As the nurse informatician moves toward implementation of a system, user support becomes paramount. Procedure manuals will be developed that will describe how to perform business tasks while using the system.

Gap analysis is used to determine the steps required to move from a current state or actual performance or situation to a new one or potential performance or situation, and the “gap” between the two that requires action or resources. Steps to gap analysis include:

• assessing the current situation and listing important factors, such as performance levels, costs, staffing, and satisfaction, and all processes
• identifying the current outcomes of processes
• identifying the target outcomes for projected processes
• outlining the process required to achieve target outcomes
• identifying the gaps that are present
• identifying resources and methods to close the gaps

While performance appraisal is sometimes prompted by disciplinary action, this is not usually the case, and while the actual review of the performance appraisal may be scheduled and the time in which an individual should reach a goal limited, generally performance appraisal should be an ongoing process that continues from one review period to another (usually annually) in order to provide feedback to the individual and help the individual reach goals.

The GUI (graphical user interface) facilitates interaction between the user and the computer. The user interface is the means by which the individual interacts with the computer. Provided by Microsoft Windows, the GUI provides a means of navigating within the computer environment. The GUI is part of the computer operating system. It is the “desktop”screen, usually with icons that can be activated by clicking them with a mouse or selecting with a trackball or other device, such as menus, windows, and other standard screen features intended to make using a computer as intuitive as possible. The design of the GUI should be intuitive so that the user can determine what actions to take without written instructions, and thus decreasing the amount of time required to learn new programs and eliminate the need to memorize commands.

A dashboard (also called a digital dashboard), like the dashboard in a car, is an easy access and read computer program that integrates a variety of performance measures or key indicators into one display (usually with graphs or charts) to provide an overview of an organization. It might include data regarding patient satisfaction, infection rates, financial status, or any other measurement that is important to assess performance. The dashboard provides a running picture of the status of the department or organization at any point in time, and may be updated as desired, such as daily, weekly, or monthly.

• dashboard display
  • is intended to piece all of relevant information together from various systems on one screen
  • reflect real-time data
  • bring together key performance indicators for business decisions or clinical data from several systems into clinical dashboard

The ADA provides disabled persons, including those with mental impairment, access to employment and the community. Employers are only allowed to ask applicants if they need accommodations, not if they have disabilities. Applicants may be asked if they can carry out essential functions of a job, not incidental, and medical examinations can only be required after a job is offered. Accommodations can include alterations in a work station, speech recognition software, screen magnifying software, optical character recognition systems, video captioning, Braille readers and screen readers, adapted keyboards, and on-screen keyboard, TTYs (text telephones), and amplification systems.

CPT codes:

• developed by the American Medical Association (AMA) in 1966
• define those licensed to provide services and describe medical and surgical treatments, diagnostics, and procedures.
• The use of CPT codes is mandated by both CMS and HIPPA to provide a uniform language and to aid research.
• The code set is copyrighted by the AMA and is continually evaluated and updated annually in October of each year coordination with CMS.
• These codes are used primarily for billing purposes for insurances (public and private). HHS has designed CPT codes as part of the national standard for electronic health care transactions: (Medicare utilizes an adjusted form of CPT, the HCPCS code. While ICD-9 codes are used to code for procedures, ICD-9 coding is used only for inpatients.
• 3 categories of CPT
  • Category I: Identify a procedure or services
    • evaluation and management
    • anesthesiology
    • surgery
    • radiology
    • pathology and laboratory
    • medicine
  • Category II: Identify performance measures, including diagnostic procedures
  • Category III: Identify temporary codes for technology and data collection
• The HCPCS: developed to covered the CPT coded services and other services, such as DME, supplies, drugs, or ambulance services.
  • is in 2 levels
    • level I: same as CPT codes
    • level II: more extensively for supplies, equipment, and auxilliary services not normally passing through a physician’s office.

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