https://www.theverge.com/2017/11/30/16719458/apple-watch-study-irregular-heart-rhythms-stanford-university 

 

Williamson, E. (2016).,
Nurses rank #1 once again Gallup poll for ethics and honesty., Nurses.com Retrieved from: https://www.nurse.com/blog/2016/12/21/nurses-rank-1-once-again-in-gallup-poll-for-ethics-and-honesty/

It seems clear that it is important to behave in an ethical way when using informatics in healthcare. There is a proper way “legal and ethical way” use software when disclosing of patients’ information, diseases and risks. Whenever sharing data amongst providers or other healthcare organizations there must be handled safely, and there must be practice guidelines to avoid conflicts or even damages. (Hatieganu, 2016) Professionals who are using informatics must be trained on a regular basis. A clear set up of guidelines and legal regulations must be reviewed at least once a year to prevent errors.

A Code of Ethics related to healthcare informatics was created in 2002 and it is international. It defines the importance of data protection and can be easily accessed online in several languages. It provides guidance for the professionals, principals of conduct and provides the public with a clear statement of ethical consideration that providers must follow. (Hatieganu, 2016)

Carolina Guimaraes, RN-C

Hatieganu, I. (2016). Ethics and Legal Considerations of Healthcare Informatics. Applied Medical Informatics, 38(34), 91-98.

 

 

I believe nurses will always be top ranked, but not necessarily continually at #1.  Certain events tend to alter the public’s view, such as September 11^th.  In the 2001 Gallup Most Trusted Professions, firefighters beat out nursing for the top spot, a well-deserved rank.  Since then, nursing has taken the #1 spot for the last 15 years.  I think nursing will continue to rank high on the poll simply because of what our profession stands for and how we are viewed by our community and the public.  Our profession treats people no matter their medical coverage, ability to pay for care, gender, sex, and religion to name just a few.  Nursing does not play middle man and we treat the patient as a person.  

Application-integratable devices have many advantages for patients.  Blood pressure cuffs can now sync with smart devices and track information within an application.  It is then relayed to a patient’s health care provider to monitor and intervene if needed.  Now, CHF patients do not need to necessarily physically visit their provider and can instead use electronic communication regarding their health.  One of the downsides of these devices and applications is data sharing and storing.  There have been many conversations regarding the ethics of storing this data and using it later for research.  Does the patient give consent for the use of their information when they consent to use the device?  Should separate consent need to be given?  Despite laws and regulations, uncertainties remain surrounding patient consent (Haynes, Cook, & Jones, 2007).  While patients consent to hospitalizations and medical and surgical interventions, their consent is not explicitly given for their data to be dumped into a data repository.  Though all patient identifiers are supposed to be removed to protect confidentiality, the amount of data collected still poses risk.  There should always be a risk-benefit analysis.  These questions have strong reasons on both sides and as the technology develops and advances, I believe we will see more of this debate.

I think any application related to population health would be an exciting implementation.  There are a variety of applications available to assist patients with their medical care.  One application has medication and health maintenance reminders for the patient.  If the patient dismisses the reminder after a predetermined number of times, or hasn’t logged an activity, an alert can also be triggered to their care giver.  This engages the patient and their family to take an active role in their medical management plan.  Data storage and exchange related to security and privacy could be a potential issue.

Reference

Haynes, C. L., Cook, G. A., & Jones, M. A. (2007). Legal and ethical considerations in processing patient-identifiable data without patient consent: Lessons learnt from developing a disease register. Journal of Medical Ethics, 33(5), 302–307. doi:10.1136/jme.2006.016907

Natalie Peleg

2.  The Moffitt Cancer Center (2017) noted that one of the positives of wearable technology is that most patients claim to wear the tracking device constantly, except when the device is charging. One of the cons noted by the Moffitt Cancer Center (2017) was that patients reported when they forgot to wear their device they were less apt to work out, because they would not receive “credit” for their activity (The Cons section, para. 1).

3. I work in the GI specialty and I found a new medical technology called “Breathprint” that would be very exciting to utilize in our clinic. Karban et al. (2016) designed Breathprint to analyze collected breath samples from patients to then determine whether a patient is healthy, versus having Irritable Bowel Syndrome (IBS) versus having Inflammatory Bowel Disease (IBD), in a manner that is cheap, reproducible and easy-to-use. This would save so much money for unnecessary labs and procedures (such as colonoscopies) and would really maximize efficiency of our clinic because differentiating a patient’s diagnosis could be completed before a patient is even seen in the clinic. This would also ensure that the correct patient is scheduled for their follow-up (if necessary) with the correct GI specialist. I will have to speak to my providers to see if they’ve heard of this, but the results are promising, showing 81% accuracy between IBD and IBS and 75% between Crohn's and Colitis (the two types of IBD) (Karban et al., 2016, p. 2342).

I do not see any ethical issues with this technology, it would work like any other lab ordered by the GI provider.

 

Resources

Carlson, K. (2017, January 22) The Gallup Poll, healthcare, and nurses’ reputation. Retrieved from https://nurse.org/articles/gallup-ethical-standards-poll-nurses-rank-highest/.

Karban, A., Nakhleh, M., Cancilla, J., Vishinkin, R., Rainis, T., Koifman, E., . . . Haick, H. (2016). Programmed nanoparticles for tailoring the detection of Inflammatory Bowel Diseases and Irritable Bowel Syndrome Disease via Breathprint. Advanced Healthcare Materials., 5(18), 2339-2344. doi:  10.1002/adhm.201600588

Moffitt Cancer Center (2017, January 18).  The pros and cons of fitness trackers. Retrieved from https://moffitt.org/take-charge/take-charge-story-archive/the-pros-and-cons-of-fitness-trackers/.

 

Sewell, J. (2016). Legal and ethical issues. In Informatics and Nursing: Opportunities and Challenges (5th ed., pp. 387-399). Philadelphia, PA: Wolters Kluwer

I think that one pro to wearable trackers is that it allows the patient to take charge in their own healthcare and treatment. They are able to track their trends and be an active participant in their care, seeing what works and what does not work, or better understand why a physician is choosing their plan of care based on these readings. I think that a con, like most things would be compliance related. Some patients may not want to wear such devices at all times, especially during physical activity or during sleep etc. I know that when I sleep I do not want anything on me to be most comfortable and relaxed, or just that the patient doesn’t fully understand the importance of being compliant with wearing such devices at all times, and approach it in more of a relaxed manner.  
 

3. What new medical technology have you heard of that would be exciting to implement in your field of practice? Are there any associated ethical issues? As a Labor and Delivery nurse oftentimes if a patient has a higher BMI, wants to ambulate, or is just plain difficult to get an appropriate fetal and contraction reading by external monitors, we as nurses are continuously in the room making adjustments, the patient is uncomfortable and the calm, labor environment is continuously disrupted by making failed attempts to get accurate readings. There has been the introduction of wireless, strapless, external monitors, supposedly to cater to the bariatric as well as patient population who wishes to ambulate during labor. We have had numerous representatives comes to our unit to explain the product, however when testing the device on our unit there were a few glitches and we were unable to obtain an accurate reading with the device. We also found some issues with the Bluetooth/wireless connection. I would love to see technology such as this make advancements toward success, as I feel this benefits the patient drastically but also the healthcare provider.  

Regards, Kaitlyn Morris

Reference 

Accardie, A. (2016). How Biosensing Wearable Technology is Revolutionizing the Healthcare Industry- Part 1- Types of Wearables. Engagemobile. Retrieved from http://www.engagemobile.com/how-biosensing-wearable-technology-is-revolutionizing-the-healthcare-industry-part-1/ 

Regards, Kaitlyn Morris
 

Reference

Bonato, P. (2005) Advances in Wearable Technology and Applicationsin Physical Medicine and Rehabilitation. Journal of NeuroEngineering and Rehabilitation. Retrieved from https://doi.org/10.1186/1743-0003-2-2

Reference

Summary of the HIPAA Privacy Rule. (n.d.). Retrieved from https://www.hhs.gov/hipaa/for-professionals/privacy/laws-regulations/index.html

Natalie Peleg

 

 

Lee, L. (2016) Scientists identify unique “breathprint” of 17 diseases. ACS Nano. Retrieved from https://newatlas.com/different-diseases-different-breathprints/47088/ 

 

 

2.        I explored Google glass and found it to be interesting. Google glass has become popular amongst consumers. Google glass is a device that displays information into a smartphone -like hands free format that interact with the internet. Google glass has the potential to bring new possibilities to educators and students. An advantage of google glass is it could guide a surgeon using visuals of the technique or allow a surgeon to view radiology images during surgery (Sewell, 2016). Disadvantage-google glass could lead to eye strain and visual confusion due to the positioning of the micro displayed outside of the person’s natural field of view (Spargaliyev, 2014).

 

3.       What new medical technology have you heard of that would be exciting to implement in your field of practice? Are there any associated ethical issues? The breath glucose detector which is designed to measure exhaled acetone for diabetes management. I don’t see this associated with any ethical issues compared to implantable chips.

Reference

Sewell, J. (2016). Informatics and Nursing: Opportunities and Challenges (5^th e.d). Philadelphia, P.A: Wolters &Kluwer

Spargaliyev, D. (2014). Wearable Learning:  How Google Glass is Changing Education. Retrieved from ceur-ws.org/vol 1154/paper18.pdf
Delia MaxwellWhite

Nurses are the eyes, ears, and hands of the doctors and we are always at the patient’s bedside providing care and building trust and rapport with the patients.  When the patient needs something, they call their nurse.  When the patient has a question, they ask their nurse.  When the patients need a medical professional to talk to they come to their nurse.  The patients have an inherent trust in our skills and integrity.  In my opinion, there is not another profession that can carry so much weight when it comes to trust, integrity, and ethics.  Our work directly affects the well-being of individuals regardless of their age, race, ethnicity, and background.  Patients are more empowered to have better outcomes if they have someone on their side advocating for them.  Without this trust, patients are more reluctant to make poor health choices and have poor outcomes.  Without trust, our efforts can be in vain.

 

American Nurses Association. (2016, December 19). Nurses Rank #1 Most Trusted Profession for 15th Year in a Row. Retrieved from American Nurses Association: http://www.nursingworld.org/FunctionalMenuCategories/MediaResources/PressReleases/2016-News-Releases/Nurses-Rank-1-Most-Trusted-Profession-2.pdf

I was able to read your paper today and wanted to commend you on a job well done. I especially enjoyed the section that discussed the Hospital of the University of Pennsylvania’s study on the use of text messaging and you asked some great questions at the end of that paragraph, which lead me to do some of my own research on the topic. 

I found a research study completed by Haun, Patel, Lind & Antinori (2015), which showed that participants were “satisfied with secure messaging” because they found it to be a quick, safe and easy-to-use communication tool (p.5). According to the authors, patients utilized the messaging tool for the following reasons: medication refills, obtaining lab results, appointment management, asking health-related questions and for discussion of sensitive health topics, respectively (Haun et al., 2015, p. 1). The authors note that a patient’s gender, level of education, income, health and E-literacy levels also play a role in a patient’s level of satisfaction with and perceived ease of use with messaging, as well as whether or not they will choose to use such a tool (Haun et al, 2015, p. 11). I’ve attached the article for anyone interested in reading more details of this study.

Reference:

Haun, J., Patel, N., Lind, J., & Antinori, N. (2015). Large-scale survey findings inform patients' experiences in using secure messaging to engage in patient-provider communication and self-care management: A quantitative assessment. Journal of Medical Internet Research., 17(12), 1-12. doi:10.2196/jmir.5152