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1. How do the Stage 2 Meaningful Use Certification Criteria affect that feeder or source system?

2. Do you think Scholar would benefit from more filters? What would you add?

3. Can you have multiple search elements at the same time, like domain =.edu, country = USA and language = English? Compare this with Google.

4. How does Duck Duck Go compare to Google?

5. Wolfram Alpha:  This is a new computational knowledge engine and not a search engine, per se. Type in the city where you live and see what appears and try out some of the ideas posted on the right to search on. With digitization of the world's information, you will see more engines like this to amass, organize and analyze information.

6. PubMed: Type in H1N1 in the search box. You should see about 5000+ hits. Then select the "Limits" option, under "Text Options," check "links to free full text.", Under "Date," select "Published in the last 1 year" in the drop down menu. Select "humans" under "Species," "English" under "Language," "MEDLINE" under "Subsets," and "Adult: 19-44" under "Ages." Click the "Search" button, and you should see fewer references which means the filters were very helpful. Without these filters you would have been overwhelmed.

Questions

Meaningful use stage 2 is the second stage of the meaningful use agenda which aims at providing minimum standards required for electronic health records (EHR) and even for the exchange of patient medical information among healthcare givers and patients, and even the insurers. The stage 2 emphasizes on care management and the exchanging of information of patients.  It expands the limits of standard fulfillment and initiates more medical assessment support, care management necessities as well as the simple patient commitment rules. However, this stage of certification criteria affects the feeder system of laboratories and pathologists in several different ways.

The stage 2 meaningful use certification criteria for electronic health records (EHR) mention the laboratory and the diagnostic test results. These requirements are aligned with the meaningful use objectives and thus very essential for pathologists and laboratories. First, the requirement which relates to the substance and the manner in which the laboratory results are displayed in the certification criteria is that EHRs exhibit the basics of the laboratory reports. These test reports must indicate the test results, the units of measurement as well as well as the interpretation. This is to ensure that a clinical officer attending to the patient can easily interpret the information and appropriately diagnose the patient. For positive patient identification, the criterion requires that either the patient’s name and identity number or even a distinctive patient identifier be used. This is for the purpose of ensuring that the right information captured belongs to the right patient. In addition to that, the test report should be able to present all the information for the specified test report by electronic means. This is to ensure that there is clarity and thus the right diagnosis. It also requires that the incorporated results be electronically attributed, associated or linked to the tests to a laboratory order or test patient.

The meaningful use stage 2 requirements and the increase in the EHR use are also offering several opportunities to the laboratories. The implementation of an electronic boundary from the laboratory’s data system to a provider’s EHR facilitates achieving the requirements for the integration of medical laboratory test outcomes. This ensures realistically meeting the requirements and possibly achieving the intended objectives. This helps laboratories to be able to discover chances to facilitate their patient’s capacity to achieve these meaningful use treatment necessities. At least, qualified providers will probably desire to obtain the test results data in a way that will naturally populate data into their EHRs.

Answers

However, these laboratories are likely to face several challenges. Further widespread and time delicate desires for the interfaces present extensive problems and carry with them contemplations to go past the explicit prerequisites. The laboratory has the liability for accurateness of test result information which is being transferred from the laboratory to the systems in receipt. It is therefore required to have ample guide or systems ready so as to make sure that test outcomes and additional patient detailed information are perfectly and consistently transmitted from the point of information entry to the last report target in a well-timed approach. When meeting these requirements as well as in quest of the stewardship responsibility for the value of laboratory information, the laboratories should recognize the impacts of the variances that might cause ineffectiveness of how they display their data. These may include descriptive explanation and annotations, reference range management, preface reporting and reviews, unsolicited results and reflex tests as well as abnormal result flags. 

More filters are very essential for a scholar because it presents more information, details and resources that a scholar can choose from. The fact that a scholar does not strain to look for more complex materials makes it even of great essence to a scholar. The wide range of interdisciplinary results that Google Scholar provides helps a scholar to be able to select what is important, find more information related to their search requirements as well as be able to identify the available editions. The quoted characteristic permits a scholar to view the editorials that have quoted the document a scholar is looking for. This helps in the research process due to the fact that it connects to other editorials that have been mentioned on the original document established thus giving a scholar an enhanced understanding of how applicable and consistent the original document is to the research topic.

However, I would add a section that filters peer reviewed and non peer reviewed documents. Google scholar does not offer this opportunity and thus displays all articles. This can lead to confusion and thus shallow research by a scholar. The peer reviewed section will also help in reducing more robust library databases.

Both Bing and Google appear and feel extraordinarily alike when it comes to the essential search outcomes. However, Bing has a compiler help which is integrated by default. With just one click from the compiler error code, Bing automatically opens and searches the web using contextual information from the development environment. This feature fetches web results using a combination of multiple contextual elements and then gives the best results for the compiler error. The query can also be modified at the search box thus further narrowing down the results. Google on the other hand has custom search which offers a controlled search mechanisms that enables one to explore into the subsets of search results based on the structured information which is found in the pages. Google can restrict search results by custom date range while Bing allows time specifications on its new results. Bing exhibits more auto complete proposals than Google as a rule.

Trying Out Databases

However, Bing does not display broadly related topics. Unlike Gogle, Bing’s instant search results do not provide more relevant results in faster way as Google. This makes Google to instantly save search time.  Google also tends to provide more background information than Bing.

Duck Duck Go is a search engine just like Google. However, they have comparable features and these are what make a consumer to choose either of them. Unlike Google, Duck Duck Go is very private since there are no advertisements. It does this by generating its search results from key crowd sourced websites and partnering with other search engines. Duck Duck Go does not log a researcher’s query results or look through their GPS coordinates. They may sometimes log in the queries but can never track the researcher unlike Google that uses GPS tracker to find a researcher’s location.  This privacy feature in Duck Duck Go encourages anonymity thus improving a researcher’s security.                  

Another comparable feature between Google and Duck Duck Go is that Duck Duck Go is capable of providing a code snippet incase a researcher has a code which is not working. It does this by     providing the exact webpage to a non-working code network thus a researcher does not need to go through the entire link one by one to find the exact documents. It also narrows down search options by a creating a sort of bubble filter where opinions are biased and may get polarized. Google does not offer such features.

However, in addition to the relevancy of the search term, Google has the capability of giving one a personalized search based on interests and location unlike Duck Duck Go. Moreover, it tracks down a researcher’s history and provides updates on the topics searched for. A researcher can go back to find   the research history thus making one become aware of what they have been doing in the past recent times.

This is an online computational engine which directly responds to realistic queries by computing the responses from superficially resourced curated information instead of providing a list of documents or website pages that may contain the answer to the question asked. This computational engine has a text field where users submit their queries and requests of computation. It also uses a portfolio of automated and manual methods which enables it to use standardized phrases and symbols when giving out responses.

Wolfram Alpha works very well even if many arguments are concatenated in the query. It is able to compute a lot of data and also give accurate information on all the data. This is due to the fact that it does not necessarily depend on other sites for data and therefore making its localization work better. For instance, if you type the name of a city, it will also provide your currency.                     

Wolfram Alpha is very precise. One can rely on it to either get the accurate answer or no answer at all. For instance when one types their own names they may not get the results. This saves the researchers a lot from approximating results and rounding off numbers to have a better chance of finding an answer.  Finding comparisons in this computational engine between two or more data sets is very easy. For instance, comparing sales tax rates for up to five cities in the US is very possible. It easily compares data samples and one does not only get results but also ratios, graphs, tables as well as historical data comparisons.]

This is a free search engine which primarily accesses MEDLINE databases of references and abstracts of biomedical science. PubMed has simple standard searches which allows for the translation of initial search formulations by automatically adding field names, synonyms thus significantly enhancing the search formulation.

PubMed also grants entry to the references which are older from the published editions of index medicus back to 1951 or even earlier than that. It also contains very current access to records for a document or journal before its indexing and finally being added to the MEDLINE. In addition to that, it offers access to a compilation of books which are available in full texts and other subsets of records. It also gives access to PMC citations and NCBI bookshelf.

List all of the places where health information technology might be used to improve operations

Managing patient personal information by identifying them to the system

Making financial payments

Managing patient clinical information for instance medical history, medication, demographics, allergies

Maintaining order in the hospital

Conducting patient clinical tests

Recording patient clinical results

Carrying out patient examination

Clinical audit

Determining the appropriate medical treatment for patients

Making doctor appointments 

When taking the Medscape training, the module 1 which entailed the patient privacy: A Guide for Providers was very easy. This module is meant to describe the rights of patients as provided by HIPAA privacy rule as well as provide physicians with strategies to build and maintain a culture of compliance with the HIPAA act. The rules are very easy to understand as it gives history of the rule as well as the terminologies which defines the rule thus making it easy to understand. Module 2 which comprises of HIPAA and You: Building a Culture of Compliance was a little bit complicated for me. Understanding the legislations and building a compliance culture can be hard because there are security breaches and data threats associated with it. However, module 3 which entails Examining Compliance With the HIPAA Privacy Rule was easy because it gives details on how to analyze if a physician is within or against the legislations. It gives broader details on methods that the covered entities can use to ensure that they comply with the HIPAA rule. Module 4 Understanding the Basics of HIPAA Security Risk Analysis and Risk Management was also very easy because it expands on what risk analysis is, the vulnerabilities, threats and risks which may be involved. It gives common definitions of the terms used as well as the steps involved in analyzing and managing risks. Nonetheless, Your Mobile Device and Health Information Privacy and Security which was module 5 proved very difficult to understand. This is due to the fact that it only gives tips on how to ensure ePHI is secure on mobile devices but does not put into consideration the fact that others share mobile phones, mobile phones can be hacked or stolen. It does not provide room for the fact that backing up personal health records in the internet can also be risky.  Module 6 of the training which entailed EHRs and HIPAA: Steps for Maintaining the Privacy and Security of Patient Information was very hard to understand. This training’s goal was to propose steps that practitioners can take to safeguard patient’s a data, plan communication and evaluate meaningful use.  Understanding this module proved difficult due to the fact that it comprises of several regulations, certification criteria all intertwined together. Understanding the relationship between HIPAA, meaningful use, EHRs and EHR incentive programs proved a little difficult.

While playing the ONC privacy game, I was surprised to learn that one should use firewall to protect their performance against an array of coercions. I learned that proper setting up is very important to the effectiveness of a firewall thus a practitioner should hire a technology expert to ensure that the practice is properly and well protected using the necessary devices as well as configurations. I also learnt that it is important to ask the technology expert about the risks associated with the firewalls and also ask for their recommendations. I was also surprised that passwords should be changed quarterly and not after every 30 days as I thought. According to the game, changing passwords on a regular basis means changing passwords on a quarterly basis. I was also surprised that in order to destroy a PHI I need to totally render it unreadable by using cross-cut type shredders.  

I believe that the ONC privacy training game is a very useful learning tool because physicians get to learn how to protect the electronic health information and also avoid the security breaches. This is very important for the purpose of protecting patient health records. I believe this gaming method is an innovative approach whose main aim is to educate physicians to be able to make more informed decisions regarding privacy and the security of health information. Another reason why this tool is of great importance is because it offers training on security procedures, security risk assessments, all of which are essential for evaluating security practices, identifying the weaknesses and documenting all the changes required.

The thought of linking clinical librarians and value health and quality health information assets with personal health record consumers has proved to be very beneficial to the users. Personal health records are very beneficial because it provides the consumers with a wide variety of realistic health data, information as well as knowledge thus enhancing the quality of care. Consumers are likely to engage with these tools because of the number of benefits it offers them.

One reason as to why patients are likely to engage with patient health record tools is the fact that the patients can control access so as to advance their health outcomes and cope up with their diseases. A lot of what patients do to improve their health is outside a medical setting. When a patient can follow up his or her health progress over time as well as have tools and information to manage their health, it increases their chances of being more engaged in their health, therapeutic alliances and health care. A patient health record also promotes collaborative health tracking. According to Saleem (2013), Patients with chronic illnesses are likely to track their own diseases in union with the care providers thus promoting earlier intervention in any case they encounter a deviation or a problem. Collaborative tracking is also beneficial because it reduces the communication difficulties between the patients and their caregivers (Legaz-García, et al., 2015). Most of these personal health record tools offer secure, direct and confidential communication between the patient and the care providers thus its enhancement. The communication is also easier and faster due to the open lines nature of communication. This communication is also of great essence as it improves the relationship between the patient and the caregiver. In addition to that, personal health records encourage family health management. Having a system for tracking and updating the health care information of the patient helps the caregivers to manage the patient’s care and coordinate with the family to improve the patient’s health care quality (Legaz-García, 2013).

Another reason as to why consumers are likely to use personal health record tools is due to the fact that the patients can track the doctor’s appointment even if the doctor’s office is closed. This is essential for the patient’s preparation as well as enhancing punctuality. This also helps the patient to be able to track their vaccinations hence jogging their memories. Personal health records also help the patients to track the wellness services available to manage their conditions thus improving their quality of life (Saleem, 2013). In addition to that, patients who use personal health records are likely to enjoy the lower management costs of chronic diseases, lower medication costs as well as lower wellness program costs.  Personal health records are universally available thus making it easy to access when there is need. For instance, when a patient is traveling, personal health records ensures that the information is readily and easily available in case of emergencies.

In conclusion, the fact that personal health records have proved important and beneficial to its users will continue to engage more consumers to use them. It is therefore important to note that the trend towards consumer online health services is clear and their use will still be on the rise.

References

Legaz-García, M. D. C., Menárguez-Tortosa, M., Fernández-Breis, J. T., Chute, C. G., & Tao, C. (2015). Transformation of standardized clinical models based on OWL technologies: from CEM to OpenEHR archetypes. Journal of the American Medical Informatics Association, 22(3), 536-544.

Saleem, J. J., Flanagan, M. E., Wilck, N. R., Demetriades, J., & Doebbeling, B. N. (2013). The next-generation electronic health record: perspectives of key leaders from the US Department of Veterans Affairs. Journal of the American Medical Informatics Association, 20(e1), e175-e177.

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