Future Healthcare

Future Healthcare The Smartphone Ripple By Lorraine Gdanetz, RN

Objectives • Describe future healthcare • Discuss future hardware and software • Describe and evaluate usability • Describe and review of information system • Discuss advantages and disadvantages • Discuss legal and ethical issues • Describe nursing competencies

Future Healthcare • By 2014 complete implementation of electronic health records • Electronic health records will save “hundreds of billions of dollars” • In U.S. today 99% of physicians use the internet • Fewer than 25% of physicians have electronic medical records I thought I moved slow! (manhattanResearch, 2009) (Waegeman, 2008)

Smartphone Technology Now we are moving! ( Dolan, 2009)

The “Smartphone Generation” • Mobile • access to EMR at any time • Connected • to EMR interface Catch me if you can!

“First stand-alone EMR for the iPhone was launched in September of 2008.” • The popularity, convenience, and technology of Smartphones will allow professionals to access Electronic Medical Records at any time or place; changing the face of healthcare forever. Keep moving! (Dolan, 2009)

CareTools iChart for iPhone • iPrescribing • Prescriptions can be sent directly and securely to patients’ pharmacy • iBilling • A tool for organizing diagnosis and procedure codes using ICD9 codes • iLab Reports • A lab and study organizer, labs can be reviewed and signed • iNotes • Create and review clinical notes Patient records in the palm of your hand (Caretools), 2008 (Berg, 2008)

iNotes Usability • Quick patient data entry • Document patient photos • Automated note integration • Automated dictation • Customize documentation templates • Sharing of patient information “Information management at the point-of-care” (Caretools, 2008) (Berg , 2008)

Database Management System (DBMS) • Set of software programs • Controls creation and maintenance of an organizations database including access by end users • Organize, store, manage and retrieve data in a database (Macios, 2009)

Review of Database Management System • A clinical system • Accessed by all healthcare providers • Documentation, billing, physician ordering, scheduling, access to lab results, digital images and patients medical records • Local Area Network and Point of Care • Health Level 7 (HL7) Now we are Connected! (Berg, 2008)

Advantages Mobile Technology Use for EMR • Documentation at point-of-care • Enhanced communication between patients, physicians, hospitals and pharmacies • Capture real-time financial information • Streamline work flow • Ability to interface with larger servers • Error reduction (Dolan, 2009) (Zabrek, 2008)

DisadvantagesMobile Technology Use for EMR • Currently requires Web and Broadband access • Applications only available for iPhones and iPod touch • Privacy issues • Limited remote access • Interface issues • Old patient record incorporation (Dolan, 2009) (Berg, 2008)

Mobile EMR TechnologyEthical and Legal Issues • Medical records must be kept in unaltered form and authenticated by creator • Preservation of content and structure • Economic stimulus package aims at offering incentives to physicians that adopt EMR (mHealth Initiative, 2009)

Mobile EMR and Nursing Competencies • Proficiency in E-mail and mobile phone text message technology • Skilled use of internet to locate and download information • Competent in computerized monitoring systems • Identify the basic components of a computer and mobile phone system • Perform basic troubleshooting of applications used • Participate in the selection, design, implementation, and evaluation of the systems (McGonigle & Mastrian, 2009)

Functions and Responsibilities ofInformatics Nurse Specialistin use of Mobile EMR • Responsible for Education • Manages and evaluates the system • Develops the application to meet nursing needs • Will use Evidence Based Research in development of system • Will manage data reliability and integrity (McGonigle & Mastrian, 2009)

Conclusion Future Healthcare • Federal mandate for EMR by 2014 • Physician use of mobile phones 100% • Smartphone applications for use by practitioners to allow mobile access to review and create EMR • Need for Informatics Nurses and Informatics Nurse Specialist I am catching up to you! Oh No! (mHealth Initiative, 2009)

References Waegemann, C.P. (2008). Cellphone EMR: Can you cure me now?. Emergency Physicians Monthly, Retrieved 06/05/2009, from http://epmonthly.com/index2.php?option=com_content&task=view&id=228&pop=1 Dolan, P.L. (05/25/2009). Can a surge in physicians' use of smartphones ripple to health IT adoption?. American Medical News, Retrieved 06/05/2009, from http://www.amaassn.org.ezaccess.libraries.psu.edu/amednews/2009/05/25/bil20525.htm (2009). mHealth Initiative. Retrieved 06/05/2009, from mHealth Initiative INC. Web site: http://www.mhealthinitiative.org/ (2009). manhattanRESEARCH. Retrieved 06/05/2009, from Taking The Pulse : Physicians and Emerging Information Technologies Web site: http://www.manhattanresearch.com/Products/Strategic_Advisory/ttp/

Macios, A. (03/16/2009). The 411 on cell phone applications in healthcare. For The Record, 21, Retrieved 07/13/2009,from http://www.fortherecordmag.com/ftr_coverstory.shtml (2008). Caretools. Retrieved 07/13/2009, from Caretools.com Web site: http://www.caretools.com/about_technical.html Zabrek, E. M. (2008). Robust and affordable medical apps. Smartphone Magazine, 1(2), 87-89. Berg, T (07/22/2008). Digital medical record system for iPhone. Retrieved 07/13/2009, from eNewsChannels Web site: http://enewschannels.com/2008/07/22/enc3434_170851.php McGonigle, D., & Mastrian, K. (2009). Nursing informatics and the foundation of knowlege.Sudbury: Jones and Bartlett Publishers, LLC.

Future Healthcare