Health Informatics Jean Johnson, PhD, RN, FAAN Dean and Professor George Washington University This program generously funded by the Robert Wood Johnson Foundation Health Informatics Use information and technology to communicate, manage knowledge, mitigate error, and support decision making. Intersection of data management and quality. Key Message Technology is changing how patients manage their own health care needs and how nurses manage patient care. Nurses need new skills to use and contribute to the development of electronic health records, to find and evaluate the relevance of evidence to support clinical decisions and to use data to solve patient and system problems. Jean Johnson, PhD, RN, FAAN 1
Learner Objectives At completion of the session participants will be able to: Describe the cloud and health care Analyze large data computing and health care Analyze mobile computing s use in health care Describe social media s use in health care Nexus of Forces (Gartner, 2012) The Cloud Large Data Mobile Computing Social Media The Cloud National Institute of Standards definition: convenient, on-demand network access to a shared pool of configurable computing resources (e.g., networks, servers, storage, applications and services) that can be rapidly provisioned and released with minimal management effort or service provider interaction. Jean Johnson, PhD, RN, FAAN 2
How the Cloud Works The foundation for the other forces Web-based computing Providers have storage and computing as part of a total package that can be accessed through an app Greater Efficiency with the Cloud Flexibility of computing Shift in economic and business models for computing Reduce operations and maintenance costs of computing Agility to size up or down Large Data Electronic health record data Personalized health record data Administrative data Health quality data Medicare and Medicaid data Insurance data Pharmacy data You get the idea about DATA Jean Johnson, PhD, RN, FAAN 3
Large Data Computing and Health Care Vision is to use large data for true patient centered care Answer questions about population care as well as individual care Efficiency of data analysis Application to quality improvement Challenge to ensure privacy Ethical issues related to use of data Electronic Health Records Use of electronic health records the norm Patient Access to data/ownership Huge amounts of data Link to quality and efficiency Meaningful Use Domains Improve Quality, Safety, Efficiency Engage Patients & Families Improve Care Coordination Improve Public and Population Health Ensure Privacy and Security for Personal Health Information Student Learning: Large Data Analyze how large data is improving health care delivery Assess impact of EHR on workflow Analyze the use and impact of data from EHRs Prepare students to conduct research using large data sets Jean Johnson, PhD, RN, FAAN 4
Mobile Computing Tablets, smartphones, monitoring devices and other Apps June 2009: 65,000 July 2013: 900,000 Mhealth Mobile Medlineplus-NLM 44 million health related apps downloaded in 2011 Is moving health care out of hospitals and physician offices Patient centered with large data analysis contributing to clinician and patient decision making Innovations will change workflow Consumer/Patient User of Mobile Computing 90% of the world s population was within reach of a mobile network in 2010 Disease specific apps ie Mobile MedlinePlus Health and wellness apps (13,000 in 2012) Biosensors GPS tracking Home and on the go monitoring monitoring service to account for 65% of global Mhealth market by 2017 9 million Kaiser Patients can get medical records from iphone and us email for care decisions Challenges to Mhealth (Ernst and Young, 2012) Privacy/security Customer experience and change management Incentives/compensation and rewards Liability/tort reform (US) Inability to create value from universe of data Lack of standards/ interoperability Need for integrated IT/ human capital talent Information silos Jean Johnson, PhD, RN, FAAN 5
Student Learning: Mobile Technology Establish criteria to review health apps for recommendations to patients and identify the top 10 for disease specific information and/or top 10 for wellness Team up with engineering or computer science students to develop an app Implement the use of apps into the clinical setting so that providers are recommending pre-selected apps to patients and that app information is in health materials Social Media (Pew Research Center, 2012) Facebook, Linkedin, twitter, Instagram, Pinterest, MySpace and others 72% of online adults are social media users Affinity groups for many different issues More informed patients Appropriate use by students and providers Ethical issues Professional issues Stats for Social Media Average time spent on Facebook per month: 15.3 hours 1 in 4 people worldwide (1.75 billion people) will use SM in 2013 Social networking sites are increasingly used to keep up with close social ties The average user of a social networking site has more close ties and is half as likely to be socially isolated as the average American More frequent users: Women, black and Hispanic populations Youtube is more popular that cable TV Jean Johnson, PhD, RN, FAAN 6
Student Learning: Social Media Participate in a health/wellness related social media group that is relevant to them, analyze the strengths and weaknesses, and develop a plan that would enhance the effectiveness of the group. Develop policies for a clinical setting for linking patients to relevant social media group Select a topic and use social media to disseminate information to patients and a plan to evaluate the impact More Student Learning Strategies Analyze the use of HIT (EHR, use of mobile technologies etc) by patients and staff in clinical setting to improve patient care As a group project create a roadmap for use of HIT in a clinical site. Students can be grouped based on type of clinical practice Review literature on new technologies and write a paper on the most promising for creating more patient centered care or creating a more efficient system Work on an implementation plan for linking HIT to quality in a clinical site Jean Johnson, PhD, RN, FAAN 7