Emerging Trends in Healthcare Informatics and Global Health

Presented by:

Sin Ting Chan

Lauren Mountanos

Nicole O’Neil

Elsa Owens

Alexsandra Youkhanneh

NURS 640

Overview, Beginnings, and Present Day

Evolution of Emerging Technologies Impact on Nursing and Global Health Various Technologies

Today’s Discussion:

Origination of Technology and Technology Trends

Highlight Misleading/Misinformation Explore and Discuss Current and Future Impacts Privacy and Ethics

The Air Force, the 50’s and the Lusted Brothers:

Informatics Present Since the 20th Century Military Introduction: Dental Project Ledley and Lee Lusted NIH-1ST Major Effort in Uniting Medicine and

Technology

2010 and Forward

Meaningful Use Government Incentive

The Perils of Misleading Information In Health Care Technology

Origination & Spread Flawed Information Insubstantial New Reporting Internet Accessibility: Risks vs. Reward

Emerging Technology– Vehicle for Combating the Spread of Misleading Information? Leveraging Same Technology Social Networking Public Health Crisis Management Telemedicine

Emerging Technology & Patient Protection and Affordable Care Act (PPACA) PPACA = Potential for Improved Outcomes Improved Health Outcomes Long-term financial benefits

In the struggle to provide high-quality patient care economically and ethically, the Patient Protection and Affordable Care Act (PPACA) aims to “expand insurance coverage, control costs and target prevention” (Sorrell, 2012).

Emerging trends in healthcare informatics and global health impact on patient care.

In terms of QUALITY,

EHR (Electronic Health Records): Manage longitudinal health records, exchange healthcare information, and integrate records across providers (Cohen, Grote, Pietraszek, & Laflamme, 2010, p. SP40).

CPOE (Computerized Physician/Provider Order Entry): Helps physicians in making better plan and treatment decisions for their patients.

Telemedicine or telehealth technologies: Enable health care providers to monitor, educate, and administer care remotely.

Robotics: Helps provide a less invasive and more comfortable experience for patients.

Bioinformatics: Helps provide better healthcare services and treatments by analyzing patients’ bio and health data.

Emerging trends in healthcare informatics and global health impact on patient care.

In terms of SAFETY,

EHR and CPOE: Reduce communication and medication errors.

Telemedicine or telehealth technologies: Guard patients’ safety with a series of technical standards, telemedicine guidelines, and best practices for the health care providers to follow (ATA, 2012).

Robotics: Robotic surgery will have less blood loss and trauma on patients when performed by a certified provider (UK HealthCare, 2014).

Bioinformatics: Patients’ diseases could be identified and treated more efficiently with the right medicines and treatments.

Emerging trends in healthcare informatics and global health impact on patient care.

In terms of COST SAVING,

EHR and CPOE: Reduce errors and adverse drug events which translate to significant cost savings.

Telemedicine or telehealth technologies:

a. Offers significant savings on transportation and office visit fees.b. Medicare and Medicaid coverage

Robotics: Robotic surgery helps decrease patients’ hospital length of stay.

Bioinformatics: With the bio data analyzed and correct disease identified with bioinformatics technology, unnecessary treatments and costs can be avoided.

Emerging trends in healthcare informatics and global health impact on patient care in the Future.

A. Emerging trends in healthcare informatics will continue to grow to raise quality of patient care. 1. Genetic advances allow new organs to be grown from a patient’s own tissues (Huston, 2013).

2. Clinical trials for clone teeth are in progress in Europe (Cohen, Grote, Pietraszek, & Laflamme, 2010).

B. Emerging trends in healthcare informatics will continue to enhance patient safety. In the hospital of the future, for example, ambient intelligence

would be embedded into the work environment functioning to assist healthcare providers with safe, cost-effective delivery of high quality care to patients.

Emerging trends in healthcare informatics and the privacy or ethical implications.

In Terms of Computer Order Physician Entry and Electronic Health Records :

Patients Fear

A fear their information may get in the wrong hand Fear seeing their personal information on social

media Fear loosing personal information to others to be

used for fraud Computer generated information may be wrong for

their personal needs Don’t want to feel their care is lacking human

element of care and empathy

How Patients View: Emerging trends in healthcare informatics.

COPE:• Patients feel this ensures they are getting up to date information

for their plan of care• Feel the care is faster • Appreciate the added security features

Electronic Health Care Records:• Feel comfort in the ability to access their personal health

information in one spot• Feel secure in the knowledge that doctors can share or receive

information needed for their care promptly

Robotics:• Feels it is faster way of delivering care• Feel that safety measures are in place• Fear the loss of human interaction• Feel that robots lack ability to share connection or show emotions

such as empathy or compassion

How Caregivers View: Emerging trends in healthcare informatics.

Caregivers:• Fear that the increase in the use of technology

will create a lazy or unskillful workforce that depends on technology to complete task and find solutions

• Unsure what can be shared and with who to ensure patients privacy rights are protected

• Fear a decrease in healthcare personal due to technology being able to complete task

• Appreciate the increased speed and safety that technology offers in patient care

The Adaptation of CPOE Many incentives result from the incorporation of such practices such as:

• it can decrease delays in order completion

• reduce errors related to handwriting misinterpretation

• allow order entry at the point of care or off-site which can save time

• allow healthcare professionals to eliminate errors such as duplicate or incorrect doses or tests.

This type of patient information management system also has a few disincentives worth mentioning. For instance:

• it can delay communication in an emergency situation as staff have to wait for order retrieval and updates on plan of care

Also, since many providers and healthcare team members are working independently, it can cause a breakdown in communication. Automation causes a false sense of security, a misconception that when technology suggests a course of action, errors are avoided.

Another disincentive according to one source, frequent alerts and warnings can interrupt work flow, which can cause these messages to be ignored or overridden due to alert fatigue.

The advancement of Mobile Technology & Telemedicine in the Healthcare Field:

Many opportunities to improve health largely rely on cell phone technologies, since cell phones are so rapidly expanding in many parts of the world that otherwise don't have much access to communication; therefore, research continues to imply that mobile technology can be an excellent source and incentive to improve patient care outcomes.

Telemedicine is a tool that has the potential to help millions of people all over the world regardless of what their medical conditions are or what their ethnic background is. This form of healthcare information management can be a great

asset to any healthcare organization as a way to improve communication and share critical information

An incentive of this tool is that it can be of use for military personnel as they are oftentimes located in areas of the world that telemedicine is the only way to diagnose and treat them.

Telemedicine can save provider time and decrease staffing as many times the patient can be seen by a doctor through this device and it eliminates the need for the patient to be seen in the office setting.

Robotics is another emerging trend and was first introduced to the healthcare industry as a way to use modern technology to perform repetitive tasks.

Another emerging trend in the healthcare sector is bioinformatics.

Bioinformatics is the combination of biological computer science and medical research.

As healthcare research and discoveries continue to grow, the need to involve computers to categorize, organize, analyze and keep track of all the information is critical.

The goal with bioinformatics is to record information in a way the machine can understand and then link it to knowledge resources, decision support and monitoring resources (Andrews, 2012).

The Effects of these Emerging Trends On inter-disciplinary and intra-disciplinary teams

As mentioned, CPOE can potentially obstruct inter and intra-disciplinary teams by weakening communication related to potential delays in information.

The use of this newer system eliminates real time and face-to-face interactions and communication with other members of the team; which in some instances, such as in an emergency, this form of communication is most necessary.

The use of mobile technology can drastically improve inter and intra-disciplinary teams by increasing availability of social networks so internal members of the team and health care providers can easily communicate with one another to exchange needed medical data.

Telemedicine, as already mentioned, can bring together many different healthcare providers that otherwise wouldn’t have the opportunity to collaborate on patient care; therefore, it can be a great tool to improve intra-disciplinary teams.

Robotics, on the other hand, while effective at reducing errors, these types of procedures add to the workload of people who are already stressed and working at their limits and therefore may possibly obstruct teams in the healthcare field.

References (1)Agaku, I. T., Adisa, A. O., Ayo-Yusuf, O. A., & Connolly, G. N. (2014). Concern about security

and privacy, and perceived control over collection and use of health information are

related to withholding of health information from healthcare providers. Journal of the

American Medical Informatics Association, 21(2), 374-378.

Andrews, J. (2012). Bioinformatics Evolution Continues. Retrieved from:

http://www.healthcareitnews.com/news/bioinformatics-evolution-continues?page=1

Andrews, M. (2013, April 23). Questions arise about robotic surgery's cost, effectiveness.

Retrieved March 5, 2015, from Kaiser Health News:

http://kaiserhealthnews.org/news/042313-michelle-andrews-robotic-surgery/

ATA. (2012). Telemedicine frequently asked questions. Retrieved March 5, 2015, from

American Telemedicine Association: http://www.americantelemed.org/about-

telemedicine/faqs#.VPj4YfnF8Ys

ATA. (2013, April). Examples of research outcomes: Telemedicine's impact on healthcare cost

nd quality. Retrieved March 5, 2015, from American Telemedicine Association:

http://www.americantelemed.org/docs/default-source/policy/examples-of-research-

outcomes---telemedicine's-impact-on-healthcare-cost-and-quality.pdf

Barris, M. (2014). Health marketers leverage mobile to correct Ebola misinformation. Mobile

Marketer. Retrieved from: http://www.mobilemarketer.com/cms/news/software-

technology/19229.html?utm_referrer=direct%2Fnot%20provided&utm_referrer=direct%

2Fnot%20provided

References (2)Charles, K., Cannon, M., Hall, R., & Coustasse, A. (2014, October 14). Can Utilizing a

Computerized Provider Order Entry (CPOE) System Prevent Hospital medical errors and

adverse drug events? Perspectives in Health Information Management, 1-16.

Cohen, S., Grote, K., Pietraszek, W. E., & Laflamme, F. (2010, December). Increasing

consumerism in healthcare through intelligent information technology. The American

Journal of Managed Care, 16, SP37-SP43. Retrieved February 23, 2015

Collins, F. (2011). Mobile Technology and Health Care. Retrieved from:

http://www.nlm.nih.gov/medlineplus/magazine/issues/winter11/articles/winter11pg2-

3.html

Fairbrother, P., Ure, J., Hanley, J., McCloughan, L., Denvir, M., Sheikh, A., & McKinstry, B.

(2014, January 1). Telemonitoring for chronic heart failure: the views of patients and

healthcare professionals – a qualitative study. Journal of Clinical Nursing, 23, 132-144.

Hillestad, R., Bigelow, J., Bower, A., Girosi, F., Meili, R., Scoville, R., & Taylor, R. (2005,

September/October). Can electronic medical record systems transform health care?

Potential health benefits, savings and costs. Health Affairs, 24(5), 1103-1117.

doi:10.1377/hlthaff.24.5.1103

Huston, C. (2013, May 31). The impact of emerging technology on nursing care: Warp speed

ahead. The Online Journal of Issues in Nursing, 18(2), Manuscript 1.

doi:10.3912/OJIN.Vol18No02Man01

Kim, M., Jung, Y., Jung, D., & Hur, C. (2014). Investigating the congruence of crowdsourced

information with official government data: the case of pediatric clinics. Journal Of

Medical Internet Research, 16(2), e29. doi:10.2196/jmir.3078

References (3)Loscalzo, J. (2011, May). Systems biology and personalized medicine a network approach to

human disease. American Thoracic Journal, 11(2), 196-198.

Metzler, T. A., & Barnes, S. J. (2014, Janurary 1). Three dialogues concerning robots in elder

care. Nursing Philosophy, 15, 4-13.

Pickering, B., Litell, J., Herasevich, V., & Gajic, O. (2012, April 26). Clinical Review: The

hospital of the future-building intelligent environments to facilitate safe and effective

acute care delivery. Critical Care, 16(220), 1-11. doi:10.1186/cc11142

Ranney, M. L., Choo, E. K., Wang, Y., Baum, A., Clark, M. A., & Mello, M. J. (2012, August).

Emergency Department Patients’ Preferences for technology-based behavioral

interventions . Annals of Emergency Medicine , 60(2), 218-227.

Ross, G. (2012). Robotics in Healthcare: Challenges and Opportunities. Retrieved

from:http://medicaldesign.com/archive/robotics-healthcare-challenges-and-opportunities-

0

UK HealthCare. (2014, December 18). Quality and safety: Robotic surgery. Retrieved March 5,

2015, from UK HealthCare: http://ukhealthcare.uky.edu/quality/conditions-and-

procedures/robotic-surgery/

University Alliance. (2015). Telemedicine: The Future of Healthcare. Retrieved from:

http://www.villanovau.com/resources/nursing/telemedicine-technology/#.VPlBT_nF-So

Versel, N. (2014). CPOE: A 'new ball game'. Retrieved from:

http://www.healthcareitnews.com/news/cpoe-new-ball-game

References (4)

Won, J. Y. (2014, April 15). Bioinformatics-how data analytics is changing healthcare and our

lives. Retrieved March 5, 2015, from Digital Assets: Data and Analytics:

http://blog.hbs.edu/dighbs/bioinformatics-how-data-analytics-is-changing-healthcare-

and-our-lives/

World of DTC Marketing.com. (n.d.).The dangers of misinformation in healthcare. Retrieved

from: http://worldofdtcmarketing.com/the-dangers-of-misinformation-in-health/health-

information-online/

Young, S. (2011). Recommendations for Using Online Social Networking Technologies to

Reduce Inaccurate Online Health Information.

Annotated Bibliography (1)

Agaku, I. T., Adisa, A. O., Ayo-Yusuf, O. A., & Connolly, G. N. (2014). Concern about security and privacy, and perceived control over collection and use of health information are related to withholding of health information from healthcare providers. Journal of the American Medical Informatics Association, 21(2), 374-378.

This article explores the range of social media platforms used by patients and examines the benefits and challenges of using these tools from a patient perspective. Most relevant to this paper, is the article’s key points surrounding challenges relating to privacy and security concerns, usability, the manipulation of identity, and misinformation. Data in the article suggests technology holds promise for improving patient engagement and empowerment and community building. This article was found this through the Fusion database through the folllowing search: “misinformation and health technologies.”

Andrews, M. (2013, April 23). Questions arise about robotic surgery's cost, effectiveness. Retrieved March 5, 2015, from Kaiser Health News: http://kaiserhealthnews.org/news/042313-michelle-andrews-robotic-surgery/

This site discussed questions related to cost and effectiveness of robotic surgery. This article is supported by research studies. The author revealed the benefits of undergoing robot-assisted surgery might have been overstated. This article is useful when discussing the cost saving and robotic surgery effectiveness. This article was found through the Google search engine with a search of “Robotics and Cost”. ATA. (2012). Telemedicine frequently asked questions. Retrieved March 5, 2015, from

American Telemedicine Association: http://www.americantelemed.org/about-telemedicine/faqs#.VPj4YfnF8Ys

This site provided an overview of telemedicine. It explained the differences between telemedicine and telehealth, safety, patient access, and Medicare or Medicaid payment. This article is useful when defining telemedicine and its payment for providers when patients are utilizing the services. This article was found through the Google search engine and search: “what is telemedicine.”

Annotated Bibliography (2)ATA. (2013, April). Examples of research outcomes: Telemedicine's impact on healthcare cost

nd quality. Retrieved March 5, 2015, from American Telemedicine Association: http://www.americantelemed.org/docs/default-source/policy/examples-of-research-outcomes---telemedicine's-impact-on-healthcare-cost-and-quality.pdf

This site discussed research outcomes related to telemedicine and health cost and quality. The authors cited multiple research studies to support the cost effectiveness and efficacy of many telemedicine applications. This article is useful when discussing the cost saving and viability of telemedicine. This article was found through Google Scholar with the search “telemedicine and cost saving.”

Charles, K., Cannon, M., Hall, R., & Coustasse, A. (2014, October 14). Can Utilizing a Computerized Provider Order Entry (CPOE) System Prevent Hospital medical errors and adverse drug events? Perspectives in Health Information Management, 1-16

This is a peer review study, examining if the adaption of Computerized Provider Order

Entry (CPOE) will assist in decreasing hospital errors and patient injuries due to late order completion, unrecognizable hand writing and inability to retrieve patients charts for order entry or review. The study found the order completion was decreased from 100 minutes to 64 minutes. Hospitals that switch to a COPE system could see up to a 48% reduction in medical errors. Many COPEs are paired with Clinical Decision Support Services (CDSS) that can alert care providers of allergies, drug interactions and may alert a physician when another service may be in order. Many physicians feel that structured order sets and support systems tie their hands with scripting how physicians order care. According the study patients have also felt distant and disconnected to caregivers that seem to be working on the computer and not connecting with the patient.

Cohen, S., Grote, K., Pietraszek, W. E., & Laflamme, F. (2010, December). Increasing consumerism in healthcare through intelligent information technology. The American Journal of Managed Care, 16, SP37-SP43. Retrieved February 23, 2015

This article discussed the benefits of increasing consumerism in healthcare through intelligent information technology. It defined the current role of health information technology. The authors described four steps that lead to consumer engagement, which are attract, engage, change behavior, and sustain. Also, it provided an overview of different types of technologies that enable patient engagement, such as telemedicine and remote care management, clinical decision support, electronic health records (EHR), and health intelligence. The definitions of clinical decision support and EHR are useful in providing the background information for this project. This article was located in the CINAHL database. I searched for “electronic health record and impact”.

Annotated Bibliography (3)Fairbrother, P., Ure, J., Hanley, J., McCloughan, L., Denvir, M., Sheikh, A., & McKinstry, B.

(2014, January 1). Telemonitoring for chronic heart failure: the views of patients and healthcare professionals – a qualitative study. Journal of Clinical Nursing, 23, 132-144.

This is a quantitative study examining the patients and care providers views on use of Home Telemonitoring on the Congestive Heart Failure Patient. According to the study many patients felt cared for, more informed and better prepared to self manage after completion of the program. Many patients had issue with equipment and felt the technology could have been mare efficient and user friendly. Nursing had the following reflections: the program was not a good match with all patients in their caseload and wanted a more accurate screening tool for program entry, if the other systems did not pair well there was an disconnect between physician response and patients’ needs, the program caused patient dependence on program and caregiver, and that the telemonitoring was limited in its capability. Hillestad, R., Bigelow, J., Bower, A., Girosi, F., Meili, R., Scoville, R., & Taylor, R. (2005,

September/October). Can electronic medical record systems transform health care? Potential health benefits, savings and costs. Health Affairs, 24(5), 1103-1117. doi:10.1377/hlthaff.24.5.1103

This article provided a detailed overview about the potential health benefits, savings, and costs associated with the adaptation of electronic health record (EHR) systems in health care. It discussed the estimating of potential of health information technology efficiency savings, estimating the costs of adoption, estimating potential safety benefits, and estimating other potential health benefits. This article was written in 2005 but it includes useful data for the project, such as alert and reminder system in EHR, computerized physician order entry (CPOE), and elimination of adverse drug events using CPOE and its cost saving. The authors demonstrated the potential efficiency savings with adoption of EHR systems in 5 year, 10 year, and 15 year. Huston, C. (2013, May 31). The impact of emerging technology on nursing care: Warp speed

ahead. The Online Journal of Issues in Nursing, 18(2), Manuscript 1. doi:10.3912/OJIN.Vol18No02Man01

This is a peer-reviewed journal that talked about how seven emerging technologies impact the practice of nursing care. It also discussed three skill sets and four challenges that nurses will need to develop and face in integrating these new technologies. This article is well written and supported by other research journal and articles. This article is useful when discussing details in robotics, EHR, and CPOE. This article was found through Google Scholar with a search for “informatics technologies and nursing.”

Annotated Bibliography (4)

Annotated Bibliography (5)

Thank You!