Advances in Technology

1
Advances in Technology
2
Advances in Technology

• Patient-centered technologies and health
  informatics

3
Whats the problem?

• Health care consumers have experiences, opinions,
  knowledge and objective data regarding their
  health that are not systematically incorporated
  into their care.
• Modern assessment and monitoring of an
  individuals health status, and delivery of
  cutting-edge interventions, require orchestration
  of not only patients and direct care providers,
  but also an entire community of technology
  experts, innovators and service providers.

McGlynn et al. 2003
4
Whats the Problem?

• Our current health system is characterized by
  limited face-to-face patient-provider contacts
  that occur at times and locations that are
  inconvenient, or at times impossible, for the
  patient.
• The system fails to provide the adequate
  opportunities for the integration of clinical
  data with patients subjective and objective
  information, which are required to provide care
  that is safe, effective, patient-centered,
  timely, efficient, and equitable1

1 Committee on Quality Health Care - IOM, 2001
5
Solutions?

• The future of health care delivery in the United
  States is moving well beyond the boundaries of
  the centralized, hospital based system.
• The deployment of assessment and intervention
  techniques must be distributed in all locations,
  from the barbershop, to the independent pharmacy,
  to patients home or vacation locations, to the
  inpatient unit and the surgical suite.

6
Solutions?

• Assessing and incorporating patient preferences
  and values, engaging the patient in the
  diagnostic processes and therapeutic
  interventions and extending the interaction to
  the place and time favored by the patient are
  necessary to bring meaning to the term,
  patient-centered.

7
Solutions?

• Technological approaches to distributing patient
  assessments and interventions can offer the
  patient an opportunity to participate more fully
  in the clinical process, by allowing information
  gathering, interventions and follow-up to occur a
  convenient location, at a convenient time, and
  without the clock ticking away the minutes of an
  office visit.
• Who has this skill set to conceptualize, design
  and test such systems?
• Nurse Informaticians (aka, nurse informaticists)

8
Clinical Nursing Informatics

• nursing informatics is a combination of
  computer science, information science and nursing
  science designed to assist in the management and
  processing of nursing data, information and
  knowledge to support the practice of nursing and
  the delivery of nursing care. 
• Graves Corcoran, 1989

9
Wheres the Science

• Columbia (Bakken)
• Wisconsin (Brennan)
• Georgetown (Saba)
• Utah (Staggers)

10
At least 2 directions

• Information systems within organizations
• Relay information electronically
• Institution and provider oriented
• Standardizes
• Nursing strong on classification systems and
  regulations

• Telehealth telemedicine interactive health
  communication
• Relay information electronically
• Patient-centered
• Tailors and customizes

Bakken, S., 2001Lauver et al., 2002
11
Strategies for Patient-centered Work

• Interactive two-way video technology
• Teaching skills, behaviors
• Remote monitoring devices, "store and forward"
  devices
• Heart respiratory rates, serum glucose
• Digital photos of wounds
• Survey administration for patient-reported
  outcomes
• Risk assessment, symptom status
• Tailored coaching and education based on personal
  factors

Berry, 2004 Nguyen, 2004 Kurth, 2001Russo, 2001
12
Solutions?

• Personal Health Records
• PHIMS, Pursuing Perfection, many others
• GW Bush has set a goal that most Americans will
  have a PHR by the year 2014 (Apr 26, 2004).
• Universal, affordable access to broadband
• National Health Information Infrastructure(NHII)
• The broad goal of the NHII is to deliver
  information to individuals consumers, patients,
  and professionals when and where they need it,
  so they can use this information to make informed
  decisions about health and healthcare.
• Dr. David Brailer is new director

13
(No Transcript)