Thursday, July 25, 2013



Healthcare is emerging into the new era of informatics technology. President Bush set this emergence forth in 2004, during his state of the union address when he mandated that all Americans would be using electronic health records by 2014. The first national Health Information Technology (HIT) summit was convened by Dr. Davis Brailer, then national coordinator of HIT. Several nursing informatics leaders attended, only to discover nurses were not included in the discussion, neither were they mentioned in any of the presentations about the future of HIT. According to the AACN (American Association of Critical Nurses), 2013, nursing is the nation’s largest health care profession in the healthcare. The oversight of nurses spurred a group of nursing informatics leaders to act and form the Technology Informatics Guiding Education Reform (TIGER) Initiative, to strengthen the voices of nurses in the HIT reform.

The role of nursing in HIT is critical. Nursing is the forefront of healthcare and is greatly affected by the HIT changes affecting practice and education. The TIGER vision serves two purposes:
1.    To allow informatics tools, principles, theories, and practices to be used by nurses to make healthcare safer, effective, efficient, patient-centered, timely, and equitable.
2.    To interweave enabling technologies transparently into nursing practice and education, making information and technology “the stethoscope for the 21st century” (TIGER Summit, 2006).
One aspect of HIT is telehealth. Telehealth is the delivery of health-related services and information via telecommunication technologies. It can be as simple as two health professionals discussing a case over the telephone, or as sophisticated as doing robotic surgery between facilities at different end of the globes. Telehealth is an expansion of telemedicine; it encompasses preventative, and curative aspects of health. Telehealth is a way of monitoring patients’ health in their own homes in place of the standard clinic visit. Telehealth uses various technologies, aiming to help people with health problems that live at home. Technologies include videoconferencing, the internet, store-and-forward imaging, streaming media, and terrestrial and wireless communications. Blood pressure or blood glucose levels, for example, can be measured at home and transmitted electronically to a health professional. Telehealth is viewed as a cost-effective alternative to the more traditional face-to-face way of providing medical care which is consultation or examination between the provider and the patient.

Benefits of Telehealth
1.    Telehealth is used to access expert advice and is used in areas such as cardiology, dermatology, endoscopy, home monitoring, and continuous education for clinicians, community nursing, radiology imaging, and psychiatry.
2.    Telehealth can help rural providers deliver better health care by connecting rural providers and their patients to services at distant sites and promoting patient-centered healthcare.
3.    Telehealth improves access to primary and specialty medical care. It allows the entire care team which consists of the primary care providers, nurses, specialists, and family members to collaborate.  
4.    Telehealth benefits patients whose delivery of health services is affected by distance and lack of local clinicians to deliver services. Telehealth have been demonstrated to improve disease management and patient’s quality of life while drastically reducing re-hospitalization and emergency visits. (Cook, 2012).


Slow Rate of Adoption of Telehealth Services and HIT
The rate of adoption of telehealth services is frequently influenced by factors such as the adequacy and cost of existing conventional health services in meeting patients’ needs. Another barrier to HIT is privacy or security concerns. Many researchers agree that using computerized systems is an issue that can have a negative impact on patient privacy. Healthcare providers fear that data may be accessible to people who are unauthorized to obtain it.

Link : https://www.osc.edu/node/2341

Question: Nursing has taken an aggressive initiative to be active participants in electronic health records (EHRs) and health information technology (HIT). Will the TIGER initiative give nursing the recognition they deserve? Why?
References
Boonstra, A., & Broekhuis, M. (2010). Barriers to the acceptance of electronic medical records by physicians from systematic review to taxonomy and interventions. BMC Health Services Research, 10, 231. doi: 10.1186/1472-6963-10-231
Cook, R. (2012). Exploring the benefits and challenges of telehealth. Nursing Times, 108, 24.
TIGER Initiative. (2006). Informatics competencies for every practicing nurse: Recommendations from the TIGER collaborative. Retrieved from: http://www.tigersummit.com/9_Collaboratives.html