You don't need to be a 'techy'

While you were working, have you ever wondered if there was a better way of
doing something? You are probably right. Technology can facilitate a new
way of providing patient care. The use of technology in healthcare is
called electronic healthcare or eHealth.

Learning what technology is available, how to use and the benefits to
patient care can be overwhelming. At times you may feel it's easier to
continue with the current ways of doing things. I agree it probably is
easier. Speaking up for a change requires time spent learning about
eHealth, leadership and courage. The personal growth and reward in watching
the change unfold make it all worth it in the end.

Take it from me; you don't need to be an expert in all things "techy". You
just need to have a passion for learning, and providing exemplary patient
care. Before I got involved in eHealth I had been a nurse for eight
months, and didn't have much experience in nursing or eHealth.

So you might be wondering; where should I begin? Taking the RNAO eHealth
workshop and volunteering in projects helped me build the skills and
knowledge I would later need. I encourage you to take advantage of the
Registered Nurses Associations online courses, workshops, toolkits, and peer
mentors. Many of these resources are free and provide you with the knowledge
and leaderships skills to integrate eHealth technology in your practice. I
hope you're up for the challenge!

http://www.rnao.org/Page.asp?PageID=924&ContentID=3156

(The first ten people to register for the online eHealth and Every Nurse
course get a $50.00 gift certificate for an RNAO course. )

Skip the cart and move to iPads: Telemedicine in Long Term Care

        I have been starting to think about how to make telehealth more accessible to nurses on units in long term care. Integrating telehealth into long term care to improve access to specialist consultation has many benefits as seen in the RAVEN study currently being conducted at the University of Pittsburgh. To access telehealth services, special telehealth carts are wheeled into each room. Or, each room has a Telehealth unit installed. Either situation the unit is expensive, and requires a large capital investment. Accessibility questions, such as what units should the carts be placed on, how many carts are need must be determined to know the capital investment required. However, since Telemedicine is a new frontier for long term care there is unease with investing too much in the technology. Under utilization with a large capital investment is a very valid concern. The training costs are high as well. Specialized training is required on the carts, and due to the large turnover of staff in long term care facilities keeping up with the training requirements is also a challenge.
    I was thinking how can we minimize the capital investment for long term care and make telehealth more accessible for nurses?  MD's are moving to Ipads for charting and to do telemedicine consultation. What would it look like if  we moved away from the carts for nurses and have them initiate telemedicine consultations with iPads? At a Health 2.0 event in Pittsburgh this week on Aging, Mildred Morrison from the Area Agency on Aging discussed that we need to make technology invisible, and integrated it into every day life.  That way it doesn't seem as scary and foreign.   The carts are intimidating, and only a select few "champions" or specialized "Telemedicine Coordinators" often are the ones to operate and use Telemedicine carts. Most RN's have iphones in their pockets and are comfortable using the technology. By using iPads to initiate telemedicine calls it becomes the new age pager for nurses. The remote telemedicine specialist team now becomes an extension of their in house care team.
     Of course you will say, but how can they hold the iPad and help examine their client? How can they zoom in and see a wound? I'm sure there is a place and time for the telemedicine carts.  However, if people are accessing specialists in their own homes using smart phones,  let's put this easy to use, widely available technology into the hands of nurses.

eHealh vs eHealth Ontario

The word eHealth has been in the news and many of you maybe wondering what is eHealth? eHealth is a term used to describe electronic healthcare. eHealth Ontario is the provincial organization is responsible for overseeing and creating an electronic healthcare record for all Ontarian’s. Nurses who work in areas such as nursing informatics, telemedicine and who collaborate on teams to implement online medication order entry or electronic charting are employed by their individual healthcare organizations.

It is now more then ever that nurses can step up and be the voice for improving the delivery of patient care through the use of eHealth technologies.

The RNAO has provided you with information on eHealth through a free online course.

Learn how to make a difference, learn about eHealth click on the link below:

http://www.rnao.org/ehealth_course/

E-health Leadership Toronto, Central

Lydia Lee's role
Leads e-health projects in the Toronto Central LHIN #7. She works with healthcare organizations (Health Service Providers) in the Toronto Central LHIN and GTA to effectively implement e-health projects.

Lydia said that there are three main projects that are important for nurses to know and where nursing has an opportunity to participate.

1. Discharge Planning also known as RMR project (Resource Matching and Referral Project)

If you work in an acute care surgical or GIM unit in downtown Toronto you already use this. It is an electronic discharge summary that is linked to referral agencies associated with the hospital ex. long term care, rehab sites and CCAC. Coming in the future will be the capacity to submit your discharge summary and then a report will be automatically generated giving you information on the type of patient that facility can except. Just imagine how efficient your discharge planning can be if you knew that a male bed was available at St.Johns Rehab facility and a female bed was available at West Park! The TCLHIN is currently investigating how they will role this out to other units and facilities and this concept will be adopted by the province.

2. Connecting GTA:

Wondering when you will be able to get information about your patient from the transfering healthcare facility? Connecting GTA is bringing you one step closer to doing this. Using a single web based portal/highway healthcare providers will have a secure and private access to patient information. It is not a universal electronic patient record, however the goal is to bring many of the different systems together into one common access location. For example lab results and discharge summaries will be included. Lydia said that nursing input will be key and is looking to organize working groups. Let me know if you are interested.

3. GTA West Diagnostic Repository:
Tired of looking at a faxed report of a patients imaging or arranging to get a CD of the image sent to your institution? As a Telemedicine Coordinator I am. There are many projects happening around the province and this project plans to link 24 hospitals imaging repositories (ie PACS) in the GTA area together.

Lydia will be sending me updates on these projects so I will keep you posted.

An unusual career path pays off

Here I am 2.5 years after posting my thoughts after my interview for a position as a Telemedicine Coordinator in "My Moments" blog where I expressed my anxiety about being considered a suitable candidate for a position within Nursing Informatics. An area I knew very little about at the time. What I have realized 2. 5 years later that the world of nursing informatics/Ehealth is vast and has tremendous opportunities. You need not know the definition of informatics or E-health to begin.

This blog will attempt to provide insight into what is happening in nursing and E-health within Toronto; Canada's largest city as part of an E-health peer-to-peer project with the Registered Nurses Association.

Please add comments and post links to your work in E-health.


Look forward to sharing,
Kambria