Rutgers 30th Conference – Day 1, Kulikowski Keynote

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

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