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To attain goals at work, I rely on the goal-setting theory as a source of motivation. This
To attain goals at work, I rely on the goal-setting theory as a source of motivation. This theory provides an effective means of attaining goals effectively as it highlights the specific goals that need to be met. A clear direction on the specific objectives to be met makes it easier for one to strive toward accomplishing specific tasks. The goal-setting theory works best for me as it serves to increase my engagement levels at work. Increased engagement results in increased productivity and work performance. Improved performance serves as a motivation to set and achieve more significant challenges, hence resulting in an overall sense of job satisfaction.
Based on personal experience, the best way to motivate friends and family to achieve their goals is by using the reinforcement theory. Positive reinforcement is an effective method of encouraging positive behavior. Positive reinforcement utilizes tools such as words of affirmation, and they make one feel motivated to keep doing better and strive to achieve their goals. Positive reinforcement shows that one cares, and it serves to encourage individuals to keep doing better, for people are watching and cheering them on. Lastly, positive reinforcement helps boost confidence levels, a factor that motivates individuals to work towards attaining their goals.
Response to Peer
Hi Robyn,
Mapping out a plan to get tasks done is an effective way of attaining goals and objectives. Also, I agree with you that one can rely on goal-setting theory, self-efficacy, and reinforcement theory to create a whole motivational package. I believe that different theories serve different individuals better. Based on your example of teaching a class, I agree that using all three theories can motivate people to attain goals. Using all three theories works as you are dealing with a group of different individuals that require different means of motivation.
What are the main differences between spoken and written English grammar
TLGV 2
What are the main differences between spoken and written English grammar? To what extent and in what circumstances is it appropriate to teach ‘spoken grammar’? Make use of relevant literature in your answer.
Introduction
Spoken grammar provides learners with grammatical choices to create utterances which can provide a deeper interactive and interpersonal use of language. (McCarthy, 2017). It is spontaneous and transient. However, it is still struggling under the burden of grammatical metalanguage inherited from writing, leading to a notable loss of its natural and informal qualities. Meanwhile, the development of technology forces us to consider conversation and spoken grammar deeply. Thanks to the advent of computer software and some
sound recording technologies, spoken grammar can be analyzed and transcribed faithfully and completely as a corpus. Corpus is a principled collection of texts stored in a computer and is always transcribed and stored for purposes and specific types such as businesses (Carter, 2003). However, there were a hundred million written grammar words for storing only ten million words of spoken grammar. Issues affecting the development of corpus include the difficulty of finding participants and transcribing content. In their research, Goh (2009) and Shin (2007) independently identify the evolution of the English language as another issue. Although the corpus data exists in its inequality, this essay stresses the importance of spoken grammar in the following sections. Based on this short introduction and the following historical foundation, the main purposes can better explore the differences between spoken and written grammar and discuss the implications and appropriate circumstances to teach spoken grammar from both students’ and teachers’ perspectives.
Background of Spoken Grammar
The Origins of Spoken Grammar
Spoken grammar has existed since people began to speak. Many young British people communicated with gentlemen around the world in Latin to learn about different cultures. At that time, what they learned in school is spoken Latin, which is the spoken grammar. Vulgaria is the Latin they learned in school. It means common and ordinary things as opposed to classic literature. (McCarthy&Carter 2017). The examples Vulgaria used to teach students were very colloquial and supportive of the spoen language. It acquired students to use spoken Latin for their ‘real-life’ and suggested students spoken Latin on school premises.
The Decline of Spoken Grammar
However, Vulgaria provided the grammar for speaking. There was no authentic record left for teaching spoken grammar. Therefore, although Latin grammar was the
guiding paradigm of English grammar and influenced some grammarians like Lowth and Harris, it was targeted by the later formed trend towards prescriptivism and explicit proscriptions. (McCarthy & Carter 2017). Prescriptivism refers to the practices where correct and incorrect use of language or specific linguistic items are laid down by rules externally imposed on the user of the language. Explcit proscriptions are also based on creating rules on forbidden use of items or certain formulas in language. The familiar styles of speaking grammar such as ellipsis and fronting can prevail in common conversation but cannot be suitable to the solemn style because it omitted the relatives and over-focused on the familiar styles. Prescriptivism has seriously influenced the development of grammar in the following centuries. The authority of grammar is almost always along with written conventions, although it has always been mentioned in speaking.
The Status Change of Spoken Grammar
The development, such as the broadcasting and recording technology and the international commerce in the 20th century, along with the thinking of language study, spoken grammar has been re-asserted because of its importance in description and pedagogy. Many grammarians re-stressed the spoken grammar. Henry Sweet (1899) stated that teaching language should be in accordance with the principles ‘starting from the spoken rather than the literacy language.’ He pointed out the importance of chunk and clusters because it has characteristics like ellipsis and disconnections; however, they are always neglected in pedagogy because they are difficult to bring in the conventional grammar system. (Sweet 1899:121-169).
The Revival of Spoken Grammar
In the latter 20th century, the advent of corpora such as London-Lund Corpus of spoken English and other corpora developed and collected a majority of spoken data for different purposes like business. These data resulted in an explosion of publications demonstrating the features of spoken grammar, especially for daily conversation. The corpus investigations into various chunks in the daily spoken language provided a large amount of data basis for the research of spoken grammar and forced people to re-think the spoken grammar of ordinary people as opposed to the written grammar for use in literature.
The Main Differences between Spoken Grammar and Written Grammar
Many grammarians have provided definitions of spoken and written grammar. One of the definitions is that, written grammar is
typically associated with materials such as course books, some prose, and classic literature. It is formal and academic. This section will discuss several differences that will influence the teaching approaches and the purposes in the teaching process. However, spoken grammar tends to be full of incomplete sentences, corrections, repetitions, and interruptions. Moreover, Carter (1995) issued that it needs speakers to use intonation, volume, gesture, facial expressions, and pitch to express their feeling to complete the face-to- face interaction.
The Functional Difference
The fundamental difference between spoken grammar and written grammar is that spoken grammar focuses on fluency; however, written grammar focuses on accuracy. Written grammar consists of grammar rules for writing academic styles, such as punctuation and verb tenses (Shin, 2007). Written grammar is prepared for demonstrating accuracy and preciseness. However, the fluency emphasized in spoken grammar does not match up to the standards used in the past. Usually, testing the speaker’s fluency, schools, or teachers will provide some oral exams or allow the speaker to talk about a topic for one or two minutes. According to McCarthy (1995), this kind of oral test cannot represent how natural conversation is demonstrated in our daily lives. He stresses the fluency of spoken grammar is expressing the same meaning of the word flow, which comes from the word fluo ray in Latin. Fluency means to speak like flowing on a river. For example, fluency demonstrates daily routine, such as a casual conversation between two peers on a friendly topic. The fluency concept is not in accordance with the fluency that academics and professional language educators share with ordinary people. Besides, fluency means someone can understand what the previous speaker says and give feedback. Timmis (2002) terms it as a fundamental element of fluency to show the ability to bridge the conversation by understanding what the topic discusses and hooking the subordinate clause onto the previous speaker.
Meanwhile, the functional difference should be taken into consideration when syllabus designers select the content for language teaching. On the one hand, a syllabus for oral class should naturally be composed of spoken grammar, which improves learners’ ability to speak fluently and confidently in the target language. For example, setting typically daily communication scenarios for students to complete dialogue in English. It should be emphasized on students’ ability to naturally and emotionally express themselves in real conversations with appropriate words
accompanied by facial expression as native speakers always do in their conversations. On the other hand, for written grammar, the materials and syllabus should be chosen for improving writing skills, which should consist of grammatical rules such as tense. In accordance with the functions of spoken grammar and written grammar, the courses should contain different materials and methods to meet the purposes in the class.
The Difference in Lexical Selection
Some grammarians discussed in the literature the differences between spoken and written grammar. Carter and McCarthy (1997) stated that common grammatical features found in a rare conversational corpus function differently in writing. Many words are frequently used in speaking; however, they are either absent from writing or less commonly used in writing. For example, according to Shin (2007), he collected around 10,000,000 running words from the British National Corpus. What he found is that the most frequent two words phrase is you know in speaking in English. This means that about twelve thousand examples of you know in a corpus of five million words.
However, according to his findings, based on several written corpus including the Brown corpus, the Wellington Written (WWC), and the British National Corpus, the frequency of you know in written language is higher than that in spoken English. Therefore, the lexical choice of spoken and written grammar is different. Another example is that people change the word say in spoken grammar to other words like declare, confirm and state because many coursebooks such as Cambridge grammar of English suggested learners to use these words in academic styles to show their preciseness and authority. Therefore, in teaching spoken grammar, the materials should be selected, like mainly containing spoken grammar since it is always served for listening class to comprehend the context because it is more effective for learners to process the information in a shorter time. Therefore, the difference in lexical selection provides thinking of audio materials when teachers teach language.
The Difference in Syntactic Structure
Another difference between spoken and written grammar is the syntactic structure. In the field of written grammar, the articles should basically contain complete sentences
in the academic style. However, in a real conversation, the distinct characteristic of spoken grammar is incomplete syntactic structures and short clauses, often called conversational sentence structure (Timmis, 2005). The main reason is that the immediate social and interpersonal situation often influences spoken language. Besides, it must be occurred in real-time and tends to be unplanned. According to Carter & McCarthy (1997), it is called situational ellipsis. For example, some short sentences used in casual conversations do not make any sense in written grammar. For example, the question ready yet? Is used in a real conversation as a complete sentence, yet makes no sense in written grammar. The whole process is called situational ellipsis because all the conversations take place in their situations. Ellipsis, in the traditional meaning, is leaving out or omitting things that should be there. (Carter & McCarthy, 1997). This is the incomplete syntactic structure in which written grammar does not involve. When people write texts, they elaborate and complement the sentences to understand no matter where they are or when they are read. Therefore, written texts need complete sentences to support the authors’ meaning.
The Main Features of Spoken Grammar
Discussing the main features of spoken grammar can be beneficial for finding its appropriate place in language teaching. Spoken grammar has various features such as interruption, incomplete sentence structure, back-channeling, and ellipsis. Some professional grammarians and linguists provide their views on spoken grammar. The great grammarian Yan (2014) stated that conversation reflects online, linear nature in the brevity of utterances. Conversation is where we find the most outstanding differences between speaking and writing. This essay will discuss some key features of spoken grammar, demonstrating its importance and providing its value, especially in teaching language.
The Co-construction
The co-construction concept is proposed by McCarthy (1998) and it means doing things together. The co-construction occurs in ordinary conversation, which consists of several people. For example, person A said: Nobody’s at home. I have to cook by myself. Person B replied: which will be very hard for you. Person C said: Yeah, because you are poor at cooking. The whole conversation includes some complete sentences which have some main clauses and subordinate clauses like which clauses. However, they are created by three people, and it is prevalent in spoken language. It means that spoken language facilitates interpersonal bonding because it is a social action that will unconsciously help one person bond with another. Moreover, it enables the negotiation of meanings. Human has to search out what the speaker talking about and try to respond by negotiating. This is the most important element what the essay discussed before. It shows the fluency in the whole conversation; namely, people can connect their clauses to the previous speaker. The implications and applications of this feature will be discussed in the next section.
The Strategic Use of Tense-Aspect System
The second feature of spoken grammar is the tense-aspect system. In English, tense refers to time, which mainly is four tense: present, past, present continuous, and past continuous tense. Aspect refers to the speaker’s interpretation of time, such as perfect, non-perfect, continuous, and simple (McCarthy, 2017). An example of a tense-aspect system is the usage of say. In the section of reported speech in many coursebooks, there are lots of practice like Tony says we are going for a picnic. Furthermore, learners should change it like: Tony said they were going for a picnic. According to Carter (2003), the corpus records that what people use hundreds of times are not Tony said, but Tony was saying. This means they use past continuous form to report people to say. However, many coursebooks do not involve because it is a part of speaking. What surprises are people always use this tense like here’s a new topic instead of I have a report of someone to preface something interesting. This means spoken grammar has a signal like here: grammatical chunks to draw other people’s attention.
Another example of the tense-aspect system of spoken grammar is that I was wanting to book a room. From the perspective of many native speakers I wanted to book a room does not exist any grammar mistakes. However, was wanting can express a sense of distance by demonstrating the politeness which wanted cannot
express (Yan, 2014). This can also show the importance of spoken grammar to demonstrate speakers’ politeness and relations.
The Back-Channels and Fillers
On the one hand, in linguistics, backchannels happen in conversations when one participant needs to respond to his feedback to the previous speaker. Backchannels can be divided into verbal, non-verbal, and both. Verbal backchannel response would be like ‘uh-huh’ ‘I see’ ‘yeah’ to acknowledge what the previous speaker is saying and show his encouragement to continue the topic. Non-verbal backchannel response like some vocalized sounds which have no meaning. They are widely used in conversation for surprising, thinking, and agreement. Back-channels are an essential component of spoken languages because they are frequently presented in all cultures and have various usages. For example, people can use different tones of uh-huh to express their different feelings on the same event. On the other hand, fillers are some short utterances and words like Don’t tell me, By the way, Well, you see. Sometimes, fillers do not have a specific meaning, but it can help native speakers and language learners to talk fluently. They can provide the speakers with time to consider and organize the sentence structure. According to linguist Barbara A. Fox, he pointed out that filler words may have fairly minimal lexical content; however, they can play a strategic syntactic role in an unfolding utterance. (Fillers 2010). There are some advantages to fillers. Firstly, fillers can be seen as a hesitation form. For example, you know it is one of the most common hesitation forms. It can push the topic for the next thought. If there are no fillers, what can fill the moment of silence? It is an essential element for pushing the conversation. Secondly, fillers can help reduce anxiety and nervousness. Recent research at Columbia University has found that speakers use fillers to pauses when searching the word. To investigate the idea, they counted and compared the number of filler words used by various speakers. Then they found the conclusion that fillers can help cope with the time limitation for searching the words. (Timmis, 2011).
The circumstances and reasons of teaching spoken grammar
This essay has introduced the characteristics of spoken grammar and its differences from written grammar (3.1, above). In this section, this essay will provide some circumstances of teaching and learning spoken grammar and theoretical reasons for
teaching spoken grammar which can show its value and significance in language teaching. In the last part, it also will provide some suggestions of spoken grammar.
Circumstance 1 and Its Reasons to Teach Spoken Grammar
Learners have mastered written grammar and usually have the ability to write in academic style, however, they might weak in everyday communication. Many Chinese students always complain that they have difficulty to communicate in English, however, their listening, reading and writing skills are not as weak as speaking. Based on this situation, Spoken grammar might be appropriately taught through combing different tasks such as cultural access tasks, noticing tasks, language discussion tasks to help learners understand and interact with spoken grammar. For example, the cultural access task provides some context of the target language. Teachers can ask learners about the advantages and disadvantages of living in the place. Cultural access task aims to help learners relate the texts of the target language to their own culture. Through this way which combined cultural elements to teach spoken grammar, teachers play a role to as demonstrators to illustrate the key features of spoken grammar meanwhile it is relatively natural to help learners to wake up their notice to ordinary conversation.They can illustrate how the features happened in ordinary conversation because learners do not know the corpus data, and they should try to noticed the spoken grammar by observation from their teachers. McCarthy(1995) called this show in the conversation, which means it is important for learners to notice the features and let students’ interact with these conversations. According to Timmis(2005), spoken grammar teaching will be more reasonable in the natural conversation and engage students’ interest. Based on these two criteria, it is appropriate to teach spoken grammar with various communicative tasks to learners who lack ability to communicate in target language. A teacher interviewed in Goh(2009) stated that spoken grammar reveals an authentic picture of language use to students, a world full of incomplete sentences, phrases, vague language, discourse markers, etc. It also proves that spoken grammar should be taught in more familiar way.
Circumstance 2 and Its Appropriacy of Teaching Spoken Grammar
Apart from students who can not speak in English, another situation is students can not speak out without over-thinking the sentence structures. According to Goh (2009),
L2 learners are bound to sound bookish without using spoken grammar features. Some students even consider that the way of speaking sounds ridiculous because it is like a TV announcer. According to the research of Goh (2009), many teachers found a misconception among Chinese learners, which should construct perfect sentences modeled after written language. They may always over-think the sentence structure, which prevents the communicating process. Based on this circumstance, teaching spoken grammar is appropriate because spoken grammar can be seen as a practice for learners. It can be a springboard for their personalization. It helps them to create their own sentences like native speakers. According to another research of Goh(2000), in China, 87% of Chinese teachers consider that learning spoken grammar is useful and essential because the characteristics of spoken grammar can meet the learning purpose of most language learners, which is to communicate as fluently as a native speaker. The fluency learners pursue is not just the monologue from a single person but also the ability to listen to and respond to native speakers in everyday conversation. Furthermore, that is what exactly the features of the spoken grammar embody. Meanwhile, learning fillers and backchannels(4.3, above) is also a method for learners to understand native speakers’ reactions to everyday conversations. Spoken grammar is a must for language learners, as it helps them to increase confidence. Learning the features of spoken grammar such as ellipsis can release learners’ anxiety and help them overcome the psychological disorder. Moreover, it can also help learners produce natural spoken output by understanding spoken grammar knowledge.
Therefore, teaching spoken grammar for L2 learners are useful and essential. Although there are some concerns about how to teach spoken grammar have not been solved based on different teaching situations, many grammarians still consider that teaching spoken grammar is beneficial to learners.
Theoretical Supports of Teaching Spoken Grammar
After analyzing some circumstances, there are three grounds for believing that it is appropriate to teach native speaker spoken language in the classroom: Firstly, according to some linguists such as Carter and McCarthy(1995) pointed out that the key features of spoken grammar(section 3, above) have been omitted and neglected in many ELT materials, although they are widely used by a large number of native speakers. For example, the tense-aspect system(4.2, above) and the fluency(4.1,
above) of spoken grammar the essay have mentioned before. Secondly, according to Timmis (2002) stated that despite the increasing use of English in international contexts, a considerable number of teachers and learners in various teaching and learning contexts, express their desires to comply with native-speaker grammar norms, including informal grammar, (although they are more colloquial). It means that teachers and learners desire to attach spoken language. Thirdly, Timmis also (2002) still indicated there is a consensus among teachers that learners should at least be exposed to spoken grammar.
Although it cannot be a conclusive case for teaching spoken grammar, it still indicate spoken grammar should be investigated and it has the value and significance of teaching.
Suggestions of Teaching Spoken Grammar
There are some suggestions from the perspectives of teachers and learners. On one side, to maximize the benefits of spoken grammar, teachers should attempt their teaching of spoken grammar under the linguistic and social environment. According to Timmis(2005), native speakers are habitual users of English for all communicative purposes like talking jokes and stories. However, this does not mean that they are more persuasive users of English than non-native speakers. On the other side, the learner should practice more by communicating in English to reinforcing the features and create better interaction with other people. Besides, they should distinguish what is for spoken and what is for writing.
Conclusion
This essay has mainly provided some main differences between written and spoken grammar: Spoken grammar focuses on fluency while written grammar stresses accuracy. Spoken grammar is prone to use different lexis from written grammar. It is plausible for spoken grammar to occur incomplete sentences which are not allowed to appear in written grammar. This essay also provided a strong foundation for teaching spoken grammar in different situations by introducing the key features of spoken grammar such as co-construction, tense-aspect system, fillers, and backchannels. In the fourth part, this essay has stressed the significance of teaching spoken grammar and provided the relevant connections between the features and
the implications of learning spoken grammar. The fluency concept can help learners speak more naturally; meanwhile, fillers and backchannels reduce anxiety and encourage learners to speak in English. Besides, the essay has suggested teaching by some task-based approaches, for example, culture across tasks for learners to consider and understand the target language’s culture. However, the main problem should not be neglected, for teachers, the use of methodologies which should be carefully applied to an appropriate linguistic and social environment. Besides, learners should practice more to familiarize themselves with spoken grammar features to communicate in English.
References
Biber, D.&G. Leech. (2002) Longman Student Grammar of Spoken and Written English. UK: Pearson Education Limited.
Carter, R. (2003) The grammar of talk: spoken English, grammar and the classroom in New Perspectives on Spoken English in the Classroom. London: Qualifications and Curriculum Authority.
Carter, R.&M, McCarthy. (1997) Exploring Spoken English. Cambridge: Cambridge University Press.
Goh, C. (2009) Perspective on Spoken Grammar Oxford: Oxford University Press. McCarthy, M. & R. Carter. (1995) What is spoken grammar and how should we teach it?. ELT Journal 49/3: 207–17.
McCarthy, M. (1998) The Spoken Language and Applied Linguistics. Cambridge: Cambridge University Press.
McCarthy, M.(2017) Spoken Grammar: Where Are We and Where Are We Going?.
Oxford: Oxford University Press.
Shin, D. (2007) The High Frequency of Spoken and Written English. New Zealand: Universtiy of Victoria of Wellington. Vol.62.
Timmis, I. (2002) Native-speaker norms and international English: a classroom view. ELT Journal 56/3: 240–9.
Timmis, I. (2005) Towards a framework for teaching spoken grammar. ELT Journal 59/2: 117–25.
Yan, X. (2014) Differences between Spoken Language and Written Language and Their Influence in English Teaching. Oversea English:126-127.
Primary & Public Health Informatics
Primary & Public Health Informatics
Name
Institutional Affiliation
Introduction
Health informatics involves acquisition, utilization, and storage of information in healthcare, biomedical research and public health informatics and many facets of IT are widely used in the healthcare environment. Several Health information systems cover topics such as implementation of IT in the healthcare settings that involve significant decisions regarding patient care, clinical activities, network infrastructure and databases, patients’ privacy and security and all other IT related issues deemed vital in the healthcare environment (Harle & Menachemi, 2012). The idea of informatics triggers information that defines future approaches that improves information and knowledge management in clinical care, public health, and primary health through development, introduction, and evaluation of new bio-medically motivated methods in areas such as decision support.
Field of informatics is inherently interdisciplinary because it draws on a large number of other components such as computer science, information science, and organizational theory whose goal is motivated by the need to create new solutions using information technology. Some of the issues that health informatics focusses on are the health of the populace, quality and safety of care and other issues that have a wide applicability across all the applied domains in health care (National Health Informatics Conference, Grain & Schaper, 2013). Health informatics is therefore an applied research and practice of informatics across the clinical and public health domains and mostly focusses on scope and breadth of biomedical informatics, theory and methodology, technical approach and human and social context. Health informatics comprises many elements including records, information, and knowledge deemed essential in delivering reachable and convenient information to the users. Users of informatics generate, retrieve and use information to support healthcare and the general healthcare delivery, planning and public health hugely depend on good health informatics.
Overview
Informatics have made major contributions to clinical practice including delivering patient care, recording information in a patient’s record and reflection and learning. Health informatics has made information accessible to colleagues across the healthcare environment, for instance, technology provides very reliable and convenient information that can be utilized during consultations. Informatics has offered access to records in both primary and public care and patients can acquire information regarding their own health records and personal data. Moreover, information is usually keyed after it has been structured in a manner that clinical users and data analysts can fully understand and ensures accuracy in reporting and that health records can be retrieved at point of patient care. Reinforcing common clinical language across the professionals concerned as a way of maintaining consistency of medical terms as well as protecting the confidentiality of patients’ records by limiting access on the system.
Informatics hugely contributes to the professional development of healthcare staff as well as improving innovations in technology and access to ever-increasing sources of information online to support research. Informatics also offers straightforward access to sources of knowledge as well as audit information at the touch of a button. In addition, data collected within a healthcare setting aids research to encourage clinical practice and provides knowledge and tools that can help in collection, analysis, and interpretation of health care information. It is apparent that reflecting upon and learning about healthcare takes place every day for students and health care providers as technology brings people together to share information about health and healthcare (Pichardo et al, 2012). Health informatics play significant role in decision making, problem solving, resource allocation and enhances a move towards citizen centered information consistent with the government’s philosophy. Informatics have several benefits that include improved health outcomes through quality service delivery, availability of information, evidence based decision making, decision support and expert systems as well as security and confidentiality (Ellis & Howard, 2011). When it comes to patient care, health informatics can improve health outcomes and learning through research and development and providing access to specialist knowledge and skills as well as making services available to meet patient needs.
Public Health Informatics
Public health informatics is primarily an engineering discipline oriented to the accomplishment of specific tasks and it includes conceptualization, design, development, deployment, refinement, and information systems relevant to public health after applying knowledge from various fields (Pichardo et al, 2012). Some of the disciplines relevant to public health informatics include computer science, organizational theory and incorporate knowledge from different fields contributing to public health such as epidemiology, microbiology, and statistics. Computer science and information science are the main underlying disciplines that relate with public health informatics because of their contents that focus on automating existing activities and redesigning systems using approaches that were initially impractical or not contemplated.
Public health informatics is linked with medical informatics in many areas because both disciplines use information science and technology to enhance human health. There are also systems of accessing public health data from electronic medical recording associated with public health informatics as well as principles underlying respective application domains that differentiate it from other informatics specialty areas (Hovenga, 2010). Some of the issues that have enabled operations of public health informatics include internet cafes, computer centers and mobile devices from cell phones even through the challenges are how to enhance the delivery of high quality, contextually relevant content focused on broad range of data. There is a great potential for public health informatics innovations that can improve health in various areas including communication amongst geographically dispersed health workers, delivery of public health services by strengthening and streamlining data collection as well as data collection for research studies (Borycki & ITCH, 2011).
Moreover, public health informatics can improve support of primary and secondary prevention through electronic health records and improved systems and enhance environmental health interventions such as bio-surveillance and road safety. The quick expansion of eHealth interventions in many nations has increasingly improved efficiency of the public health informatics by introducing new methods of expanding connectivity and facilitating provider education (Hovenga, 2010). Another advantage of eHealth is the availability of breakthrough technology tools and devices as well as built applications designed to meet the needs of specific disease especially in the areas of lab and pharmaceutical data.
Primary Health Informatics
Primary Health informatics is an emerging academic field that ensures the improvement of its own informatics persuasion that encompasses distinctive focus on primary care. It can further be described as a science and a subdivision of health informatics whose core concepts and theory tend to underpin the subject as it is described (Hayes, & Aspray, 2010). Primary health informatics is described both as a science and health informatics family and in some countries such as UK, it is an established specialty, and the primary focus has been advanced as an epiphenomenon in main programs and core activity (Pichardo et al, 2012). Primary care is the first point of contact for patients that see any patient with any combination of problems and its uniqueness serves as the primary justification for its own informatics subspecialty. Primary health informatics tends to have three definitions based on technology, role, and concepts that are facilitated using electronic ambulatory information system at the time and place of care. Primary health informatics produces structures that represent data and knowledge to visualize sophisticated relationships and develops methods for acquisition and presentation of data to avoid overload (Graham-Jones et al., 2012). In addition, primary health informatics helps in managing change among people, process and information technology to optimize use of information and integrating information from diverse sources into work processes to have a huge effect (Hayes, & Aspray, 2010). Core concepts where primary health informatics are conducted include epistemology of knowledge and ontology, epistemology of knowledge and ontology for primary care.
Review of specific case study
Safety warning
This review is going to look at one of the most important things in health informatics such as safety warning. In this case, the chosen patient safety warning is email alerts and SMS alerts where email alerts involve the use of the internet to disseminate information to the population through the individual email addresses of the patients (Hayes, & Aspray, 2010). The other alert system is through the SMS system where information is sent directly to the individual phone number and therefore in general, these two information systems allow for immediate passing of information from the medical practitioners to their clients thus enabling ease of communication.
It is worth noting that by integrating behavioral and systems strategies to change clinical practice, SMS technology is the simplest and still the most resourceful technique to communicate because of its widespread use and availability amongst many users. SMS messages become a principally appropriate means for communication in healthcare industry, as well and this functionality is the greatest answer for cases when patients fail to remember their appointments, there is inefficiency in the administration, and the fact that disabled people cannot communicate efficiently. Widespread use and accessibility of SMS gives the system recognition and suitability that every technology should associate itself with especially in the field of health (National Health Informatics Conference, Grain & Schaper, 2013).
Operational ways that SMS works as well as the SMS gateway forwards messages to the mobile network either through GSM or IP SMS interconnectivity are very significant in catapulting communication. On the onset, there is a GSM modem attached to the PC by a data cable and the IP SMS connection means that the SMS gateway connects straight to the SMS hub of the mobile service provider of the Internet. In addition, people who intend to increase capacity need to attach more than one GSM modem to the computer or switch to IP SMS connection in a more dependable way for data to be sent to all would be recipients.
Nowadays clinicians and other healthcare providers employ SMS technology to improve healthcare services for patients and reduce their workload because SMS messages are targeted messages with exceptional ways for passing information. Some of the important uses of SMS are campaign for smoking cessation, notification for appointments and sending health information (Pichardo et al, 2012). SMS are always sent to the expected individual because they guarantee watchful informing and therefore implies that just the expected individual will get the data that is continuously passed over or about his wellbeing. Moreover, SMS messages could be seen and read everywhere and anywhere and are also shape nosy contrasted with phone discussions thus enhancing their suitability in the health care set up.
Merits and Demerits of Using SMS as A Safety Warning
Medical alerts are instant, the information is relayed on a real-time basis, and this has the advantage of enabling the patients to stop taking any of the recalled medication. In addition, there is no restriction of the time and place of receiving the text messages for they can be received at any place or time without any restrictions. Another advantage of SMS as a safety warning is the detailed nature of email alerts that pass relevant information. The SMS alert system has the advantages of individual personal delivery of information and instant delivery of the information as well as personalized message delivery system because access to email information is also restricted to the use of passwords (Ellis & Howard, 2011). Demerit of email and SMS alerts is that they may fail because of system failure perhaps because of network services failure and at times, the individual mobile phones or the email accounts being switched off and therefore the information is not passed over to the intended recipient.
Patient confidentiality
Health informatics has hugely contributed in maintaining patient confidentiality, which is intended to respect the patients’ rights and deny individuals who are not certified to the right of use of patient information access to the patients’ information. In the first instance, the patient confidentiality will be maintained by enabling authorized personnel to send the intended message to the intended recipients while for the SMS alerts, the confidentiality could be maintained through having a proper individual’s number verification system so that the information is sent to the intended recipient.
Dissemination of Work Plan
The goal of a dissemination work plan is that the plan should provide information on the activities that are carried out and the benefits to society, patients and to the health community in general and such a plan will define and detail the strategy and procedures necessary to reach the intention of stakeholders, including participation in relevant international conferences. Communication with national agencies such as health management and health intervention, civil protection and environmental monitoring would be established.
The effectiveness of such a plan is that it will enable the patient population be able to know the actions that has been taken and the intended timeframe for this action would be able to know the person responsible for any action that they may require or any guidance and direction they may seek. This is possible by knowing about the interested parties, the other parties who are possibly interested it is easier to know where to concentrate on to effectively receive the desired results, and therefore the distribution of information must be effectively undertaken through the proper understanding of the dissemination plan.
According to Zullig, Shah and Bosworth (2013), the recommended approach to the executive leadership team is the SMS alert system for it is much more reliable and this is one of the electronic system on health record management and is a real-time as well as point-of-care. There will be patient-centric information resource for all health staffs represented as a major domain of health information technology (HIT) and of recent times, an electronic medical records system (EMR) or electronic health record (EHR) has been described as “a longitudinal electronic documentation of patient health details. Information about the patient as a health difficulty list, orders, and X- beam reports, around others are suitably depicted and decently put away, which will create a complete record of clinical patient experience or scene of forethought and underpins consideration related exercises such as choice making, better administration, and clinical reporting.
Why the electronic notification system is recommended
The choice of this method of electronic system is best because once the data is captured it will be able to disseminate any information to the patients, at any time and additionally on the following factors
Better human services by enhancing all parts of patient mind that Include security, viability, quiet centeredness, correspondence, and training
Better health by encouraging healthier lifestyles in the entire population, including increased physical activity, enhanced nutrition, evading of behavioral risks, and wider use of preventative care
Improved efficiencies and lesser health care expenditure by promoting preventative medicine and improved coordination of health care services.
Superior clinical decision making by integrating the patient information from various sources
The Advantages of Electronic Health Records is that EHRs and the capacity to exchange health information electronically can help supply elevated quality and safer care for patients while creating concrete enhancements for the hospital. EHRs help provider’s good managed care for patients and provide better health care by:
Providing true, up-to-date, and full information about patients at the point of care
Steadily sharing electronic information with patients and other clinical staff
Helping provide more effective patient diagnostics and reduction in medical errors
Enabling better, more reliable prescriptions to inpatients and outpatients
Helping encourage complete legible documentation and correct, modernized coding and billing of patient details
Improvement of patient data security and patient confidentiality
Fewer Discrepancies in records and better health records management
Patient confidentiality could be maintained through the following;
Electronic medical records require comprehensive shield at the national level and there is definitely a need for access to medical information and guard patients’ information from secondary users (Harle & Menachemi, 2012). It is important to note that patients should be given the alternative to place a disclosure restraint on their health records. It is argued that legislation or an amendment to the patient protecting policy the doctor-patient relationship would make better the access and quality of care because without the assurance of privacy, patients may avoid medical care. Security and ensuring the integrity of healthcare data by preventing modification of information enables patient confidentiality.
Timely notifications are integral in ensuring that patients discharged by from hospitals receive the exact care, at the correct time and in the precise place, so they can stay healthy and avoid return trips to the hospital (Smith et al., 2011). This will make sure that health care providers are aware of the confidentiality policy and make sure that they do not disclose patients’ information to the third party or the third gets access to the information because of a practitioner’s negligence. It is also significant to avoid sharing service user’s information with any other individuals other than health staff. There is an urgent situation where medical practitioners may need to access the information (National Health Informatics Conference, Grain & Schaper, 2013). As a priority, Permission needs to be sought first. Future developments in this area
It is recommended that safety measures should be on a three level basis to incorporate all the healthcare stakeholders, government, clinics, hospitals, health staffs as follows
A Stage One “warning” alert issued to ensure healthcare personnel are made aware of the potential health issues at the earliest opportunity. This will allow health care organizations to assess similar risks in their own organizations, and take urgent action.
In the event that Stage One alert requires further action, the Stage Two “resource” alert ought to come next, with more in-depth information and advice. Stage Two alerts will include examples of good practice to tone down the risk that have been shared by providers following a Stage One alert; being allowed to access resources to help initiate new measures to lessen risks; and access to appropriate training programs (Harle & Menachemi, 2012).
If need be, a third stage “directive” alert ought to be issued, that requires organizations to verify that they have undertaken relevant actions and set up detailed steps to ease the risk. health givers ought to be issued with a checklist of intended actions, customized to the individual patients
EMR drug safety alerts do have a big potential to decrease the adverse drug effects and improve patient safety when properly implemented and utilized, this needs to be enhanced at various health care institutions and replicated in all other health institutions.
There should be a well-functioning information technology system design that is effective and working properly to achieve the desired health information development and when all these is done the Competency: Leadership in Information Technology will be achieved. The knowledge of technology and nursing initiatives will be substantially improved, professional organizations, and the leadership must form strategies for enhancing the nursing information technology (Harle & Menachemi, 2012). Competency: About Information Security will be within reach. Competency: On Technology Supporting Quality Improvement must be greatly enhanced.
Conclusion
Public and primary health informatics are of great significance to the health providers, patients and the public at large. Public health informatics are vital in affecting implementation and ultimately success of various projects both for public and primary health care. Health care management issues linked with high quality facilitated resolution of the IT combined with high level skills are important in enabling achievements of health informatics (Harle & Menachemi, 2012).
Anticipated effect and flexibility of health parameters can only succeed if they are sandwiched if the health informatics are implemented successfully. Aims of public and primary informatics is to provide information to the concerned parties across medicine, nursing, computing, and technology as well as giving main information to support health care including making a patient an effective participant in their own care (Hovenga, 2010). Health informatics encourages use of technology at the point of care and considers community based interventions such as eHealth that improve the quality and use of routinely collected data for quality improvement.
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