The final keynote presentation was given by Dame June Clark - with a title of “The impact of ICT on health, healthcare, and nursing in the next 20 years”. June tried to draw together many of the themes of the conference in her consideration of where we are now and where we might be going.
NI2006, healthcare futures
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Blogging the Blog team session
On Wednesday morning the team behind this blog presented a sesion on Blogs, podcasts, wikis etc. Peter gave an introduction and overview of some the topics. Rod then talked about and demonstrated the conference blog and some blog tools. Margaret then took over to demonstrate podcasting and vodcasting, including a vodcast she ecorded in Seoul yesterday. She added some of the educational examples of the use of some of these technologies, and future developments.
Unfortunately due to problems with the wireless ntwork we were unable to include the photos taken during the session however they are now included below.
The slides etc will be posted asap, however food travel & other issues may delay this for a while. In the meantime you might want to visit the Hi Blogs team site at http://www.hi-blogs.info/ to see details of other conferences and events we have blogged and links to further information and resources.
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The conference Gala Dinner was held on the Tuesday evening (when Korea were playing their first match in the worldcup). The dinner was soup, salad, steak and a mouse & quite pleasant (although they had problems with deleagtes who were vegetarian or on Gluten free diets etc). The wine (possibly rice wine) didn’t taste too good to some western palates & alternative wine/beer had to be purchased at high prices.
Several foreign delegates and many of the Koreans wore national dress and paraded and danced, including a dance around the entire hall, there was also professional entertainment from drummers and a Korean Jazz Band. In the foyer was a large ice sculpture containing the logo of the conference.
The dinner was quite restrained in comparison with some similar events and many delagtes had left before the finish time of 22.00 (which was also kick off for the football.
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Lifelong learning in Nursing Informatics
Kathleen Smith and Carol J. Bickfordled this workshop and started by getting everyone to introduce themselves & saying what they wanted to get out of it.
They described there experience and purposes in setting up the Weekend Immersion in Nursing Informatics moving from clinical topics to informatics and education. They tried to use the Who, What, Where, When, Why and How approach and applied these to nursing informatics programmes. They described who attends WINI’s and the identification of learner needs. Issues raised included the context, resources and the content which needs to be included - although it was very, very US centric some of the issues could be transferred to other settings, including the levels on NI competancy.
They got delegates into groups to look at case studies which brought out lots of experiences and ideas for the future, and triggered further questions. Kathleen and Carolprovided references and concluded with some questions and discussion.
There was some interesting ideas about running events - but it did come across as a sales pitch for WINI.
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Ursula Huebner form Fachochsule Osnabruck, Germany asked the question eHealth in Nursing - is it already routine? She used a definition of e-health (from Gnter Eysenbach) which suggests it is a state of mind and wa of wrking, as well as being about technology. The presentation was based on 2 case studies, 1 at national level for general health and one at regional level for nurses.
The national programme involves electronic cards for patients and professionslas - but nursing can not access the EHR. The second study is built around the nursing record in nursing homes and hospitals. She attempted to compare the two particluarly in relation to purposes and user involvement.
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After my own presentation on the use of ICT to support students in practice - which I will let someone else comment on - I attended a presentation by Stephen Timmons a sociologist for Nottingham, Uk who reported a study looking at a teledermatology project. He reported the view that the technology was not important but that the introduction of the new service was about working practices. One finding was that nurses didn’t need to refer very often as they had the necessary knowledge & that fact that a telehealth route for support was made available enabled them to use theirexisting knowledgemore fully. Patients which would traditionally have been under consultant care in hospital were cared for at home by nurses who were able to refer if needed but were making their own “diagnoses”. This let patients avoid the travelling (and parking) at the hospital. The pateints and nurses both valued the expertise of the nurses. Controversy surrounded this “advanced” nursing and the development of new roles. Stephen then moved on to look at the policy context and related it to Actor Network Theory and sociological constructs.
NI2006, teledermatology, healthcare roles
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Dr. Michael Dreher/Drexel University
I was able to attend Michael Dreher’s presentation on the Geriatric Reasoning Informatics Project (GRIP) at Drexel University, USA. The GRIP project revolved around the use of a geriatric assessment tool that is provided on a PDA. The tool assists the nursing student in developing a nursing diagnosis for a patient by automatically calculating a score for the patient. Michael did a great job of demonstrating the program during the presentation. Constraints / limits to expanding use of this tool include money and programming time (also money). Since its inception in 2002 faculty & students are now both active & enthusiastic users. This is a tool with tremendous potential for additional use in nursing education. It is introduced during the first semester of clinical nursing education.
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education attitudes and design
After coffee by jumping between rooms I was able to listen to a variety of presentations.
The first was by Jill Phillips of Unitec in New Zealand who described work they had underaken in partnership with the local health board to develop asimulation learning lab. She described the context and issues aboutthe working between the two differnt organisations and the staged aproach adopted. She talked about moves towards advanced simulation in addition to the KIWIN project with students using PDAs which is described elesewhere in the conference.
Next was a paper from Norway which described a study comparing the information needs and satisfaction between hospital and community nurses. They found that both the format and content of information needed between the two groups was different. This was analysed in the context of Proctes information filtering model.
A further paper from Taiwan looked at attitude towards end user development amongst nurses. They concluded that computer compeancy was vital to include in nursing problems, and focused on standards and quality issues.
NI2006, education, attitudes, interface design
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Tuesday morning started with a keynote presentation by Vilma L. Patel from Columbia University, USA. She started by looking at CPOE and error and their links to human cognition foucsing on how technology links to safety. She gave an overview of cognitive cience and some of the methods used and theunderpinning theories and conceptual frameworks.
She used 3 case studies from nursing practice to illustrate how the concepts can be related to practice. The first related to Decision-making strategies for telephone triage in emergency medical services written with Leprohon, J. In this study physicians were better wen physical symptoms were clear, but nurses were better at taking the context into account.
The second study, with coleagues Laxmisan, A., Hakimzada, F., Sayan, O.R., Green, R.A., looked at decision making in the emergecy room and the cognitive demands with complex workflow and constant interuptions and multitasking. The study examined the variety of decisions made during a patients visit.
The third study looked at te nurses role as a coordinator, mapping activities and interactions amongst a clinical team, exploring collaborative and distributed cognition, including the role of technology and shared intellectual property.
She concluded by considering clinical cognition and the implications for informatis and plugged a chapter in a recent book on Biomedical Informatics: Computer Applications in Health Care and Biomedicine
Questions inclded a discussion of the useof technicans supported by algorithms rather than qualified nurses in services such as the UK’s NHS Direct and the balance between quality and cost.
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My final session of the day (while some others sneaked off for Gi & Tonic) was a panel entitled Nursing Informatics: A Historyof the future. The eminent panel consisted of; W. Scott Erdley, Marion Ball, Peter Murray, Susan Newbold and Karl Oyri.
After Scott’s introductions Marion Ball took over to present some ideas about where we might be going in the future. She suggested we are currently undergoing a revolution in health care and technology. She highlighted some of the previous speakers calls for informatics (and the skills to use the technology) to underpin all aspects of practice including educational curriculae (including the TIGER project (Addressing Information Technology Competencies in Curriculum and Workforce) in the USA).
Susan Newbold took over to present some history of nursing informatics over the last 20 or so years. She listed the top 30 titles informatics nurses use, showing the diversity of roles. She suggested how complex and confusing this can be for everyone. She closed with a set of questions asking who we are and how we can “get our arms around our profession”.
Kar Oyri spoke next suggesting that this conference is about the collection and processing of knowledge - Karl suggested we should start at the other end of the process and define watwe want to get from our data. He gave an insight into the ubiquitous enviornment. He argued that we need specialists in sensor and body area networks as in all other areas of practice. He sees Wirless Sensor Networks driven by tiny sensors as a way forward to provide monitoring and care to a new level. He descrbed some current research in his unit and suggested we will see a lot more of it in years to come. He also talked about patient owenrship of patient records with an added hypertext glossary to explain the medical terms. He also touched on classification systems and how a search engine can handle the classification of terms, and the implications of genomics, proteomics and micro array scanning.
Peter Murray then took over with some future considerations based on a scenario of a newly qualified nurse in 2010 adapted from a blog post by Dale Hunscher entitled “Resident Physician, 2010
This nurse would have constant contact via the technology - but have shorter attention spans & wonder why they can’t have constant contact. Moore’s Law will have moved on giving the power of todays high end workstations in a palm top or wearable computing. Suggesting that we need some scenaio planning for these and other future scenarios both optimistic and pessimistic from pandemics to trojans which wipe out all health records?
His possible futures will need changes to research and theoretical constructs and well as personal behaviours and these were raised as trigers for the discussion, which Scott then picked up some future planning from 20 years ago & tried to link this to issues speakers had raised before opening it to the floor.
Questions, Coments and Suggestions were welcomed.
The first was about having nursing in the title - is nursing informatics alive or should it evolve & can we drop medicine forever. Panel responses highlighted the fact that that this debate has gone on for years, & moving to interdisciplinary health informatics, or clinical informatics.
NI2006, nursing informatics, health informatics
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