Palomar College Health Information Technology Report Paper

You will give a summary of the informatics system, including its history and background, the founding organization, and how the system currently interacts with the U.S. health care system.

You will share the perspectives of health professionals, including reflections and recommendations for improving both documentation, documentation technology, and/or informatics skills.

You will describe some clinical decision support tools that benefit (if in existence) or would benefit clinicians, care teams, and patients utilizing your chosen system.  Think about how the workflow can be improved for practitioners and health care safer for patients. You will discuss the impact of wireless mobile devices in accessing health care information.  Does your system have accessibility via the internet or portable devices?  You will identify and describe some of the potential risks and proposed risk management strategies for accessing, storing, and transmitting EPHI.   

Finally, you will identify the potential opportunities and limitations of your health information technology system.  Taking the role of either a clinician or a patient, you will discuss changes you hope to see in the future to improve workflow or patient care.

It is highly encouraged for you to include materials you have already created in your Supportive Submissions, Homework, and Reflections if appropriate.  These were all designed to assist in building your report.  Make sure to incorporate any feedback I have given previously.

You must integrate information learned throughout the course to fully address all aspects and requirements of the critical assignment.Please reference this book which should be in the other essays as well: Mastrian, K. G., & McGonigle, D.  (2017).  Informatics for Health Professionals.Burlington, MA: Jones & Bartlett Learning.

ISBN-13: 978-1284102635, ISBN-10: 1284102635

Clinical Decision Support Tools
Julie Thenethaysong
California Baptist University
HCA330: Health Information Systems
Dr. Bryan Schneider
Clinical Decision Support Tools
The use of technology in healthcare has resulted in many advantages, including reducing
medical errors. The increased physicians’ ability to make a correct diagnosis is due to the timely
information and updates provided by various clinical decision support (CDS) tools. They
effectively sift through large amounts of data and suggest the most appropriate interventions.
These tools are suitable for EHR and telehealth. The data in these integrated systems is so
untenable that the average clinician cannot incorporate all of it when making decisions. The
current research is interested in some of the CDS tools integrated with EHR telehealth to
understand how healthcare organizations leverage them to improve clinical workflows.
Examples of CDS Tools in EHR Telehealth
CDS tools use cognitive science to execute their functions. According to Mastrian (2016),
it is an interdisciplinary field that addresses the gap between how information is interpreted in
the human mind and how it is applied in practice. For example, the care alerts and reminders
integrated with the EHR system follow clinical diagnoses and procedures to notify practitioners
about how and when actions should be taken. They contain information about the efficacy or
risks associated with specific interventions, such as prescribing medications or a patient’s
allergy. An excellent example of a reminder tool is RAMPmedical. It is a German invention that
enables practitioners to make optimal psychoanalytical decisions for clients between treatment
schemes (Vijayalakshmi et al., 2021). The software evaluates the previously-decided
interventions and presents the findings of each guideline with its potential conflicts.
CDS tools are also utilized in EHRs to support documentation by ensuring the data
collected is recorded appropriately (Sutton et al., 2020). The tools execute this function through
well-designed forms and templates that allow the recording of additional information as
treatment continues. Any physician attending to the patient gets a complete picture of the
patient’s condition and progress. An example is a Medal. This innovation by the Medical
Algorithms Company based in the UK works by sifting through more than 30,000 decisionmaking CDS tools and calculators to provide practitioners with detailed checklists personalized
to different medical needs (Medal, 2022). The aim is to provide errorless documentations that
enhance the accuracy and reliability of patient assessment.
Besides accurate records, EHR telehealth relies on targeted questions to provide an
appropriate diagnosis. The diagnostic decision supports systems are incorporated into the system
to consider a variety of diagnoses based on the patient’s history and responses. They offer a
checklist of signs and symptoms according to the patient’s data. An example is the HERA-MI
developed in France (Vijayalakshmi et al., 2021). It uses machine learning to differentiate
between problematic and non-problematic breast cancer cases.
Finally, telehealth is broadly consulted for condition-specific issues. The integrated CDS
tools provide pre-defined templates for most special conditions and suitable medical procedures
or interventions (Sutton et al., 2020). The order sets are grouped into several items compared to
the patient’s data to enable evidence-based care. An example is the Rapid Electronic Assessment
Data Systems (READS) that enable clinicians to make mobile assessments. The information
collected predicts the deterioration or effectiveness of a specific medical intervention and
recommends ways to improve the outcomes.
Improving Workflow Among Practitioners
The healthcare landscape requires clinicians to perform multiple actions or continue on
procedures started by others. Most of these tasks in telehealth have multi-step plans designed to
provide long-term care (Sandhu et al., 2020). Thus, the CDS tools are designed to analyze the
simultaneous procedures and recommend the appropriate pathways based on previous treatment
reactions. All the mentioned tools execute their functions through scientific evidence (Mastrian,
2016). Every CDS tool contains this artificial intelligence that explores the diagnostic workflow
to offer insights about the patient’s condition and even suggests the best diagnostic tests or
interventions at that point of care. This provision enables practitioners to feel more confident
when making clinical decisions. The improved accuracy saves time and quickly redirects nurses
to other equally important tasks.
While the CDS tools have proven effective in improving the diagnostic flow,
practitioners should be wary of the burnout associated with their use. Olakotan and Yusof (2020)
state that fatigue is a common problem of poorly implemented CDS tools. They may create false
alters that overwhelm users. They may also contain unimportant data that hinders smooth
workflows. Mastrian (2016) recommends more familiarity with machine learning in healthcare
as it is essential to integrating CDS tools with other technologies. The expertise enables more
efficient and impactful data output. The competence’s purpose is to improve the prediction of the
most appropriate interventions.
As the demand for more personalized care increases, most healthcare organizations have
turned to technology to leverage its accuracy in medical decisions. CDS tools in information
technology are widespread as they combine specific patient data with evidence-based knowledge
and dispense the information intelligently. They alert practitioners to data they might overlook
while identifying any risks associated with the recommended treatment, such as adverse
reactions from medication interactions. While they are a gem in improving workflow, caution
should be taken because their overuse could lead to burnout. The research also finds that they
should not be substituted for clinical expertise as their effectiveness depends on the users’
knowledge about how they work to provide reliable output.
Mastrian, K. (2016). Informatics for health professionals. Jones & Bartlett Learning.
Medal. (2022). Consult tool benefits. The Medical Algorithms Company Limited. Retrieved 24
September 2022 from
Olakotan, O. O., & Yusof, M. M. (2020). Evaluating the alert appropriateness of clinical decision
support systems in supporting clinical workflow. Journal Of Biomedical
Informatics, 106(3), 103-124.
RAMP (2022). Essential medical support: Smart. Accessible. Simple. Retrieved 24 September
2022 from
Sandhu, S., Lin, A. L., Brajer, N., Sperling, J., Ratliff, W., Bedoya, A. D., … & Sendak, M. P.
(2020). Integrating a machine learning system into clinical workflows: qualitative
study. Journal of Medical Internet Research, 22(11), e22421.
Sutton, R. T., Pincock, D., Baumgart, D. C., Sadowski, D. C., Fedorak, R. N., & Kroeker, K. I.
(2020). An overview of clinical decision support systems: Benefits, risks, and strategies
for success. NPJ Digital Medicine, 3(1), 1-10.
Vijayalakshmi, S., Gayathri, S. P., & Janarthanan, S. (2021). Blockchain security for artificial
intelligence-based clinical decision support tool. In Internet of Things, Artificial
Intelligence and Blockchain Technology (pp. 209-240). Springer, Cham.
Healthcare Information Technology: Telehealth
Julie Thenethaysong
California Baptist University
HCA330: Health Information Systems
Dr. Bryan Schneider
Healthcare Information Technology: Telehealth
Healthcare information technology (HIT) uses computer software and hardware to
process data and make decisions in healthcare. HIT stores, transmit, retrieves, and applies healthrelated data, information, and expertise—the uses of health information technology span from
simple charting to complicated decision assistance and medical device integration (Piscotty,
Kalisch & Gracey, 2015). Due to advances in health I.T., adverse drug reactions, prescription
errors, and noncompliance with practice guidelines have decreased, ultimately benefiting
patients. To that end, this paper analyzes Telehealth and reviews its potential opportunities and
limitations. Telehealth provides and facilitates health services, such as healthcare data services,
medical treatment, patient plus provider education, and self-care, using digital communication
and telecommunications technology. Telehealth technologies include real-time video
conferencing, mobile health applications, and remote patient monitoring (RPM). However,
“telemedicine” and “telehealth” are commonly used interchangeably. However, “Telehealth”
refers to a more extensive range of online healthcare activities and services (Piscotty, Kalisch &
Gracey, 2015). Telehealth allows physicians and patients to connect by video or phone; hence, it
is advantageous for both health and convenience. More physicians now offer to “see” patients via
mobile device or computer. Technological advancements have made telemedicine more
accessible to individuals who may not consider themselves computer literate (Mastrian &
McGonigle, 2017). Patients may seek a virtual consultation with a practitioner, physician, or
therapist via Telehealth.
Background, history, and founding organization of Telehealth
The discovery of radio in the early nineteenth century profoundly impacted human
communication. Numerous imaginative people were moved by radio’s surprising increase in
popularity in various disciplines (from the arts to the military). They imagined a day when
patients might get medical treatment through the radio. In a 1924 edition of Radio News
Magazine, the picture of a doctor treating a patient through video call is accompanied by the
headline “The Radio Doctor-Maybe!” At the time, it was only the wild speculation of one editor,
but 90 years later, it all came true (Mort, May & Williams, 2003).
In the 1940s, radiography images were sent 24 miles over a telephone line in
Pennsylvania, marking the first secure electronic communication of medical data. In the 1950s, a
Canadian physician employed this approach to construct a teleradiology system deployed in and
around Montreal. As these preferences grew in popularity, motion pictures were produced, and
as cutting-edge film technology advanced, considerable attention was given to video medicine.
University of Nebraska clinics were the first to use video conferencing for therapeutic purposes.
In 1959, the institution created a two-way television system to facilitate campus-wide
communication for medical students. By 1964, they had established a video consultation
connection with a state hospital.
Telehealth swiftly gained popularity in rural areas where inhabitants previously had
limited access to healthcare to connect them with experts from beyond their immediate region. In
the 1960s and 1970s, the Department of Defense, NASA, the Public Health Service, and the
United States financed telemedicine research (Mort, May & Williams, 2003). Agency for Health
and Human Services
Even while modern telehealth technology is inspiring ancestors in telemedicine, it is
more compact and feature-rich. Fitness bracelets and heart rate monitors were among the first
mobile health devices to monitor patients’ vital signs. Wearable computer technology, such as
eyeglasses and smartwatches, is already popular with physicians and will soon relieve them of
administrative duties. Ian Shakil and Pelu Tran, medical students at Stanford University, founded
Augmedix using Google Glass. Although physicians may find it hard to accept at the moment,
telemedicine will become as commonplace as it was in 1924. Fortunately, there is still a muchundiscovered territory in the telehealth industry. Researchers in the public and private sectors are
spending heavily on Telehealth, accelerating technology advancement to the point that
physicians can no longer keep up.
Current interaction of Telehealth with the U.S. health care system
Telehealth helps patients with cost-effective, high-quality care during the current
pandemic while maintaining physical separation for the safety of both patients and clinicians.
Currently, in the U.S., Telehealth ensures patients get the essential therapy at the correct time
and place by expanding access to physicians and specialists. Now, 76% of hospitals in the United
States use video and other technology to engage remotely with patients and consulting
practitioners. Private payers now cover numerous telehealth services. The majority of state
Medicaid programs provide coverage for telehealth services. Medicare in the United States has
recently expanded its range to include telemedicine services for stroke patients and substance
misuse treatment in response to legislative changes. Additionally, Medicare has boosted the
rewards for online check-ins.
Potential opportunities and limitations of Telehealth
Telehealth has the potential to transform the treatment of pediatric patients by expanding
access to pediatric care across geographic borders, boosting the workforce for care delivery, and
decreasing access disparities. In addition, Telehealth can enhance social support, educational
opportunities, health outcomes, treatment quality, and cost-effectiveness. Telehealth will need
substantial efforts to bridge the digital divide to prevent unintentionally aggravating care
inequities (Chi & Demiris, 2017).
Telehealth has numerous potential benefits but also some limitations. For instance,
technology is not always reliable, and technological issues may make therapy more difficult.
Telehealth visits do not replace face-to-face consultations and are unsuitable for many patients or
clinical settings. The inability to do an in-person physical examination is a significant barrier.
Failure to weigh patients may result in inappropriate medicine delivery depending on patient
weight (e.g., pediatric medication and chemotherapy treatments). In the workplace, digital
technology may restrict the use of touch, physical presence, and emotional connection. Some
patients may feel uneasy with video meetings and prefer in-person consultations. Similar
preferences for face-to-face interactions have been seen in specialized care settings.
Telehealth provides and facilitates healthcare services, such as medical treatment,
healthcare data services, and self-care, using digital communication and telecommunications
technology. Telehealth allows physicians and patients to connect by video or phone; hence, it is
advantageous for both health and convenience. Telehealth has the potential to transform the
treatment of pediatric patients by expanding access to pediatric care across geographic borders,
boosting the workforce for care delivery, and decreasing access disparities.
Piscotty Jr, R. J., Kalisch, B., & Gracey‐Thomas, A. (2015). Impact of healthcare information
technology on nursing practice. Journal of Nursing Scholarship, 47(4), 287-293.
Mastrian, K., & McGonigle, D. (2017). Informatics for health professionals. Jones & Bartlett
Mort, M., May, C. R., & Williams, T. (2003). Remote doctors and absent patients: acting at a
distance in telemedicine?. Science, Technology, & Human Values, 28(2), 274-295.
Chi, N. C., & Demiris, G. (2017). The roles of telehealth tools in supporting family caregivers:
current evidence, opportunities, and limitations. Journal of gerontological nursing, 43(2),
Use of Health Information Technology (HIT) in Professional Settings
Julie Thenethaysong
California Baptist University
HCA330: Health Information Systems
Dr. Bryan Schneider
Use of Health Information Technology (HIT) in Professional Settings
The advancements in technology have affected almost every institution in the
professional environment. In healthcare, the acceleration and adoption of HIT have varying
impacts on nursing practice. On the one hand, telehealth, one of the digitalization in the industry,
is associated with advantages such as cost-effectiveness, a better physician-to-patient ratio, and a
decrease in hospital admissions. On the downside, some critics have cited that technology causes
difficulties in developing meaningful rapport, conducting full-body examinations, and reducing
the digital divide. Since the technology is also highly reliant on electronic health records (EHR),
professionals focus on the problems arising from the complementary implementation. This paper
reviews HIT, particularly telehealth, to establish health professionals’ perspectives regarding the
advancement and its alignment with EHR. The purpose is to share the reflections and provide
recommendations for improving documentation and informatics skills.
EHR Concerns with Information Technology
The EHR is an electronic version that stores patient medical history data. It is designed to
meet the industry’s primary goal of providing quality and cost-effective patient care (Mastrian &
McGonigle, 2017). The EHR does not work singly and has been integrated with other
technological tools such as telehealth. It uses information technology to deliver health care
services to patients in their preferred locations. EHR and telehealth have significant benefits,
such as enhanced performance capacity, reduced medical errors, and increased supervision.
However, there have been concerns raised about the adoption.
First, EHR telehealth functionalities are associated with interoperability issues. Not all
functions between EHR and telehealth are synchronized, creating problems with information
sharing. According to Ndlovu et al. (2021), this poor integration makes virtual care more
difficult. The second problem is data privacy. Combining EHR and telehealth functions means
big data is transferred through the systems daily and handled by more people, making it easy for
patient information to be accessed by unauthorized people. Also, hackers may infiltrate the
systems during the data transfer process.
Additionally, most practitioners lack the technical ability to operate the systems. Issues
such as shared passwords, outdated systems, and the recording of wrong information stem from
physicians’ limited experience with digital tools (Ndlovu et al. (2021). Most are unaware of the
importance of integrity and confidentiality when using the systems. As the expansion of EHR
telehealth increases, it is crucial to know how healthcare professionals, as the primary
participants, adapt to the new care system.
Perspectives and Reflections from Health Professionals
Most health professionals are or have already adapted to EHR telehealth. Some state that
the integration has dramatically increased care access as patients can be attended to remotely
(Bashir & Bastola, 2018). The advancement has also decreased travel costs and reduced hospital
patient capacity. The HIT has also improved communication between stakeholders and quality of
life through prompt treatments and monitoring. However, these positive outcomes are associated
with system incompatibilities (Bashir & Bastola, 2018). For instance, the professionals state that
there are constant conflicts between providers and billing departments due to the difficulties in
transferring and sharing patient data. Sometimes, hospital equipment is inconsistent with the
patients’, creating difficulties in providing directions.
Additionally, some practitioners do not know when the systems should be updated,
leading to costly downtimes (Zaman et al., 2021). They do not know or understand the cues that
indicate that the system may go out of service soon. Although this problem is widespread, the
practitioners are not given training opportunities or do not have time to develop the required
Recommendations for Improving Documentation and Informatics
The documentation quality in EHR telehealth is often viewed as a critical reflection of the
quality of care provided. The information stored in EHR informs the services provided through
telehealth. From the practitioners’ reflections, incompatibility and inconsistency are among the
significant issues. Thus, the first recommendation is to equip nurses with basic computer skills
that improve their self-efficacy in using the systems (Mastrian & McGonigle, 2017). The
competence allows them to perform broad activities such as recording and analyzing the
information to ensure it integrates and aligns throughout the system. Self-efficacy reduces
conflict as practitioners provide satisfactory explanations to inquiries by third parties, such as
insurance companies. Literacy in electronic systems also influences nurses’ attitudes towards eservices (Kuek & Hakkennes, 2020). They understand the benefits of EHRs possessing certain
aspects, such as intuitive interfaces that reduce consistency issues. It is also vital for health
professionals to change their attitudes about training. Using EHR telehealth efficiently requires
constant updating and a willingness to take on IT education programs. Most participants in the
nursing practice state they do not have time to enroll in training camps. Organizations should
introduce more flexible schedules to accommodate this growth, enhancing professional and
organizational growth. The aim is to change nurses’ perceptions of electronic documentation and
reduce security concerns and downtimes.
EHR’s integration with telehealth in healthcare is no longer a fringe practice but an
integral part of the landscape. It has helped physicians become more effective in diagnosing and
providing patient-centered care. However, this proliferation has excellent problems such as
interoperability, data privacy, and limited tech skills. These concerns should be addressed
through organizational support in training to equip users with skills that help them identify and
address the risk factors they may encounter when using informatics.
Bashir, A., & Bastola, D. R. (2018). Perspectives of nurses toward telehealth efficacy and quality
of health care: pilot study. JMIR Medical Informatics, 6(2), e9080.
Kuek, A., & Hakkennes, S. (2020). Healthcare staff digital literacy levels and their attitudes
towards information systems. Health Informatics Journal, 26(1), 592-612.
Mastrian, K., & McGonigle, D. (2017). Informatics for health professionals. Jones & Bartlett
Ndlovu, K., Mars, M., & Scott, R. E. (2021). Interoperability frameworks linking mHealth
applications to electronic record systems. BMC Health Services Research, 21(1), 1-10.
Zaman, N., Goldberg, D. M., Kelly, S., Russell, R. S., & Drye, S. L. (2021). The relationship
between nurses’ training and perceptions of electronic documentation systems. Nursing
Reports, 11(1), 12-27.

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