Telehealth and Stroke Management

I read an interesting news story this morning in Healthcare IT about how the Swedish Medical Center in Seattle, Washington uses telehealth to manage stroke care.  The story is at http://www.healthcareitnews.com/news/physician-shortage-drives-telemedicine-market

The medical center connects to remote areas of the state of Washington to link stroke specialists with patients using GCI ConnectMD services (http://www.connectmd.com/ ).  The equipment allows remote facilities to transfer CTs of the head with HIPAA compliancy.  The patient outcome goal is to minimize neurologic damage from the stroke.

Podcasting and the Future of Digital Audio

A Forrester(R) research report (2005) projected that by next year (2010), 20.1 million households will use satellite radio and 12.3 million will listen to podcasts that they have synchronized to their MP3 players.  It will be interesting to discover the "real" numbers in just a couple of months. The Future of Digital Audio report is available from http://www.forrester.com/Research/Document/0,7211,36428,00.html . Registration (free) is required access and download the report.

The availability of podcasts on the Internet is amazing.  Students in my NRSG 6121 class took an advantage of podcasts to address knowledge needs regarding how a computer works.  The students were all issued a iPod at the beginning of the semester with a microphone for recording audio and encouraged to create podcasts.  They shared findings from their searches in the iTunes store for medical and nursing educational podcasts.  Observing their excitement about the value of podcasts for eductational purposes has been wonderful!

Health Information Technology Automation of Quality Measurement: Quality Data Set and Data Flow

Tracy, who works in quality, shared the update from the Health Information Expert Panel: Health Information Technology Automation of Quality Measurement: Quality Data Set (QDS)  and Data Flow.  An executive summary of the report (22 pages) which is available as a PDF (Adobe Reader) download is at http://www.qualityforum.org/Publications/2009/11/Health_Information_Technology_Automation_of_Quality_Measurement__Quality_Data_Set_and_Data_Flow.aspx
The QDS provides common language for quality measure used in resources such as:

• Electronic health records (EHRs)
• Personal health records (PHRs)
• Registries
• Health information exchanges (HIEs)

Online and Mobile Tools that Empower the Chronically Ill to Manage Their Care

Linda shared a wonderful resource, Participatory Health: Online and Mobile Tools Help Chronically Ill Manage Care, that discusses the development of online and mobile tools that can help individuals manage their chronic conditions.  The 27-page PDF (Adobe Reader) file was developed by the California Healthcare Foundation and is available at http://www.chcf.org/documents/chronicdisease/ParticipatoryHealthTools.pdf

Included are examples of computer applications that have been successfully used in chronic care beginning on page 10. The tools were categorized as:

• Health video games
• Medication management
• The "other" medical home
• Diabetes care
• Weight management 
• Wellness

Examples are provided for each of the categories.  It is an interesting read.
(Added to Chapter 22 on the textbook  web site at  http://dlthede.net/Informatics/Informatics.html )


Sarasohn-Kahn, J. (2009, September). "Participatory Health: Online and Mobile Tools Help Chronically Ill Manage Care. Retrieved from http://www.chcf.org/documents/chronicdisease/ParticipatoryHealthTools.pdf

Health Data Privacy

Linda shared a web site that addresses issues associated with health data privacy.  The site is the Electronic Privacy Information Center (EPIC) at http://epic.org/privacy/medical/  The web site has comprehensive information on privacy policy issues.  Examples of policy issues include the Google Books, Facebook, and Cloud Computing. The URL was added to our textbook web site at http://dlthede.net/Informatics/Chap21EHRIssues/Chap21.html#Other

Creating a Combination Column & Line Chart

In healthcare we often want to compare data from different sources to see if there is any type of relationship; for example, comparing staffing with patient outcomes.  An activity for the Thede & Sewell Informatics and Nursing textbook, chapter 24, asks the learner to create a chart that compares the number of patient falls and pressure ulcers with staffing using the percentage of registered nurses. The mixed type of chart is not addressed in the textbook and may pose as a challenging task.  The task is easier than it might appear. It is a two step process.

If using Excel 2007

1. Highlight the entire chart and then select the Column Chart type.
2. Right-click on the Percentage of Registered Nurses column and select Change Series Chart Type from the menu - and select Line with Markers

The resulting chart should like like the graphic below.

A website at http://www.techonthenet.com/excel/charts/column_line.php may be helpful for earlier versions of Excel.

Informatics and Nursing on Facebook

Informatics & Nursing is now a new Facebook group.  Consider joining!  To find the group, use the Facebook search feature.  Use the & symbol for the word "and" - and then select groups from the left-hand menu (if you don't see the group).  I look forward to having you join!

As you probably know, Facebook is a popular social networking tool used in the United States.  Other social networking tools include:

• Friendster
• MySpace
• Linked In
• Plaxo

According to a wikipedia site, http://en.wikipedia.org/wiki/List_of_social_networking_websites, Facebook has about 300,000,000 users.  Social networking tools allow users to have an online community of friends and colleagues.  Social networking tools are examples of the interactive (Web 2.00) web.  Instead of reading static web pages, users are able to self-publish and share ideas, photos, videos, and more.

Statistical Software

Statistical software can be a prohibitive expense!  I am always on the lookout for robust free or shareware applications.  Today I ran across a couple of web sites

• Free Statistical Software at http://www.freestatistics.info/stat.php  with links to many free applications.   The site includes a number of add-ins to extend the function of Excel spreadsheet software. 
• Free Statistical Software at http://statpages.org/javasta2.html includes a short summary about each application.
  

If you have used one of the applications - please share your experiences. 

Medical Identity Theft

This past weekend, Linda and I spent time discussing the textbook reviews for the 3rd edition.  I thought that the reviewers provided some excellent suggestions.  One of the suggestions was to address medical identity theft.  Although security breaches are discussed on p. 438 in Chapter 16, the ramifications of the breaches are not detailed.  We have included a link to comprehensive information about medical identity theft on the textbook web page http://dlthede.net/Informatics/Informatics.html%20in the section Corrections & Additions.  There is now a link to the World Privacy Forum resources on medical identity theft http://www.worldprivacyforum.org/medicalidentitytheft.html%20.

I continue to be amazed and repulsed about the extent of malicous criminal behavior!  For example, a Boston psychiatrist who created fictitious medical diagnoses for his patients for billing purposes.  The common theme for medical identity theft is personal greed!  The perpetrators steal identities in order to obtain money, illegal drugs, or medical treatment.  A PowerPoint presentation that provides a comprehensive overview about medical identity theft is available online at http://www.ehcca.com/presentations/HIPAA13/4_02.ppt

Google Wave

I received my invitation to join Google Wave this morning (4 days after I submitted my request for an account)!  As noted in the video links below, Google Wave was designed to provide real time email collaboration and includes the ability to use multimedia.

I had heard about it a while back did not take the time to explore until I talked to NW the other day after the Serious Gaming presentation. Take the time to check out these videos for more information:

• http://wave.google.com/help/wave/about.html
• http://www.youtube.com/watch?v=rDu2A3WzQpo

Computer and Office Software Competencies

Nursing computer competencies is a topic that comes up over and over in the literature and in faculty discussions.  Yesterday, I read an article by Elder and Koehn (2009) that describes my experience with nursing students' computer and office competencies.  The researchers surveyed 90 first and second semester nursing students and 19 RN-BSN students to identify self-perception of computer skills and compared the results to computer assessment skills outcomes.  The study results indicated that while students self-assessed themselves to be experts in specific skill areas, such as word processing, in actuality, they lacked many of the skills necessary for college work.

Marc Prensky (http://www.marcprensky.com/)  is known for his work about Digital Natives and Digital Immigrants (http://www.marcprensky.com/writing/Prensky%20-%20Digital%20Natives,%20Digital%20Immigrants%20-%20Part1.pdf ).  Essentially, Digital Natives grew up with technology, whereas, Digital Immigrants, like myself, adopted technology.  The potential misconception that instructors make is that Digital Natives are technology experts.  I suggest that "you never miss what you never had" and that many Digital Natives have knowledge gaps related to computers in general and office software in particular.

Examples of word processing and spreadsheet software knowledge gaps include competencies for:

• Word Processing
• Using word wrap
• Creating tables
• Using spellcheck, thesauras, and word count functions
• Using endnotes, footnotes, and personal reference management functions
• Using the outline function
• Creating headers and footers
• Creating a hanging indent
• Inserting page numbers
• Saving files into other file formats
• Using search and replace
• Spreadsheet
• Using formulas with spreadsheet software
• Formatting spreadsheet software to function as a database
• Importing and exporting in comma in other file formats such as a CSV (comma separated value)
• Using filters
• Using search and replace
• Using conditional formatting

I read a posting on the nursing informatics listserv about a free online resource sponsored by the Goodwill Community Foundation International, which provides free online learning resources.  The link is at
http://www.gcflearnfree.org/default3d.aspx

Registration is free!  The site provides educational resources for computer basics, office software, and exploring life (see screenshot below). I especially like the fact the the OpenOffice software is included.  I use OpenOffice to create all of the HTML (hypertext markup language) files for Blackboard learning management system courses, because it creates "clean code" and is very user friendly. 

I plan to explore the learning resources on the GCF site over the next few weeks.  Please feel free to comment on this topic.

Elder, B. L., & Koehn, M. L. (2009). Assessment tool for nursing student computer competencies. Nursing Education Perspectives, 30(3), 148-152.