIO:__________________________________________________________________________________________
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3. Because several disciplines support the foundation of informatics nursing, it is important for the informatics nurse to
understand that:
A. Informatics nursing differs from other disciplines, as it focuses on supporting the process of obtaining data.
B. Informatics nursing uses the concepts, tools, and methods of various disciplines to facilitate nursing process.
C. Information technology and nursing technology are synonymous, as they have the same goal.
D. The boundaries between the various disciplines are clearly defined.
ANSWER: ________
RATIO:__________________________________________________________________________________________
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4. Adherence to a standardized nursing language will lead to:
A. A barrier in national interoperability.
B.A larger database of interventions.
C. Improved evaluation of nursing outcomes.
D. Increased nursing competencies.
ANSWER: ________
RATIO:__________________________________________________________________________________________
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5. The informatics nurse violates a patient's legal right to privacy and confidentiality
A. discussing a patient's diagnosis with an authorized family member.
B. discussing care-related information with the patient's physical therapist.
C. looking up a colleague's diagnosis and laboratory results while he or she is hospitalized.
D. providing a handoff report containing patient information to another department.
ANSWER: ________
RATIO:__________________________________________________________________________________________
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6. Using parallel strategy for the roll-out of an electronic medication administration system means that all:
A. Data entries are cosigned by two health care team members.
B. Medications are documented using both the current method and the new system.
C. Notebook computers and bar code scanners are positioned on the same surface.
D. Vital signs are entered on the same screen as is medication administration.
ANSWER: ________
RATIO:_____________________________________________________________________________ _____________
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7. A downtime of the electronic health record (EHR) system is planned for three months from today. The informatics nurse
is formulating a communication plan for the clinical staff about the downtime. The nurse plans to:
A. Announce the upcoming downtime at system-wide meetings, and at department meetings of specific system hospitals
affected by the downtime.
B. Bring copies of the communication plan to IT meetings, and discuss it with the IT directors and managers.
C. Present the information at the super-user meetings, department and unit meetings, and at other specialty clinician
meetings, in addition to having a message posted on the message-of-the-day screen in the EHR.
D. Print fliers with the downtime plan and post them in bathrooms and breakrooms, as well as on bulletin boards in
various locations in the hospitals.
ANSWER: ________
RATIO:__________________________________________________________________________________________
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8. Adult learners most effectively learn about a new clinical information system when the instructor:
A. Assumes that the learner knows nothing about the system.
B. Begins the formal training as early as possible in the implementation process.
C. Emphasizes the technical specifications of the structure of the system.
D. Encourages the learner to use previous experience to interpret new learning.
ANSWER: ________
RATIO:__________________________________________________________________________________________
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9. The informatics nurse is working on a chart to demonstrate the increasing incidence of obesity in the patient population
at a health clinic. The data will represent patients who are of normal weight, overweight, obese, and morbidly obese, and
it will include the percentage of the total population for each group. This type of data is most effectively represented by a:
A. Bar chart.
B. Column chart.
C. Line chart.
D. Pie chart.
ANSWER: ________
RATIO:__________________________________________________________________________________________
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10. Integrating clinical practice guidelines with an electronic health record facilitates quality improvement measurement
by:
A. Comparing guideline parameters to clinical outcomes.
B. Presenting results at the point of treatment decisions.
C. Providing reference information to measurement staff.
D. Presenting patient acuity data.
ANSWER: ________
RATIO:__________________________________________________________________________________________
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RATIONALIZATION ACTIVITY (THIS WILL BE DONE DURING THE FACE-TO-FACE INTERACTION)

The instructor will now rationalize the answers to the students. You can now ask questions and debate among yourselves.
Write the correct answer and correct/additional ratio in the space provided.

1. ANSWER: ________
RATIO:_______________________________________________________________________________________
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2. ANSWER: ________
RATIO:_______________________________________________________________________________________
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3. ANSWER: ________
RATIO:_______________________________________________________________________________________
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4. ANSWER: ________
RATIO:_______________________________________________________________________________________
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5. ANSWER: ________
RATIO:_______________________________________________________________________________________
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6. ANSWER: ________
RATIO:_______________________________________________________________________________________
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7. ANSWER: ________

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 RATIO:_______________________________________________________________________________________
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8. ANSWER: ________
RATIO:_______________________________________________________________________________________
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9. ANSWER: ________
RATIO:_______________________________________________________________________________________
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10. ANSWER: ________

RATIO:_______________________________________________________________________________________
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LESSON WRAP-UP (5 minutes)

You will now mark (encircle) the session you have finished today in the tracker below. This is simply a visual to help you
track how much work you have accomplished and how much work there is left to do.

You are done with the session! Let’s track your progress.

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AL Activity: Muddiest Point:

In today’s session, what was least clear to you?
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