The success of the National Quality Strategy (NQS) hinges on the ability of providers and health care organizations to successfully use health information technology (health IT) and data within the electronic health record (EHR) to improve quality. The NQS called for under the Patient Protection and Affordable Care Act focused on promoting quality of healthcare services and improved health of patients, families, and communities. This strategy aligns with the triple aim, namely, better care, healthy communities, and lower costs. One of the primary levers that the nation is using to ensure the success of this plan is to encourage the use of health IT to improve communication, transparency, and efficiency for better coordinated health and to effectively measure performance on key indicators of. Finally, it provides a case study to provoke a thoughtful dialogue on strategies to meet the challenges associated with electronic clinical quality measures submissions.

This chapter discusses the history of healthcare data standards and the importance of the standards to the overall national health information technology (HIT) plan for the United States. It also discusses the historical development of the Nationwide Health Information Network (NHIN) standards and their relationship to the Public Health Information Network (PHIN). The chapter helps to understand the four different methods of standards creation and identify which electronic health record (EHR) standards are required for compliance with value-based purchasing and other regulations, including “advancing care information” under the Quality Payment Program (QPP). It also helps the reader to perform a gap analysis to determine where standards might need to be created. The chapter determines potential positive and negative consequences of mapping between data standards. It defines the different nursing data standards and their potential use within EHRs.

The technology underlying health information systems is an important aspect that advanced practice nurses (APNs) have to understand, as they are the ones who are to lead teams to adopt and implement health information technology (HIT) systems. This chapter discusses the basics of computer technology related to hardware, software, and networking. It describes hardware specifications and criteria to implement health information technology. The chapter examines the ergonomics requirements needed when implementing HIT for nurses and other healthcare professionals. It identifies and describes various programming languages utilized in the healthcare setting. The chapter analyzes various types of software utilized in healthcare settings relevant to HIT, including functionality, usability, human factors considerations, configuration languages, modules versus full platforms, and other important considerations when purchasing software applications.

Electronic health records (EHRs) have been around in some form since the 1970s, but prior to the passage of the Health Information Technology for Economic and Clinical Health (HITECH) Act in 2009, their penetration rate had been relatively modest. This chapter reviews historical and recent efforts to expand the access and use of health information technology (HIT) in the United States. It discusses how various programs are designed to be layered to support one another, particularly about HIT adoption and use. The chapter describes the elements of law, policy, and regulation creation and the potential advocacy role of an advanced practice nurse. It also describes the important roles that advanced practice nurses play in interprofessional teams within national HIT initiatives. The chapter reviews best practices used in the nation to examine case studies on how organizations can successfully implement strategies to fully realize the national aims.

This chapter applies the telemedicine approach to patient care assessment in a description of one’s own clinical environment. It helps the reader to identify the role of telehealth (telemedicine, remote patient management, and mobile health) in the events surrounding the 2020–2021 coronavirus pandemic. The chapter demonstrates an understanding of the professional licensure requirements applicable to telehealth-based care delivery. It describes the Medicare and Medicaid regulations for delivery of telehealth service via the Medicare Chronic Care Management program. The chapter describes the growth of mobile health (mHealth) and lists the top two categories for healthcare providers. It identifies a strategy involving mHealth that is applied to existing patient services to enhance care delivery for both supplier and patient. The chapter compares the privacy and security needs in telehealth with traditional healthcare delivery services.

This chapter covers the basics of clinical decision support (CDS) definitions, types of CDS tools, and the essential elements that organizations should have in place for ensuring a successful CDS program. These elements include leadership and executive support, as well as interprofessional teams representing the stakeholders most impacted by changes to workflow. These teams are fundamental to helping design the CDS strategies. The chapter discusses the alignment of the CDS program with fundamental strategies for QI, along with the importance of involving departments that can help with optimizing the overall impact of the CDS intervention on patient safety and quality. It reviews the life cycle intervention with important steps, and discusses concerns with liability for clinicians and hospitals. Finally, the chapter presents four case studies; Obstetrical Screening; Think Sepsis; Normal Newborn; and Ebola and Infectious Disease Screening/Intervention Supported by CDS.

The Systems Development Life Cycle (SDLC) is a standardized approach used to develop and implement information technology (IT). This framework is often used across industries to structure best practices for IT development and deployment. SDLC is a phased approach used to analyze and design information systems that is broken into distinct phases. Health information technology (HIT) projects can be deployed haphazardly or can follow a structured and methodical approach, such as with the SDLC. This chapter outlines the SDLC framework, discusses each phase, compares and contrasts development compared to implementing a product off the shelf. It examines SDLC compared to the Professional Project Management framework, examining similarities and differences. Finally, the chapter concludes with a case study that examines SDLC in a clinical use case for promoting interoperability of electronic health records (EHRs) under the Promoting Interoperability Program instituted as a follow-up to the HITECH Act Meaningful Use Program.

The healthcare environment in which advanced practice registered nurses are currently practicing is a complex setting with rapid change underway driven by a need to transform the healthcare delivery system. Nurses plays an essential role within interprofessional teams in transforming the healthcare delivery system and critical team members for success, particularly related to the effective and efficient deployment of Health information technology (HIT). In the last 10 years, the United States has focused on laying the HIT Electronic Health Record foundation established under the HIT for Economic and Clinical Health (HITECH) Act of 2009. This chapter examines the changing landscape of the U.S. healthcare system in the context of many global challenges and opportunities. It covers regulatory requirements and policy that influence the U.S. healthcare system and the importance of Health I.T. to the strategy, addressing nursing’s critical role to optimize technology and data for safety, quality, and population health.

Nurses must collaborate with many stakeholders in every setting to effect patient-centric care that includes identified outcomes, implementation plans, and outcomes evaluation. Such care also incorporates the concept of patient–clinician partnerships and decision making, as well as interprofessional collaboration. The inclusion of everincreasing technology solutions and the reliance on technology devices as communication and work tools for the healthcare consumer and interprofessional teams, create diverse needs and specific challenges. Assurance of positive user experiences merits greater attention and can be best accomplished by interprofessional team awareness of the patients’ needs. This chapter describes the Interprofessional Team for Health Informatics Model (IT-HI Model) and focuses on characterizing the importance and contributions of clinicians in advanced practice roles and high performing interprofessional teams leading to improved health care. It also focuses on how the Nursing Education for Healthcare Informatics (NEHI) model can be expanded for application to interprofessional teams.

This chapter covers the basics of workflow redesign and places this important tool within a framework for quality improvement, as well as public health crises. It describes fundamental tools such as the project charter as an important mechanism for defining what one intend to do to improve the process and how one will measure improvement and key components relevant to the redesign. Prior to beginning a workflow redesign project with any major impact to a practice setting, the chapter outlines a project charter. It provides an important overview of best practices for workflow redesign and has identified key areas where workflow maps should be created in order to achieve optimization of health information technology in both acute care and ambulatory care settings. The chapter describes rapidly evolving development related to advanced uses of workflow redesign strategies to automate processes and addresses global public health concerns such as the COVID19 pandemic.