The use of electronic communication is one way in which technology is influencing changes in the delivery of healthcare today. I recently heard a physician interview on NPR (National Public Radio). The physician, a general practitioner, uses email to communicate with his patients. The physician’s rationale is that by using email he can respond to patients in a fast and efficient manner and perhaps save them a trip to the office. I see potential advantages as well as disadvantages with this form of communication. Use of e-mail is convenient and might be seen as increasing accessibility to the healthcare provider. One potential problem I see is in the area of cultural considerations as discussed in Chapter 3 of one of my Textbooks. Many cultures use body language and other nonverbal cues in communicating concerns or revealing symptoms. Without visual observation, the healthcare provider may miss important information required to make an accurate diagnosis.
Archive for the ‘Communication’ Category
Advantages and disadvantages of using electronic communication between pts and healthcare providers
March 6, 2011Dehumanized provider relationships
May 3, 2010Taking a full head to toe assessment is vital in the care and treatment of patients. Sometimes having someone listen to your problems, make eye contact, touch your hand during conversation, smile, or even make a joke can make patients feel better. I use all of the above when it comes to assessing patients. When providers or nurses are harsh and have poor interpersonal skills, patients sense this. Even if you resolve the patients problems and give them the best medication, the patient will forever remember that healthcare worker as "not nice". When an interaction is formed between the provider and patient that is positive, it may make the patient feel better instantly. Countless times I have cared for an anxious, worried, or even angry patient and was able to turn the situation into a positive one by listening and providing care tailored to each individual patient. What if that interaction is taken away? When a provider enters a patients room and only makes eye contact at the start then directly looks at a laptop for the whole assessment, the interpersonal connection with the patient significantly changes. I would even say there is no connection at all. I have seen this take place at the hospital I currently work at. The younger, more savvy doctor walks in with his cool laptop and begins his interview. Business transactions are sometimes warmer than this technique in the hospital. Then I have seen the older providers grab a seat, cross their legs, lean in and listen to the patients. What a difference it makes! The patients feel special, listened to, and this may even help the provider obtain more information from the patients. Although there are many reasons electronic charting is beneficial, the way of going about obtaining the information is crucial. Maintaining eye contact, smiling, therapeutic touch are all vital during an interview, even when the laptop is the focus of attention.
Tags: Healthcare Informatics, Healthcare Informatics Resources, Healthcare Informatics Patient Communication, Healthcare Informatics Computer Use
Computer based education programs
May 3, 2010Computer based education for patients is a unique way to try and bridge the gap on health disparities. Many patients are seen in a diverse population that are not understanding their medical care. For example, the doctor enters the room quickly bolts out the diagnosis and a prescription for a new medication and leaves the room. Often I have seen this happen and the patients are left confused. I have even had a patient say, “I didn’t understand one word the doctor said”. I inquired why he didn’t ask the doctor to repeat himself or explain in a different manner, but he didn’t have an answer. Often times, nurses are incorporated in the education of a patient and discharge instructions.
When a patient comes from a different cultural background than the doctor or nurse, it may be more challenging to teach them. Some cultures have a tremendous amount of respect towards doctors: to not interrupt, argue, say no, or challenge them. Others simply nod and say yes to everything, come to learn they speak not one word of English. There are many more challenges when it comes to varying cultures, but to be able to provide education in a language that suits the patient, with a representative from their country on the computer, taking into account their cultural needs would be an excellent tool. If the patients are not ready to learn in the hospital setting, providing access to the information online when they are home and feeling better would be another benefit to computer based education.
Tags: Healthcare Informatics, Healthcare Informatics Resources, Healthcare Informatics Computer based Education
Lessons learned:The completion of a new installation, comment
February 22, 2010The small community hospital where I work is currently coordinating the install of our second electronic charting system. The initial install with the first company was a complete disaster as communication between project managers and management was lacking. It is vital for all departments to communicate in order to best meet the needs of all involved. After training our entire staff, it was discovered that the different departments of the hospital had different goals and needs for their EC and the departments were unable to communicate with each other via the charting system chosen. The entire project was scrapped and a new company chosen that could meet everyone’s needs. It was unfortunate that the time and money was wasted due to each Department manager having separate discussions with the IS department and the IS department not coordinating their discussions amongst everyone. We are two years later, no electronic charting as of yet, still need to train the staff again on the new system, and a lot of money wasted that healthcare just doesn’t have to absorb right now.
Original Post
March 9, 2009
Title: Lessons learned: The completion of a new installation
It is said that life imitates art. I have found that for me recently life has paralleled my studies. I have recently completed a project that I followed from inception to completion. It has been an interesting journey.
I began this journey in October of 2006. I was new to healthcare informatics and project management having just taken a new position a month earlier. I was asked by the CNO who I report to directly, to coordinate the demos of three companies who were to show us their vital sign solutions for a system that would integrate with our Meditech EMR. This was a bit of a challenge at first as I had not done anything like this in my nursing career; however my family owned several retail stores so I was familiar with salesmen and felt confident in my ability to deal with them.
After having arranged the demonstrations and gone through the process of narrowing it down to 2 vendors we had many discussions between IS and nursing about which vendor we would choose. The CIO moved ahead and approved purchase from a vendor who would also supply us carts on wheels. After receiving the carts it was found that the vital signs equipment they had shown us in the demo was not what was on the carts. The equipment did not work and there was not a previous interface with Meditech as they had told us.
First lesson, communication is of utmost importance in selecting a vendor and implementing a new system. The CIO had made this decision without the approval of the CNO and had not talked with me about this also. Therefore the system did not meet the needs of the clinical staff though the IS staff felt it was the best choice. This was the second lesson which has been discussed in these chapters of Health Care Informatics, An Interdisciplinary Approach, the need for the healthcare informatics professional to understand the needs of the clinicians.
After more discussion and deliberation another vendor was chosen and we began the task of assessing and deciding how much equipment to buy, getting board approval and going through with the purchasing process. At this time the CNO officially appointed me as the project manager.
I began setting up the acceptance of the products and working with the implementation team to coordinate not only training of the end users but working with the IS staff on the integration with Meditech. This provides the 3rd lesson which is also discussed in this module of my educational program. Never underestimate how many different entities are involved in a project. Not only were IS and the nursing staff effected but so were the bioengineering, purchasing, physicians, of course patients as well as safety and quality assurance departments.
One of the issues that are discussed in this module is the need to meet standards set by many agencies that the hospital answers to from JCAHO and OSHA to IEEE and AHRQ. It was interesting to see how this project required attention to many of these standards.
We came across many “bumps in the road” on this project. There was a previously unplanned upgrade to Meditech which delayed implementation. There then was a problem with Meditech not accepting messages from the PDA’s used to download vitals into the Meditech module which required a “special build” from Meditech. There were wireless assessments, training to both the IS and the bioengineering staff for support and maintenance of the system. There were builds needed both in Meditech and in the software on the PDA’s for the integration and then there was the issue of a lost shipment of PDA’s.
At times I doubted the project would ever come to fruition. However, with much communication, organization and attention to detail we were able to complete implementation of the project with the final go live on March 4th. We are live on 5 inpatient units and are now looking to expand this to the outpatient arena. The staff loves the new processes and feels it has improved safety with positive patient ID and real time documentation of the vital signs. The team worked together, IS, bioengineering, and nursing as well as the other involved entities as well as the implementation team from our vendor, making the actual go live was a very smooth and positive process for all involved.
The final lessons learned, timing is everything, expect the unexpected, communication is essential and there are no small projects!
Online Education Health Care Informatics Certificate Program
Technorati Tags: Healthcare Informatics, Healthcare Informatics Resources, Health Care Information Systems, Health Care Communication, Health Care Informatics Certificate Program Online Education, Health Care Informatics Electronic Charting, Health Care Electronic Medical Record
Lessons Learned: The completion of a new installation
March 10, 2009It is said that life imitates art. I have found that for me recently life has paralleled my studies. I have recently completed a project that I followed from inception to completion. It has been an interesting journey.
I began this journey in October of 2006. I was new to healthcare informatics and project management having just taken a new position a month earlier. I was asked by the CNO who I report to directly, to coordinate the demos of three companies who were to show us their vital sign solutions for a system that would integrate with our Meditech EMR. This was a bit of a challenge at first as I had not done anything like this in my nursing career; however my family owned several retail stores so I was familiar with salesmen and felt confident in my ability to deal with them.
After having arranged the demonstrations and gone through the process of narrowing it down to 2 vendors we had many discussions between IS and nursing about which vendor we would choose. The CIO moved ahead and approved purchase from a vendor who would also supply us carts on wheels. After receiving the carts it was found that the vital signs equipment they had shown us in the demo was not what was on the carts. The equipment did not work and there was not a previous interface with Meditech as they had told us.
First lesson, communication is of utmost importance in selecting a vendor and implementing a new system. The CIO had made this decision without the approval of the CNO and had not talked with me about this also. Therefore the system did not meet the needs of the clinical staff though the IS staff felt it was the best choice. This was the second lesson which has been discussed in these chapters of Health Care Informatics, An Interdisciplinary Approach, the need for the healthcare informatics professional to understand the needs of the clinicians.
After more discussion and deliberation another vendor was chosen and we began the task of assessing and deciding how much equipment to buy, getting board approval and going through with the purchasing process. At this time the CNO officially appointed me as the project manager.
I began setting up the acceptance of the products and working with the implementation team to coordinate not only training of the end users but working with the IS staff on the integration with Meditech. This provides the 3rd lesson which is also discussed in this module of my educational program. Never underestimate how many different entities are involved in a project. Not only were IS and the nursing staff effected but so were the bioengineering, purchasing, physicians, of course patients as well as safety and quality assurance departments.
One of the issues that are discussed in this module is the need to meet standards set by many agencies that the hospital answers to from JCAHO and OSHA to IEEE and AHRQ. It was interesting to see how this project required attention to many of these standards.
We came across many “bumps in the road” on this project. There was a previously unplanned upgrade to Meditech which delayed implementation. There then was a problem with Meditech not accepting messages from the PDA’s used to download vitals into the Meditech module which required a “special build” from Meditech. There were wireless assessments, training to both the IS and the bioengineering staff for support and maintenance of the system. There were builds needed both in Meditech and in the software on the PDA’s for the integration and then there was the issue of a lost shipment of PDA’s.
At times I doubted the project would ever come to fruition. However, with much communication, organization and attention to detail we were able to complete implementation of the project with the final go live on March 4th. We are live on 5 inpatient units and are now looking to expand this to the outpatient arena. The staff loves the new processes and feels it has improved safety with positive patient ID and real time documentation of the vital signs. The team worked together, IS, bioengineering, and nursing as well as the other involved entities as well as the implementation team from our vendor, making the actual go live was a very smooth and positive process for all involved.
The final lessons learned, timing is everything, expect the unexpected, communication is essential and there are no small projects!
Technorati Tags: Healthcare Informatics, Healthcare Informatics Resources, Health Care Information Systems, Health Care Communication
Computer Assisted Communication
March 8, 2009Computer assisted Communication. Communication is the process of sending and receiving information by a variety of means. Email is a common form of communication used in the health care systems. It can be sent to one person or a group of people. The person types a message, and instead of printing the message and sending it via the postal system, the sender click a send button on the email program and the mail arrives at its destinations within seconds. Internet conferencing is another method of communication for the health care systems. This happens when one of more persons interact in real time, receiving almost immediate replies depending on the speed of the connections. This can involve text, audio and or video. There is a leader who sets up the conference and sends out invites for others to join. This can be used as a meeting to vehicle to get people from around the work together in on forum to discuss the same topic together in real time. Video Conferencing involves a computer video camera microphone and speakers. Along with hearing the audio whatever images appear in front of the video camera are delivered to the participants monitor. Video conferencing can involve just 2 participants or multiple participants in conferences. My facility uses video conferencing to link the two hospitals for management meeting or to deliver other important information to the staff from our 2 hospitals simultaneously. We also use video conferencing for in-service training; getting expert speakers from different countries to do talks related to their fields in health-care the doctors, nurses, and other hospital staff. In computer assisted communication both the receiver and the sender of the message must have the appropriate hardware, software and connection to the network in order to communicate. Hospitals are networked. The network consists of the computers and related devices that are connected together for the purpose of sharing devices, programs, and data. There is the main Server, which runs user and computer software programs, stores data and controls network traffic. The Internet links the computer network using Transmission Control Protocol/Internet Protocol communication standards.
Healthcare Informatics Resources 