InterOpNurse: A Nurse working in the field of Healthcare Information Technology. Chronicling my experiences as I go through the different stages and struggles of software maintenance and implementation. Technology tools for nurses must adapt to their workflow and be configurable and always available. Technology will continue to positively impact nurses, decreasing their workload, helping them deliver proactive care and supplying critical information by unit or hospital-wide. I hope to first hand go through this journey of change as I look for tools designed for and by nurses; a personal journey to see how technology can meets nurses' high needs and expectations.

Posted by InterOpNurse on July 9, 2008

6 Ways to Recruit Nurses through the Internet


By InterOpNurse guest contributor:   Heather Johnson

 

The internet has extended its tentacles all over the nursing industry.  While information technology is one of the best ways nurses’ jobs are made easier, the internet has made it possible for hiring managers to find the best available nurses for their staff.  There are thousands of websites that claim to be the best out there for finding nurses, if you’re going to be in the recruiting business for your facility you need to be honest and up front.  Aside from that most crucial piece of recruiting advice, here are six more things you need to know about recruiting on the internet:

 

  1. Explicitly define your benefits package.  Nowadays, your benefits that you offer your workers are often deal breakers or deal makers.  Explain your salary structure, retirement savings plan, health insurance plan, time off procedures, etc.  This will be one of, if not the, first things that prospective nurses will look at.
  2. Let nurses know who you serve.  Identifying your demographic base will give nurses an honest description of where they may be working.  This goes hand-in-hand with our cardinal rule of being up front with your prospective employment base.
  3. What kind of environment can nurses expect?  Explain the resources you have available for your nurses.  Let them know what kind of experience your staff has.  Who makes the decisions for nursing care?  Is personal and professional growth a priority?  These are all things you should be advertising and questions you should be answering.
  4. Introduce key personnel.  On your main page, introduce the people that your new nurses will be reporting to on the administration and nursing levels.  This will foster a more personal attitude for the prospective nurses.  Don’t be afraid to put faces to the people that your nurses will be working with and if this is a problem then that’s something that could be a major issue down the road.
  5. Be current with the times.  Most reputable organizations welcome online resume submissions.  It’s not enough just to accept resumes in this fashion but you need to take ownership and provide initial feedback within a day.  This practice will make you come off as an organization that is responsive to the technological demands of the incoming crop of nurses.
  6. Make your mission known.  We recommend that you put your mission statement somewhere prominent on your main page.  Let visitors to your site know your methods and what you expect from all levels of personnel.

 

By-line:

 

This article is contributed by Heather Johnson, who regularly writes on top nursing school. She invites your questions and writing job opportunities at her personal email address: heatherjohnson2323 at gmail dot com.

 

Posted by InterOpNurse on July 8, 2008

Most Doctors Aren’t Using Electronic Health Records


This is such a good article with wealth of information, I found it necessary to embed here…

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The New York Times: June 19, 2008

Most Doctors Aren’t Using Electronic Health Records

By STEVE LOHR

 

A government-sponsored survey of the use of computerized patient records by doctors points to two seemingly contradictory conclusions, and a health care system at odds with itself. The report, published online on Wednesday in The New England Journal of Medicine, found that doctors who use electronic health records say overwhelmingly that such records have helped improve the quality and timeliness of care. Yet fewer than one in five of the nation’s doctors has started using such records.

 

Bringing patient records into the computer age, experts say, is crucial to improving care, reducing errors and containing costs in the American health care system. The slow adoption of the technology is mainly economic. Most doctors in private practice, especially those in small practices, lack the financial incentive to invest in computerized records.

 

The national survey found that electronic records were used in less than 9 percent of small offices with one to three doctors, where nearly half of the country’s doctors practice medicine.  Dr. Paul Feldan, one of three doctors in a primary care practice in Mount Laurel, N.J., considered investing in electronic health records, and decided against it. The initial cost of upgrading the office’s personal computers, buying new software and obtaining technical support to make the shift would be $15,000 to $20,000 a doctor, he estimated. Then, during the time-consuming conversion from paper to computer records, the practice would be able to see far fewer patients, perhaps doubling the cost. “Certainly, the idea of electronic records is terrific,” Dr. Feldan said. “But if we don’t see patients, we don’t get paid. The economics of it just seem so daunting.”

 

Private and government insurers and hospitals can save money as a result of less paper handling, lower administration expenses and fewer unnecessary lab tests when they are connected to electronic health records in doctors’ offices. Still, it is mainly doctors who bear the burden making the initial investment.
“We have a broken market for electronic health record adoption because the people who gain financially are not the people who pay,” said Dr. Blackford Middleton, a health technology expert at Partners Healthcare, a nonprofit medical group that includes Massachusetts General Hospital in Boston.
To fix the market, Dr. Middleton, like others, recommends that the government play a role in providing incentives or subsidies to speed the use of computerized patient records in the United States, whose adoption rate trails most developed nations. The government took a step in that direction last week, announcing a $150 million Medicare project that will offer doctors incentives to move from paper to electronic patient records. The program is intended to help up to 1,200 small practices in 12 cities and states make the conversion. Individual doctors will be offered up to $58,000 over the five-year span of the project, which is intended to test the impact of incentives on the spread of electronic health records.

 

Further programs across the country are planned.  The report published in the journal also found that electronic health records were used by 51 percent of larger practices, with 50 or more doctors.
Indeed, electronic health records are pervasive in the largest integrated medical groups like Kaiser Permanente, the Mayo Clinic, the Cleveland Clinic, University of Pittsburgh Medical Center and others. These integrated groups not only have deep pockets. By combining doctors, clinics, hospitals and often some insurance they can also capture the financial savings from electronic health records.  The findings of the study, which was paid for by the Department of Health and Human Services and a grant from the Robert Wood Johnson Foundation, broadly echo previous research on the adoption of electronic health records. Large medical groups have long been the early adopters, and small practices have struggled.
But the new study is based on a large sampling — more than 2,600 doctors across the country — and a detailed survey, making it more definitive than past research, experts say. The results, they say, also show a strong endorsement of electronic health records by doctors who have them, especially for what the report termed “fully functional” records, which include reminders of care guidelines, based on a patient’s age, gender or medical history.  For example, 82 percent of those using such electronic records said they improved the quality of clinical decisions, 86 percent said they helped in avoiding medication errors and 85 percent said they improved the delivery of preventative care.  “Those numbers are huge and very encouraging,” said Dr. David J. Brailer, the former health information technology coordinator in the Bush administration.

 

Dr. Brailer also pointed to the 54 percent of doctors without electronic health records who said that not finding an electronic health record that met their needs was a “major barrier” to adoption. In short, they are not satisfied with the existing products, which tend to be designed for hospitals — big customers — instead of small practices.  “What we see is a deficit in innovation, and that is something innovators and the capital markets can address,” said Dr. Brailer, who leads a firm that invests in medical ventures, Health Evolution Partners.  One wave of innovation is coming from big technology companies, like Microsoft and Google, which recently have begun services that offer consumer-controlled personal health records over the Web, which are stored in the companies’ data centers. These consumer-controlled health records are intended to link up and exchange information with electronic patient records in doctors’ offices and hospitals. Dr. Peter Masucci, a pediatrician with his own office in Everett, Mass., embraced electronic health records to “try to get our practice into the 21st century.”  He could not afford conventional software, and chose a Web-based service from Athenahealth, a company supplying online financial and electronic health record services to doctors’ offices.  Dr. Masucci was already using Athenahealth’s outsourced financial service, and less than two years ago adopted the online medical record.

 

Today, Dr. Masucci is an enthusiast, talking about the wealth of patient information, drug interaction warnings and guidelines for care, all in the Web-based records.  “Do I see more patients because of this technology? Probably no,” Dr. Masucci said. “But I am doing a better job with the patients I am seeing. It almost forces you to be a better doctor.”

 

Copyright 2008 The New York Times Company

Posted by InterOpNurse on July 8, 2008

In The News 07/08/2008

Best Careers for 2008

32% of RNs Say They Shouldn’t Be Driving After Work  

Thought everyone might be interested in this article from the Congressional Budget Office on the Evidence on the costs and benefits of health information technology. It might help with those trying to determine metrics for the implementation of an EHR.

Telehealth PromiseBetter Health Care and Cost Savings for the 21st Century - report from AT&T Center for Telehealth research and Policy, U of Texas


Telecare made easyA very strong case can be made that the UK is way ahead of the US in Telecare.

 

Advances in electronic medical records have led to the need for standardization of nursing language and “finding a place for nursing’s voice to be heard,” says a Florida Atlantic University professor of nursing. She is working on an e-records model that will allow nurses to enter not only medical data but also their notes on relationships with patients

A great website concept for connecting cancer survivors.

 

Has anyone seen the new device from Amazon called the “Kindle.”  If they actually start having nursing and medical textbooks be available, this might actually have a place in the health care sector.

 

Here are some EMR/EHR company spoof sites.  This is too funny.  If you do not read teh fine prints, you can be fooled to thinking it is a legitimate company.  Great website design at least.  Here you go:

  • Extormity = “At the confluence of extortion and conformity lies Extormity, the electronic health records mega-corporation dedicated to offering highly proprietary, difficult to customize and prohibitively expensive healthcare IT solutions.”
  • Seedie = “SEEDIE, the Society for Exorbitantly Expensive and Difficult to Implement EHR’s”

Nurses aren’t trained to be managers. They’re trained to be clinicians. So how can your hospital ensure that it is providing the additional training and leadership development needed to create the next generation of chief nursing officers…

Doctors using Virtual ApproachRush University Medical Center’s new study reports that elederly patients suffering from chronic illnesses receiving virtual care from a team of medical experts linked together via phone, fax, and email make fewer emergency room visits. Also download a presentation on the Virtual Integrated Practice approach.

CMS’ proposed rule to allow physicians to be reimbursed for telehealth follow-up inpatient consultations could encourage insurers to provide similar reimbursements, Modern Healthcare reports (Vesely, Modern Healthcare, 7/2).

Details of Proposed Rule

The proposed CMS rule for 2009 Medicare payments, released this week, would allow physicians to bill for electronic consultations following inpatient visits. It also would add new codes specifically for telemedicine consultations for health care providers who are consulted by a patient’s physician but are not available for in-person consultations (iHealthBeat, 6/30).

The telehealth consultations would include monitoring a patient’s progress, recommending care-management changes or providing a new plan of care. The e-visits would be performed in real time with interactive communications systems in all states except for Alaska and Hawaii, where store and forward technology is being used in federal telemedicine demonstration projects, according to CMS.

The three new billing codes would reflect the complexity of each different e-visit and the amount of time spent by the physician.

Private Insurers

Jonah Frolich, senior program officer for the California HealthCare Foundation, said that while e-visits are still new, some insurers already have begun reimbursing health care providers for the service. Five California insurers are paying $40 per e-visit, and some national plans have launched telemedicine reimbursement pilot projects, Frolich said.

He added that insurers tend to adopt billing practices used by CMS (Modern Healthcare, 7/2).

Considering telecare for someone with dementia.  In this social worker’s blog he/she describes going to assess a client for the first time. It’s heartening to see that some form of telecare is automatically considered as part of that process

Posted by InterOpNurse on May 27, 2008

In the News 05/27/2008

A blogger Alfred Fortin came up with 101 things to do with a mobile phone in healthcare. 

AHRQ is currently seeking for clinicians to provide them input via a web based focus group, to understand how to get a broader perspective on adoption of Healthcare IT tools.

Video tool would aid sign language interpretation.

Where are we on the ADN versus BSN debate.  I personally believe that from a professional standpoint and development of Nursing, the BSN should be a minimum requirement.  I understand that we are at a shortage, and require a medium to fast track nurses into the work force.  But, there is no relief in sight for the shortage, so now more than ever, a professional standard should be imposed…

CIGNA Healthcare to offer expert online second medical opinion services through E-Cleveland Clinic.  Isn’t Cleveland clinic the pilot area for the new Google PHR.  I wonder if there is a future plan to merge the two services together?

Cultivating an informatics culture within nursing education.  I agree 100% that education about uinformatics needs to start in the academic setting.  But, personally, noramlly it is the new grads that get it…that know the impoiratnce of integrating informatics in practice.  The question is, how do you cultivate already practicing nurses?

A nursing professor - Patrick Hickey will climb Everest to help bring attention to the nations nursing shortage issue. 

Posted by InterOpNurse on May 23, 2008

In the News 05/23/2008

I will be trying this new column, I am calling “In the News.”  My plan is to of course include Healthcare IT (HIT) related stories, but to also have a column to collate news I find interesting.  Hopefully I can enage you, my readers to comment on them and utilize these columns to dialogue about news and events.  For now, until I find a clever way to enable comments without attracting all the spam, I will require you to register.  Any suggestions on how I can manage this better is welcome and appreciated.  Shall we give this a try….

Microsoft came out with a medical imaging product at this years HIMSS conference in Orlando called Amalga (formerly known as Azyxxi).  It looks like they are now trying to staff for this product.

Thanks to Facebook, a top ten list has been compile as to why someone should date a nurse.  My top two favorite from the list is #5 “you will never need to buy condoms, paracetamol, toothbrushes or any hospital supplies” and #6 “they know how to handle bodily fluids!”

I do no mean to sound like a pessimist, but according to this article, RN’s are warming up to Inforamtion Technology…please wake me up, I am apparently dreaming. 

Apparently research work done at UCLA has shown a correlation between children behavioral problems and mobile phone use.

HP joins the Tiny Notebook race, as it competes with ASUS Eee, Classmate, Netbook and Sony Vaio.

Apple will be holding its Worldwide develpoers conference on June 9-13 in San Francisco.  Rumor has it that Steve jobs will be announcing the release of iPhone 2.0 which will now have Microsoft’s activesync support.  I wonder what the impact this will have for IT departments who utilizes Mocrosoft exchange and the surge of people whol will now want the iPhone?

Todd Davis, CEO of LifeLock who made a bold move to promote his company by publishing his real social security number to challenge identity theft.  Apparently after two years of daring people to steal his identity…it finally happened.

Posted by InterOpNurse on May 15, 2008

Nagging via text messages to help teens remember meds

Doctors in Cincinnati are experimenting with text messaging to get tweens and teens to take their medications for chronic illnesses, such as diabetes, kidney disease and asthma. “It’s a time of so much change in these kids’ lives,” says Dr. Marva Moxey-Mims, of the National Institutes of Health. “It’s very difficult when you’ve got a life-threatening illness to say, ‘Let them make their mistakes.

Read more…

Posted by InterOpNurse on May 12, 2008

Bill would foster growth of nurse educator corps

A federal legislator has a filed a bill designed to encourage active-duty military nurses and those retiring from military service to become nurse educators. The legislation, modeled after a Defense Department program helping military personnel move into education, offers varied fellowships and scholarships to nurses interested in faculty positions. Retired nurses would get financial incentives for serving as full-time faculty at an accredited school of nursing. The bill hopes to address the drastic shortage of nurse educators that prevails today. According to the American Association of Colleges of Nursing, U.S. nursing schools turned away almost 43,000 qualified applicants in 2006.
http://www.modernhealthcare.com/

Posted by InterOpNurse on April 24, 2008

Montana Clinic Reaches Goals in CMS Pilot

This is quite an impressive account of user-friendly telemetry implementation, both productive and economically feasible!

BILLINGS, MT – The Centers for Medicare and Medicaid Services has just closed the books on the second performance year of its Medicare Physician Group Practice demonstration, and the Billings Clinic released a case study on its participation of that pilot.

Read more…

Posted by InterOpNurse on April 24, 2008

Health Care Meets Online SocialMedia

From Jane Sarasohn-Kahn

Social media on the Internet are empowering, engaging, and educating health care consumers and providers. While consumers use social media — including social networks, personal blogging, wikis, video-sharing, and other formats — for emotional support, they also heavily rely on them to manage health conditions.

Read more…

You may want to visit her blog at http://www.healthpopuli.com/

Posted by InterOpNurse on April 24, 2008

10 Great Careers You’ve Probably Never Heard Of

Found this great article on 10 great careers you probably have never hear of.  Article states:

“Technology, demographic shifts, new legislation, and consumer preference changes have effectively eliminated many jobs. (Met any dodo trainers lately? Or FORTRAN pros, for that matter?) However, there’s an upside to obsolescence: the creation of jobs that, until recently, no one had ever heard of–and perhaps you still haven’t.”

Guess which one is at #1?

Read more…

Posted by InterOpNurse on April 23, 2008

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Posted by InterOpNurse on April 22, 2008

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Posted by InterOpNurse on April 21, 2008

Experts Say Technology Can Help Seniors Remain Independent

Experts involved in two recent studies say that home health care technologies, such as electronic pill dispensers and systems that monitor patients’ vital signs, offer benefits that outweigh their costs, MarketWatch reports.

Majd Alwan — co-author of a Center for Aging Services Technologies’ study, titled “State of Technology in Aging Services” — said the cost of technology that allows seniors to remain independent might be a “couple hundred dollars” per month, while the cost of a nursing home could be $6,000 per month.

Posted by InterOpNurse on April 20, 2008

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