Computers & Technology in Healthcare Ch 18

Every aspect of patient care has computer technology involved these days. Even before your patient comes into office or hospital!

HCP's need to be literate and competent in computer use. Does computer literate mean you know how to write a computer program?

What does it mean? You have a basic understanding how they work and what is currently available in HC applications.

3 major operations in HC:

1. Stores huge amounts of data- and accessible to many users at one time in different locations

2. Calculates data quickly and accurately

3. High speed communication

repetitious tasks are gone!!! Revision, deletions, changes to documents are instant in things that used to take weeks!

People who work in smaller places might need more knowledge because larger facilities have computer specialists.

Information Management

A database is an organized collection of data in a structured way.

Databases can be set up by the user with applied software that is usually purchased. Then all the information is stored in the computer for easy access and useful format.

Info can be stored and organized in many ways.

The basic set up of the database is key to its USEFULNESS!

User friendly is the goal!

Each collection of related data is called a RECORD.(example data about individual data)

Then this data is entered into a FIELD (Ex:Name, address)

A group of related records is a FILE

Page 378 in book

Computer databases are only valuable if it serves the need of the user.

Computerized databases vs paper!!

Why is it better?

retrieval of records is fast

sorted,organized and reported in many different ways

accessed by more than one person one place at a time

additions/changes made fast/easy

generate reports

readable

QI studies

EMR What & why

Electronic Medical Record

Oh yeah and its better if you want to get paid from the GOVERNMENT! All offices have until 2015 to get EMR or no pay from Medicare to facilities! OUCH

But they were told in 2009!!!- and were given a lot of money to comply!

Our government invested BILIONS  $$ to create a computerized health care system- so we have to move forward even the small offices!

Why would Dr's fight EMR?

1-$$$$$$$$$$

2-MaintainingTraining

3-Dr resistance

general theory that EMR- IMPROVE  care efficacy, REDUCE errors, and help LOWER costs.

ACCURACY IS KEY!! Your patient is negatively affected on incorrect data entry- you must review and verify all data.

Software/
spreadsheets

Software-turns computer lets user create customized error free documents. Software allows user to:

Design appearance

Store for later use

Edit,spell check, grammar check

Print and send info to other computers

Software also allows to make and study charts and graphs.

VOICE dictation software is eliminating jobs!-it turns spoken words into text! The HCP dictates then edits as needed-prn

This is sooo much better than before we had transcription services and degrees!

No relying on illegible handwriting, we talk faster than we write so speeds things up, same accuracy as written, waaaaayyyy cheaper!

Spreadsheets

What is a spreadsheet?

A spreadsheet is any document with a grid of columns and rows. For centuries, managers have used paper that was lined with columns and rows for their computations

Why spreadsheets in HC?

The most essential feature of electronic spreadsheets is the ability to recompute results quickly, easily, and reliably as any element in the spreadsheet changes. One number within the spreadsheet can be changed, and the results of the analysis can be automatically and quickly updated. This helps deliver high quality patient care while making smart business decisions. Cuz its all about the BILLING! So make sure you check your typing one number off can make a huge difference!

Billing

In 2000 ALL Medicare and Medicaid had to be electronically submitted, standardized codes have been developed so it is universal and consistent.

Wait computers are not just for $$$

Internet

BEGAN for government to communicate in case of nuclear attack-now its a primary way to communicate...

Does the government regulate info on the Internet?

Who does?  sshh no- body! scary

Different ways to search for info:

1. web directory-large collection in broad topics ex:yahoo.com then you click on health or whatever category

2. Gateway-major websites with links for specific info

3. search engine- you put in key words and the search engine will locate documents with those key words

WHATEVER INFO YOU GET FROM INTERNET AND USED NEEDS TO BE CITED JUST AS IF YOU WERE COPYING FROM PUBLISHED BOOK! OR ITS----------

What is plagiarism?

How do you know if your or your patient went to reputable site for info?Here are guidelines to know:

Identify source...

Who is author...

Check for references...

Verify data....

Look for quality....

Check for currency...

We can also be emailing patients info! Always make sure your message is clear.

Is work e-mail my business or the owners business?

So no personal e-mails at work ever!!!! It can and will be used against you.

And as far as the social sites..what do we keep telling you about posting pics and your info on these sites? Future employers are looking at these sites before they hire you! google yourself.

Telemedicine-

is the use of medical information exchanged from one site to another via electronic communications to improve a patient’s clinical health status. Telemedicine includes  using two-way video, email, smart phones, wireless tools and other forms of telecommunications technology. what are advantages?

A barrier to the growth of this is...Dr's practicing across state lines and reimbursement from pt's and medicare and medicaid...technology moving faster than society.

Telepharmacy is the delivery of pharmaceutical care via telecommunications to patients in locations where they may not have direct contact with a pharmacist. It is an instance of the wider phenomenon of telemedicine, as implemented in the field of pharmacy.

Also pharmacies are dispensing drugs with computer counting the pills=less people to pay, less errors, better tracking means less theft.

We now scan every patient before we give any meds or iv fluids. Talk about a pain in the knees! How great is that we are not giving wrong meds to people!

Virtual Community-

A virtual community is a social network of individuals who interact through specific social media, potentially crossing geographical and political boundaries in order to pursue mutual interests like healthcare professionals and patients sharing info about specific conditions or CLASSES!CTE

Education

Soo much education is done on computers now a days which means less jobs, more convenient for employees, less time consuming, less cost to employers to train. Virtual reality gives scenarios and real life examples. Very expensive! OB doll yells "i did crack last night" while she is bleeding and you have to act on that!

In 1994, (OMG) IU nursing students were the first ones to take state licensing test on computers. All done on paper before that. Yes that was me.

Diagnostics

Diagnostic tools made available to you from computers and technology! Growing everyday-what are some areas where technology is helping people?

X-rays can now get to soft tissue!

Parts are smaller so less radiation exposure

CT Computed tomography-x-rays from many angleas that measures density of tissues ex:clots, tumors,fractures

MRI Magnetic resonance imaging-magnets are used to measure Hydrogen activity in tissue. ex:tumors, blood flow, basic structure and abnormalities.

PET positron emission tomography- radioactive substance injected into pt then detected by scanner =3d views ex: brain function, epilepsy, cancer,

US ultrasound- uses high frequency sound waves hit tissue and bounce back as echoes which is obtained to create an image. ex: view mvmt, if xray is harmful, tumors, blood vessel abnormality, anuerysm

Fiber optics is technology using hair-thin cables to transmit data-used in dentistry using tiny canmera inside mouth to project on screen for better exam! The use of these has increased safety of surgery for pt! NO MORE LARGE INCISIONS!

TREATMENTS

Based on computer technology! How?

Robotic technology using minimal invasive technique and increasing accuracy. Provides HCP with 3 dimensional bigger images, some can even follow oral commands.

smaller incision means,means smaller risk of infection, smaller healing time means smaller $$ cost to everyone.

Laser technology is used to cut tissue by focused light rays. Common in eye surgery.

Health Info!

Patients are using computers to sign in and enter own data!

Also it spits out a BMI, EDD in the split second!

REHAB- people with disabilities have a lot of advantages with technology and computers! Touch or voice command even eye contact command for quadriplegics! Remember exoskeleton from nervous system?

Just how are tech nerds getting involved in health care? Here are five ways:

1. Crunching data to offer a better diagnosis and treatment: Just call the computer “Dr. Watson.” Researchers to help physicians make better diagnoses and recommend treatments.

2. Helping doctors communicate with patient ,app that lets doctors speak into the app — asking, if a patient is allergic to penicillin — and translate the message instantly into another language. Given that there are 47 million U.S. residents who don’t speak English fluently, the program could be a boon for doctors who would otherwise need to rely on translators and medical assistants to communicate.

3. Linking doctors with other doctors: Could social networking help doctors work better together to take care of their patients? They collaborate online on difficult cases.

4. Connecting doctors and patients: New York City offers patients medical consultations online and over the phone, potentially saving a trip to the ER. The medical advice doesn’t come from just anyone, but from some of the city’s top medical specialists.

5. Helping patients stay healthy: and gadgets aim to help people stay active, sleep well and eat healthy. Among them are Fitbit, a pedometer that tracks daily sleep and activity and uses social networking and gaming to motivate its users. Lark is a silent alarm clock and sleep monitor that tracks and analyzes a person’s quality of sleep over time, offering suggestions to help the person get better rest. And there are dozens upon dozens of calorie-counting, food-monitoring and menu-tracking apps to aid the diet-conscious.

It’s clear that technology is giving the health care industry a much-needed upgrade. Though much is still in the early and experimental stages, the advances in technology could help save money in health care costs and improve patient treatment.

Basic Computer Info

Computer hardware is the collection of physical parts of a computer system. This includes the computer case, monitor, keyboard, and mouse. It also includes all the parts inside the computer case, such as the hard disk drive, motherboard, video card, and many others.

Dust Is Not Your Friend

Canned Air IS Your Friend

The cheapest and safest way to clean the screen is to use a very soft cotton cloth lightly dampened with water

Hard drive- storage device inside the computer, able to store huge amounts of info...

to protect against losing all this data what do we do to make sure if it crashes we don't lose?

YES we back it up using a zip or flash or other area in hard drive.

That was hardware-now what about software? It has instructions that enable computers to function.

An application program is specific to what you want to do.

COMPUTER SECURITY

Dont breach that confidentiality! How to protect?

There are laws put in place-page 395

Choose passwords carefully

close your charts

if you dont belong in here get out

shredding pile not just regular garbage

Now what about a virus?

A computer virus is a program that, when executed, replicates by inserting copies of itself (possibly modified) into other computer programs, data files, or the boot sector of the hard drive; when this replication succeeds, the affected areas are then said to be "infected". This can erase or scramble data.

Keep learning about computers- go to classes,read manuals, do tutorials, read, search on internet

Computers lack eye contact and a friendly smile

Remember to look at patients and really listen when you are working with computers...work first, charting second.