Posts Tagged ‘Online Healthcare Informatics Courses’

Informatics: Where in the World is Google Health

October 18, 2011

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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Rosetta Translation

September 8, 2011

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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The Impact of HIPAA on Patients and Nursing Staff

August 9, 2011

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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Foundations of an EHR

July 21, 2011

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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Technology in Education, comment

May 30, 2011

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.

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The Importance of Health Assessment, comment

May 25, 2011

The quantity and quality of nursing charting can be improved by using Computer On Wheels, or an electronic hand-held or similar device. Your health assessment skills will definitely take a turn for the better.

Original Post
March 3, 2011
The Importance of Health Assessment
As a seasoned nurse I think I perform a pretty good assessment. However, reading the first four chapters of our textbook and doing the first lab exercise has reminded me about a basic concept that in our fast pace world we tend to loose sight of. That is the concept asking open ended and non-judgmental questions and then listening to the answers and asking follow up questions. Today’s healthcare environment doesn’t allow for much time but I realize I can better utilize the time I have by improving my assessment skills of asking questions and listening more to the answers I receive.

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President Obama will not release public pictures of the dead Osama bin Laden, comment

May 17, 2011

The speed and outer boundries of healthcare informatics resources used in the case of Osama bin Laden has to be mind blowing!

I imagine that the USA armed service personnel had pictures and documentation stored on electronic devices to identify Osama bin Laden on the spot. These items had to include markings, scars, and maybe birthmarks. The same things we identify patients by in the hospital and other settings.

There also may have been a small portable lab setup present to quickly identify blood type. This does not identify a specific person. But it allows the personnel to quickly keep searching if the wrong blood type is shown. Again, this blood typing is used in the USA for quick close identification.

Telemedicine had to be in place also. It may or may not have been used during the raid. If the armed service personnel needed an answer or needed to send data, then Telemedicine or some form of it had to be quickly accessible.

I will let other healthcare informatics professionals discuss the aspect of rapid DNA analysis.

Original Post
May 11, 2011
President Obama will not release public pictures of the dead Osama bin Laden, comment
I wished I were part of the team that performed an autopsy on Osama bin Laden. There were more than the usual number of personnel for a single autopsy and/or there were several shortcuts to accomplish such an autopsy in a very short time. An autopsy will continue weeks, months, and sometimes years after a person is dissected and buried. Looking at television videos, I will guess that Osama bin Laden may have arthritis. This will show up in the forensic investigation of his death especially if it is chronic.

Original Post
May 5, 2011
President Obama will not release public pictures of the dead Osama bin Laden
Is President Barack Obama correct on this decision not to release disfigured photos of the dead Osama Bin Laden? Yes, he is.

The spirit of international and US laws prohibit the public release of photos of the deceased. Note that the US is unhappy when pictures of dead Americans are broadcasted publicly.

Morally speaking, most Americans would not want pictures of their disfigured passed away loved one broadcasted publicly. The moral, social and spiritual beliefs of a victim and family members should be taken into account. Also the moral, social, and spiritual belief of the country in possession of the pictures should be taken into account.

Ethically speaking, members of the Forensic Medical and Nursing profession are not permitted to show public pictures of the deceased. This brings me to another point. Forensic physicians, nurses, and personnel should be involved with the handling of Osama bin Laden and others. Forensic healthcare personnel are trained to be objective. They will confirm the cause of death, the time of death, the identification, and identify extra factors. The forensic healthcare personnel are removed from political and military biases. Their training includes caring for victims of war on both sides and innocent bystanders.

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Importance of Skin Assessment in Elderly and Child Abuse, comment

May 17, 2011

This is one area where healthcare informatics can be of great help. Instead of nurses trying to remember what to assess and what to write down, the health electronic record will indicate what assessment needs to be done and documented. If the nursing and hospital administration wants skin assessment done, they can include it in the program. And they can set the computer program to indicate to the nurse when this assessment should be done. Thus, the nurse does not have to guess in most circumstances.

Another part of the medical electronic record is the use of cameras. Some camera systems are able to insert an image of the skin assessment directly into the electronic chart. This is a huge time saver for of all nurses. No more writing essays on what was seen on the patients skin.

Original Post
October 18, 2010
Importance of Skin Assessment in Elderly and Child Abuse, comment
Skin assessment is a more valuable tool than we give it credit or time for. There are so many clues to a long list of health issues; from the varience in color, turgor, texture, temperature and thickness, to hair distribution, and condition of the nails. All of these variances from norm could be linked to some health issue. Issues like nutritional deficiency, allergy, local or systemic disease; such as melanoma or systemic lupus erythematosus; or they could be signs or the ‘remnants’ of abuse.

Unfortunately, I don’t think the nurse on the floor routinely gives skin assessment the time or attention needed to pick up on these clues. The most opportune time to find these signs would be on admission, during the initial assessment. What I see on the floor, is short staffing more often than not, trying to care for more patients than can be fully cared for during their shift, and bed shortages, requiring ’quick’ turnover. I am also afraid that the gains in my staffing numbers over the past year are in jeopardy with the reforms and cuts in reimbursement that I think are coming. Thorough assessments are an essential part of health care, of preventative medicine, and all of our professional practices; so I truly hope there will be the time and ability going forward to complete this valuable task.

Original Post

May 26, 2009

Title: Importance of Skin Assessment in Elderly and Child Abuse

In studying skin assessment, one cannot help feeling overwhelmed. Without a desire to pursue dermatology, the unlimited amount of skin lesions, pustules, macules and papules can lead one to skim over information out of the pure necessity for mental sanity. The mind can only hold so many pictures at once. However, I do see the need to ensure the memorization and ability to recognize and diagnose normal skin variations. In reading articles and working with children and the elderly, one unfortunately sees the reality firsthand of physical abuse and neglect. This can often be recognized by assessing the skin. Breakdown, malnutrition, physical abuse, bruises, injuries at different stages of healing can all be noted by a thorogh assessment of the skin. As follow up care and the big picture should always be a part of our thought process in nursing assessment, the ability to note whether a skin assessment finding is simply normal or abnormal is vital to our practice.

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Advantages and disadvantages of using electronic communication between pts and healthcare providers

March 6, 2011

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.

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Data—Information

March 3, 2011

As defined, data are plain facts. When data are processed, organized, structured or presented in a given context so as to make them useful, this becomes information. Data themselves are fairly useless. But when these data are interpreted and processed to determine its true meaning, they become useful and can be called information. A database is a structured collection of individual data elements. A good database must contain the information needed to assist with solving an identified area of need. A database can be a powerful tool of information collection and allows discernment of that information. A well-structured database that allows for easy input by the end-user will enhance its use and increase the productivity of that end-user. Using a database provides an effective method to review and analyze data. This data can support decisions, provide solutions, and help with predicting outcomes. When identifying the requirements for a database, careful consideration should be given to the intended use of the data. Recognizing the current need and use of the data is important; however, recognizing the ongoing future need and use of the collection of data is ultimately what determines the worth and strength of the database. Databases capturing quality data can provide a foundation for future needs of an organization. Organizations have information everywhere. For example, sources of information are located in documents, spreadsheets, e-mails, presentations, and multiple databases. Proper management and integration of its data sources, will allow an organization to maximize the effective use of its information and truly harness the power of information.

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