Nursing meets the Millennium:Future of Nursing in the Information AgePatricia Flatley Brennan, RN, PhD, FAAN
Moehlman Bascom ProfessorSchool of Nursing and College of EngineeringUniversity of Wisconsin-Madison
GoalsDefine nursing’s social role.Describe the present and future role
of information technology in the practice of nursing
Identify modifications in nursing practice to capitalize on information technology
Nursing
the diagnosis and treatment of human response
Nursing’s Social Responsibility
Nursing’s Social Responsibility
diagnose and treat human responses
Critical Events in YOUR Nursing Life
Think of an incident during the last 4 days in which you fulfilled nursing’s social role Be as explicit as possible - time of day, who involved,
how you felt
Now -- identify three points in this incident at which information or communication was important
Could you get what you wanted? Express what you had to say? Know what you needed to know?
Informatics needed to support Nursing’s Social RoleIdentify & describe phenomena indicative of the
human response INFORMATICS NEED: Produce a language
Discover & evaluate therapeutic interventions to treat human responses INFORMATICS NEED: Create therapeutics Record
interventions, Monitor responses
Collaborate with other disciplines to fulfill health care goals INFORMATICS NEED: Communicate
Information Technology today
Promises almost met Computer-based patient records
DataRepositoriesFormal languages
TelemedicineRemote access to expertise and consultationConsumer Health Informatics
The Challenges Security Authentication The digital Divide Legacy systems
Moving the site of care
On the horizon...
Integration of different data types, with particular emphasis on time-variant data
Intelligent agents and meta-data that support efficient use of knowledge resources (text, images, sound)
Merging of public health and personal health data
Re-engineering of clinical practice to capitalize on informatics advances
Promising (ie, not yet here)IT Applications
Distributed records management systems W3EMRs and CareWeb: Web front-end to legacy
information systems
Authentication and Authorization Healtheon
Consumer Health Informatics CareLink CHESS HeartCare
HeartCare: Meeting the Challenges of CABG Recovery
Monitor, Manage, Mend, Motivate
Demands in the discharge encounter
Patient-centered, tailored information
The HeartCare InterventionHome-based Unit:
WebTV(C) box & 19” television
Server supplies:Monitor & Recovery Information
• Four periods: Wks 1-2, 3-6, 7-12, & 13-26
Professional & Peer contact
Tailoring Recovery Resources to Patients
Establishing the tailoring model Patient Profiles Access (TM) database
Delivering WWW resources ‘on-the-fly’, across the recovery period Active server pages sorting nurse-
identified or developed WWW pages
Contemporary Health Care rests on a
successful partnership between
Clinicians, Delivery Systems,
and Patients
SMART Patients
SMART Patients
Self-assured Motivated Aware Resourceful Talented
Remember they may also be:
Scared Minors! Anxious Reluctant Time consuming
Common behaviors of SMART patients
self triagevalues and preference clarificationparticipativecollaborativeindependently engage in health
promotion
What they aren’t :
complacentquietunchallengingsimilar
Clinician’s responses to the SMART patient:
engaging tolerant dismissive condescending
The Challenges for Clinicians
Use technology to help make patients SMART
Treat them as a resourceChange our practice activities to
capitalize on their talentsReorganize our practice environments
Clinical Practice Issues
Henderson “...what the patient can do...”
Re-examining every action Find the right balance of workers
Trusting our colleaguesTiming of interventions
What must be done now, what should wait for later?
Nursing Roles
Content ExpertEnvision a clinical practice that
makes use of the patient as a resource
Re-organize care and care activities to incorporate patients
Constructing a Health Care Delivery
System responsive to
SMART Patientsrests on
effective, appropriate IT!
Critical Event, Take II
Recall the event identified earlier Review the information intensive and communication
sensitive elements
Circle those for which today’s presentation suggested a solution
Star one for action on MondayList at least one IT-related aspectList at least one System Level aspectList at least one clinical aspect
Patient-Centered Systems
Clinical Records Network Communication
Consumer Health Informatics
Clinic
Hospital
Physician Office
Pharmacy
FurtiveRecords
Dentist
Patient-Centered Information Systems
Seen any ‘SMART’ patients lately?
...they’re there,
everywhere!
Slides and references will be available on Monday November 1 at
http://heartcare.ie.wisc.edu
