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Disaster
Health Information System (HIS):

HIS integrates information science, processing practices, and system

engineering.

It captures data related to emergency preparedness and response (One

important job of HIS is to gather information that can be crucial during
emergencies. This includes data about patients' medical conditions, any
medications they're taking, and any allergies they may have. Having this
information readily available can help healthcare providers make quick
decisions during emergencies)

Examples → Electronic Health Records (EHR), hospital information systems,

clinical information systems

Emergency and Response Process:

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 It aims to stop the spread of diseases and manage disasters like terrorism and
natural calamities.

Healthcare providers act as first responders, identifying symptoms and

irregularities.

Example: Quick identification and isolation of patients during a disease

outbreak.

1. Stopping the Spread of Diseases and Managing Disasters - The primary goal
of the emergency and response process is to prevent the spread of diseases
and effectively manage various types of disasters, whether they are natural
calamities like hurricanes or earthquakes, or human-made crises like terrorist
attacks.

2. Healthcare Providers as First Responders - Healthcare professionals,

including nurses, are often among the first to provide medical assistance
during emergencies. HCP will quickly assess and address medical needs,
identify symptoms, and initiate appropriate interventions to save lives and
minimize the impact of the emergency.

Early Response:

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 Early response focuses on proactive measures to detect and address
emergencies as quickly as possible, with the aim of minimizing their impact on
public health and safety. This phase of emergency management emphasizes
surveillance, communication, and coordination to ensure a rapid and effective
response.

Requires real-time situational analysis to assess needs and resources.

Example - Using smart devices and wireless connectivity for quick

communication and coordination.

1. Surveillance and Bio-surveillance - Early response involves the continuous

monitoring and surveillance of public health data to detect any signs of
emerging threats or outbreaks. This includes tracking disease trends,
analyzing surveillance data, and conducting bio-surveillance to identify
potential bioterrorism threats.

2. Disaster Response Efficiency - Early response efforts aim to enhance the

efficiency and effectiveness of disaster response activities. This includes
establishing communication channels, mobilizing resources, and implementing
response plans to address the immediate needs of affected populations.

3. Real-time Situational Analysis - Early response requires real-time situational

analysis to assess the needs and resources available during an emergency.
This involves collecting and analyzing data, coordinating response efforts, and
making informed decisions to allocate resources and prioritize actions.

National Electronic Disease Surveillance System (NEDSS):

The National Electronic Disease Surveillance System (NEDSS) is a program

initiated by the Centers for Disease Control and Prevention (CDC) to enhance
disease surveillance and monitor public health at a national level

Facilitates electronic transfer of clinical data to public health departments.

Example: Providing public health departments with real-time data on disease

outbreaks.

1. CDC Initiative for Disease Detection - To improve the early detection of

disease outbreaks and monitor the overall health status of the nation.
Electronic health record (EHR) systems in hospitals and clinics can

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 automatically report certain diseases or conditions to the local health
department through NEDSS.

2. Facilitation of Data Transfer - NEDSS facilitates the electronic transfer of

clinical data from healthcare facilities to public health departments. This
enables rapid and efficient sharing of information about disease cases,
outbreaks, and trends. Suppose, there's a sudden increase in flu-like
illnesses reported by healthcare providers, NEDSS can quickly flag this as a
potential outbreak

WHO Phases of Pandemic Alert:

1. Low risk of human cases - few or no reported cases of human infection with
the particular disease

2. Higher risk of human cases - there is an increased risk of human infection, but
transmission remains limited or sporadic

3. No or limited human-to-human cases - there may be isolated cases of human

infection, but there is no sustained human-to-human transmission

4. Increased human-to-human cases - significant increase in human-to-human

transmission, with the potential for widespread outbreak

5. Significant human-to-human transmission - there is efficient and sustained

human-to-human transmission of the disease, leading to widespread outbreak

Four Phases of Disaster Management

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 1. Mitigation

Involves sustained actions to decrease the risk of a hazard or reduce the

potential negative consequences.

Implementing laws and regulations to prevent deforestation, relocating

structures to minimize flood damage, and securing buildings against
earthquakes.

2. Preparedness

Involves planning and procedures designed to minimize damage and

ensure an effective response when a disaster occurs.

Planning, training personnel, conducting disaster drills, and using health

information systems for emergency preparation and response.

3. Response

Actions taken to decrease mortality, prevent further property damage, and

meet basic human needs when a hazard occurs.

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 Search and rescue operations, providing acute medical care, sheltering
victims, and relocating medical records.

4. Recovery

Actions taken to return to normal following an event, such as repairing

buildings and replacing homes.

Standardization of Data Transformation and Information Reporting:

Standardizing data transformation and information reporting is crucial for effective

disaster management

1. Detailed Resolution of Data

Data should be defined with the necessary details to provide a

comprehensive understanding of the situation. For example, instead of
reporting the total number of dengue cases, it's beneficial to categorize
cases by age group, status, and environmental factors.

2. Real-time Submission of Data

Data should be submitted in real time to enable immediate preparedness

and response. This ensures that healthcare providers can respond
promptly to emerging situations and allocate resources effectively.

3. Segregation of Data

Data segregation helps eliminate redundancy and maintain the integrity of

results. By organizing data into distinct categories, it becomes easier to
analyze and interpret information accurately

4. Standard Reporting Formats

Standardized reporting formats ensure consistency and interoperability

across different systems. This allows for easy comparison and analysis of
data, regardless of its source or format.

5. Integration of Health Information Systems

Integrating health information systems at the national level and within

healthcare facilities improves data access, retrieval, and analysis. It
enables healthcare providers to make informed decisions and coordinate
response efforts more effectively.

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 Data Regulation

HIPAA (Health Insurance Portability and Accountability Act of 1996)

HIPAA is a federal law designed to protect patients' private health information.

It protects patients' personal health information and ensures it's not disclosed
without their consent.

HIPAA Examples

Logging out of computers when not in use.

Using alarms on mobile devices to prevent theft of sensitive information.

Using complex passwords and not sharing them with others.

Shredding documents containing patient information.

Keeping fax machines and computers in secure areas.

ARRA (American Recovery and Reinvestment Act of 2009)

Part A (HITECH Act) - Provides financial incentives for healthcare providers to

adopt electronic health records (EHR) technology.

Part B - Focuses on expanding access to healthcare and improving healthcare

delivery.

Focuses on the development, adoption, and implementation of health

information technology policies and standards

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 Health Care Information and Management Systems Society (HIMSS)

Provides guidelines for sharing electronic health information through the

development and integration of electronic interfaces

HIMSS develops standards to ensure that different electronic health record

systems can communicate with each other effectively

Administrative Assistive and Workplace

Technologies in Nursing
Technological Advances - Nurses now use various technologies to manage
patient information, schedule care, and communicate effectively.

Electronic Charting - One major change is the shift from handwritten charts to
electronic charting systems. Nurses now input patient information and update
records online, making it easier to access and manage patient data.

Online Patient Portals - Patients can also access their medical records and
test results through online portals, improving communication and providing
quick access to important information.

Enhanced Communication - Technologies like pagers or cell phones are used

for better communication between nurses, doctors, and patients.

GPS Tracking - Medical equipment can be tagged and tracked using GPS
technology, ensuring efficient use and management of resources.

Diagnostic Devices - Advances in technology have led to the development of

smarter diagnostic devices, improving accuracy and efficiency in patient care.

Alarm System - Smarter alarm systems help nurses monitor patient conditions
more effectively, ensuring timely interventions when necessary.

Lifting Devices - Innovative lifting devices assist nurses in lifting patients

without risking injury to themselves, promoting a safer work environment.

Standout Technologies

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 Automated IV Pumps:

These pumps control medication dosages and drips for patients, reducing
wait times for adjustments.

Portable Monitors:

Vital signs like ECG, respiratory rates, and oxygen saturations can be
monitored remotely, providing constant patient monitoring.

Nurses receive alerts and alarms in case of emergencies, improving patient

safety.

Smart Beds:

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 Smart bed technology tracks movement, weight, and vitals, enhancing
patient safety and comfort during hospital stays.

Nurses receive updates on patient activities, helping identify patterns and

ensure timely interventions.

Wearable Devices:

Devices and apps track various health metrics like heart rates, exercise,
and sleep, empowering patients to monitor their health.

Examples include smartphone stethoscopes and wearable health trackers,

which provide real-time data for better patient care.

Electronic Health Records (EHR):

EHR systems replace paper filing methods, allowing nurses to document

care and access patient information efficiently.

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 HIPAA laws ensure security and privacy of electronic records, while real-
time updates improve medical care accuracy and speed.

Centralized Command Centers:

These centers use software applications to provide real-time updates on

room availability, OR schedules, and patient needs, improving hospital
efficiency.

Nurses and doctors can actively manage supplies, technology, and

capacity for better patient experiences.

Telehealth and Applications:

Telehealth enables virtual consultations between patients and healthcare

providers, saving time and resources.

Medical apps and wearables help monitor vital signs remotely, address
mental health concerns, and provide health guidance to patients.

Telenursing

Telenursing, a subset of telehealth, involves using telecommunications and

information technology to provide nursing services when there is a large physical
distance between the patient and the nurse or among multiple nurses.

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 Objectives of Telenursing:

Deliver care and expertise for curative, preventive, and rehabilitative

purposes.

Provide training and information to patients.

Types of Telenursing:

1. Remote Monitoring - Nurses monitor patients remotely from their homes,

managing chronic diseases like heart disease and diabetes.

2. Interactive Telenursing Services - Involves interactive sessions via phone or

online communication for assessments and consultations.

3. Store and Forward Telenursing - Allows forwarding of medical images or data

to nurses for offline evaluation, commonly used in dermatology and radiology.

4. Specialist and Primary Care Consultations - Patients consult nurses via live
video connections or diagnostic images, facilitating access to specialized
care.

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