Nursing Informatics by Kimmie Catahan https://padlet.com/catahan/s5eqobjqf4o2kgy2 en-us 2021-09-14 16:23:15 UTC 2021-12-13 01:09:28 UTC hello@padlet.com Week 1 Health Informatics catahan https://padlet.com/catahan/s5eqobjqf4o2kgy2/wish/1740738055 What is Health Informatics?
Information to help make better decisions to improve health care 
  • The use of technology, science, and data collection to improve healthcare outcomes. 
  • Utilization of 'resources, devices, methods, guidelines and communication systems'
  • Collaboration amongst various organizations 
Health Informatics For The Patient:
  • Improves access to medical records for various healthcare entities (insurance, outside hospitals, specialty clinics, etc)
  • Improves workflow of their health care providers
  • Allows for easier access to health information for patients
  • Can essentially improve health care costs  

Health Informatics In My Practice: 
We utilize CareEverywhere which is a shared electronic medical record interface that various institutions use. This is important for us because we are a very specialized clinic and by the time patients see us, they are often already seen by a few other providers who have performed some diagnostic testing. This helps trend the progression of their disease, understand what treatments they have tried already, and decrease the need to order tests that were already performed.
]]> 2021-09-14 21:20:11 UTC https://padlet.com/catahan/s5eqobjqf4o2kgy2/wish/1740738055 Verifiable- The modern infrastructure using automated data to verify credentialing and simplify networking. catahan https://padlet.com/catahan/s5eqobjqf4o2kgy2/wish/1740780465 "They are the people between the healthcare system and the patient, so to have access to their data, patients can form a relationship with them, which is a powerful position.”]]> 2021-09-14 21:49:56 UTC https://padlet.com/catahan/s5eqobjqf4o2kgy2/wish/1740780465 Patchwork Health - App for hospital staffing needs catahan https://padlet.com/catahan/s5eqobjqf4o2kgy2/wish/1740796365 2021-09-14 22:02:31 UTC https://padlet.com/catahan/s5eqobjqf4o2kgy2/wish/1740796365 Week 2 Informatics Competencies catahan https://padlet.com/catahan/s5eqobjqf4o2kgy2/wish/1740797681 This week we learned about QSEN and HIMSS

QSEN (Quality and Safety Education for Nurses)  HIMSS(Healthcare Information and Management Systems Society)
QSEN: Equip nursing education contributing to KSA needs
  • Focus on patient center care while involving family
  • Pain culture 
  • Evidence based practice is important to optimize health care and helps individualize care
  • Quality Improvement uses data to make changes to healthcare/improve outcomes 
  • Use technology Minimize Risks/Improve safety
  • Use of information and technology to communicate within a healthcare setting 
  • Consider the attitudes around change and adapting to technology
HIMSS: Organization that looks at impact of information in Nurses/health care organization
  • Impact on safety, workflow, and use acceptance
  • Tiger Initiative started around 2004 when President Bush declared it the year of medical technology
    • This movement NEEDS to involve nurses, as we are and will be the main utilizers 
]]> 2021-09-14 22:03:39 UTC https://padlet.com/catahan/s5eqobjqf4o2kgy2/wish/1740797681 TIGER Initiative catahan https://padlet.com/catahan/s5eqobjqf4o2kgy2/wish/1740800114 One step in the TIGER initiative's three -year action plan is education. This pillar focuses on the use of technology and how it can improve the learning experience and capabilities of disseminating knowledge. One experience that I had with this is the BLS courses offered by American Heart Association and my institution, Stanford Health Care. Their new learning model to renew a BLS certification is an online hybrid program. Users interact with online characters in various simulations. Quiz questions re very algorithmic. At the beginning of the course they informed that quiz question will repeat itself as a way to improve the learning experience. I found this interesting as I recall from prior in-person BLS classes, I would often forget the exam questions I had right after turning it in. When seeing these quiz repeatedly, I seemed to retain more information.]]> 2021-09-14 22:05:47 UTC https://padlet.com/catahan/s5eqobjqf4o2kgy2/wish/1740800114 Big Data TED Tiranee Achalakul catahan https://padlet.com/catahan/s5eqobjqf4o2kgy2/wish/1750472744 Takeaway Points:
  • Smart Inhaler with GPS tracker is an interesting idea! It is designed to track what environments trigger asthma exacerbations for a patient. This can help customize treatment plan per customer 
  • Goal: make healthcare more inclusive 
  • Pick technology that is a best fit for the user (healthcare providers and patients)/Don’t want the latest and most complicated technology so it can be user friendly 
  • Individualized recommendations via online portal that can be disseminated to areas that are hard to access/remote areas
  • Can use current data into AI/machine, this would be standard recommendations that can be accessed by anyone
  • Food Chatbot
]]> 2021-09-18 14:21:13 UTC https://padlet.com/catahan/s5eqobjqf4o2kgy2/wish/1750472744 Week 3 How can interoperability enhance my current practice? catahan https://padlet.com/catahan/s5eqobjqf4o2kgy2/wish/1750488269 I work at a university hospital in a specialized Inflammatory Bowel Disease (IBD) clinic. This is an evolving subspecialty where many treatment options are experimental. We get many patients from very rural parts of California referred to us. Many of these areas are still using paper charting or do not share our EMR interface. This has caused lack of communication in important diagnostic results and treatment plans. 
One example in particular is the contraindicated use of NSAIDs in IBD as it can cause a flare of the disease. A patient of ours went to their local ER for abdominal pain (a common symptom of an IBD flare), the hospital was unfamiliar with treating IBD patients and prescribed high dose NSAIDs which exacerbated the flare even more. If the local ER provider had access to our office notes, they would have been able to see our recommendations for an IBD flare available in the patient's chart. This includes the avoidance of NSAIDs. ]]> 2021-09-18 14:34:59 UTC https://padlet.com/catahan/s5eqobjqf4o2kgy2/wish/1750488269 The Path to Interoperability catahan https://padlet.com/catahan/s5eqobjqf4o2kgy2/wish/1750494820 Interoperability: When two or more systems exchange and use the information 
  • Standardize tools like EMRs
  • Standardize "common language" 
  • Benefits doctors, hospitals, pharmacies, health plans, and patients  
  • Goal: "make patient health information available when and where they need it"
This is an amazing idea and something that should have more focus the more we expand healthcare. One thing the COVID19 pandemic brought on was the increased use of Telehealth video visits. Interoperability will improve the care that is being offered virtually.

]]> 2021-09-18 14:40:20 UTC https://padlet.com/catahan/s5eqobjqf4o2kgy2/wish/1750494820 catahan https://padlet.com/catahan/s5eqobjqf4o2kgy2/wish/1758606494 2021-09-22 00:07:44 UTC https://padlet.com/catahan/s5eqobjqf4o2kgy2/wish/1758606494 HITECH Act Simplified catahan https://padlet.com/catahan/s5eqobjqf4o2kgy2/wish/1758669507 Incentive program turned penalizing program]]> 2021-09-22 00:50:58 UTC https://padlet.com/catahan/s5eqobjqf4o2kgy2/wish/1758669507 Week 4 Data, Information, Knowledge, Wisdom catahan https://padlet.com/catahan/s5eqobjqf4o2kgy2/wish/1758676888 DIKW hierarchy is a framework that grows data into wisdom. Data is a factual point. Information gives more context to a data point giving it more meaning. From this information, knowledge is applied to into something that has theoretical understanding. From this, we have wisdom that applied to an experience. An example of the DIKW hierarchy is the idea of water trending to the use of an umbrella. Water is the data point. Information we know about the water is that it fell from the sky. Common knowledge about water falling from the sky is that it is referred to as rain. Wisdom that can be applied to this knowledge is that one would use an umbrella when it rains. 
DIKW hierarchy influences public health by finding common data points of a common population that can lead to a well studied preventative intervention. An example of this is linking the occurrences of rainy weather with increased rates of depression.

]]> 2021-09-22 00:55:39 UTC https://padlet.com/catahan/s5eqobjqf4o2kgy2/wish/1758676888 Week 5 Meaningful Use catahan https://padlet.com/catahan/s5eqobjqf4o2kgy2/wish/1758681301 Meaningful use is a very interesting concept that I didn't realize was behind the EHR that I currently use at work. In my position at an outpatient clinic, nurses are able to pend prescriptions for providers to sign. I often come across a built in safety mechanisms when prescribing medications if a patient has a listed contraindicated allergy. There are 'hard stops' for medications that are being prescribed that the patient has an allergy to and 'soft stops' if a patient has a listed allergy that may be an ingredient in the prescribed medication. Either stop will ask the provider to review the contraindication and review the allergies. I believe this has prevented many adverse reactions in my practice. ]]> 2021-09-22 00:58:29 UTC https://padlet.com/catahan/s5eqobjqf4o2kgy2/wish/1758681301 Week 6 My Thoughts On Medical Record Access catahan https://padlet.com/catahan/s5eqobjqf4o2kgy2/wish/1805893450 I work in an outpatient specialty clinic and work directly with a electronic medical records (EMR). I have found many great things about the EMR and many bad things as well. The EMR has allowed our specialty providers to review prior work up and therapy, extensive health history, and has allowed for better multi-disciplinary communication. There is far less paper work involved and providers are able to keep a close track of their patients' health. With increased access to this information, patients and providers are able to work together more efficiently on care plans. Some challenges I have seen the EMR cause are disagreements with the patient in the few cases they don't agree with their providers, and abuse of the system giving patients the false hope that their inquiries will be addressed just as quickly as they were asked.]]> 2021-10-10 18:34:34 UTC https://padlet.com/catahan/s5eqobjqf4o2kgy2/wish/1805893450 Cost of EHR catahan https://padlet.com/catahan/s5eqobjqf4o2kgy2/wish/1805895918 This was an interesting article that breaks down the costs of an EHR. Just reading through it makes me realize how a practice would be deterred by the process of implementing a costly EHR system. ]]> 2021-10-10 18:36:34 UTC https://padlet.com/catahan/s5eqobjqf4o2kgy2/wish/1805895918 Big Data in HealthCare catahan https://padlet.com/catahan/s5eqobjqf4o2kgy2/wish/1805897871 2021-10-10 18:37:59 UTC https://padlet.com/catahan/s5eqobjqf4o2kgy2/wish/1805897871 Week 7 California Health Information Exchange catahan https://padlet.com/catahan/s5eqobjqf4o2kgy2/wish/1805900299 California has a health information exchanges system called the California Trusted Exchange Network (CTEN). Instead of using public-private networks like many other states, California uses a regional initiative that is shared through voluntary self-governance. Based on their website, it looks like a fee is required to partake with a discounted fee for some. CTEN covers 39 of 58 counties statewide and includes various health care facilities including primary care, specialists, acute hospitals, social services, etc. Ways this platform is used are direct messaging, alerts, and text reports. One example I work with often is a COVID testing platform that links my self-swab results to my employer. ]]> 2021-10-10 18:39:59 UTC https://padlet.com/catahan/s5eqobjqf4o2kgy2/wish/1805900299 Health Information Exchange in California catahan https://padlet.com/catahan/s5eqobjqf4o2kgy2/wish/1805902330 2021-10-10 18:41:35 UTC https://padlet.com/catahan/s5eqobjqf4o2kgy2/wish/1805902330 About E-Prescribing catahan https://padlet.com/catahan/s5eqobjqf4o2kgy2/wish/1829153633 Key benefits for patients, providers, and pharmacies ]]> 2021-10-20 02:53:05 UTC https://padlet.com/catahan/s5eqobjqf4o2kgy2/wish/1829153633 E-Prescribing - Making Patient Care Effective and Efficient catahan https://padlet.com/catahan/s5eqobjqf4o2kgy2/wish/1829160837 I thought this was a great article. A few key benefits of e-prescribe that I didn't think about before:
-Better utilization of staff time 
-Reduced readmission rates to the hospital
-Improved medication adherence

]]> 2021-10-20 02:56:01 UTC https://padlet.com/catahan/s5eqobjqf4o2kgy2/wish/1829160837 Incident To Billing for NPs catahan https://padlet.com/catahan/s5eqobjqf4o2kgy2/wish/1839814306 I plan to do my A2 assignment on how informatics can help or somehow improve how nurse practitioners and other advanced practice providers bill for services. In doing my research, I came across "incident to" billing. I initially disagreed with this provision and knew I needed to do more investigating on the topic. ]]> 2021-10-24 19:59:51 UTC https://padlet.com/catahan/s5eqobjqf4o2kgy2/wish/1839814306 "Incident To" Billing catahan https://padlet.com/catahan/s5eqobjqf4o2kgy2/wish/1839814867 2021-10-24 20:00:23 UTC https://padlet.com/catahan/s5eqobjqf4o2kgy2/wish/1839814867 Week 8 Telehealth catahan https://padlet.com/catahan/s5eqobjqf4o2kgy2/wish/1839819079 I use Telehealth everyday for my job as a nurse coordinator. I see many many benefits and challenges to the system. A few benefits better access to care for patients in rural areas via video visits, quicker access to results, and an online messaging portal. Challenges of video visits is that both the provider and patient may rely too heavily on this form of an appointment that it then becomes a "burden" when an in-person appointment is needed. Another challenge is the reliance of online messaging with your care team. I have seen this online messaging as an easy way to communicate with your doctor but as a provider using this system, I also see how many patients abuse the messaging portal. Patients will write in length messages trying to relay all of their health information and concerns expecting an instant reply. When really, their concerns should be addressed in an hour long appointment. ]]> 2021-10-24 20:04:21 UTC https://padlet.com/catahan/s5eqobjqf4o2kgy2/wish/1839819079 Sea Quest Hero catahan https://padlet.com/catahan/s5eqobjqf4o2kgy2/wish/1839822295 Alzheimer's and dementia hold a very special place in my heart. My grandmother suffered from Alzhemier's and it was truly the hardest thing to watch. To know that this disease is still not fully understood and we still don't have a cure for this, is one of my greatest motivations to stay in healthcare. I loved to idea Sea Quest Hero and utilizing "gamification" to collect data that will contribute to Alzheimer's research! ]]> 2021-10-24 20:07:20 UTC https://padlet.com/catahan/s5eqobjqf4o2kgy2/wish/1839822295 Week 9 Gamification catahan https://padlet.com/catahan/s5eqobjqf4o2kgy2/wish/1839824245 Gamification is such a fascinating topic to bring into healthcare research! We have such advanced technology that can help us capture the data we need to keep progressing in medicine. 

I decided to play Jerry the Bear. I thought this was such a cute app for young children. I enjoyed that they made small details very simplified. For example, hand washing really took the full 20 seconds to complete. I enjoyed making a snack for Jerry but I couldn't quite understand the conversion of the green and blue dots to carb and insulin ratios-or how this was going to be useful for the child. I also enjoyed that Jerry had a sister around to help notify the player when he needed his sugar checked. While the concept is there, I think it would be great if this app had more real life scenarios for a child to experience like adding a grocery store or adding more snack options to choose from.]]> 2021-10-24 20:09:11 UTC https://padlet.com/catahan/s5eqobjqf4o2kgy2/wish/1839824245 Data Storytelling catahan https://padlet.com/catahan/s5eqobjqf4o2kgy2/wish/1862243342 Great example on how anyone can use data for storytelling! ]]> 2021-11-02 16:40:07 UTC https://padlet.com/catahan/s5eqobjqf4o2kgy2/wish/1862243342 Week 10 My experience with alarm fatigue catahan https://padlet.com/catahan/s5eqobjqf4o2kgy2/wish/1862274399 I've worked on both a telemetry unit and a med-surg unit that had telemetry capability. I found that I paid more attention to the arrhythmia alerts on a telemetry unit likely because the patients were admitted specifically for their heart. However, on a med-surg unit our telemetry monitored patients were often there for observation for things like an electrolyte imbalance. Med-surg patients are also more mobile so I found that the alarms on our telemetry monitors would go off too often. These monitors also ran on AA batteries that needed to be changed so frequently. That too would set off the alarm that many of us would fatigue from. I think a great solution is to have a differentiating soft and hard alarm possibly with an added variable of flashing monitors if the alert needs more immediate attention.]]> 2021-11-02 16:51:30 UTC https://padlet.com/catahan/s5eqobjqf4o2kgy2/wish/1862274399 Impact of Patient Portal catahan https://padlet.com/catahan/s5eqobjqf4o2kgy2/wish/1862276034 2021-11-02 16:52:05 UTC https://padlet.com/catahan/s5eqobjqf4o2kgy2/wish/1862276034 Week 11 Privacy and Security catahan https://padlet.com/catahan/s5eqobjqf4o2kgy2/wish/1862278437 My current practice utilizes Epic as an EHR, which utilizes many privacy factors including a password/authentication to get into the computer system and then into the patient's chart. Most patient's charts also include their photo in their profile which has helped our check in team correctly identify patients.]]> 2021-11-02 16:52:57 UTC https://padlet.com/catahan/s5eqobjqf4o2kgy2/wish/1862278437 Week 12 Data Use catahan https://padlet.com/catahan/s5eqobjqf4o2kgy2/wish/1862280882 These were great examples of how data can be used for storytelling. A strong starting point from both videos is they each had a focal question with very simple data. The focal question grasped the audience as the storyteller aimed to connect using relatable examples. As data was collected, the research continued to expand. Both presenters utilized multiple visual graphs which helped the audience understand the key points of the story being presented from data.]]> 2021-11-02 16:53:53 UTC https://padlet.com/catahan/s5eqobjqf4o2kgy2/wish/1862280882 Health Data Storytelling catahan https://padlet.com/catahan/s5eqobjqf4o2kgy2/wish/1862283887 Great step-by-step guide for using data for storytelling]]> 2021-11-02 16:55:02 UTC https://padlet.com/catahan/s5eqobjqf4o2kgy2/wish/1862283887 "Big data doesn't matter on a fundamental level" catahan https://padlet.com/catahan/s5eqobjqf4o2kgy2/wish/1862287891 2021-11-02 16:56:28 UTC https://padlet.com/catahan/s5eqobjqf4o2kgy2/wish/1862287891 Week 13 Data Visualization catahan https://padlet.com/catahan/s5eqobjqf4o2kgy2/wish/1888358642 Data visualization can be helpful to improve patient engagement. For example, I had a patient with fatty liver disease who had a poor understanding of the risks and outcomes of untreated disease. She heard that fatty liver disease was very common in the United States and therefore wasn't too concerns about pursuing interventions to improve her outcome. Over 25% of Americans live with fatty liver disease, a condition that can progressively cause complications yet can be managed with lifestyle modifications. Using data visualization for patients like this can help them better understand the incident rates of both the disease and poor outcomes. In turn, they may be more inclined to take action to improve their health. ]]> 2021-11-13 16:13:29 UTC https://padlet.com/catahan/s5eqobjqf4o2kgy2/wish/1888358642 The Beauty of Data Visualization catahan https://padlet.com/catahan/s5eqobjqf4o2kgy2/wish/1888359992 Great example of how data visualization can connect data patterns to tell a story]]> 2021-11-13 16:15:22 UTC https://padlet.com/catahan/s5eqobjqf4o2kgy2/wish/1888359992 IBD & Me catahan https://padlet.com/catahan/s5eqobjqf4o2kgy2/wish/1934497043 I currently work with patients who have Inflammatory Bowel Disease (IBD) and discovered that they have utilized gamification to create "IBD & Me" targeted to children and parents who have IBD. Great to see what we're learning in my actual practice! ]]> 2021-12-07 20:31:15 UTC https://padlet.com/catahan/s5eqobjqf4o2kgy2/wish/1934497043 Implementing Statewide Telehealth catahan https://padlet.com/catahan/s5eqobjqf4o2kgy2/wish/1934505908 Great article done on implementing a statewide telehealth system. Kearly et al. (2020) discuss the steps taken to implement this system including 1- assuring that all have access to resources needed for telehealth 2- collaborating with other governing bodies and 3- coordinating logistics across public and commercial parties involved. ]]> 2021-12-07 20:37:15 UTC https://padlet.com/catahan/s5eqobjqf4o2kgy2/wish/1934505908 At-Home DNA Tests catahan https://padlet.com/catahan/s5eqobjqf4o2kgy2/wish/1934512850 At-home DNA tests are becoming so popular, they are even being marketed as the latest and greatest holiday gifts. What companies fail to mention are the ethical concerns that come with these tests. One being, people fail to involve a medical professional when interpreting results. ]]> 2021-12-07 20:42:11 UTC https://padlet.com/catahan/s5eqobjqf4o2kgy2/wish/1934512850 Color catahan https://padlet.com/catahan/s5eqobjqf4o2kgy2/wish/1934519262 Color is a health tech company most recently known for self-COVID testing and reporting. With more funding, they may have the opportunity to build an interoperable system that can communicate these important results to healthcare providers, government, and employers.

]]> 2021-12-07 20:47:03 UTC https://padlet.com/catahan/s5eqobjqf4o2kgy2/wish/1934519262 EasyHealth catahan https://padlet.com/catahan/s5eqobjqf4o2kgy2/wish/1934524189 EasyHealth is an online advisor to aid the Medicare enrollment process and navigating through the system. I think this is such a wonderful idea. I have too many patients today struggling with the healthcare system and most are Medicare patients. ]]> 2021-12-07 20:50:37 UTC https://padlet.com/catahan/s5eqobjqf4o2kgy2/wish/1934524189 OpenNote catahan https://padlet.com/catahan/s5eqobjqf4o2kgy2/wish/1943402451 OpenNote is a "movement" that was started to learn the effects of open and transparent communication between patients and their clinicians. 
-Promotes improved patient safety and quality of care
-Goal is to standardize the use of OpenNote
-Collaboration of doctors, nurses, mental health professionals, patient advocates, social scientists, researchers, and communication scientists

]]> 2021-12-13 00:58:33 UTC https://padlet.com/catahan/s5eqobjqf4o2kgy2/wish/1943402451 Can Open Notes Reduce Healthcare Disparities? catahan https://padlet.com/catahan/s5eqobjqf4o2kgy2/wish/1943415958 Researchers surveyed older, less, educated non-white, ESL patients on the use of open notes.

Findings: 
-Patient Safety
-Patient Provider Relationship
-Patient Engagement
-Improved Interactions ]]> 2021-12-13 01:09:28 UTC https://padlet.com/catahan/s5eqobjqf4o2kgy2/wish/1943415958