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Ensuring security and privacy: The secure and private exchange


of healthcare information is a primary concern for consumers and other stakeholders. There is potential for human error, such losing thumb drives containing patient information, sharing passwords among teammembers andfailing to encryptdata thatmaybe entering a nonsecure domain. Especially in such areas asmental health and substance abuse treatment, consensus needs to be reached on appro- priate patient consent, data sharing, and data privacy and security.4 Ensuring security andprivacy ofpatientdata require intensiveongoing education, organization and legal policy changes, and implementing penalties for transgressions.5


Ona systemic level, theremay be risk of


large-scale hacking, as evidenced by a recent breachof securityonthe Healthcare.gov site, which fortunately did not result in the hackers gaining access to personal information.20


executive leaders need to be knowledgeable about HIPAA laws and standards, and develop a plan when breaching is imminent. Developing regulation standards: Amajor concern of health


system leaders in the quest for interoperability is finding the balance between creating regulation standards to maintain ease of information sharing and allowing for the freedom to improve current technology. If standards are too strict, newand improved


CE721


1. Currently, healthcare information ex- change is:


a. Cohesive b. Fragmented c. Fully realized d. Completely electronic


2. Interoperability fosters an environment in which:


a. Cost and safety of care are improved b. Risk of errors is increased c. More paperwork is needed


d. Diagnostic testing redundancy is increased


3. Why is meaningful use is important to RNs?


a. They can be reimbursed for meeting criteria.


b. It doesn’t matter to nursing.


c. Nursing input can drive meaningful use in direction of safe patient care.


d. It requires redundant documentation.


4. Semantic interoperability is: a. Unrelated to nursing care


b. Generally considered the most simple component of interoperability


c. A high level of data exchange, including the structuring and coding of data and the use of standardized terminologies


d. Easy to achieve across healthcare disciplines and the continuum of care


5. Clinical decision support systems are:


a. A way for clinicians to connect with other clinicians for input and deci- sion making


b.More effective if there are more of them


c. Designed to add complexity to clinical workflow


d. Coded tools to help clinicians make real-time, evidence-based clinical judgments that are patient specific


6. What is the best way to improve delivery of nursing care with an in- teroperable EHR?


a. Through frequent and repetitive alerts


b. By supplying the nurse with support tools and promoting ease of infor- mation sharing without increasing unnecessary tasks


c. Through a broad order set that covers any number of patients


d. By increasing the number of nursing tasks


7. A personal health record is: a. The same as an EHR


b. Independent from the EHR and solely patient controlled


c. A risky idea; it will give the patient too much control over their health information


d. Most valuable if healthcare providers help with updates and maintenance


8. The VA Blue Button:


a. Is a successful patient health record (PHR) program


b. Is an EHR vendor for the VA


c. Keeps patients from viewing progress notes


d. Only gives providers authority to approve access by other providers


9. A nurse’s scanning a patient’s ID sticker rather than his or her bracelet before administering a medication is an example of:


a. Meaningful use b. Interoperability c. Clinical workaround d. Clinical decision support system


10. Clinical workflow refers to:


a. A highly sophisticated way to ex- change and use data


b. The day-to-day real-life tasks of healthcare delivery


c. A nursing flow sheet in the ER


d. Transference of information from provider to provider


11.How can nurses play a role in the de- velopment of an interoperable HER?


a. They must meet meaningful use criteria for reimbursement.


b. They must obtaining a degree in informatics.


c. They can become involved in groups that develop EHR policies and procedures.


d. They can document patient care.


12.A major challenge in developing an interoperable health information exchange system is:


a. Covering the costs of implementation


b. Getting the government to see in- teroperability as a priority


c. Persuading patients to get involved in their own care


d. Meeting meaningful use requirements Visit us at NURSE.com • JANUARY/FEBRUARY 2016 27 Organizations and nurse


systems will not fitwithin those rigid boundaries. Too lenient, and systems will develop discordantly fromone another,21


exacerbating


the problem that the healthcare industry is working to get away from: having fragmented systems that don’t communicate with one another. Nurses can help with developing regulations and standards by being involved in their organizations development of the EHR and interoperability efforts.


The future looks bright As we move toward a nationwide interoperable HIE system, many challenges and opportunities are expected. It is also an exciting time as nurses lead the new frontier with infinite possibilities for improving patient care. There is great need for nurses to understand how HIE and interoperability work, how they affect patient care and what role nurses have in the evolution of a standardized, yet innovative, future of HIE. •


Meaghan O’Keeffe, BSN, RN, is a freelance healthcare writer in Fram- ingham, Mass. Sarah R. Tupper, MS, RN-BC, LHIT, CPHIMS, is principle, TaylorTupper & Associates, LLC.


EDITOR’S NOTE: References available at CE.Nurse.com/Course/CE721.


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