Second area of authentication is something
the user has, such as an identification (ID)
card
Something a user is biometrics
Something a user knows is a password
KEY - interoperability
Blockchain is a digital database containing a
record of transactions, maintained across
several computers linked in a network, that
can be simultaneously used and shared
within a large, decentralized publicly
accessible network.
Lockchain
chainblock
black hat (i.e., malicious) hackers (also
called crackers)
Hackers as outsiders
ethical hackers (i.e., white hat hackers)
hackers skilled at looking for and closing
network security vulnerabilities
Spyware and adware are normally
controlled in a corporate network by
limiting the functions of the browsers used
to surf the internet.
Ransomware which is malicious code that
blocks the organization from using its
computer systems until a ransom is paid to
the hacker
Antivirus A computer program that is
designed to recognize and neutralize
computer viruses, which are malicious
codes that replicate over and over and
eventually take over the computer’s
memory and interfere with its normal
functioning.
malicious code Software that includes
spyware, adware, ransomware, viruses,
worms, and Trojan horses. Malware, or
malicious code, that infiltrates a network
can collect easily accessible data
Code
cookie is a very small file written to the hard
drive of a computer whose user is surfing
the internet
Spyware that does steal user IDs and
passwords contains malicious code that is
normally hidden in a seemingly.
Worms A form of malicious code. A self-
replicating computer program that uses a
network to send multiple copies of itself to
other computers, subsequently tying up
bandwidth and incapacitating networks.
baiting, which is when a malware-infected
USB flash drive is left in a public area, thus
tricking the finder into loading it to identify
its owner
SCAREWARE - which is when the scam email
reports that the user has been hacked and
tricks him or her into giving the hacker
remote access to the computer to “fix” it
spear phishing, which is a more specifically
targeted scheme whereby the attacker
takes advantage of contact information
provided in an organization’s directory and
tailors the scam email to a specific person
phishing, which is an attempt to steal
information by manipulating the recipient
of an email or phone call to provide
passwords or other private information
social engineering, which is the
manipulation of a relationship based on
one’s position (or pretend position) in an
organization
Effective educational programming must be
instituted and mandated for all personnel to
ensure safe computing practices associated
with remote locations and remote access
Remote access must be restricted to
company-owned and company-configured
computers and devices.
Separation of privileges is a common
security tool, which means that no single
employee should be able to complete a task
that could cause a critical event without the
knowledge of another employee
antivirus
firewall can be hardware or software or a
combination of both and is used to examine
all incoming messages or traffic to the
network.
proxy server keeps track of which
employees are using which masks and
directs the traffic appropriately
Adware most common security threats
Malware, or malicious code, that infiltrates
a network can collect easily accessible data.
Software that includes spyware, adware,
ransomware, viruses, worms, and Trojan
horses
 electronic protected health information
(EPHI) via a wireless laptop connection
during a home visit, or a physician might
use a smartphone to get specific patient
information related to a prescription refill in
response to a patient request
The virtual desktop interface (VDI) allows
the user to have a computer for which the
operating system, applications, and data are
located and accessed on a central server,
instead of on the local desktop
Cloud desktop
Desktop cloud
human–technology interface The hardware
and software through which the user
interacts with any technology (e.g.,
computers, patient monitors, or
telephones).
how the user will interact with it, the user
interface (UI)
user experience (UX) is the user’s
experience from interacting with an object,
product, or service.
Human interface
ecological interface design (EID) is an
approach to interface design that was
introduced explicitly for multifaceted,
complex sociotechnical, real-time, and
dynamic systems; it has been applied in
many fields, including health care.
how the user will interact with it, the user
interface (UI)
user experience (UX) is the user’s
experience from interacting with an object,
product, or service.
… information and knowledge needed to
Task analysis examines how a task must be
accomplished
Cognitive analysis
Cognitive task analysis usually starts by
identifying, through interviews or
questionnaires, the particular task and its
typicality and frequency.
 can be used to develop training
programs.
Cognitive work analysis (CWA) includes five types of
analysis: (1) work domain, (2) control tasks, (3)
strategies, (4) social–organizational, and (5) worker
competencies.
work domain analysis describes the
functions of the system and identifies the
information that users need to accomplish
their task goals.
control task analysis investigates the control
structures through which the user interacts
with or controls the system.
strategies looks at how work is actually
done by users to facilitate the design of
appropriate human–computer dialogues
social–organizational analysis identifies the
responsibilities of various users (e.g.,
doctors, nurses, clerks, or therapists) so that
the system can support collaboration,
communication, and a viable organizational
structure
worker competencies analysis identifies
design constraints related to the users
themselves
strategies looks at how work is actually
done by users to facilitate the design of
appropriate human–computer dialogues
Coding
Mining
mapping is used to describe how
environmental facts (e.g., the order of light
switches or variables in a physiologic
monitoring display) are accurately depicted
by the information presentation.
processing Acting on something by taking it
through established procedures to convert
it from one form to another. Examples
include the processing of information into
data and the processing of a credit
application to get a loan.
accessibility Ease of accessing the
deliver care or manage a health service; the
extent to which a system is usable by as
many users as possible. The right user must
be able to obtain the right information at
the right time and at the right format.
Viability
Usability is a term that denotes the ease
with which people can use an interface to
achieve a particular goal.
 Typical usability indicators include ease
of use, ease of learning, satisfaction
with using, efficiency of use, error
tolerance, and fit of the system to the
task
Cognitive walkthrough , evaluators assess a
paper mock-up, working prototype, or
completed interface by observing the steps
users are likely to take to use the interface
to accomplish typical tasks
focus groups can help the designer better
understand users’ responses to potential
interface designs and to content that might
be included in the interface.
heuristic evaluation has become the most
popular of what are called “discount
usability evaluation” methods
 to detect problems early in the design
process, when they can be most easily
and economically corrected.
field study, end users evaluate a prototype
in the actual work setting just before its
general release
Formal usability tests typically use either
experimental or observational studies of
actual users using the interface to
accomplish real-world tasks
health information exchange (HIE) requires
the nursing informaticist to visualize how
patients move through the entire
continuum of care and not just a specific
patient care area.
American Health Information Management
Association (AHIMA) collaborated with the
Health Professions Network and the
Employment and Training Administration to
create a graphic depiction of competencies
necessary for EHR interaction
Office of the National Coordinator for
Health Information Technology (ONC)
released an interoperability road map to
promote ease of access and use of
electronic healthcare data
National Institute of Standards and
Technology (NIST) A nonregulatory federal
agency within the U.S. Department of
Commerce that was founded in 1901; its
mission is to promote U.S. innovation and
industrial competitiveness by advancing
measurement science, standards, and
technology in ways that enhance economic
security and improve the quality of life.
social determinants of health (SDOH) The
economic and social conditions in relation
to their diffusion and distribution among
the population that actually influence
individual and group differences and
disparities in health status
 five key domains for the SDOH:
1. Economic Stability,
2. Education,
3. Health and Health Care,
4. Neighborhood and Built
Environment, and
5. Social and Community Context”
Institute of Medicine’s (IOM) noted how the
technology (defined broadly) used often
does not fit well with human characteristics.
hospital information system (HIS) An
information system intended to manage the
clinical, financial, and administrative needs
of the hospital;
Health Electronic Record (HER)
computerized provider order entry (CPOE),
for example, helps us to focus more
specifically on workflow impacts.
…
Clinical transformation is the complete
alteration of the clinical environment;
therefore, this term should be used
cautiously to describe redesign efforts
Health Transformation
Optimization is the process of moving
conditions past their current state and into
more efficient and effective methods of
performing tasks.
 act, process, or methodology of
making something (as a design, system,
or decision) as fully perfect, functional,
or effective as possible.
Upgrading
Transformation
Process upgrading
Process improvement When the process is
addressed alone
Process design
Process Decision
Process Map A typical output of workflow
analysis is a visual depiction of the process,
Process Flow the term workflow is used
interchangeably with process or process
flows,
Task actions that are value added and
necessary

Workflow analysis is not an optional part of
clinical implementations but rather is a
necessity for safe patient care supported by
technology.
 The ultimate goal of workflow
analysis is to create a future-state
solution that maximizes the use of
technology and eliminates non–
value-added activities.
Efficient Little waste
Effective suggests that the process or end
product is in the most desirable state
Updated
Quality
… 13 Achieving Excellence by Managing
Multiplayer applicability
Gap Analysis zeroes in on the major areas
most affected by the change, Achieving
Excellence by Managing Workflow and
Initiating Quality Projects namely,
technology
Clinical Practice Guidelines Informal or
formal rules guiding principle
… management plan
Health information system implementation
is complex, with important implications for
learning and adaptation.
One area of practice that is particularly
susceptible to inadequate preparation is the
ability to facilitate process analysis.
Process Owners are those persons who
directly engage in the workflow to be
analyzed and redesigned
Workflow owner
… The last area of information security is
value-added step is one that ultimately
brings the process closer to completion or
changes the product or service for the
better
non– value-added step does not alter the
outcome of a process or product.
Non-Added
Garbage
… of the computer network and the
Waste is classified as unnecessary activities
or an excess of products used to perform
tasks
Surplus
Unused
Variation in workflow is considered the
enemy of all good processes and therefore
should be eliminated when possible.
Variation occurs when workers perform the
same function in different ways
Disparity
Gap
…
Discrepancy This technology check ensures
that the five rights of medication
administration are met
Process analysis Breaking down the work
process into a sequential series of steps that
can be examined and assessed to improve
effectiveness and efficiency; explains how
work takes place or gets done or how it can
be done.
Gap analysis zeroes in on the major areas
most affected by the change, 280 CHAPTER
Workflow and Initiating Quality Projects
namely, technology
Variation analysis
Waste analysis
Response
Change management plan Every workflow
redesign effort should begin with a change
Change agent Technology implementations
represent a significant change for clinicians,
as does the workflow redesign that
accompanies adoption of technology
The three main areas of secure network information
are confidentiality, availability, and integrity
Availability refers to network information
being accessible when needed
integrity. Employees need to have
confidence that the information they are
reading is true
confidentiality policy should clearly define
which data are confidential and how those
data should be handled
accessibility policy covers issues associated
with protecting the key hardware elements
procedures to follow in case of a major
electrical or internet outage.
Validation
Authentication A process that serves to prove who is
accessing the system.
certification is a program “designed to test the
knowledge, skills, and abilities required to perform a
particular job, and, upon successfully passing a
certification exam, to represent a declaration of a
particular individual’s professional competence
Verification
Actual users Participants were asked their preferences
for a number of design characteristics, such as display
color, menu buttons, text, photo size, icon metaphor,
and layout, by selecting on a computer screen their
preferences for each item from two or three options.
Operability
Interoperability is defined as the “[a]bility of a system
or a product to work with other systems or products
without special effort on the part of the customer.
Case Management Information System identify
resources, patterns, and variances in care to prevent
costly complications related to chronic conditions and
to enhance the overall outcomes for patients with
chronic illness..
 case management systems
provide decision support that
promotes preventive care
care plan is an evidence-based set of care guidelines
that outline the course of treatment and the
recommended interventions that should be
implemented to achieve optimal results,
Foundational interoperability defines the
requirements necessary between systems to
communicate data
Organizational interoperability refers to shared trust
and consistency of policies and social and legal
meanings to facilitate seamless workflows between
organizations.
Semantic interoperability is more complex and refers
to consistency of clinical terminology and shared
meanings.
structural interoperability defines syntax and format
to facilitate data exchange
Decision support entails the use of computer
reminders and alerts to improve the diagnosis and
care of a patient, including screening for correct drug
selection and dosing, screening for medication
interactions with other medications, preventive
health reminders in such areas as vaccinations, health
risk screening and detection, and clinical guidelines
for patient disease treatment
Communication systems promote interaction among
healthcare providers and between providers and
patients and are designed to be HIPAA compliant.
Admission, discharge, and transfer (ADT) systems
provide the backbone structure for the other types of
clinical and business systems and, when automated,
provide opportunities for health information
exchange leading to care coordination
Acuity systems monitor the range of patient types
within a healthcare organization using specific
indicators.
Financial systems manage the expenses and revenue
for providing health care.
Scheduling systems coordinate staff, services,
equipment, and allocation of patient beds
Laboratory information systems (IS) were perhaps
some of the first CISs ever used in health care
The final type of patient care support system
commonly found within health care is the radiology
information system (RIS) found in radiology
departments
Clinical documentation systems, also known as
“clinical information systems,” are the most
commonly used type of patient care support system
within healthcare organizations. CISs are designed to
collect patient data in real time
Pharmacy information systems also have become
mainstream patient care support systems.
data mining A process of utilizing software to sort
through data to discover patterns and ascertain or
establish relationships
Data Mart- represents a large database in which the
data used by one of the units or a division of a
healthcare system are stored and maintained.
Database is a structured or organized collection of
data that is typically the main component of an IS.
Data Query
field study - the end users evaluate a prototype in the
actual work setting just before its general release
Feasibility used to determine whether the project
should be initiated and supported.
Viability
Practicability
rapid prototyping, also known as rapid application
development (RAD), provides a fast way to add
functionality through prototyping and user testing. It
is easier for users to examine an actual prototype
than documentation
object-oriented systems development (OOSD) model
blends SDLC logic with object-oriented modeling and
programming power (Stair & Reynolds, 2016). Object-
oriented modeling represents real-world objects by
modeling the real-world entities or things
dynamic system development method (DSDM) is a
highly iterative and incremental approach with a high
level of user input and involvement
SDLC, is an ongoing development with a life cycle.
SDLC is a way to deliver efficient and effective
information systems (ISs) that fit with the strategic
business plan, which stems from the mission, of the
organization
Health Insurance Portability and Accountability Act
(HIPAA)
HITECH Health Information Technology for Economic
and Clinical Health Act
In the project manager role, the INS is responsible for
the planning and implementation of informatics
projects.
consultant role provides expert advice, opinions, and
recommendations based on his or her area of
expertise
product developer role participates in the design,
production, and marketing of new informatics
solutions
entrepreneur role combine their passion, skills, and
knowledge to develop marketable business ideas by
analyzing nursing information needs and developing
and marketing solutions.
facilitate teamwork and relationships across the
continuum of care.
Management & Leadership Revolutionary leadership
that drives, empowers, and executes the
transformation of health care
Information Technology Smart, people-centered,
affordable technologies that are universal, useable,
useful, and standards based.
Voice and video recordings (client interviews
and observations, diagnostic procedures, and
ultrasounds)
Voice-to-text files (voice recognition for
documentation)
Medical devices (infusion pumps, ventilators,
and hemodynamic monitors)
Telehomecare monitoring (for use in diabetes
and other chronic disease management)

A certificate program “is an educational or training

program that is used to teach learning objectives and
assess whether those objectives were achieved by the
student”
certification is a program “designed to test the
knowledge, skills, and abilities required to perform a
particular job, and, upon successfully passing a
certification exam, to represent a declaration of a
particular individual’s professional competence”
Permit

Nursing Informatics - the specialty that integrates

nursing science with multiple information and
analytical sciences to identify, define, manage, and
communicate data, information, knowledge and
wisdom in nursing practice
The conceptual framework underpinning the science
and practice of NI centers on the core concepts of
data, information, knowledge, and wisdom, also
known as the DIKW paradigm
DIKW paradigm - Not exclusive in nursing
AI is the field that deals with the conception,
development, and implementation of informatics
tools based on intelligent technologies
expert systems which implement knowledge
automatically without human intervention

Communication & Collaboration Standardized,

person-centered, technology-enabled processes to