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What procedure related to privacy and confidentiality would you recommend to prevent students’ unintentional exposure of patient data  to the public?

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Mini-Lecture
I. Types of Standardized Terminologies (Formalism)
Thesauri are defined as lexical vocabularies. A thesaurus is a linear list of all possible terms and its cross-references (e.g. MeSH).
Classification systems are enumerated lists of disjunctive and exhaustive terms represented as hierarchies (e.g. ICD, NANDA, NIC, NOC, Omaha, and CCC).
Nomenclatures are referred to as classifications with more poly-hierarchic structures. Terms within a nomenclature may be combined into complex concepts using semantic grammar; however, explicit rules for the unambiguous representation of terms are lacking. The creation of meaningless clinical concepts is possible. (e.g. SNOMED Intern., ICNP).
Formal terminologies are systems based on concepts, rather than on terms. Each concept has a well-defined meaning. Also, a nomenclature provides explicit rules for sensible composing simple concepts into complex concepts. The concepts are represented using knowledge formalism such as conceptual graphs. (e.g. SNOMED RT, GALEN, Kaiser Permanente CMT).
II. Multidisciplinary Terminologies
Please review Kim & Matney’s (2014)’s Chapter 22 Standards (pp 352-358)
III. Standardized Nursing Terminologies (SNTs)
Please review the attached my Powerpoint slides about SNTs: NURS6323_Standardizd Nursing Terminologies_LeeM.pdf Download NURS6323_Standardizd Nursing Terminologies_LeeM.pdf
Also, please read Kim & Matney’s (2014)’s Chapter 22 Standards (pp. 359-362)
Nursing Minimum Data Set is a minimum set of items of information with uniform definitions and categories concerning the particular dimension of professional nursing which meet the information needs of multiple data users in the health care system. Since the creation of NMDS in the United States, numerous other countries have developed their unique NMDS. Here is an article comparing the NMDS across countries: Goossen, W. T. F., Epping, P. J. M. M., Feuth, T., Dassen, T. W. N., Hasman, A., & van den Heuvel, W. J. A. (1998). A Comparison of Nursing Minimal Data Sets. Download A Comparison of Nursing Minimal Data Sets. Journal of American Medical Informatics Association, 5(2): 152–163.
More information about the Nursing Management Minimum Data Set (NMMDS) is available at the link: NMMDS Download NMMDS is a minimum collection of core variables needed by nurse managers to make decisions and compare nursing practice across institutions and geographical areas.
IV. Evaluation Criteria for Language Systems (Standardized Terminologies)
Please review the evaluation criteria on pages 27-35 on the following report by the Office of the National Coordinator for Health Information Technology (ONC-HIT, 2017): https://www.healthit.gov/sites/default/files/snt_final_05302017.pdf (Links to an external site.)
V. Reference Terminologies VS Interface Terminologies
The Interface terminology supplies the terms used by clinicians as they talk about clinical concepts or the set of terms displayed in an EHR for the clinicians to use. So the interface terminology assists entry and display of data and information. Examples of interface terminology: NANDA, NIC, NOC, local expressions, and preferences. The terms of the interface terminology need to be linked/mapped to a standard reference terminology to achieve the benefits of using standardized terminologies for interoperability. The reference terminology represents a large number and range of possible concepts in a consistent manner and specifies relationships between concepts. The reference terminology would then provide a semantic foundation for reliable data/information retrieval. Examples of reference terminologies: LOINC, SNOMED CT. A combination of Interface & Reference Terminology features will be the best to meet both data entry and retrieval requirements.
Figure 1 Relationshp between interface-reference-aggregate terminologies.jpg
Figure 1 Relationship between the interface, reference and aggregate terminologies
Note: From Scott P, et al. (2002). An introduction to health terminologies. Lidcombe: National Centre for Classification in Health.
DRG, diagnosis-related group; ICD-10-AM, International Classification of Diseases, Tenth Revision, Australian Modification; ICPC, International Classification of Primary Care; SNOMED, Systematized Nomenclature of Medicine.

(Links to an external site.)VI. Communicating and Interoperating Different Terminologies
Founded in 1987, Health Level Seven International (HL7) is a not-for-profit, ANSI-accredited standards developing organization dedicated to providing a comprehensive framework and related standards for the exchange, integration, sharing, and retrieval of electronic health information that supports clinical practice and the management, delivery and evaluation of health services. HL7 is supported by more than 1,600 members from over 50 countries, including 500+ corporate members representing healthcare providers, government stakeholders, payers, pharmaceutical companies, vendors/suppliers, and consulting firms (http://www.hl7.org/about/index.cfm?ref=nav (Links to an external site.)). HL7 provides standards to create flexible, cost-effective approaches, guidelines, methodologies, and related services for interoperability between healthcare information systems.
Figure 2 HL7 Message in Clinical Practice.jpg
Figure 2 HL7 Message in Clinical Practice
Source: Goossen, W. Preparing for eHealth Collaborative efforts in Nursing: Using Health Level 7 Version 3 for Information Exchange
HL7 takes each action occurs in a context of “Who does it?” “To whom is it done?” “Why is it done?” “Where is it done?” “How is it done?” and “When is it done?”
Figure 3 HL7 CCD.jpg
Figure 3 HL7 Continuity of Care Document
Source: Warren J. J. ‘Informatics enablers and resources: the regulation and standards landscape
FHIR® (Fast Healthcare Interoperability Resources) is a next-generation standards framework created by HL7 to facilitate the exchange of
healthcare information. There are 2 parts, the resources (content model) and the specification on how to exchange these resources. More information is available at https://www.hl7.org/fhir/ (Links to an external site.)
FHIR.JPG
Source: Heermann, L. (2021). FHIR Today. 2021 [Pre-conferrence workshop]. 2021 Nursing Knowledge: Big Data Science Conference, Minneapolis, MN.
VII. Privacy, Confidentiality, Security & Integrity
McGonigle & Mastrian (2022) Chapter 12 gives you basic technical information about the terms, methods, tools to secure data and information. It would be good to at least be familiar with the terms. Staggers et al. (2014) Chapter 19 introduces very important information about privacy, confidentiality, security, and data integrity in a concise and precise manner.
You don’t need to post answers to the following questions. However, I would strongly recommend you to think about the following questions by yourself.
Nowadays, the patient portal (=personal health record platform) is increasingly adopted by clinics, hospitals, insurance entities, and information companies. It includes individual health data given by health care providers as well as generated by individuals. What and how the privacy and security policy should be included in this patient portal?
What procedure related to privacy and confidentiality would you recommend to prevent students’ unintentional exposure of patient data  to the public?
Assignment
With the following case, please address the questions below.
“A community hospital is part of an integrated healthcare delivery system with services ranging from inpatient acute care to outpatient care, home care, and long-term care. The information flow in each service is supported by a clinical information system that includes interventions by nurses and other healthcare providers. The problem, though, is that each service has adopted a system unique for documenting the care provided. The NANDA, NIC, and NOC are used to document inpatient nursing care. ICF is used to document the practice by physical therapists and rehabilitation professionals. The nursing administration uses NMMDS to organize their activities. The home care agency has adopted the OMAHA system over the years. The long-term care services have not adopted any particular standardized health care language to document their care, but they use the OASIS system (Links to an external site.), mainly for administrative purposes.”
What is your take on the problem?
What are the benefits and barriers of each terminology system (i.e., NANDA, NIC, NOC, ICF, NMMDS, OMAHA, & OASIS)? Try to compare and contrast each system.
What solution would you propose for this case?
By 7/8 midnight, post your initial posting with the rationale for your proposed solution based on the literature and your experiences and have discussions
By 7/11 midnight, read our colleagues’ postings, compare/contrast them, and respond as appropriate

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