The Hierarchy of Informatics that this objective will need to span across to accomplish it successfully includes a few areas within the hierarchy. The initial step is the data query from the CHS electronic health record (EHR). In performing this step, it utilizes the Clinical research informatics and clinical informatics realms. The query is specific to the outpatient settings of the clinics and ASC, so the consumer and population informatics areas are utilized to identify the populations that will be utilizing the outpatient areas. The area of interest is based in behavioral informatics within the selected population. This is for the benefit of public health as the selected group from the EHR is part of the collective whole. The importance of any endeavor is to evaluate and measure to the desired outcome, hence the informatics impact evaluation area is also utilized. The education scope will be utilizing the nursing informatics to further detail the provided information derived from the pamphlets which were available through Healthfinder.gov (Nelson 2018).

The design for the pamphlets would have information within them that the scope of nursing practice would be able to assist with. The initial part of the education that would need to be included is how smoking can affect the human body and what risk does it have to everyone. With this considered then heart disease, cancer risk and mental health education material would need to be a part of the pamphlet. Part of this education is answering why would quitting smoking benefit the patient (Quitting smoking 2019). Secondly the need to have a patient identify what their risk is. This would then need information on tools such as screenings that would be available to be facilitated by nursing. The initial intake information questionnaires that patients fill out as well as the oral interviews upon admission to the ASC for their procedure as well as the oral interview at the time of visitation to the outpatient clinic after the patient is roomed. This information can then be continued to be queried from the EHR with specific data points that can be utilized for identification and outcomes. The third necessary design point is to ensure there are resources that assist in quitting. This ranges from medical management, mental wellbeing, support groups/guidance, and technical aids such as mobile apps (Tobacco use 2020). All these options are vital to have available for the patient, so the next step does not overwhelm them. These resources will help the patient identify why they would choose to quit develop a plan on how to be successful and track their success via multiple forms of feedback.

To evaluate the effectiveness of the tobacco education informatics solution a time continued analysis and a regression discontinuity design would be effective to understand what the overall effect of the information being disseminated to the outpatient population within CHS (Nelson 2018). This would offer information about enrollment to smoking cessation programs. A measurement of the population before the pamphlets and then after that use tobacco. The regression design could then compare the two groups of people that chose to quit versus those that did not and the health outcomes that are associated with. These groups would be from the initial query group. The effectiveness of the education provided to prompt smoking cessation could then be derived as to it effectiveness. All this information could be queried from the EHR in discrete data extraction.

Centers for disease control and intervention (2019) Quitting smoking https://www.cdc.gov/tobacco/data_statistics/fact_sheets/cessation/quitting/index.htm (Links to an external site.)

US Department of Health and Human Services. (2020) Cancer https://health.gov/myhealthfinder/topics/health-conditions/cancer (Links to an external site.)

Office of Disease Prevention and Health Promotion (2020) Tobacco Use https://www.healthypeople.gov/2020/topics-objectives/topic/tobacco-use (Links to an external site.)

Nelson, R. & Staggers. N. (2018). Health informatics: an interprofessional approach (2nd ed.). Retrieved from https://redshelf.com

There are several different areas of the hierarchy of informatics diagram that would need to be used to accomplish the task assigned by leadership in the case study. The first step in completing the job would be to find out which patients in the health system were current smokers or may be at high risk for starting tobacco use. The clinical research informatics subgroup of the clinical informatics domain would be the most effective way to gain the information needed for the initial step of the project. (Nelson 2018). The nursing staff will use the information gathered to create a list of all the patients within the health system that will benefit from the new program.

The next step in the process would require the use of many different domains in the hierarchy falling under the health informatics side. Nursing informatics, consumer informatics, and population informatics could all come into play at this stage. (Nelson, 2018). The nursing staff responsible for the project would need to look at consumer and population informatics to get a better idea of the patient population, their socio-economic backgrounds, the average level of education and ability to understand the teaching, and the cost of tobacco products being purchased. All these factors will be important when deciding how to best approach the new education programs. From the nursing perspective, it will be important to include all the risk factors and health concerns associated with tobacco use and the effects of smoking on the body (Quit Smoking, 2020). The staff could then use the electronic health record to implement a system that flags the known tobacco users as well as those most at risk for starting tobacco use for follow up questions and extra education on tobacco cessation and resources to help with that. At each visit, the current tobacco use status will be re-evaluated and updated in the electronic medical record.

In order to evaluate the effectiveness of the new education program, I would most likely use the social cognitive theory or the information theory (Nelson, 2018). The social cognitive theory would help to predict if the new program would be effective within the given patient population being served. The information theory would be helpful in measuring the effectiveness after the fact. How many of our patients stopped using tobacco products? How many of those attribute their quitting to education or resources provided through our program? This information will provide the statistics needed to evaluate the effectiveness or need for adjustments in the system.

Charles P Friedman, What informatics is and isn’t, Journal of the American Medical Informatics Association, Volume 20, Issue 2, March 2013, Pages 224–226, https://doi.org/10.1136/amiajnl-2012-001206 (Links to an external site.)

Office of Disease Prevention and Health Promotion https://health.gov/myhealthfinder/topics/health-conditions/diabetes/quit-smoking (Links to an external site.)

Nelson, R. & Staggers. N. (2018). Health informatics: an interprofessional approach (2nd ed.). https://redshelf.com (Links to an external site.)