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NI2012 – Pre-Conference Overview for Collaboration May 7, 2012

Posted by peterjmurray in AMIA, conference, education, IMIA, NI2012, nursing informatics.
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The next major event we will be blogging, tweeting, etc. will be NI2012 (www.ni2012.org), the 11th International Congress on Nursing Informatics, to be held in Montreal, Canada on 23-27 June, 2012.

We would like to hear from others who will be there and who will be using social media so that we can collaborate in sharing content, tools, experiences, etc.

There is a Twitter stream (@NI2012) and the hashtag #IMIANI2012 is encouraged.

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Rutgers 30th Conference – Final Round-up, Part 2 May 7, 2012

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Among presentations at the final day and a half of the Rutgers College of Nursing’s Thirtieth Annual International Interprofessional Technology Conference, in New Brunswick, New Jersey:

Debra Wolf explored the role of the informatics nurse, while Bonnie Anton built on her overview and noted that the role is becoming increasingly patient-focused, with new competencies needed in supporting the delivery of health information for consumers; these include issues of information literacy and health literacy. Bonnie also addressed the role of social media, as communications tools, for user-generated, collaboration activities, and enabling patients and others to find ‘people like me’, although raised issues of “is it safe?” She raised the need to include the patient as an active member of the healthcare team, and aspects of Health 2.0 and educational guidelines re:social media use were introduced.

Dennis Crain explored the proliferation of private data on the internet (‘digital exhaust’) that can be collected, mined, and used for personalised targeting of products. Greg Alexander focused on ageing populations, and how advances in science, medicine etc have lead to reductions in mortality, leading into an exploration of monitoring devices and systems for home care. Bernie Garrett (University of British Columbia) explored “Using Web 2.0 tools to globalise the curriculum”, and discussed the International Science Education Partnerships Project (Canada-UK links), a pilot project to establish the potential of freely available social networking tools to support educational international partnerships. The project generated discussion on the value of philosophical perspectives, and evaluated the potential of using tools
(more information at http://www.plymouth.ac.uk/staff/rcutting). Evaluation of the project was done with surveys/questionnaires and online focus groups (plus Google Analytics).

In the closing keynote, Marion Ball explored a wide range of issues around using smarter technology to improve health globally. Among here messages, she raised questions of “are we asking the right questions?” and whether the workload for clinicians has been increased through use of IT, rather than reducing it. She covered a wide range of topics including TIGER, IBM’s Watson, and other developments.

Rutgers 30th Conference – Final Round-up, Part 1 May 7, 2012

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These final blog posts from the Rutgers College of Nursing’s Thirtieth Annual International Interprofessional Technology Conference, in New Brunswick, New Jersey, USA  are a belated round-up of the final two days of the event. Among the various presenters:

Sarah Farrell spoke on “Teaching nurses in remote clinics to access information”. She began from the premise that still talking about the IOM 2002 report, 10 years on, around the need for  patient-centred care, interdisciplinary teams and evidence-based practice – and we still have along way to go. She promoted the  use of GIS etc for visualising data on maps and other graphical representations, and gave examples based in the use of materials from the website http://phpartners.org/health_stats.html She has been encouraging students to create surveys online, use Evernote and similar for creating tagged notes, and encouraging nurses’ use of WordPress and similar tools for developing team-writing skills. In the second part of her talk, “Use of portable and connected devices to increase access to health information in remote global settings”, she explored community participatory action research.

Diane Skiba explored several studies into the use of social media content for health purposes – including Orizio et al 2010 studies on the use of social networks; Weitzman et al 2011; noted several studies on Twitter relating to health issues; Greene et al 2010, who found clinically inaccurate recommendations were infrequent, but were usually associated with promotion of a specific product or services; and Ahmed et al (2010) on peer-to-peer interaction as a key aspect, with rich information being shared.

Jacqueline Norrell explored “Cloud based computing and the EHR” – she began with an overview of “revenge effects: why things bite back – technology and the revenge of unintended consequences” and noted that, while it may be good to have many things automated, there may be unexpected or unintended consequences that may result in problems. She explored definition/descriptions of cloud computing, discussing  the use of networked or remote servers, their access through the internet for storage, management and processing of data, and that they are typically sold ‘on demand’ – so offering software/platform/infrastructure as a service. She noted the existence of different types of cloud – public, rivet, virtual private, hybrid, federation, etc., and raised several issues for discussion, including that of how does one connect to cloud if there is power outage??

The opening panel session on Tuesday morning was titled “Where Are We In The United States in Implementing HIE?” and featured four speakers providing a range of perspectives. Gil Kuperman began by providing national level perspectives on health information exchange (HIE) before covering some issues specific to his experience in New York issues, and addressing how to use HIE to support coordinated models of care. He began by noting that while EHRs are applications, HIE is a capability not an application, that different HIE scenarios and organisational models exist and that one size won’t fit all. He gave a brief overview of how federal policy has evolved in relation to HIE: in the period 2004-08, there were RHIOs at the start, with not a great deal of funding – about 200 RHIOs by 2010. From 2009, the HITECH Act and Meaningful Use were a shift of policy, with more focus on EHRs rather than HIE. In the current landscape, there is a transition period, with competing/conflicting approaches, no single model, some legacy HIE organisations inc RHIOs, some vendor-based HIEs (‘family and friends’), State HIE cooperative programe, and the Nationwide Health Information Network (NwHIN). Among questions he raised where “Will HIE enable innovative care models?”

In outlining the ONC HIE Strategy, Gil noted that it encompassed setting goals, leading development of standards, and keeping a focus on patient care. ONC sees roles at state level in building/maintaining infrastructure, engaging stakeholders and supporting rural and low resource settings. In relation to New York State: HEAL-NY, he noted that they NY had been an early supporter of HIE, with an advanced RHIO model and support for EHRs, including public funds to support “21st century health information infrastructure”.

Helen Connors provided “the Kansas HIE Initiatives overview”, noting that Kansas is a very rural state, so has different needs to some other areas, but that this has brought stakeholders together from across the state to develop strategy and plan. She discussed, in particular, privacy law harmonisation as an important area of work. Colleen Woods gave an overview of issues in New Jersey, in particular the challenges of EHR-HIE interoperability across state boundaries (NJ-NY), and noted that an interoperability WG set up to address standards issues. Rainu Kaushal, the final panelist, addressed “The value of HIE” and covered issues of value including cost and quality, noting there existed limited data on HIE and quality, although some studies (eg the Frisse et al 2011 JAMIA study) found evidence of costs savings, but from perspective of patients rather than that of provider. She noted the need for data on patient outcomes.

Rutgers 30th Conference – Day 2 Summary April 17, 2012

Posted by peterjmurray in conference, education, future, Keynote, nursing informatics.
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I think I am losing my ‘blogging touch’; I find it increasingly difficult to do the live blogging ‘on the fly’ of conference sessions that I have done in the past. maybe it is simply lack of practice, due to doing more tweeting from events. So, this post is a summary of Monday’s presentations and activity. My tweets can be found on @peterjmurray, or searching for hashtag #Rutgers30

The first full day of the conference began with a keynote from Michelle Troseth (@CPMRCmichelle on Twitter). Michelle is Chief Professional Practice Officer at Elsevier CPM Resource Center, and her talk was titled “Bridging the gap between interprofessional education and evidence-based practice: leveraging technology”. She began by noting the many problems of system integration in healthcare services, and that evidence-based care will be critical to the future, so there is a need to think about team-based care and interprofessional care-planning. She asked whether computer nowadays are getting in the way of interprofessional relationships, and discussed the need to design patient-centric systems.

She introduced the TIGER Initiative (http://www.thetigerinitiative.org/)  and TIGER recommendations around being interdisciplinary and evidence-based, as well as covering a number of reports that over the years have advocated the need for transformation of practice and modes of working, including:

  • Carnegie Foundation – Preparation of the Professions – studies call for radical transformation on how we teach and prepare nurses and clinicians for future of care.
  • IOM report on future of nursing – “nurses should be full partners with physicians and other health professions in redesigning care”

Michelle was also awarded the 15th Annual Award for the advancement of technology in healthcare that is traditionally presented at this event.

Other speakers during the day (I was only able attend one of each parallel session, most of which I was chairing/moderating):

Darlene Scott (Saskatchewan, Canada): Connecting the dots: using Web 2.0 tools for interprofessional education –  explored the development of a core IPE (interprofessional education) curriculum to embed in nursing and science and health programmes. It was designed to prepare collaborative, practice-ready care givers.

The conference continues today (Tuesday), beginning with a panel session and followed by individual presentations and keynotes. The conference website is at http://nursing.rutgers.edu/conferences/30th-annual-international-interprofessional-technology-conference

Rutgers 30th Conference – Day 1, Kulikowski Keynote April 16, 2012

Posted by peterjmurray in conference, education, future, Keynote, nursing informatics.
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The Rutgers College of Nursing’s Thirtieth Annual International Interprofessional Technology Conference, in New Brunswick, New Jersey, USA  formally started on 15 April, 2012. Held at the Hyatt Regency New Brunswick, the fact that this year sees the 30th offering of this event makes it probably the longest-running annual event of its kind within nursing informatics within the USA. At least two of this year’s speakers, Casimir Kulikowski and Diane Skiba spoke at the second event, in 1984.

After pre-conference workshops, the opening keynote was given by Prof. Casimir Kulikowski, Board of Governors Professor of Computer Science at Rutgers University. Cas is also, among other post, a Vice president of the International Medical Informatics Association (IMIA – www.imia.org) and a co-editor of the IMIA Yearbook of Medical Informatics. He spoke on “How technology helps to improve healthcare globally”, although many of the points raised in his presentation pointed to areas in which technology does not always work at its best to improve health, but has other impacts.

Cas noted that, while we continue to see major advances in computer-information sciences, and advances around increasingly distributed, ubiquitous and mobile technologies, their impacts vary due to the contrasting challenges of developed and developing countries in applying information and computer technologies to health. The application of current technologies to the challenges of the burdens of chronic disease in the ageing in developed countries is still immature, and technologies are not readily available in many parts of the developing world where younger populations still face burdens of infectious disease. He noted the increasing economic challenges of radical shifts in the population support ratio, and also noted that wide disparities exist in terms of gender differences in the incidence of many diseases.

Among the questions he raised was whether it is better to invest spending (especially in terms of health spending) in breakthrough technologies that might have major impact, or to incremental improvements in systems. He noted that incremental changes often result in changes to systems and processes, and do not necessarily benefit people, or work in the best interests of patients.  They often occur in a system of legal constraints, and are responses to needs to reduce costs rather than improve care. He suggested the need to look at technologies that stimulate best care practices, and outlined examples of health-enabling technologies, smart homes/environments and social computing, to provide patient empowerment, self-care and preventive healthcare. He cited the work of colleagues such as Patti Brennan in Wisconsin, George Demiris and colleagues in Washington state, and Haux and Marschollek in Germany who are researching many of these areas, although noted that such work is still in early stages and many of the technologies remain immature.

Cas raised the idea that technology should not at the centre, but be part of a movement towards changing how people interact with technology in the home. There is, he suggests, a need for pervasive, personalised technologies to provide support (ambient assisted living), and that there are demonstrable cost savings if older persons can be supported in homes as opposed to being in hospital.  He introduced Demiris’ work on resistance to care if it is obtrusive, and noted that while smart home technology has the potential to support independence etc.,  using technology can also promote dependency.

Monday sees the first full day of presentations. The conference website is at http://nursing.rutgers.edu/conferences/30th-annual-international-interprofessional-technology-conference

Rutgers 30th Annual International Interprofessional Technology Conference April 12, 2012

Posted by peterjmurray in conference, education, nursing informatics, USA.
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Peter will be attending and presenting at the Rutgers College of Nursing’s Thirtieth Annual International Interprofessional Technology Conference, in New Brunswick, New Jersey, USA – from 14-18 April, 2012. The conference website is at http://nursing.rutgers.edu/conferences/30th-annual-international-interprofessional-technology-conference  There should also be tweets via @peterjmurray with hashtag #Rutgers30 – and information will be added here about any other bloggers, tweeters, etc at the event.

Looking for the MIE2011 Blog? August 10, 2011

Posted by peterjmurray in conference, EFMI, Europe.
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UPDATED, 23 August 2011:

For the MIE2011 blog, please go to http://mie2011blog.wordpress.com – Thanks to Karl Oyri for setting up this blog for the MIE2011 conference and related activities.

Blogging MIE2011 from Oslo August 8, 2011

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We will be blogging MIE2011 at the end of August.

MIE2011 – the XXIII International Conference of the European Federation for Medical Informatics – will be held in Oslo, Norway on 28-31 August, 2011. See http://www.mie2011.org for the latest information on the event.

See also on Twitter (http://twitter.com/#!/mie2011) and Facebook (https://www.facebook.com/group.php?gid=363398669412)

More information later as we get nearer the event.

SINI2010 over – on to 2011 July 25, 2010

Posted by peterjmurray in conference, nursing informatics, SINI2010, Uncategorized, USA.
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A successful SINI2010 is over. Once again, over 400 nurse informaticians gathered to learn, discuss and network, exploring the important issues of the day. As ever, the event was well organised by the local team and SPC – and the newly opened Southern Management Corporation Campus Center (SMC), linked to the School of Nursing building, is definitely a bonus in terms of space and facilities.

Next year will see the 21st SINI – SINI2011. It will be held on July 20-23, 2011, with pre-conferences on July 18-20. Keep an eye on nursing.umaryland.edu/sini for more information.

SINI2010 – final morning sessions July 24, 2010

Posted by peterjmurray in conference, education, nursing informatics, SINI2010, USA.
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The first distinguished lecture this morning is from Marilyn Chow, Vice President, Patient Care Services at Kaiser Permanente, and Murielle S. Beene, Chief Nursing Informatics Officer at Department of Veterans Affairs, and titled “Where’s the Quality in EHRs? A Collaborative Model to Promote Data Sharing and Quality Reporting”. Their talk will aim to describe how nursing leaders can have a transformative role in influencing EHR-related decisions that improve clinical effectiveness, efficiency, patient safety, and the delivery of quality-based patient care; define an emerging information model related to pressure ulcer risk that standardizes and informs nursing practice and reflects real-time clinical decision-making; and demonstrate the usefulness of common information models and reference terminologies to achieve semantic interoperability across different technology platforms.

Marilyn began by talking about her vision of being able to exchange information between the Kaiser Permanente (KP) and VA systems. KP is the US’s largest no-profit health plan, with 8.7 million members and over 40,000 nurses, while VA covers 7.8 million enrollees and 70,000 nurses. VistA, the VA system has been recognised as a world-leader for over 20 years.

The speakers summarise ‘meaningful use’ as being about financial incentives and penalties designed to support the adoption of EHRs, with the goal of linking healthcare resource use to patient outcomes. The vision is to derive quality measures directly from EHRs, improve care coordination with electronic exchange of health information, share baseline patient data across settings, and enhance clinical decision making. They went on to explore the implications of meaningful use for nurses, which include:

  • identify structures and content that would meet U. S. meaningful use criteria for a quality measure;
  • facilitate data portability between software applications and between organizations;
  • improve the ability to aggregate outcome data for research, comparison, quality and process improvement; and
  • promote nursing participation in standards development.

Currently, they say, valuable patient information is “locked” within an organization’s EHR, and data is often tightly bound to proprietary data models, which causes current and future potential problems.

The collaborative goals of work between KP and VA include defining a common Information Model driven by nursing practice that enables data capture, data re-use, and data sharing within and outside organizations. Also, they aim to facilitate the measurement and extraction of data for meaningful EHR use specific to the delivery of nursing care to support quality, safety, efficiency and clinical decision support. Nursing documentation represents a large part of the content of EHRs and therefore there is a need for nurse-lead initiatives.

They described a ‘replicable process’ for the development of the information model and data sets, and the use case scenarios, and determining the meaningful data capture, though:

1. Evaluate the Evidence
2. Leverage Clinical Expertise
3. Develop Optimum Data Sets
4. Information Harmonization – Identify the Gaps
5. Map to Reference Terminologies
6. Develop Practice-driven Information Models
7. Validate the Models

The presentation concluded by reporting that, although the work was just beginning, already made some significant progress had been made through a collaboration between the largest public and the largest private healthcare organizations on developing a nursing information model. They hope that the work promises to have an direct impact on both patient care activities and the future direction of nursing informatics within KP and the VA. They closed with a ‘call for action’ to demand the inclusion of nurse sensitive measures in the 2013 Meaningful Use criteria, and claim that the project demonstrates that the data for nursing sensitive measures can be “unlocked” from the EHR and used directly for quality reporting.