The ‘highest scholarship award’ for papers went to Cynthia Murphy and colleagues from University of Texas MD Anderson Cancer Center in Houston; their paper is titled ‘Patient entered electronic health records with EMR integration: lessons learned’.

We will be posting on coveritlive, so click on the following link to follow our report or access the replay: >>>

Technorati Tags: SINI, nursing, Maryland, Baltimore, nursing informatics, PHR, EMR, health record, cancer

Listen to this podcast

The first of the parallel sessions has started. Judy Murphy, from Aurora Health Care, Milwaukee. Wisconsin, is giving a talk titled ‘The Copernican Shift: Patient as Center of the Universe’.

We will be posting on coveritlive, so click on the following link to follow our report or access the replay: >>>

Technorati Tags: SINI, nursing, Maryland, Baltimore, nursing informatics, Aurora

Listen to this podcast

Keynote speaker is Stanlie Daniels with the Veterans Administration in the US. She addresses the VA as a whole as well as specifically why informatics is important to the VA success. Her position is technology is a means, not a goal. Use of informatics to achieve high-quality care is the focus of her presentation.

Parallel live blogging is being completed by Peter whilst I’m going a more ‘conventional’ route.

She outlines why IT is a ‘quality’ strategy using background stats (use of IT and such) along with effectiveness of IT as a strategy for quality. She discusses the CPRS and some screen shots of it. VistA is a piece of the CPRS. It is a windows-based system. There is also, well, as least used to be, a demo of VistA available online. I believe it is available somewhere on the VA’s site but don’t have the exact path at hand (sorry).

She goes into detail about the CPRS and its quality via informatics (build in quality). Example cited is clinical reminders. A key piece also described by her is BCMA. I’m afraid some of the material may be ‘old hat’ for a fair number of attendees; hoping I’m wrong. What she is presenting of difference is linking all the pieces together in a ‘quality’ web.

The presentation continues with demographics of today’s soldier (age, gender, ‘Net savvy-ness’, and such).  Use of IT to help with prospective risk assessment to deal with potential future issues in an efficient/cost-saving manner. Considering emerging national health care delivery trends is also offered (ranging from patient-centered to point of care to tele-health / -radiology). Because of these trends Daniels outlines 10 goals for the VA electronic health record. These goals include patient-centric record, seameless transition with DoD to biosurveillance to co-care with private sector.

Next topic is patient-centered care and its attributes. Automated patient history entry is also outlined located at kiosk. Next on the list is medication reconciliation for patients. This also helps patients re: education and heightened awareness.Home tele-health technologies is outlined mainly for diabetic & CHF patients. This sort of program has been in practice for about 10 years at the Buffalo VA. Daniels continues with the web portal of the VA titled “MyHealtheVet” site; allows for online perscription filling as well as reminders and quick links for the patient. Patients can also work with a wide-range of health reminders to self-monitor on range of items (HR, BS, pain, tests, pulse-ox, etc.). VA now performs teleretinal imaging for screening DM retinopathy using store-n-forward technology to overcome geographic barrier(s). CMOP / consolidated mail outpatient pharmacy - ‘net scripting’ function for vets. Decision support tools include CPRS tools (ranging from consent form to patient profile to protocols. Example is heparin protocol and use of informatics’ tools. Spinal cord injury & disease outcomes database now provides a wide-range of indicators and areas of need. There is also a nursing outcomes database. Example is skin care (Braden scale / skin patches). Cardiovascular assessment & tracking system (CART-CL) is another example of nursing and informatics collaboration.

Also described is molecular medicine as preemptive, not curative. Prevent / delay disease is one opportunity for nurses. This was closing topic by speaker. Enough time available for Q & A from audience.

Listen to this podcast

Well, final thoughts are now emerging as I sit in Detroit airport waiting to complete the last leg of the return home to Buffalo, NY, USA. Long day (aren’t all trans-oceanic ones?). Anyway, wanted to close out the blog for this conference.

First, the software used for this blog is not quite smooth - spaces between paragraphs are not ’staying’ when the entry is published. My apology. Secondly, we did not complete the last day of the conference. Myself and colleagues decided to be tourists but our plans for the day did not turn out as anticipated. We never did make Paris as there was not return TGV train for Friday. We could get to Paris but would have had to stay overnight and return Saturday morning. Instead we traveled to Vianden and tripped lightly up a long inclined road to walk through. A really cool site with great history and spectacular views! Nice quaint town to stroll through - no crowds, either, as it was off-season.

OK, enough of the touristy sidebar. On to final thoughts of the conference. First, the conference was an exceptional demonstration of the utility and need for telehealth and all of its associated sub-specialties on patient care around the world. There was a great diversity of attendees, too, with what I recall as over 50 countries represented. The conference was well run, too, with minimal technical difficulties noted (at least to me). Given the nature of the attendees the need for net access was a given. The wireless was of great quality compared to some conferences I have recently attended (no names, please). Public transportation was excellent to get around, too.

A few items offered as areas of improvement include the ‘group’ plenary session. This was a session on the opening day, which ran for 2 hours during which 8 keynote speakers each had 15 minutes (that was the plan). It was a tough sell and perchance consideration might be to space out these speakers so attendees can relish a ‘richer’ experience. A second item has to do with the environment. The 2 conference rooms (2 & 3) opened onto the exhibition / snack area. The room plan included no doors with a sound wall to deflect the incoming ambient noise. However, this did not happen. For the sessions I participated and or moderated the noise was more than moderately distracting; with no door to close the only alternative was to increase the volume of the speakers.

In spite of the devalue of the dollar I maintain this conference, as a first timer, was worth the investment. There is a concerted effort and desire by the conference administrators to encourage and promote the role of nurses in telehealth / telemedicine. The plan, as I understand, is for more nursing presentations at the next conference, April 1 - 3, 2009, once again in Luxembourg! See you then!

Listen to this podcast

I had other business to attend and so did not make any of the morning sessions. This session runs from 11:30am to 12:30pm. Of the 4 listed presentation only 3 will be offered so the time constraint is not so bad for these folks. The session is titled “eLearning” and is the first of 2 sessions. The second one will be held at 4pm in this same room later today. I hope to be in attendance for this one as well.

The first presentation is from the Ukraine titled “Multimedia teaching systems as educational tool in everyday work of pharmaceutical companies: 5 years of practical experience”. This is a vendor product show & tell aka “sales pitch”. It is an interactive and multimedia with knowledge ‘control’ & evaluation (final testing). Created from Adobe Director; 4 modules including Teaching, Control (tests/evaluation via different test types), and others. Offers a CD demo for viewing.

The second one is “A strategy for health professionals learning at distance: Focus on Brazilian Sentinels Hospital”. Presenter is same young woman as yesterday (R. S. Gundim). One objective is to ’spread’ evidence-based practice. This in effect is an evidence-based health course. Used multi-point VC via ISDN / IP changed to streaming video via Net due to connection quality issues with ISDN/IP format. Interesting findings; most folks liked the course. 94% graduated course (94/118 enrollees). 2nd course included more folks - over 23 states with 1762 participants / students still uses video-streaming format. Increase in team size due to substantial increase in numbers of participants. Scheduled to conclude in Jun2 of ‘08. Of the conclusions there are few initiatives like this public / private as this one is. Of more uniqueness is the high number of cities concurrently active. There is consideration for a 3rd course next year.

The last presentation is title “Virtual health care knowledge center in Georgia”. Presenter provided a thorough background of the eHealth efforts prior to main discussion. This center is about implementation, evaluation and adoption of telemedicine services for Georgia. Center of telemedicine / teleconsultation center is in Tbilis, the capital city, with its own server. They also use Moodle as the cms application for e-learning. Advantages include flexiblility as well as open source. This project is now working on developing an actual application based on the .NET platform with a SQL db as the “back-ends”. Screen shots of applications provided for viewing to help understand this application development.

Listen to this podcast

The opening night reception was held at the opera center called the Grand Theater. Participants were bussed over from the Luxexpo (conference site) and then returned to either their respective hotels or the conference center. A nice selection of “munchies” accompanied by local beer and champagne helped spark a large number of personal ‘networking’ sessions. It was a very nice venue for this and everyone seemed to enjoy themselves.

Listen to this podcast

This is an attempt at ‘post-session’ blogging and a bit more, my own session. I moderated and presented the session titled “Nursing Informatics: Past, Present and Future”. This is the first session ever at Med-E-Tel about nurses and for nurses. Congratulations for getting this session in place go to Frank Lievens, Secretary, International Society for Telemedicine & eHealth (and his vision / support for nurses in this specialty) as well as Mr. Bob Pyke (with long-standing history in telemedicine.

In general the session went well with a few glitches. One participant did not show so this helped with the time constraints of 15 minutes per session. In general it was the US and Brazil, the countries of presentation. About 10-15 persons were in attendance at any point in time. Topics ranged from a presentation regarding nurse roles in US-based company about telephone interaction with patients to a schematic representation of NI over time to the TIGER Initiative to a look towards the future of NI. The Brazilian presentation was very interesting in that it was a very small study comparing traditional telephone support of cancer patients versus using off-the-shelf hardware for video-conferencing with these same patients. The primary barrier to use, it turns out, is infrastructure. It seems broadband, a fair amount of the time in Brazil, is not really broadband. This several hampers transmission for video-conferencing and turned the nurses ‘off’ regarding use. If the connectivity had been better the nurses really wanted to use the video-conferencing because they perceived it provided them with additional ability to assess and work with these patients. Very interesting stuff with potential for impacting use of technology in developing countries and beyond.

The second session in this room was titled “Telenursing Implementation Strategies and Success Factors”. Speakers included I.A.C Mendes from Brazil, Bob Pyke (USA), Diane Castelli of AMD Global Telemedicine (USA) and Loretta Schlachta-Fairchild (USA). Mendes described telenursing skills in an undergraduate nursing program in Brazil. Bob Pyke reviewed various items relevant to telehealth from WHO (priorities, objectives and so forth); Diane C. reviewed a number to tips r/t successful telenursing programs, and Loretta reviewed the results of the survey of telenurses and implications of these findings. There were about the same number of attendees (12 - 15) as with the first session.

Listen to this podcast

Well, here I am, in Luxembourg. A first timer at the conference as well as visiting the country. The conference (http://www.medetel.lu) is officially titled ” The International Educational and Networking Forum for eHealth, Telemedicine and Health ICT”. The opening page provides a lengthy description of what this organization is about. Take a moment to review as it covers a lot of ground.

Myself and colleagues (Kay Sackett, Rosemary Pope) will rest and recharge this evening to be ready for our contributions to this conference tomorrow afternoon. The gentleman responsible for our attendance, Mr. Bob Pyke, is also here and already hard at work.

More to follow - Scott

Listen to this podcast

It is Tuesday morning, and the first session is another view from the European Commission (albeit with disclaimer that the views are those of the presenter, not necessarily the Commission); Dr Jorge Pereira, from the Embedded Systems and Control Unit of DG INFSO is talking on ‘Technologies for an (sic) ubiquitous society’. He again referenced Weiser’s view of ubiquity being the ‘third wave’ of computing; and the suggestion that there is no revolution in artificial intelligence needed, just embedding of computers into everyday life.

The requirements for ubiquitous IT, he says, are embedded systems and broadband for all. Beyond embedded systems, there needs to be a move to networked, co-operative embedded intelligence. His unit of the EC has funded research projects totalling over €250M over about 7-8 years. Europe lags behind in broadband access – top country is South Korea with 31% of households, followed by Hong Kong and Japan, each at over 20%, while the highest in Europe is Sweden at 7%. Japan and Korea also have large leads in numbers of mobile Internet users, compared with Europe.

(The figures recall some from yesterday, when Dr Taeyol Yoo, Head of the Management Research Lab at KT, Korea, talked about ‘The dynamic evolution of ubiquitous society in Korea’. Due to the development of an advanced IT infrastructure, currently 30% of the population in Korea have broadband access; this is expected to reach 100% by 2012, while 90% of the population have mobile/wireless access.

The u-Korea government strategy, with the vision of being ‘the first u-society on the best u-infrastructure’, is based in several projects, including u-city, u-health, u-work, telematics, etc. The aim is for IT to be absorbed into every aspects of business and life, to build a world class u-Korea.)

Dr Pereira went on to contrast ‘the Internet of things’ with ‘the Internet of smart things’, and said that much of the current and future EC funding around co-operative objects was designed to support the development of networked heterogeneity. User concerns around the development of ubiquitous IT include protecting private data, possibilities of fraud and protection of personal information, including leaks of personal information held by businesses. Ubiquity raises issues of sustainability and energy consumption; embedded intelligence has a role to play in improving energy efficiency in electronic equipment.

Technorati Tags: ubiquitous, IT, European Commission

Listen to this podcast

From a Monday afternoon session: Kostas Glinos, Head of Unit Embedded Systems and Control at the DG INFSO, European Commission, talked on ‘Advancing ubiquity through embedded systems’. He describes ubiquitous as existing everywhere at the same time; when intelligence becomes ubiquitous, people will not need to manually set preferences, he says (based in Weiser’s work); objects will learn from us and provide information based on our behaviour. When technology becomes transparent, intuitive, truly accessible to all, it will disappear. To make this vision possible, need embedding intelligence everywhere, object networking and co-operation, and intuitive information interfaces (as opposed to device interfaces).

The EC ICT programme, he says, has moved from ICT as such (competitiveness of IT industry), through ‘ICT for all’, to ‘ambient intelligence’, and now to the ‘Internet of Things’, co-operation objects., etc. One of the essentials for ubiquitous computing is pervasive embedded systems; he sees growth of embedded systems everywhere and in everything; 98% of all processors produced now are used in embedded systems, and, for example, electronics will account for 40% of a vehicle’s value by 2010; in consumer electronics, it is expected to be even higher. Drivers include miniaturisation and cheap networking. But adoption of embedded systems can be limited by complexity, architecture and interoperability problems, despite trends to open systems and networking.

Trends and challenges in networked embedded and control systems include larger deployments of increasingly heterogeneous systems, ever more complex, large-scale systems, and a growing mix of applications and services. Challenges include data fusion, semantics, localisation. sustainability.

Technorati Tags: ubiquitous, IT, embedded systems, European Commission

Listen to this podcast