Health Care Informatics, the future and beyond

As I was preparing our powerpoint presentation on the EHR I was looking through some generic sources. I didn’t want just one EHR and its pros and cons, I wanted to know what the public sees and has access to.  One website I found that I really liked was http://enwikipedia.org.  It was a very generic website that covered a lot of topics and was very much on a lay person’s level.   The EHR is here and I think it is here to stay.  I think it is a very good use of our technology and patients are seeing the benefit from it. 

Where do I see the future going with this and the EHR, I think our possibilities are endless and as more is seen, done and tweaked, I think it will just get better from here.  For nursing schools, I would like to see more courses in health informatics.  I was not crazy about this class to begin with but I now see how much I have learned, how much the information and knowledge I have gained can be put to good use in my career.  I think that nursing is going computerized for a lot of things and I think nursing students need to be ready rather than the deer in the headlight look when they are on a floor or clinic with a computer in front of them. 

As I read for my power point about safety and the EHR it made me think about what else we need in place to better protect our patients from a HIPAA violation.  When you work on the floor anyone can walk up to the desk and ask about a patient.  Most of us are good about asking for a name and checking to see if that person is on the PHI form.  But do any of us really know who those people are?  Do we really trust that they are who they say they are?  How do we make sure we are not exposing someone to harm?  Do we use driver’s license for ID, do we ask the patient before the visitor goes in if they know this person and are okay with them coming in.  What do we do to keep our patient and ourselves self.  I wish I could say the world was getting kinder but it is not.  I attended a class yesterday about HZMAT, biochemical weapons, disasters, and health care.  What I heard scared me and made me wonder if we are prepared for what the world may throw at us.  With all of our technology, the retinal scanning, the passwords, the fingerprinting, firewall, that there could be something out there that would make us know who is really seeing our patients. 

I think nurses have to be ready for change, they need to try and embrace it.  I know when we went live with our EHR where I work there was a lot of grumbling and eye-rolling.  I did some myself but then I realized what an opportunity we had and what a blessing for our patients and other healthcare providers to have that information at their fingertips rather than digging through a paper chart.  We are the front line defense for our patients and we need to use the technology we have available  for the better good of our patients.  Our patients depend on us to have accurate information and have it quickly when we need it to provide the best care possible for them.   So I think we need to be aware of all that is out there, learn from it, and use it for our patient’s greater good.  It is always about the patients so we need to reach out for change and so go for it.

Webliography- Schizophrenia and its stigma in society

Schizophrenia is a chronic, severe and disabling brain disorder.  It affects about 1% of Americans.  People with schizophrenia may hear voices others don’t hear or they may believe that others are reading their mind.  They may feel that people are trying to control their thoughts or trying to harm them.  These things can cause people to become fearful, withdrawn or extremely agitated.  They may sit for hours without moving or talking.  Because many people with schizophrenia have difficulty holding a job or caring for themselves the burden on their family and society is significant and often terrifying for those around them.   

Schizophrenia is close to my heart but not in the sense that it is in my family.  It is close to my heart because psych and mental health is where I fell in love with nursing.  While in LPN school I took a few psychology and sociology classes and I fell in love with the classes and all that came with it.  When I did my mental health rotation, I felt right at home.  My classmates called my crazy and as did some of my family.  No one could really understand why I wanted to work there.  But work there I did in an inpatient psych department.  I felt for the patients and their families.  Many did not understand their diagnosis much less all that would go with a mental health diagnosis.  The stigma that is placed on many with this type of diagnosis is often cruel and very disheartening to those who have to live with it every day.  I sat and listened to patient after patient talk about how their family would disown them or they couldn’t get a job because of their medication or history.  They talked about friends turning away when they learned about their diagnosis.   They talked about relationships gone bad because of their disease.  What do you say to those people, how do you make them feel like they are of value and they are an important part of society?  How do you make them see that God loves them and created them as a loved and valued individual?  To me, no amount of medication or therapy can fix how society views a mental health diagnosis and the impact it has on that patient when they are not accepted into society.

I went through a lot of websites and journal articles.  I tried to pick articles that were current and also articles that dealt with both the disease process and the family.  When you have a family member or loved one that has a diagnosis of schizophrenia it is life changing.  The hallucinations, delusions, and thought disorders can be terrifying and each day is a new day for both you and your family member.  I wanted the latest information and medications used for schizophrenia so that this webliography would be useful and informative for those who wanted to utilize it

Delving deeper into schizophrenia diagnosis and treatment from the American Journal of Psychiatry, May 2009.    This article talks about not just touching the surface of a schizophrenic patient but digging deeper to see if you can treat the patient holistically as well as the people around the patient.

This is one of the first articles that caught my eye was from  http://psychiatry.jwatch.org.  This is a website that sorts by date and relevance.  It has the most current articles on medication and research related to many mental health topics.  It has physician authored summaries which I thought would be more accurate than some.  It also has editorials from the top medical journals such as the American Journal of Psychiatry, Schizophrenia Research and Science Magazine.  The article talked about current trends in new research in the field of mental health and schizophrenia.

Immune System Activated in Schizophrenia.  ScienceDaily.  November 18, 2009.  This article talks about the immune system and its relation to schizophrenia.  It has found that there is an increase of levels of inflammatory substance in the brain and drugs that affect the immune system might be the next treatment for patients with schizophrenia.

The source is http://sciencedaily.com.  This website is a site that deals largely with research.  The world of mental health is constantly changing as is the world of medicine.  This site combines both worlds and provides information from both sides to treat the patient both medically and emotionally.

Depression, a common problem in caretakers of the mentally ill.  October 22, 2007 from Schizophrenia Daily.

This is another good one from http://schizophrenia.com.  This not only had an overview of the disease, how it affected the patient but also how it affected the patient’s family.  As a nurse we are trained to view the patient in a holistic manner which to me includes the family or the patient’s support system whoever that may be.  It lists other websites, journals and books that could also be a source of information.  It is a non-profit source of information, support and education as stated on its website.

Schizophrenia: a major health problem from http://news-medical.net .  September 14, 2009.     This article talks about schizophrenia being a major public health problem.  Schizophrenia is found in about 1% of the world’s population.  It talks about the long-lasting implications as well as the enormous economic and social toll.

This website was interesting in the fact that is had blogs on it and also pieces of articles by people not just from the United States but from around the world.  The website is http://news-medical.net.  It was very interesting to see what other countries were doing.  I am an American through and through and we have excellent medical research but for me it is interesting to see what others around the world are doing for their patients and in turn learn from them to better serve our patients back home.

Upcoming Agents for the treatment of Schizophrenia: mechanism of action, efficacy and tolerability.  Drugs 2008;68.  This article is from 2008 but it had some very good information on the types of medications used to treat schizophrenia.  For the lay person and even for the nurse it is nice to have up to date articles on medications that we may not use a lot but can be so powerful for our patients.

The website used for this article was PubMed.gov.  The website has 19 million citations for biomedical articles and is very easy to navigate through to find information on articles you are in need of.

I always look for creative ways of treatment for patients with schizophrenia.  This one I found I liked because when I used to work in psych we used art therapy with a lot of our patients.

Art Therapy for Schizophrenia or Schizophrenia-like Illnesses.  Cochrane Database of Systematic Reviews 2005.  Issue 4.  This article talks about using art therapy in addition to medication.  It tells that art allows exploration of the patient’s world in a non-threatening manner.  It can also be used for patients who are non verbal as a method of expressing their thoughts and emotions.

This was found on the website www.gfmer.ch.  The website if the Geneva Foundation for Medical Education and Research.  It has a wide variety of websites, medical research in an easy to use manner.

Health Care Infomatics

What is health care informatics?  Coming into this class I was really unsure myself but my advisor assured me that it was a much needed class so here I am.  Working in a facility that is recently computer based I am starting to feel a little more comfortable behind the “keyboard” so to speak.  I’m still adjusting to the new and ever changing world of technology but as a nurse change is part of nursing too so ready or not, I need to catch up.  Health care informatics is a combination of information, computer science and my world of healthcare.  Informatics to me is a lot like my kid’s lego blocks.  They start with a couple of blocks and then build it up with more and more blocks until they have a tall tower of legos.  Informatics is a lot like that as well,  you start with a small base of knowledge and then you grow and add new “blocks” of information to build your “tower of knowledge.”  I feel the more blocks you add the more you can benefit your patients and those around you.  As we get older I believe that we lose some of our blocks.  It to me is like the game of building a tower and then you pull the blocks out of places but you have to do it stargetically to avoid knocking down the tower.  We may not get to choose which blocks in our mind get pulled out but if we work on having a strong knowledge base ahead of time then we can enjoy the builiding process we call life.  There are many that can benefit from our building blocks and I enjoy getting to add a new block to my tower from this class.

The first week of class I learned a lot of computer terms that while I had heard them, I defitinely needed a refresher.  I thought a lot about the term in the power point presentation of shoulder surfing.  That is something that I probally do at work on a daily basis never once thinking of the consequences or the fact that I could be looking at information that I don’t need to be looking at.  It has caused me to be more aware of my actions and more aware of others around me when I have a EHR open.

Who do I think owns the EHR?  That is a question that has haunted me since our facility went live with our latest computer system.  In my opinion it is the patient.  They own whatever information is posted in their chart about them at any given time.  I believe in the HIPA laws and firmly believe that everyone has a right to privacy.  There is an exception when it comes to patient safety and privacy such as an abuse case or something that could directly or indirectly harm a patient should that information not be shared with the right people.   I believe that the rest of the people, nursing, physician, insurance, etc…, using the EHR are just “visitors” and need to have a respect for those patients and families who depend on us to protect their records and the information in it.