After much ado...

I have returned. I've been busy finishing school and finding interesting stuff to talk about, since I've had a few adventures in technology in the past couple of years.

More to come...stay tuned!

New year, new job, new tech

It's not just the beginning of the school year for elementary and secondary students. It's also the start of a new year for me, as I'm going into my last full year as a master's student.

When I'm not going to school, I will be working as a telehealth nurse coordinator, to bring the benefits of telehealth technology to spinal cord injury/dysfunction patients throughout our service area. Telehealth is a global term which basically encompasses delivering health care via technology, whether it is via telephone, secure video conferencing or even text messaging.

Finally, this is a very exciting area of healthcare. I hope to learn more and pass it on.

The drought is over...

I'm hoping it is anyway! Greetings to all!

I'm happy to say I'm alive and kicking and busy, busy, busy as an informatics grad student. Hopefully, by this time next year, I'll be well into completing my last year.

Anyway, there are so many interesting things I could talk about, but this news item today in the New York Times about RSA SecureIDs nearly stopped me in my tracks. I used one of these for quite some time and yes, multifactor authentication is the way to go for logins, but this is scary.

Remember to use complex passwords and rotate them on a regular basis. If your system allows it, use special characters (note: these may be limited), numbers, as well as both upper and lower case letters. Also, do not use words commonly found in the dictionary or things easily found out about you (i.e. your address, phone number, birth date, etc.)

If necessary, create your own rotating password and vary the special characters and caps every three months or however necessary.

As they used to say on one old police show, "Let's be careful out there!"

What is nursing terminology?

I've spent a semester studying this and used some really great quotes to summarize what they are and why nursing must use terminologies to describe our work and bill appropriately for it. However, I believe Thede and Sewell state it most simply: "standardized terminology is a list of terms with agreed upon definitions so that when a term is used it means the same thing to everyone." This is even more important as electronic health records become the norm for patients.

Nursing care, contrary to popular belief, is not billed separately, as many specialties are, in your typical hospital bill. We fit right in there with the room rate and paper towels. While we work 24/7 to be the "eyes and ears" of your physician, who pops in and out, and actually do work ordered by them (which incidentally, is about 33-40% of your bill) and other folks, our work has yet to be specifically defined. Implementation of standardized terminologies and data sets aims to do this.

If after reading this little bit, you are still horribly confused, I highly recommend Thede and Sewell's book, Informatics and Nursing: Competencies and Applications. It's a great overall book to start with for any nursing and computers topic about which you might have questions.

Once you've read a few chapters and want to delve into the intricacies of what exactly those terminologies are, see the links below for the ANA(American Nurses Association) recognized terminologies.


NANDA-I (North American Nursing Diagnosis Association International)
http://www.nanda.org/

Omaha System
http://www.omahasystem.org/overview.html/

CCC (Clinical Care Classification)
http://www.sabacare.com/

ICNP (International Classification of Nursing Practice)
http://www.icn.ch/pillarsprograms/about-icnpr/

NIC (Nursing Intervention Classification)
http://www.nursing.uiowa.edu/excellence/nursing_knowledge/clinical_effectiveness/nic.htm

NOC (Nursing Outcome Classification)
http://www.nursing.uiowa.edu/excellence/nursing_knowledge/clinical
_effectiveness/noc.htm

PDNS (Perioperative Nursing Data Set)
http://www.aorn.org/PracticeResources/PNDSAndStandardizedPeriopera
tiveRecord/PNDSHistoryAndMission/

SNOMED-CT (Systemized NOmenclature of MEDicine)
http://www.ihtsdo.org/snomed-ct/

LOINC (Logical Observation Identifiers Names and Codes)
http://loinc.org/

ABC codes (ABC Coding Solutions -formerly Alternative Link)
http://www.alternativelink.com/ali/abc_codes/

Enjoy your explorations of nursing terminology!

Interesting WSJ article

Can Technology Cure Health Care? (from www.wsj.com)

Some say yes, some say no, but it will always be a debate, and an interesting one at that.
I found this article is interesting to read from a nursing perspective. No nurses appear to have been interviewed for this article.

A true pioneer

No COWs or WOWs would exist without this guy, or a couple of his friends.

My virtual tour --HIMSS

I mentioned the coverage of HIMSS10 earlier today, but I have to tell you, I thoroughly enjoyed attending via Better Health's coverage at UStream.

If you can't be there, you can interact with the folks at the booth via chat, and trust me, it's very interactive.

Many thanks to Dr. Val, Dr. Anonymous and the whole crew.

HIMSS10 live from Atlanta

Check out the happenings at HIMSS10 live from Atlanta for the latest and greatest in IT for healthcare.

Happy New Year

And 2010 is starting with a bang, literally and figuratively.

The Haiti earthquake is creating a ripple effect on how people donate to charities as noted in this article on texting for a cause (from www.usatoday.com). Also in Haiti, Partners in Health is proving IT can make healthcare delivery possible, even in remote areas of the country without landlines (from www.healthcareitnews.com)

iPods and iPhones have become commonplace in everyday living, but in hospitals? Huntington Hospital in Pasadena, CA is bringing them to their hospital to end the clutter of multiple pagers and other devices nurses are required to carry. At the University of North Carolina, interpreters are using them as well to get rid of pagers.

Finally, since grad school will be starting again soon, I've been checking out a few things on SNOMED. Want to know more? Check out this page at the National Library of Medicine.

Disaster planning

Yes, it's a big deal in IT, and some people can't get enough of it. I found a great article at techsoup recently about this very subject. It's geared to non-profits, but the concepts are important nevertheless, and some of the tools can be used at home, and best of all, some are free. CSO Online has a great general section on disaster planning called Business Continuity and Disaster Planning Also, if you're interested in disaster planning in general, don't forget to check www.ready.gov.

Second, for individuals, disaster planning is a big deal, too, and not just with computers. If you own a Sidekick phone, you may be interested in this article. One server goes down and takes all your info with it...ouch!

And finally, while it's not a natural disaster, phishing and social engineering can cause lots of other disasters. This article called 9 Dirty Tricks discusses just a few of the latest scams out there.

Tales from graduate school

Well, here I am at school...and with you all. How am I doing it? I am doing it by way of distance learning and learning management tools, such as Blackboard.

I tried to start earlier by reading ahead, but I inadvertently bought the wrong book. Many titles by giants in particular areas look si milar or have similarities in titles, authors or groups of authors. Moral of the story: get the ISBN. When you have the ISBN, you'll never, ever buy the wrong book (90% of the time).

For the most part, I'm enjoying myself. I've upgraded my laptop and as a result, I'm having fun today moving some files from the old one via Belkin's Easy Transfer cable. I'll update you on that once I get it done.

I'm looking forward to using more collaboration tools in Blackboard as well as other tools such as Skype to work with my group. If nothing else, this course will help me learn more about online collaboration.

eICU

A co-worker was talking about this concept because she had the fortune (or misfortune) of being an ICU patient recently. She found it highly entertaining that she was being monitored from afar, and that the person doing the monitoring actually interacted with her.

This article discusses a recent study about the effectiveness of eICU and telemonitoring in ICUs.

In the news and helpful hints

VA halts 45 IT projects (from www.healthcareitnews.com)

SSO provides relief for password headaches (also www.healthcareitnews.com)
SSO, or Single Sign On, is one, long overdue piece that is left out of many network authentication systems. Signing on to multiple information systems (mainframe, PC, etc.) during the course of a day can be mind-boggling, considering security and logging issues in hospital systems.

HINT: Do yourself a favor--rotate your passwords in a scheme you can remember. Don't write them down, but do write down any hints that may help you remember your scheme. If you rotate them regularly, based on your network rules (every 30, 60, 90 days, etc.), it's easier to remember, too. There are some password keeper programs (such as this one from SplashData) you may be able to use on a personal device (i.e. PDA, smartphone). Whatever you do...don't write your passwords down anywhere they can be used to access your account.

Ask your system administrator (if they'll tell you) how many unique passwords you need to have in a year. Many system administrators require xx amount of unique passwords per year or per system. In one of my former lives, our system kept a record of your last 6 passwords; another system only four.

Great video

As a nurse, you're subject to lots of demands for your time and lots and lots of in-services on new equipment and procedures.

Here's a funny look at information overload courtesy of Xerox.

Online sources...beware!

Time and time again we read about mistakes. Here's another strike against Wikipedia: Irish student hoaxes world media.

Vet your sources carefully!

IT items of note

Here are a few interesting articles of note from the internet.

Nurse reflects on decades of caring (from www.citizen.com in Lavonia, NH)
A unique perspective on nursing and technology in today's environment

Nurses face a digital divide (from www.nursezone.com)

And for something a little different...
Cadets trade the trenches for firewalls (from www.nytimes.com)

Gadgets galore

The latest smartphone out there is the Palm Pre. While it's not out on the market yet, if you'd like to try out this technology and talk about it, you get a free six-month subscription and a Pre.

Check out this offer on the official Palm blog.

New product from Unbound Medicine

The Handbook of Nursing Diagnosis by Lynda Juall Carpenito-Moyet, RN, MSN,CRNP was a very popular tool for me in nursing school. This little book has lots of nursing diagnosis information in it and is now available in electronic format.

Get it from Unbound for your Palm, iPhone, Blackberry or Windows Mobile enabled device at www.unboundmedicine.com

More on Twitter

Lo and behold, I get a great bunch of links from my listservs. Here are a few of the gems noted below.

How to Safely Blend Personal and Professional from www.cio.com

How to Search Twitter Smarter also from www.cio.com

Tweet, twitter...what?

If you're overcome by anxiety because you don't know what those two words mean, they refer to one of the most talked about internet tools right now...Twitter. There's even a really great YouTube video on how Twitter works called "Twitter in Plain English".

Many folks with blogs, such as yours truly, also maintain Twitter feeds, which allow posts of 140 characters or less. Distilling posts down to 140 characters can be tricky, though. Since I don't own an iPhone and since I don't always have wifi access for my Palm, I'm currently staying out of the Twitter realm for this blog. Frankly, my day-to-day life may be exciting, but some of my stuff I can't tell you. It's five letters and starts with an H----...and it's not HORSE, but rather HIPAA.

The good folks at Clinical Cases and Images, though, are right in the fray. Here are a few of their thoughts on what's going on with medical blogging and Twitter.