NI2012 – Pre-Conference Overview for Collaboration May 7, 2012
Posted by peterjmurray in AMIA, conference, education, IMIA, NI2012, nursing informatics.Tags: AMIA, conference, education, NI2012, nursing
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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.
Rutgers 30th Conference – Final Round-up, Part 2 May 7, 2012
Posted by peterjmurray in conference, education, nursing informatics, USA.Tags: conference, education, informatics, nursing
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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 – Day 2 Summary April 17, 2012
Posted by peterjmurray in conference, education, future, Keynote, nursing informatics.Tags: conference, education, health informatics, nursing
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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.Tags: conference, education, health informatics, nursing
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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
SINI2010 over – on to 2011 July 25, 2010
Posted by peterjmurray in conference, nursing informatics, SINI2010, Uncategorized, USA.Tags: Baltimore, conference, informatics, nursing, SINI
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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.Tags: Baltimore, conference, informatics, nursing, SINI
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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.
SINI2010 – Gil Kuperman July 23, 2010
Posted by peterjmurray in conference, education, nursing informatics, SINI2010, USA.Tags: Baltimore, conference, education, nursing, SINI
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It’s Friday morning in Baltimore; temperatures are supposed to get up to near 100F today. Attendance at the Orioles game didn’t look too great last night (my hotel room overlooks Camden Yards).
The distinguished lecture this morning is from Gil Kuperman, from NewYork-Presbyterian Hospital and Columbia Biomedical Informatics in New York, NY. His talk is titled “Health Information Exchange: Why Are We Doing It and What Are We Doing?” His premise for his talk is that we are at an inflection point in respect of interoperability, and that some of the responses to ‘meaningful use’ are altering the landscape for interoperability. He outlined the role of clinical data in giving a more accurate picture of the patient’s needs, but also noted the wider uses of such data, for public health and research. He referred back to the 2001 report and recommendations on ‘A strategy for building the national health information infrastructure’, which had three components, including health care provider, personal health and population health dimensions.
Gil then went on to review the 2004 origins of ONC within a four-part strategy which had little funding for real implementation. It did highlight, however, the importance of health information exchange for EHR adoption, and some encouraging signs for interoperability. He noted the origins of the first prototype National Health Information Network (NHIN) project in 2004, and the growth of the “NHIN1” model as a ‘network of networks’. NHIN2 in 2007 aimed to demonstrate interoperable and secure health information exchange, with specific use cases.
After an exploration of other phases/stages of NHIN, Gil moved on the NHIN Direct (www.nhindirect.org), which aims to support stage 1 meaningful use. It aims to push data to a known recipient and automate health information exchange that is currently being undertaken by other modes.
He highlighted a number of challenges and questions that still exist, including:
- Is it really easier? – need an address book (central authority) – need authorization scheme – need auditing
- How much of the problem does it solve? – “Push” vs. “pull” – Important use cases left out
- Need agreed upon security standards – Need governance to create policies – Need compliance to assure policies followed
- How well does it work for large organizations? – Putting an incoming lab result in the right chart
The NHINDirect model is not seen by many as an end in itself, but is seen as complementary to other aspects, and may or may not address some of the use cases identified within NHIN2.
Gil ended by noting that many questions are raised by the contrasting models, ie “Sending messages” vs. “Information Retrieval”, does it enable innovative care models, how will it affect RHIOs in the future, and will it allow migration to more sophisticated health information exchange?
Some interesting ideas were raised, and it is useful to compare with the situation and questions raised 5 years ago in the UK with the development of the NHS Spine model.
TIGER, TIGER, burning bright July 22, 2010
Posted by peterjmurray in conference, education, future, nursing informatics, SINI2010.Tags: Baltimore, conference, e-learning, education, informatics, nursing, SINI 2009
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The parallel afternoon sessions are due to start. I am attending a very well-attended session, “The TIGER Initiative: Adoption of Health IT and Meaningful Use for Nurses and Other Disciplines”, a panel presentation and discussion with Patricia Hinton Walker, Vice President for Nursing Policy & Professor of Nursing at Uniformed Services University of the Health Sciences; Diane J. Skiba, Professor & Health Care Informatics Coordinator, University of Colorado College of Nursing; and Brian Gugerty, Gugerty Consulting, LLC. The session covers reports on TIGER Phases II and III ; specifically, outcomes of the Competencies Collaborative with implications for Education, Faculty Development, and Staff Development, along with progress on the emerging TIGER III, Virtual Learning Environment.
TIGER, for the uninitiated, is “Technology Informatics Guiding Educational Reform” (http://www.tigersummit.com). The TIGER vision is to allow informatics tools, principles, theories and practices to be used by nurses to make healthcare safer, effective, efficient, patient-centered, timely and equitable; and interweave enabling technologies transparently into nursing practice and education, making information technology the stethoscope for the 21st century.
Patricia started the session by giving an overview of the history of TIGER, especially phases I and II – reports are available at http://www.tigersummit.com/Downloads.html TIGER phase III will focus on implementation, integrating the TIGER recommendations into the nursing community along with colleagues from all disciplines across the continuum of care. These activities are focused on creating a Virtual Learning Center and developing another invitational summit.
Brian Gugerty next gave an overview of the work of nine collaboratives, focusing on the informatics competencies work (http://www.tigersummit.com/Competencies_New_B949.html). Informatics competencies for nurses were seen to be at two levels, ie all practicing and graduating nursing students; and nursing leaders. Existing work in the literature on basic computer competencies and information literacy/management was explored, from an international perspective. Work related to this is available at http://tigercompetencies.pbworks.com/
Diane Skiba talked about the education and faculty development collaborative work – http://www.tigersummit.com/Education_New.html She explored how to engage faculty to move the agenda forward, although noted the difficulties of making changes in higher education. She identified the challenge as that of preparing nurses to practice in a technology-rich world, and addressing areas of both teaching about technology and teaching with technology.
Patricia concluded the presentations by introducing TIGER phase III, which is about dissemination of the results to date of the initiatives and collaboratives, and the development of the virtual learning environment (VLE), as one of several potential solutions to addressing the problems. The VLE work is also beginning to address a wider interdisciplinary audience, including patients and ‘cosnumers’, and not just to nurses.
SINI2010 – day 2 July 22, 2010
Posted by peterjmurray in conference, education, nursing informatics, SINI2010.Tags: Baltimore, conference, education, nursing, SINI 2009
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Thursday is day 2 of SINI2010; the first speaker is Patti Brennan, who will be starting to talk soon.
The heat and humidity doesn’t seem too bad at 7am in Baltimore – but is due to get up to over 95F later today. Thanks to the jetlag, I’ve been up since 5am. Had very nice dinner with Chris Lehmann and George Kim last night – discussing ACI Journal (www.aci-journal.org), and breakfast with Ted Shortliffe from AMIA. More meetings to come over the next few days, but will try to report on various sessions over the next few days.
At 08:30 am, we have a full auditorium for the first speaker. Patti Brennan’s talk is titled ‘Let’s Make Sure That “Meaningful Users” Includes PATIENTS!” – her key message is to ensure that patients are meaningful users if investment in IT is going to be of real benefit and support patient-centred care. She said that the original ideas around ‘meaningful use’ did not take account of PHRs (personal health records), as concepts, rather than products.
Patient-centred care, Patti says, is where the patient is, not where the provider is – so, it is everywhere. She began by showing a video about the My-medi-health project (http://www.projecthealthdesign.org/projects/overview-2006_2008/405594), which shows ways in which mobile communications tools can support self-care. People, Patti says, manage their health every day, not from clinical episode to episode, and so ‘observations in daily living’ (ODLs), selected and reported by patients arising from their daily life, are important feature of PHRs and need to be available to clinicians.
Patti described how groups are looking at innovative technologies and the ways in which ODLs can expand the very nature of health data (eg mobile devices, wireless sensors and bio-monitors), and explore integration into clinical workflow, and so testing what will come to be relevant in stage 3 of meaningful use (ie, thinking forward to what will be needed in 2015). Among projects are PHRS for adults with asthma and depression/anxiety, and using mobile platforms (eg iTouch) with youths with obesity and depression.
Patti went on to say that making sure that patients are also “Meaningful Users”, then health information and policies are needed that that enable the integration of patient‐defined and
patient‐generated information into clinical care; the health information needs to be accessible to patients in a computable form, and health information for patients needs to be actionable. Among the legal/regulatory challenges that still need to be addressed are:
- Ensuring patient authorization that satisfies HIPAA
- Minimize (realistically) the security risks associated with devices
- Proper verification of identity
- Secure transmission
- Compliance with mandatory reporting and other obligations on the part of clinicians
Patti closed by summarising questions that remain, including:
- Should data obtained in the home or created by the patient be noted as such?
- In order of priority, which ODLS should be included in the clinical record?
- What is needed to extend the benefits of meaningful use to others, like the VNA, social health providers, and community drug therapies
More information on projects that Patti is involved with is at www.projecthealthdesign.org and on Twitter at @PrjHealthDesign
Dispatches from the hi-blogs.info krew 