Healthcare Informatics Resources

Progress, Change, Future

Admin — Sun, 22 Jan 2012 21:36:26 +0000

The future of healthcare information systems and a career in healthcare informatics holds exciting opportunities for healthcare organizations. Many improvements will be made in current technologies available. Although the concept of the electronic medical record (EMR) has been around for quite some time, we are just starting to see some advances in the actual implementation of automating portions of the patient medical record. To get to a fully automated health record, where all aspects of the legal medical record communicate to all systems, seems like a daunting task and yet so exciting to be a part of during these times. A career as a healthcare informatics professional will continue to be a desired profession and will gain momentum in the value these professionals will bring to an organization. Identifying their roles and responsibilities will become unique to each organization’s needs. Because of the many abilities and knowledge of healthcare informatics professionals, one healthcare facility may utilize these professionals in a different way and environment than another facility. Perhaps if there is not a developed informatics department, these professionals may even have different reporting structures based on where the organization sees them contributing and fitting into the organizational chart for that particular facility. The healthcare informatics field of study will be fundamental to bridging the gap between Information Technology Departments, Administration, clinical staff, physicians, vendors, and end-users. These positions are knowledgeable in a vast amount of areas, such as: information literacy, human computer interaction, human factors, usability testing, project management, working as change agents, standardizing language, evidence-based healthcare, numerous types of computer software such as database systems and spreadsheets. One cannot argue the fact that these knowledgeable individuals have developed skills, which bring much value to an organization. If these positions are utilized, directed, and supported, they will be extremely beneficial within a healthcare facility. Implementing, supporting, and maintaining an EMR is progress for any organization. The power of progress is amazing and builds upon each generation’s knowledge. Suppose each new generation had to rediscover numerals or language or medicine. The world would see no progress. Each generation stands on the shoulders of the previous generation to reach higher. Therefore, change is the price we pay for progress, and the EMR will bring about change for healthcare organizations. Change itself is not progress; it is the price we pay for progress. We will see some of the most advanced technology and the quest for a fully developed electronic health record will begin to take hold. As generations replace older generations an environment of automation will be expected and accepted by healthcare consumers and healthcare providers.

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Head to Toe Examination and Documentation

Admin — Wed, 11 Jan 2012 03:43:04 +0000

Completing a thorough head to toe assessment is a skill that takes practice and a broad knowledge base. No body system stands alone. Completing a quality assessment of one system may lead to clues about issues or problems in another system. Although head to toe exam is recommended, it is important for clinicians to develop methods that work for them. Patients may present with acute symptoms or complaints that do not allow time for a comprehensive exam. It is vital for the nurse to be able to discern what level of assessment is required for each individual. A patient who is in obvious distress will require a much focused assessment and relatively quick intervention. The type of assessment can also be affected by the health care setting. Nurses working in an outpatient setting may have more time to complete a comprehensive exam and history. Nurses working in hospitals may have multiple patients with various problems that require focused assessments for the sake of efficiency. Some may have a modified head to toe examination technique. Documenting assessment findings have been greatly facilitated in the facility for which I am employed. Each patient room is equipped with a computer to allow for immediate entry of assessment findings. All units have at least five to six, computers- on-wheels (COW) that can be taken from patient to patient if needed. It is interesting to observe the level of competence exhibited by nurses. Novice nurses tend to take copious notes on each system while more experience nurses can gather much information about his or her patients during the general survey. As assessment skills develop, nurses can gather information with minimal effort.

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Is it Necessary to Document Your Efforts in Providing Culturally Competent Care?

Admin — Thu, 05 Jan 2012 05:23:33 +0000

Cultural competence has been a responsibility addressed in nursing programs since before I became a student and I have noticed a steadily increasing amount of focus placed on the topic throughout the years. As with all aspects of nursing, there will always be room for improvement in how we conduct our profession in a culturally sensitive manner. It seems to be a basic understanding that any nurse be acutely aware of his or her own cultural beliefs, practices and biases. I also notice universal agreement that health care professionals need to attempt to learn about all clients’ cultural attitudes towards healthcare and allow for specific integration of these attitudes when at all possible. As this is a responsibility of the health care professional, is documentation of the practice necessary as well? Cultural competence can be applied in all aspects of nursing care; so documenting the practice is very complicated. Much discussion will be needed to determine how it can be applied to daily documentation without taking excessive time from other nursing responsibilities. A basic need of clients is to have their healthcare options given to them in their first language to maximize the potential for full understanding. Hospitals have addressed this need in a variety of ways including written translation of informed consent and having native speaking interpreters present during any medical explanation before “informed consent” is given. The practice of providing culturally sensitive care is then “documented” by the presence of the signed translated copy of the consent or the presence of the interpreter’s signature on the English version of the consent. The cost to health care providers in both the areas of finance and time is great to accommodate these needs. Therefore, the value of our current practice should be continuously evaluated in order to assure we meet the needs of the client without excessive cost. Value is the key word in this sentence. In the case of the written translated consent form, I have seen consents get signed without being read and this has forced me to think about the various reasons this might occur. Could the client read the consent? Although the consent was in the language self-identified by the client, was the terminology not familiar to the client? Were the opinion and “desires” of the healthcare professional deemed sufficient and therefore explanation not required? The signed consent, however, is placed in the client’s chart and acts as documentation that the client was explained the procedure in a manner facilitating understanding. Healthcare facilities are also managing costs by trying to minimize the amount of paper used in documenting. I have seen consents presented to clients in the form of laptop computers with electronic writing devices. Does this technology intimidate the patient and further compromise their comfort during their healthcare experience? I am sure the answers to the questions posed above are as varied as are the cultures and people of those cultures seeking healthcare in this country. Is it really of value, then, to “document” all of our efforts in providing culturally competent care? Or rather, should we seek to create an environment in healthcare settings where continued education and discussion enhances the healthcare professional’s awareness of the need for culturally competent care? This in turn might increase our accountability to this responsibility without further straining the healthcare system with the financial and emotional stress of balancing the application of good care with the documentation of the process.

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Telemedicine

Admin — Sun, 18 Dec 2011 22:02:21 +0000

I think that telemedicine should develop as fast as possible within pediatric subspecialties. I believe it is crucial to our children that medical expertise be available as much as possible. In our small town and many small towns, specialized pediatric care is available at great distances. This means that families must drive great distances, ambulances must travel many miles, and medical air transport systems must be used in many emergencies.

We see pediatric specialist leaving our small town as the economy worsens here. Years ago, they were coming to our town as recruiting efforts were great. Other types of specialists besides pediatricians were also arriving to our town years ago. But this is not the case now. Telemedicine is a viable means to fill the voids.

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Evidence-Based Healthcare, Medicine, Practice

Admin — Wed, 14 Dec 2011 16:14:41 +0000

Evidence-based healthcare is the conscientious use of current best evidence in making decisions about the care of individual patients or the delivery of health services. It is a process which combines the individual doctor’s expertise, the best available external clinical evidence, and the patient’s preferences when making decisions about the patient’s health care. (Sackett et al) Medicine has often been described as combining features of art and science. As I learned more about evidence-based healthcare the term “practicing medicine” continued to enter my mind. I began to realize that perhaps with the focus on patient safety and improving patient outcomes in regard to their particular health issue at hand, that medicine can no longer be a “practice,” which is defined as the ongoing pursuit of a craft or profession. Yet a practice based on historical facts, evidence, statistics, and proven results. So I researched the definition of medicine, I found the following: the definition of medicine encompasses a range of practices which aim to maintain and restore human health through the prevention and treatment of illness. Contemporary medicine relies upon health science, biomedical research, and medical technology to diagnose and treat injury and disease, typically through medication, surgery, or some other form of therapy. It has traditionally been regarded as both an art and a science. (Wikipedia) Furthermore, evidence-based medicine is recognition that elements of clinical practice can, like a science, be quantified. In areas where unbiased scientific evidence is available then clinical practice should take into consideration the appropriate evidence. Delivering medicine is a practice and therefore clinical decisions are typically based on personal clinical experiences, one’s own understanding of health sciences, reviewing documented findings, or consulting with another knowledgeable healthcare provider. However, in the strong efforts and awareness of patient safety guidelines and rules, which are being strictly enforced by regulatory agencies, the implications of engaging in evidence-based practice is becoming a more sought after process of clinical decision making to improve patient outcomes. The need for current information and resulting statistics to be accessible by all healthcare stakeholders, which includes the patient, will be an ongoing need. The current literature databases available and healthcare libraries will continue to improve and grow. Being information literate will prove to be a necessity with finding, retrieving, and reviewing data in support of evidence-based healthcare. Barriers to evidence-based practice include, lack of convenient access to research materials, inability to use the technology to access the information needed for clinical decision making, lack of time, and colleagues who don’t use the evidence-based healthcare process to decision making about patient problems. This leads me to wonder if the healthcare informatics professional will become increasingly involved in the processes of using evidence-based healthcare. This would utilize the healthcare informatician’s skills in information literacy, gleaning the data and reporting the findings, and working in collaboration with nursing staff and physicians to disseminate and synthesize the information. This would allow the physician to concentrate on his patients, while the research is being done to provide best patient outcomes based on evidence. This should not take away the fact that the nurse and physician should continue to read research material and continue to utilize evidence-based practice themselves. However, the fact remains that nurses and physicians continue to find it difficult to find that cherished uninterrupted time to do adequate research. Using evidence-based healthcare optimizes patient outcomes. Healthcare organizations must realize and understand the benefits of evidence-based healthcare. These organizations need to then provide a way so information-seeking behavior becomes a valued component of delivering healthcare to its consumers. Organizations should realize how incredibly useful the healthcare informatics professional is to the endeavors of utilizing evidence-based healthcare in decision-making. Perhaps utilizing and engaging the abilities of the healthcare informatics professional, to assist in the evidence-based healthcare process would facilitate ongoing efforts of controlling costs, providing standards that can be measured and evaluated, and improving patient outcomes, all of which are so often sought after by healthcare organizations.

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Walmart Holiday Specials Healthcare Informatics Textbooks

Admin — Tue, 06 Dec 2011 18:56:57 +0000

College Healthcare Informatics textbooks and more.

Shop Amazing Online Specials at Walmart.com – Free Shipping with Home Free!

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Community Health and Public Health Nursing

Admin — Mon, 05 Dec 2011 03:04:01 +0000

I progressed in the program Community and Public Health Nursing, I could understand the significance of relating the total package including healthcare informatics. Each and every component is vital to the Community Health Nurse. During the last module I was able to finally connect it altogether. From patient education to physical assessment I am now prepared to use the tools and relate them in the CPHN perspective. This course has been challenging to complete when you work full time and are not in a structured environment, however I am extremely proud to be nearing the finish line and am competent to now work as a Community Health Nurse.

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Calgary Apartments

Admin — Wed, 23 Nov 2011 16:35:54 +0000

Visitors to RentCalgary.com are people looking for Calgary Apartments. There is a section where the visitor can find a mortgage. This program checks at least 40 lenders, so a visitor can compare right online.

There is another section devoted to finding available properties. These properties are listed according to approximately 16 geographical areas. The properties are linked according to about 9 types (e.g. duplexes). Or a person can search all available types at one time. There is a link to list the properties by number of bedrooms. And a third link follows price ranges.

The last section allows property owners to advertise. The owners can list apartments and houses for rent in Calgary, Alberta.

RentCalgary also has a banner spot. They do not give details about advertising here. The company currently viewed at this one spot is Sears. A phone number is listed in the finding available properties section. Thus, a visitor can call this number and request information about the banner placement site.

Field Trip

Admin — Tue, 22 Nov 2011 18:55:41 +0000

Thanks to Darwin Barton

Today is going to be a fun day! My son’s class is going on a field tripto the local aquarium and I am taking the day off from work to go with him. I took him to the bus stop this morning with him talking all the way about how excited he was to see the big fish. Once I got him on the bus I returned home to get ready. The fact that I am going with him is a surprise—I can’t wait to see the look on his face when I arrive at school in a few hours. AS excited as he is, I may be even more so. It’s a real gift to be able to experience new things with your children. Nothing is more enjoyable for me than seeing his face as he makes new discoveries. I’m going to run a few errands on my way to his school and then we will be off on our adventure. All I have let to do is set my ADT Home Security System on my way out the door and the adventure starts!

Walmart’s Pre-Black Friday Healthcare Informatics Textbooks

Admin — Tue, 22 Nov 2011 13:55:30 +0000

Healthcare Informatics textbooks and more.

On Thursday, November 25th, Thanksgiving Day, come back here for Walmart’s Black Friday low prices.

Slipping The Nutcracker into our family’s packed holiday schedule

Admin — Mon, 21 Nov 2011 17:08:13 +0000

Guest post written by Glinda Roper

One sure thing that I can count on is our family doing all kinds of different things to celebrate the holiday season. With my family, it’s seemed like more is always more. We’re gluttons for all kinds of holiday activities and anyone who looks at our family calendar wouldn’t’ doubt that. But I thought that this year I would try and see if we could go and see The Nutcracker together. It’s something that I’ve wanted to do the past couple of Christmases, but we just didn’t get around to it.

I made it a priority this year so a few weeks ago I went online to go ahead and buy tickets for it. While I was looking online for some discounted ones, I saw information on miracle ear and after I looked through it some I decided to go and get fitted with some hearing aids.

I did find some good discounted tickets for our local Nutcracker ballet and I’m really looking forward to going and see it. It’s been way too long since I’ve seen it performed!

Standardized Language in Healthcare

Admin — Fri, 18 Nov 2011 00:18:33 +0000

As the electronic health record (EHR) becomes increasingly utilized across the nation, a standardized language will need to be implemented and followed. This will improve more accurate billing, informed patient management, increased precision of documentation, and improve knowledge. Functioning without standards would be chaotic, out of control, and confusing to all individuals. Standardization proves to enhance any process. With the strategic organizational initiatives of many physician offices, clinics, medical centers, and hospitals to implement an automated electronic environment for documenting a patient’s health history, which then automate other processes, the need increases for the uniformity of a language. The downside of the uncontrolled terminology of medicine has been accentuated by the computer age, because without standard vocabulary the ability to acquire knowledge about healing professions through information technology is limited. Many clinical applications available today have restricted utility because they cannot understand each other. It seems with the urgency of healthcare facilities implementing EMRs, the development of a standard language is critical and needs to be on a fast track to develop solutions. Healthcare information system developers are not waiting for the standards bodies, in existence today, to make these determinations. These developers know that precise medical words are needed to analyze the information from automated medical records, which will improve quality and service in healthcare. Rather than use any existing clinical vocabulary standard, they are creating their own dictionaries or vocabulary sets. Although this represents a slight improvement over un-encoded or free text documentation, each vendor working in isolation, are creating a terminology which cannot be read or understood by other systems. This makes the potential of data exchange and comparing impossible. It is imperative that healthcare organizations, vendors, and government agencies work collaboratively to implement measures to effectively localize, update, and disseminate healthcare terminologies, mappings, and other terminology-related content currently issued by national and international standards bodies. A standardized language in healthcare is something of a monumental task, but one that needs dedicated professionals in establishing these standards. Although some standard languages exist, developed by various standards organizations, the need is paramount of unifying a standardized language. Controlled medical terminology is essential to maximize the true benefits of implementing a fully operational EMR. Additionally, if all physicians, nurses, patients, hospitals, clinics, payers, and government agencies would commit to the same healthcare language, the one who unquestionably benefits from this is the patient who can be any one of us.

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Using nursing informatics to assist patients recovering from heart surgery

Admin — Wed, 02 Nov 2011 03:14:21 +0000

I am using “Health Assessment for Nursing Practice by Wilson. After reading chapter 18 of the textbook, Heart and Peripheral Vascular System, I was thinking about the many different ways in which nursing informatics could have a positive impact and possible help improve patient outcomes. I searched the internet and found an interesting article published by the Journal of Advanced Nursing titled “HeartCare: an Internet-based information and support system for patient home recovery after coronary artery bypass graft (CABG) surgery.” Heart-Care is reportedly an Internet based program designed to assist and support patients who have undergone coronary artery bypass graft surgery in the recovery process at home. This type of program offers a good example of how nursing informatics may be used extensively in the future especially if programs like this one can provide positive patient outcomes.

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Informatics: Where in the World is Google Health

Admin — Tue, 18 Oct 2011 21:47:44 +0000

As a nursing instructor it amazes me how many students reference Google as a source for information. Students today are computer savvy. They can find anything they want on the computer. What I stress to them is the reliability of their source. At our school we have a list of approved websites that students can go to for research. You have mentioned emedicine and NIH as options. Students need to become familiar with websites that use evidenced based practice and that will help them with literature review. Some of those sites include: CINAHL, MEDLINE, Medscape, and National Library of Medicine. I find that if the students begin to familiarize themselves with these sites, then the skies the limit for their research. I want students to teach their patients everyday at clinical and being able to back their teaching with evidenced-based practice is the way to go.

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Medication Errors

Admin — Thu, 29 Sep 2011 18:22:19 +0000

I am a Chronic Care Coordinator and partner with Primary Care Providers in chronic care management. Our patients have multiple chronic medical conditions. This care team provides care for patients ranging in age from 18- 75. We facilitate transitions of care between departments and external providers. Patient education is promoted for self care management. Care Coordinators review charts on patients who recently were discharged from hospital and who are in need of a telephonic hospital outreach. This outreach call helps the patient coordinate a medication care plan. A review of their medications upon discharge is verified and the medications they were instructed to stop. However, what we often find is that patients have not been given the correct names of medications or the patient gave the medical staff the correct name but the wrong time frame they have been taking the medication. Frequently the patients have failed to mention over the counter herbal medications that interfere with the reaction for many drugs. Patient education regarding their medications should cover questions as to purpose, dose, and administration time. Pending the outcome of the review we may find different compliance’s that may hinder them taking their medications with factors such as vision, education and finances. A referral to a home care service visit by a RN or an additional office visit for further education regarding medication management, screening for cognitive ability and depression, greatly increases prescription effectiveness.

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Technology Skills and Clinical Knowledge

Admin — Fri, 23 Sep 2011 20:14:08 +0000

Our nursing program is in the process of applying to become a degree-granting program. We are currently a diploma program. One of the needs we have identified is for courses (especially those that don’t require a clinical component) to be offered online. We are in the process of developing our curriculum and have identified at least five courses that we will start with as online courses. This presents the challenge of writing those courses so that they can be online. Not many of the current faculty has that skill. I have been taking courses online myself, but am not sure that I would be able or qualified to teach an online course. With the end of the nursing shortage nowhere in sight, the convenience of online courses will help. This presents another problem in that there is a shortage of nursing instructors and probably a shortage of instructors that are techno savvy. Schools need to make sure that their faculty has both the technological skills as well as the clinical knowledge.

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New baby

Admin — Tue, 13 Sep 2011 21:00:30 +0000

Content by Donny Vinson

I am now the proud mother of a beautiful baby girl. She is the most precious thing I have ever held in my entire life. Sometimes I find myself watching her sleep and thinking how peaceful she looks. When she first came, I didn’t know what I was going to do. There was no way I could afford a baby. I was starting to feel my debt downing me before I had a baby. What was I going to do with an added person? After many sleepless nights, I started thinking of anything and everything I could do. I needed to save money in every place I could. I learned how to coupon and save on groceries. I would also be able to save on diapers and formula with coupons. I found lower New york energy rates. I even cut back on my television channel package. I honestly feel that I have a good grip on my saving and spending and I am going to be able to provide a wonderful home for my little one. Life is good!

Rosetta Translation

Admin — Thu, 08 Sep 2011 19:34:59 +0000

Frequently our work requires legal translation services. Our work may involve a company outside of the USA, a division of a company outside of the country, and/or contract work with a non-English speaking person. In these situations, we may turn to legal translation companies. We search for those companies said to have highly accredited legal translators. Our company consists of primarily healthcare informaticists and secretaries. Thus, we need to outsource our legal translation work. We prefer to use companies that maintain legal professions, legal proofreaders, and legal translators. It is good to have general proofreaders and translators available. However, the expert legal proofreaders and translators provide a higher standard of service. It is best to start with the legal experts than to have to modify work done by the non-legal experts. The legal experts are not all lawyers.

Sometimes we need an accurate interpretation of a document written in a foreign language. Many of these documents are court records. No one wants to have a misinterpretation of such important documents.

There are two things people should ask about when deciding on a legal translation agency. They are the ISO 9001:2008 certification as well as the DIN EN 15038 norm. Few agencies have these two items.

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Educaster

Admin — Fri, 26 Aug 2011 03:22:15 +0000

This is an announcement for universities and colleges. Do you want Chinese students at your institutions? When your institution does not reside within China, as educational consultants in China we can help you recruit Chinese students. We will act as your agent, prescreening prospective Chinese students for interviews, organizing information events within China, and more.

We also have an announcement for Chinese students. We can help you with your application process to universities and colleges not residing within China. As higher education consultants in China, we can assist you with the minutest details of the application process.

The News

Admin — Sun, 21 Aug 2011 19:54:46 +0000

Thanks for the article from Isaiah Gaines

I absolutely love watching the local news but sometimes it makes me feel like I’m kind of in a bubble. Don’t get me wrong, there’s a lot going on in town and it’s nice to know which high school team won the game and where they’re opening a new grocery store but when I got www.TvbyDirect.com satellite last month I started watching a lot more national stuff. Now I can’t stop! Did you have any idea how many big time, all day news channels there are out there? I’m not really partial to any particular one but I would say I like CNN more than I do Fox News. MNSBC is also good but honestly, I don’t really care what it is – if it’s news, I’m interested. I don’t even really have any money in the stock market but even if it’s a show about picking stocks I’m going to watch it! I think for some reason it makes me feel better about watching so much TV when I feel like I’m actually learning something.

Patient Education Essential to Recovery

Admin — Wed, 17 Aug 2011 18:05:53 +0000

The nurse’s role in patient education cannot be more important. From the time a patient is admitted until the time they are discharged, the nurse caring for each patient need to be teaching 24/7. Having a patient educator is a waste of money in my opinion. This is one of the roles of the nurse. He/she should be constantly teaching their patient. The nurses are the ones taking care of the patient and know exactly what each patient needs. When a situation or opportunity arises, nurses need to take full advantage of it. Computer documentation can help track what has been taught. We all know that the patients need to hear this information multiple times in order to fully comprehend it. Patients are discharged quickly from the hospitals these days. Nurses need to take patient education to the next level by evaluating their teaching. Just telling or showing a patient something isn’t enough. Have the patient return demonstrate or verbalize what they now understand. Patient education is an integral part of nursing care and one of the most important things we do for our patients.

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The Impact of HIPAA on Patients and Nursing Staff

Admin — Tue, 09 Aug 2011 18:04:53 +0000

When HIPAA (Health Insurance Portability and Accountability Act) was passed in 1996 it was an important step in providing a patient with new rights to privacy, greater access to and control of their medical records. This was made necessary due to the increasing practice of electronically sharing data by fax and computer. Had this not passed we would probably be checking our medical records on “Youtube”.

However, as with all good things, there is usually a downside. There was great confusion understanding just to whom, when and how patient information could be shared. This interfered with doctors obtaining necessary information from other medical professionals when a timely response was critical to patient safety.

The stiff penalties associated with non-compliance also generated some fear in the medical institutions. Civil penalties of $25,000, in addition to fines of up to $250,000, and 10 years in jail was pretty frightening.

Much of this confusion and fear has diminished in the last few years as far as the medical profession is concerned. However, patients are another matter. As I discovered from a quick survey of family and friends, it appears that nobody actually reads the forms that they receive and sign. Most have a vague idea that it involves privacy, but have no idea of the implications.

Until a situation arises, most family members do not realize that they cannot access their adult children and sibling’s medical information without written consent of the patient. Even fewer realize that there is an expiration date to the consent form.

This misunderstanding results in many heated telephone conversations, particularly with parents of adult children. These parents want to set up appointments and get test results and do not realize that they are not entitled to this information. This can be a great distraction and time waster for the nursing staff.

How can we do a better job at educating patients and family with respect to HIPAA?

Perhaps some of the problem with HIPPA can be summed up in a joke that appeared on hippa.yale.edu in 2004.

Knock, Knock.

Who’s there?

HIPAA

HIPAA who?

Sorry, I am not allowed to disclose that information.

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Trying to spot some whales

Admin — Thu, 21 Jul 2011 18:33:54 +0000

Guest post written by Charlie Bennett

There are some really great things that I’ve done in my life. But most of those things have to do with just the accomplishments of my kids. But now that I’m a bit older and I’m not so worried about paying for their educations any more, my wife and I travel a lot more. It’s not like we’re going on these really long trips to Europe and foreign countries or anything. We’re taking short trips to see parts of our country that we’ve never seen before. There’s so much more to see here than I ever thought about!

Well, we recently went to Boston and I was working on finding some of the best things for us to do while we’re there. As i was doing that I saw the site http://hearingaids.miracle-ear.com/hearing-locations/florida/t/tarpon-springs/. I showed it to my wife and I went in to get some hearing aids. That made me more excited to go on the trip to try them out.

Whale watching really was one of the most fun things that we did while we’re there and we’re already talking about the next time that we’re going to go whale watching.

Reduce our national debt by reducing the federal electronic medical records mandate, comment

Admin — Thu, 21 Jul 2011 03:23:32 +0000

Your post Reduce our national debt by reducing the federal electronic medical records mandate is right on target. The federal government and President Obama should not be mandating electronic medical records in the way they propose. The medical/nursing community and hospitals know what is best for themselves and their budgets.

I will add that hospitals should pull the reigns on electronic medical records. What I see is fierce competition between hospitals to draw patients. This competition occurred with CAT scans, MRIs, helicopter ports, etc. Just because one hospital in town has the latest item, does not mean the other hospitals in town should follow suit. Sure, time and saving lives are critical things to consider. The money spent could be used in providing some basic and needed items for rural hospitals. This includes providing the personnel needed for some of the rural hospitals. Our rural hospitals have a greater need than our city hospitals.

Original Post
July 11, 2011

Reduce our national debt by reducing the federal electronic medical records mandate

Foundations of an EHR

Admin — Thu, 21 Jul 2011 02:58:45 +0000

Identifying current processes, paper and electronic forms, (clinical decision support tools), and workflow processes is the foundation to building an effective EHR. When an organization manages its forms, paper or electronic, it manages its processes. Many forms are necessary for collecting and documenting patient information. Unfortunately, most organizations do not see the value of managing these documents. Whether for electronic or paper, forms management includes the design, creation, revision, and obsolescence of these decision support tools. Maintaining proper version control is essential to meet the current standards of documentation dictated by regulatory agencies and the organization itself. Standardizing forms used throughout the healthcare facility plays a large role in helping the clinical staff to know what data to collect and document which forms are available, and where to access them. This facilitates the delivery of proper patient care. Additionally, standardization saves costs not only in the production of the form, but also in the use of the form. Forms management does have an effect on patient safety and the quality of care. Proper forms management can greatly assist the development of an EHR. Understanding existing forms and processes is necessary for developing accurate electronic processes in the EHR. Before an EHR is implemented a disaster recovery plan must be defined. This plan must identify the paper forms required for use. These paper forms must continue to meet the requirements of creation, revision, version control, and obsolescence to meet the ongoing needs of the current documentation processes. It is necessary to have correct, backup paper data collection tools for clinical and business operations to continue. Often a forms analysis, which documents the current state, is a first step in migrating to an EHR. This is extremely valuable for an organization to know its current used forms, volume, costs, workflow, and production information. This enables the organization to make future decisions based on this information. If a bad process is not identified before automating it, one now has a very expensive bad process. Assessing the current forms management environment can significantly decrease this risk and increase the effectiveness of the EHR and guarantee its successful implementation.

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Reduce our national debt by reducing the federal electronic medical records mandate

Admin — Mon, 11 Jul 2011 19:53:53 +0000

I agree that electronic medical records (EMR) that help to save lives, reduce paperwork, reduce expenses, and secure healthcare information. Larger vehicles like SUVs can also save lives and secure passengers. But, this does not mean that every family or business needs to trade in their fuel efficient smaller cars for larger SUVs. This is more true when these families and businesses are struggling during this economic recession (or depression).

Our government can save money by not currently dealing with the EMR mandate, by not tying up our court system with this mandate and letting our hospitals spend this money within their communities (meaning the government does not have to put extra money into these communities).

President Obama, this is one way of reducing your stress, the legislators’ stress, the courts’ stress, and the stress of the American people. Relieve our nation of the current EMR mandate. Consider a revised and later mandate.

Thank you.

Healthcare Online Education Consultant

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Risk of Injury

Admin — Thu, 07 Jul 2011 13:59:59 +0000

One of the assessment questions I ask when interviewing one of our patients is “Have you fallen in the past 3 months”? It is a part of a standard assessment questionnaire. Our electronic medical record can be set so that it always has to be answered. To my surprise, often patients answer “yes”. The populations mostly saying yes are 65-75 year olds.

As we get older our vision starts to change. The ability to see in low light decreases and it makes walking in dim hallways or night driving a challenge. The light we see lessens due to the pupil shrinking. The lens of our eye thickens and can turn a yellow color. A patient described it to me as “having a dark pair of yellow sunglasses on all the time”.

Recommendations that I give my patients are to aide them in the fall prevention. These include de-cluttering hallways in their homes and making sure all the small rugs in the house are removed. I have found that the use of a red light for a night light instead of a white light cuts down the glare and patients can then see better in the hallways. For outside, I also recommended the use glow strips on their stairs and entrances to their homes, garages and yards. If the patient is still driving, limiting nighttime driving would be a best choice for all involved. We discuss when they last had their eyes examined. One of my patients said “we do not think of those things all the time we just figure it is old age”. Getting an exam is a good way to be proactive to prevent an eye complication. Once examined, the patient can be aided by a simple pair of glasses or a surgical procedure to improve one’s vision and prevent falls. To expedite this process, I have the ability to do a direct transfer of the patient to the Eye Care Center at our clinic, so they can easily make their appointment.

Kenneth James, Jacqueline Gouldbourne, Chloe Morris, and Denise Eldemire-Shearer wrote an very good paper on “Falls and Fall Prevention in the Elderly: Insights from Jamaica.” They were effective in writing about the use of electronic data bases and electronic health records in the research of their paper. These same healthcare informatics resources can be used to identify and address falls in the seniors that may occur in almost any given community.

Healthcare Online Education Consultant

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Father’s Day gifts

Admin — Fri, 17 Jun 2011 19:18:59 +0000

June 19, 2011 is Father’s Day. Get Dad a new set of scrubs. These scrubs for men are available today at http://www.blueskyscrubs.com/categories/Scrubs/

Technology in Education, comment

Admin — Mon, 30 May 2011 19:18:50 +0000

At our office, we talk about the use of technology in seminars and conferences. In my college course, we briefly studied Technology in Education. Wanting to make a more professional presentation, I came across a Professional Speaking Course taught by Dr. Johnson. This course sounds exactly like what I desire. I have major stage fright. This course may help me to overcome it.

Original Post
March 2, 2011
Professional Speaking Course
I appreciate the college-level Professional Speaking class taught by Dr. Johnson. It is difficult to find an online college-level class such as this one. I have been searching for years for a course like the one he teaches. There are many public and general speaking classes. The class by Dr. Johnson addresses issues particular to the business and professional person.

Healthcare Online Education Consultant

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Healthcare Informatics Employment, comment

Admin — Mon, 30 May 2011 18:58:18 +0000

To the nurse writing about Acuity levels, I feel your frustration. This is a big reason I left clinical nursing to obtain a career in Healthcare Informatics. I do not worry about our nurse to patient ratio, acuity levels, or about working extra and not getting paid. In Healthcare Informatics, I handle policies, statistics, computer programs, and machines. I miss the clinical nursing. However with clinical nursing I was missing time with my family, with my health, and with my sanity. Now I feel better about myself and the work I am doing to help patients in a different way.

Original Post
March 23, 2011
Acuity levels
Using higher acuity as a talking point for our need for lower nurse:patient ratios has had no effect. I am totally frustrated, as are the nurses on my unit, on how to get the point across to administration. We are unable to provide the total amount of care our patients need.

We use HPPD, hours per patient day, to set up our allocation tables. And even though my Telemetry unit is at 8.35 HPPD and another unit may be at 7.5; we all end up with a 1:5 nurse patient ratio.

Looking for a way to assign acuity levels to the patients doesn’t seem to hold much impact. As I researched this, I found articles that found inconsistent results with changing ratios to acuity, with inconsistent results in outcomes.

So where do I go from here? Patients are barely getting the attention they need……..the patients are sicker, older, heavier, more are diabetic…..nurses can only find time to complete the tasks and not much more…nurses are so frustrated, they are looking for jobs elsewhere?

Healthcare Online Education Consultant

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