Implications of Information Technology and Consumer
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Transcript Implications of Information Technology and Consumer
Nursing meets the
Millennium:
Future of Nursing in the
Information Age
Patricia Flatley Brennan, RN, PhD, FAAN
Moehlman Bascom Professor
School of Nursing and College of Engineering
University of Wisconsin-Madison
Goals
Define nursing’s social role.
Describe the present and future role
of information technology in the
practice of nursing
Identify modifications in nursing
practice to capitalize on information
technology
Nursing
the diagnosis and
treatment of human
response
Nursing’s
Social
Responsibility
Nursing’s
Social
Responsibility
diagnose and treat human
responses
Critical Events in YOUR
Nursing Life
Think of an incident during the last 4 days
in which you fulfilled nursing’s social role
Be as explicit as possible - time of day, who
involved, how you felt
Now -- identify three points in this incident
at which information or communication
was important
Could you get what you wanted? Express
what you had to say? Know what you
Informatics needed to support
Nursing’s Social Role
Identify & describe phenomena indicative
of the human response
INFORMATICS NEED: Produce a language
Discover & evaluate therapeutic
interventions to treat human responses
INFORMATICS NEED: Create therapeutics
Record interventions, Monitor responses
Collaborate with other disciplines to fulfill
health care goals
INFORMATICS NEED: Communicate
Information Technology today
Promises almost met
Computer-based patient records
DataRepositories
Formal languages
Telemedicine
Remote access to expertise and consultation
Consumer Health Informatics
The Challenges
Security
Authentication
The digital Divide
Legacy systems
Moving the site of
care
On the horizon...
Integration of different data types, with
particular emphasis on time-variant data
Intelligent agents and meta-data that
support efficient use of knowledge
resources (text, images, sound)
Merging of public health and personal
health data
Re-engineering of clinical practice to
capitalize on informatics advances
Promising (ie, not yet here)
IT Applications
Distributed records management systems
W3EMRs and CareWeb: Web front-end to
legacy information systems
Authentication and Authorization
Healtheon
Consumer Health Informatics
CareLink
CHESS
HeartCare
HeartCare:
Meeting the Challenges of
CABG Recovery
Monitor, Manage, Mend, Motivate
Demands in the discharge
encounter
Patient-centered, tailored
information
The HeartCare Intervention
Home-based Unit:
WebTV(C) box & 19” television
Server supplies:
Monitor & Recovery Information
• Four periods: Wks 1-2, 3-6, 7-12, & 13-26
Professional & Peer contact
Tailoring Recovery Resources
to Patients
Establishing the tailoring model
Patient Profiles
Access (TM) database
Delivering WWW resources ‘on-thefly’, across the recovery period
Active server pages sorting nurseidentified or developed WWW pages
Contemporary Health Care
rests on a
successful partnership
between
Clinicians,
Delivery Systems,
and
Patients
SMART
Patients
SMART Patients
Self-assured
Motivated
Aware
Resourceful
Talented
Remember they may also be:
Scared
Minors!
Anxious
Reluctant
Time consuming
Common behaviors of
SMART patients
self triage
values and preference clarification
participative
collaborative
independently engage in health
promotion
What they aren’t :
complacent
quiet
unchallenging
similar
Clinician’s responses
to the SMART patient:
engaging
tolerant
dismissive
condescending
The Challenges for
Clinicians
Use technology to help make
patients SMART
Treat them as a resource
Change our practice activities
to capitalize on their talents
Reorganize our practice
environments
Clinical Practice Issues
Henderson “...what the patient
can do...”
Re-examining every action
Find the right balance of workers
Trusting our colleagues
Timing of interventions
What must be done now, what should wait for later?
Nursing Roles
Content Expert
Envision a clinical practice
that makes use of the patient
as a resource
Re-organize care and care
activities to incorporate
patients
Constructing a
Health Care Delivery
System
responsive to
SMART Patients
rests on
effective, appropriate IT!
Critical Event, Take II
Recall the event identified earlier
Review the information intensive and
communication sensitive elements
Circle those for which today’s presentation
suggested a solution
Star one for action on Monday
List at least one IT-related aspect
List at least one System Level aspect
List at least one clinical aspect
Patient-Centered
Systems
Clinical Records
Network
Communication
Consumer Health
Informatics
Patient-Centered Information Systems
Clinic
Physician
Office
Pharmacy
Dentist
Hospital
Furtive
Records
Seen any ‘SMART’
patients lately?
...they’re there,
everywhere!
Slides and references will
be available on Monday
November 1 at
http://heartcare.ie.wisc.edu