Module 5: Information Technology System Applicable in Nursing Practice PDF

Southern Luzon State University College of Allied Medicine Information Technology System Applicable in Nursing Practice Module 5...

Southern Luzon State University College of Allied Medicine Information Technology System Applicable in Nursing Practice Module 5 OVERVIEW This module will help you gain more knowledge about the information technology system applicable in nursing practice specifically in: Hospital/ Critical Care Application, Community Health Application, Administrative Assistive Devices and Workplace Technologies, Emergency Preparedness and Response, Ambulatory Care System and Telehealth. Through this module it may give you a way to recognize the importance and the need of Nursing Informatics in your clinical practice as a student future registered nurse on today’s modern world. There is a broad consensus that health care in the 21st century will require the intensive use of information technology and clinical informatics to acquire and manage data, transform the data to actionable information, and then disseminate this information so that it can be effectively used to improve patient care and healthcare delivery system. Southern Luzon State University Brgy Kulapi, Lucban Quezon Class Link: 1 NCM 110- Nursing Informatics | Prepared by: Reymar John I. Jordan MSN RN 2023-2024  Southern Luzon State University College of Allied Medicine LEARNING OBJECTIVES 1. Distinguish different types of information technology system used in nursing practice. 2. Discuss the role and importance of information technology system used in nursing practice. 3. Recognize the significance of information technology system in the nursing practice DISCUSSION Lesson 1- Hospital/ Critical Care Application From its beginnings, nursing has incorporated the activities of collecting, managing, processing, and transforming information and then communicating that information to others on the health care team. With the introduction of computer technology into health care, many changes have occurred in the management of information. This led to the development of informatics which essentially is a new framework for organizing and managing data and information. The present evolution in health care has created an evolution in information management, and this is being seen in critical care units everywhere. Those critical care practitioners that can manage the information will be successful in providing high-quality, cost-effective care. Intensive care medicine involves care of critically ill patients across the age spectrum, from neonates through pediatrics and into adulthood. This patients typically require invasive monitoring or advanced organ support, including invasive ventilation, dialysis, blood pressure support and oxygenation. Nursing informaticists are vital as links from the front lines of nursing, who perform most of the day-to-day tasks in the ICU, to information systems analysts who design, maintain and analyze health systems. Critical Care Information System 1. Provide real-time resource utilization data and management of information and access critical care areas through the integration of the medical facilities in the critical care or intensive care unit to an intelligent computer system which is capable of processing all data. 2. Enables the electronic collection of hospital and patient-specific critical care data of the entire patient in the critical care areas which can be processed to create a patient profile 2 NCM 110- Nursing Informatics | Prepared by: Reymar John I. Jordan MSN RN 2023-2024  Southern Luzon State University College of Allied Medicine which generate real time and historical report on indicators including bed occupancy, delayed discharges, readmission rates, and outcomes. 3. Automated collection and management of medical information will become the important task of the critical care information system. Medical Information Bus (MIB) 1. Provides a generalized method of attaching patient monitoring devices to a common interface. 2. This interface converts the unique manufacturer data communications protocol into a standardized hardware and software system. 3. It eliminates the need for custom connector and software presently needed to interface such device. 4. Has the ability to filter, store and select information sent for inclusion into the clinical medical record on the clinical computer system. Infusion pumps, ventilators, pulse, and other patient equipment are now transmitting clinical information for use in clinical data reporting and decision making. Advantages of Critical Care Information System 1. Intelligently integrates and process physiologic and diagnostic information and store it to secured clinical repository. 2. Creates trends analysis with graphical representation of results. 3. Offline stimulation can be performed to test the condition of the patients. 4. Provide clinical decision support system 5. Provide access to vital patient information 6. Providing feedback and quick evaluation of the patient condition and provides alert. 3 NCM 110- Nursing Informatics | Prepared by: Reymar John I. Jordan MSN RN 2023-2024  Southern Luzon State University College of Allied Medicine QS® Critical Care The practical approach to better patient information. QS Critical Care was developed to help you transition to a paperless information system. Its ease-of-use and logical charting structure encourage user acceptance, even for those users with little or no computer experience.QS’ scalability, open-architecture design and Windows NT® platform facilitate expansion to keep pace with growing demands. And its site- tailorable capabilities allow you to customize QS to meet each department’s unique requirements. Lab Access  An HL7 protocol offers a time-savings direct electronic link to most lab systems, allowing test results to be sent to the bedside monitor the instant they are available – an on-screen icon notifies clinicians of lab results availability.  Efficient electronic storage and recall assures immediate data access wherever and whenever it’s needed.  Multiple lab results can be viewed simultaneously for comparison. Unit Manager  Expands vital signs capabilities for the bedside monitor.  Quickly review lab results and trend critical values to speed your clinical assessment and decision-making.  APACHE scoring offers a quantifiable method for comparing patient acuity and costs between institutions.  TISS scoring gives you the ability to monitor the patient while tracking productivity. Critical Care  All caregivers can access and track patient information, including medications, monitor readouts and charting, patient progress, and other nursing and procedure documentation.  Facilitates acquisition, validation and reliability of critical patient outcome data and reporting.  QS’ flexibility lets you adapt easily to meet constantly changing healthcare documentation needs and regulations, while adhering to your facility’s formulary, clinical pathways and practice guidelines. QS is a time-saving tool – by setting up a logical, sequential charting process – with plenty of room for free descriptive comments – QS refines and automates many laborious, repetitive manual processes.  Data becomes a permanent record – the information gathered by QS in the ICU and CCU becomes part of the patient’s permanent electronic record.  Web enabled features allow easy access to an intranet, the internet or other web-enabled clinical systems from within a QS Critical Care session.  The QS MAR option is physician-designed for exceptional ease of use and clinical utility; this user-configurable medication administration record allows highly efficient electronic documentation of medications, fluids and infusions – It also performs drug calculations, fluid intakes and outputs, and automates duration of administration… helping significantly reduce administration and recording errors. Additional System Features Chalkboards  Customize chalkboards for each care area to provide cross-patient or cross-unit status displays.  Indicates patient status by color coding items. Facilitates admission, transfer and discharge functions. Reporting  Export data to a predefined system or database.  Enterprise-wide networking allows data to be exchanged between multiple care areas and departments. 4 NCM 110- Nursing Informatics | Prepared by: Reymar John I. Jordan MSN RN 2023-2024  Southern Luzon State University College of Allied Medicine Lesson 2- Community Health Application Community Health Information System Overview  Collective term for the methodical application of information science and technology to community and public health process.  Focuses on the health information system of the community, it is centered on the majority part of the public.  Emphasizes the prevention of the disease, medical intervention and public awareness.  Fulfils a unique role in the community, promoting and protecting the health of the community at the same time maintaining sustainability and integrity of health data and information. Goal of Community Health Informatics  Effective and timely assessment that involves monitoring and tracking the health status of populations including identifying and controlling disease outbreaks and epidemics.  Comprehensive directed towards the majority of individuals, families, and the community at large. Community Health Application System  Encourages optimal application of computer system, computer programs and communication system for the benefit of majority of individuals, families and community. Primary Focus of Community Health Information System  Preventing, identifying, investigating and eliminating communicable health problems.  Accessibility of data and information, through communication  Educating and empowering individuals to adopt health life style  Facilitate the retrieval of data  Effective transformation of data into information  Effective integration of information to other disciplined to concretized knowledge and creates better understanding.  Creation of computerized patient records, medical information system  Central repositions of all data such as data warehouse  Simple Graphical User Interface (GUI) for nurses and other healthcare provider, patient ad consumer Computer Based Survey System Health Statistical Surveys  Are used to collect quantitative information about items in a population to establish certain information from the obtained data.  Focused on opinions or factual information depending on its purpose and many surveys involves administering questions to individuals. Advantages of Integration of Community Health Systems 5 NCM 110- Nursing Informatics | Prepared by: Reymar John I. Jordan MSN RN 2023-2024  Southern Luzon State University College of Allied Medicine  Consistent exchange of response  Disease tracking  Data and information sharing  Building strategies  Early detection and monitoring of disease and sickness  Control of spread of disease  National alertness and preparedness  Building strong communication  Maintaining strong relation between nurses and other healthcare provider  Continuous coordination of the healthcare professionals  Synchronization of the decisions  Streamlining of the process  Effective management of data and information  Optimal operation of hospital and clinics Lesson 3- Administrative Assistive Devices and Workplace Technologies Assistive devices and technologies are those whose primary purpose is to maintain or improve an individual’s functioning and independence to facilitate participation and to enhance overall well-being. They can also help prevent impairments and secondary health conditions. Examples of assistive devices and technologies include wheelchairs, prostheses, hearings aids, visual aids, and specialized computer software and hardware that increase mobility, hearing, vision, or communication capacities. (WHO) The International Classification of Functioning, Disability and Health (ICF) defines assistive products and technology as any product, instrument, equipment or technology adapted or specially designed for improving the functioning of a person with a disability. Meanwhile, The International Organization for Standardization (ISO) defines assistive products more broadly as any product, especially produced or generally available, that is used by or for persons with disability: for participation; to protect, support, train, measure or substitute for body functions/structures and activities; or to prevent impairments, activity limitations or participation restrictions. Test your knowledge…. Activity 1 1. As you read the definition of what assistive devices and technology is, can you explain the importance of Nursing Informatics to this technology? Lesson 4- Emergency Preparedness and Response It is clear that technology and informatics are becoming increasingly important in disasters and humanitarian response. Technology is a critical tool to recording, analyzing, and predicting trends in data that could not be achieved prior to its implementation. Informatics is the translation of this data into information, knowledge, and wisdom. Combining technology and informatics 6 NCM 110- Nursing Informatics | Prepared by: Reymar John I. Jordan MSN RN 2023-2024  Southern Luzon State University College of Allied Medicine applications with response efforts has resulted in various enhanced bio surveillance efforts, advanced communications, and information management during disasters. HEALTH INFORMATION EXCHANGE EFFORTS Health information exchange (HIE) is critical to victims of disasters or other humanitarian crises events. Many times, the medical record is destroyed during an event, or if victims are forced to relocate to another area, there may be no possibility for access to their health information. Further contributing to this information dearth is the fact that stressful situations do not promote accurate recall of health information by victims involved. Technology can be used to store and control access to health care information but requires that the data and information are in electronic format. Three graduated stages for implementing meaningful use and certification of EHR software:  Stage I focuses on capturing data in a coded format,  Stage II expands the exchange of information, and  Stage III focuses on clinical decision support for high priority conditions, patient self- management, and access to comprehensive data. The exchange of information across the many entities that deliver care is necessary for coordinated, accountable, patient-centered care during times of non-disaster and is even more critical during disaster situations when victims are displaced. Shapiro et al. (2011) describe that varying architectures could be designed to support public health use including (a) centralized repositories (such as the Veterans Affairs EHR), (b) hybrid peer-to-peer fi le-sharing models, and (c) patient-controlled health records. They conclude that HIE can improve the efficiency and quality of public health reporting, facilitate public health investigation, improve emergency response, and enable public health to communicate information to the clinical community. INFORMATICS DISASTER PLANNING TOOLS Accurate public health data about air, water, sanitation, utilities, and all health care facilities (including shelters and other surge capacity facilities) are imperative for effective disaster planning and response efforts. It is also important to track such data on a pre-disaster and post- disaster basis. This information will allow for the assessment of the disaster impact and will aid in planning where emergency services are needed, determining the level of health providers required and where community infrastructure improvements are needed. (Harrison, Harrison, & Smith, 2018) Clancy (2011), describes the Emergency Preparedness Resource Inventory, a web-based tool that can be used to assess the regional supply of critical resources, prepare for incident response, identify deficiencies in services, and support resource decisions that need to be made in a timely fashion. The Inventory also includes a catalog of emergency equipment and medicines, their location and amount, and where to obtain additional supplies. Harrison et al. (2008) also discuss the use of predictive modeling software that helps in disaster relief planning. The Bioterrorism and Epidemic Outbreak Response Model predicts the staff needed to respond to a major disease outbreak or bioterrorism attack. Use of this tool allows planners to realistically plan for mass vaccination and antibiotic distribution. Predictive modeling 7 NCM 110- Nursing Informatics | Prepared by: Reymar John I. Jordan MSN RN 2023-2024  Southern Luzon State University College of Allied Medicine software for the health care industry, however, has not kept pace with the growth of its use in the nuclear disaster industry (Hallbert, 2010). BIOSURVEILLANCE Homeland Security Presidential Directive (HSPD) 21 defines the term bio surveillance as the process of active data gathering with appropriate analysis and interpretation of biosphere data that might be related to disease activity and threats to human or animal health; whether infectious, toxic, metabolic, or otherwise, and regardless of intentional or natural origin; in order to achieve early warning of health threats, early detection of health events, and overall situational awareness. (White House, 2007, p.1, para.2) A catastrophic health event such as a terrorist attack with a weapon of mass destruction (WMD), a naturally occurring pandemic, or a catastrophic meteorological or geological event could cause tens or hundreds of thousands of casualties or more; and as a result, will further weaken our global economy, damage public morale and confidence, and threaten our national security. It is therefore critical that we establish ways to detect the earliest indicators of an event and facilitate the earliest possible warning and projection of impact. How could informatics and technology solutions be used to help identify an incident and inform decision making and time sensitive actions needed at all levels to manage a health emergency? Since enactment in 2007, the International Health Regulations (WHO, 2005) require that the 194 signature countries work together to prevent, detect, and respond to public health risks that could threaten the world. Member countries must report certain types of disease outbreaks and improve their capacities and capabilities for both public health surveillance and timely response. As a result, there have been great improvements in global surveillance intended to confirm conditions, and rapidly identify the emergence of new patterns or trends, while assessing their significance. The Global Public Health Intelligence Network, a part of the WHO’s Global Outbreak Alert and Response Network, and Project ARGUS are two examples of biosurveillance systems that can provide early detection and warning of unusual events that may threaten human, plant, and animal health globally (Eysenbach, 2003; Thomas, Nelson, Jahn, Niu, & Hartley, 2011). Both systems continually examine open source news articles and the Internet with preset search terms for more than 30 communicable diseases. They also look for information about natural disasters and drug-resistant disease causing agents. Use of “open source” reporting often is much timelier than government statements or reports. These systems serve as “tipping points” identifying end users of events where actions may be considered; however, the systems themselves do nothing more than identify a novel event. Although these approaches may be helpful in countries where there is unfettered news reporting and access to the Internet, neither offers much assistance when media or Internet access is controlled by the government or the report is in a foreign language. A research group in the Clinical Informatics Lab at McGill University (Canada) is developing and evaluating automated public health surveillance methods using health care utilization data. By using already available data such as appointing, billing, and laboratory test requests and results, they hope to detect deviations from normal usage indicating an evolving incident (McGill, 2012). The CDC has had its community level and cloud-based surveillance system deployed since 2003. BioSense combines current health data from multiple sources such as health 8 NCM 110- Nursing Informatics | Prepared by: Reymar John I. Jordan MSN RN 2023-2024  Southern Luzon State University College of Allied Medicine departments, hospital emergency rooms, and pharmacies to quickly detect and respond to health events by providing public health situational awareness (CDC, 2012b). COMMUNICATION AND INFORMATION MANAGEMENT DURING RESPONSE Being able to track patients and supplies during times of disasters is also critical. The use of geographical information systems (GIS) technology has expanded this ability into real-time reporting that is important to the incident response team management. DISASTER MOBILE HEALTH TECHNOLOGY Mobile health (mHealth) technology has the potential to play an important role in providing much needed alerts and updates, tracking and patient flow data, patient care data, facility management data, and data collected at the point of care. It is feasible for mHealth platforms to create a common operational framework that improves disaster response by standardizing data acquisition, organizing information storage, and facilitating medical communication. This is particularly important during patient handoffs between volunteer providers. In addition, mHealth technology serves as the basis for the provision of a broad stream of services, depending on the remaining infrastructure following an event. Smartphones allow for phone calls and text messaging, as well as connections to several social media applications that are popular for communicating with one’s peers in today’s society. The Advanced Health and Disaster Aid Network (AID-N) was a test bed designed to improve communications and provide access to pertinent information for the user community during emergencies (Johns Hopkins University Applied Physics Laboratory, 2007). Although not all aspects of the network were mobile, the intent was to develop a next generation electronic triage system to improve the effectiveness of victim care during large-scale disasters. The system included: a. electronic triage tags, b. wearable vital sign sensors, c. robust ad hoc mesh networking software suitable for small embedded computers with limited memory and computational power, d. base station laptops with scalable algorithms to manage large number of patients, e. pervasive tracking software to locate patients at all stages of the disaster response process, (f) handheld Smartphones to provide a lightweight supplement to base stations for first responders and health care personnel, and f. a web portal for the different organizational groups involved in the response effort to be fully aware of the situation in real time Lesson 5- Ambulatory Care System Nursing Informatics in Ambulatory Care Information System Ambulatory Care 9 NCM 110- Nursing Informatics | Prepared by: Reymar John I. Jordan MSN RN 2023-2024  Southern Luzon State University College of Allied Medicine  Covers a wide range of health care services that are provided for patients who are not admitted overnight to a hospital.  These services are performed at outpatient clinics, urgent care centers, emergency rooms, ambulatory or same-day surgery centers, diagnostic and imaging centers, primary care centers, community health centers, occupational health centers, mental health clinics, and group practices. Ambulatory Care Information System  Provides automated processing of data and information such as allergies and medical alerts, patients accounting system such as charging, billing, discounts and concessions, diagnostics imaging treatments, and etc.  With this system, the patient waiting time is optimized through effective queue management.  It involves one-time registration required per visit. It also facilitates the management of doctor’s schedule. Advantages of Ambulatory Care Information System  Real-time and easy access to patient’s medical records by healthcare providers.  Improved workflow, which allows more time for comprehensive patient counseling and review.  Reduced errors with the availability of various automation engines – drug interaction engine; medical alert engine; patient billing engine, etc.  Automated and integrated back-end process such as pharmacy, billing, purchasing, inventory management, etc.  Improved clinical outcome analysis – enhanced research productivity through data mining and facilitate institutional handling of managed care challenges in a timely manner.  Improvement in hospital inventory management.  Better monitoring and management of costs – prescription, consumables, doctor’s fees, etc. Issues in Ambulatory Care Information System  Increased accountability  The need for continuous support  Privacy and confidentiality of information  Accessibility and security of data and information  Integration and support to the other system The Role of Nurse Using Information System in the Ambulatory Care System  The very basic objective of the automated ambulatory care information system is to easily integrate the data to the other data and easily translate these data into information.  The effective transformation of data can be integrated to the other processes to transform it into knowledge.  The ambulatory care nurse and other health care provider should be capable enough to implement the process effectively. 10 NCM 110- Nursing Informatics | Prepared by: Reymar John I. Jordan MSN RN 2023-2024  Southern Luzon State University College of Allied Medicine Lesson 6- Telehealth Telehealth is the distribution of health-related services and information via electronic information and telecommunication technologies. It allows long-distance patient and clinician contact, care, advice, reminders, education, intervention, monitoring, and remote admissions. Telemedicine is sometimes used as a synonym, or is used in a more limited sense to describe remote clinical services, such as diagnosis and monitoring. When rural settings, lack of transport, a lack of mobility, decreased funding, or a lack of staff restrict access to care, telehealth may bridge the gap as well as provider distance-learning; meetings, supervision, and presentations between practitioners; online information and health data management and healthcare system integration. Telehealth could include two clinicians discussing a case over video conference; a robotic surgery occurring through remote access; physical therapy done via digital monitoring instruments, live feed and application combinations; tests being forwarded between facilities for interpretation by a higher specialist; home monitoring through continuous sending of patient health data; client to practitioner online conference; or even videophone interpretation during a consult. Methods and Modalities Telehealth requires a strong, reliable broadband connection. As broadband infrastructure has improved, telehealth usage has become more widely feasible. Healthcare providers often begin telehealth with a needs assessment which assesses hardships which can be improved by telehealth such as travel time, costs or time off work. Collaborators, such as technology companies can ease the transition. Delivery can come within four distinct domains: live video (synchronous), store-and-forward (asynchronous), remote patient monitoring, and mobile health. Store and forward Store-and-forward telemedicine involves acquiring medical data (like medical images, biosignals etc.) and then transmitting this data to a doctor or medical specialist at a convenient time for assessment offline. It does not require the presence of both parties at the same time. Dermatology, radiology, and pathology are common specialties that are conducive to asynchronous telemedicine. A properly structured medical record preferably in electronic form should be a component of this transfer. The 'store-and-forward' process requires the clinician to rely on a history report and audio/video information in lieu of a physical examination. 11 NCM 110- Nursing Informatics | Prepared by: Reymar John I. Jordan MSN RN 2023-2024  Southern Luzon State University College of Allied Medicine Remote Monitoring Remote monitoring, also known as self-monitoring or testing, enables medical professionals to monitor a patient remotely using various technological devices. This method is primarily used for managing chronic diseases or specific conditions, such as heart disease, diabetes mellitus, or asthma. These services can provide comparable health outcomes to traditional in-person patient encounters, supply greater satisfaction to patients, and may be cost- effective. Examples include home-based nocturnal dialysis and improved joint management. Real-time interactive Electronic consultations are possible through interactive telemedicine services which provide real-time interactions between patient and provider. Videoconferencing has been used in a wide range of clinical disciplines and settings for various purposes including management, diagnosis, counseling and monitoring of patients. Videotelephony Videotelephony comprises the technologies for the reception and transmission of audio- video signals by users at different locations, for communication between people in real-time. Currently videotelephony is particularly useful to the deaf and speech-impaired who can use them with sign language and also with a video relay service, and well as to those with mobility issues or those who are located in distant places and are in need of telemedical or tele- educational services. Categories Emergency Care Common daily emergency telemedicine is performed by SAMU Regulator Physicians in France, Spain, Chile and Brazil. Aircraft and maritime emergencies are also handled by SAMU centers in Paris, Lisbon and Toulouse. A recent study identified three major barriers to adoption of telemedicine in emergency and critical care units. They include:  Regulatory challenges related to the difficulty and cost of obtaining licensure across multiple states, malpractice protection and privileges at multiple facilities  Lack of acceptance and reimbursement by government payers and some commercial insurance carriers creating a major financial barrier, which places the investment burden squarely upon the hospital or healthcare system.  Cultural barriers occurring from the lack of desire, or unwillingness, of some physicians to adapt clinical paradigms for telemedicine applications. Telenutrition Telenutrition refers to the use of video conferencing/ telephony to provide online consultation by a nutritionist or dietician. Patient or clients upload their vital statistics, diet logs, and food pictures etc. on TeleNutrition portal which are then used by nutritionist or dietician to analyze their current health condition. Nutritionist or dietician can then set goals for their respective client/ patients and monitor their progress regularly by follow-up consultations. 12 NCM 110- Nursing Informatics | Prepared by: Reymar John I. Jordan MSN RN 2023-2024  Southern Luzon State University College of Allied Medicine Telenutrition portals can help clients/ patients seek remote consultation for themselves and/ or their family from the best nutritionist or dietician available across the globe. This can be extremely helpful for elderly/ bed ridden patients who can consult their dietician from comfort of their homes. Telenursing Telenursing refers to the use of telecommunications and information technology in order to provide nursing services in health care whenever a large physical distance exists between patient and nurse, or between any numbers of nurses. As a field it is part of telehealth, and has many points of contacts with other medical and non-medical applications, such as telediagnosis, teleconsultation, telemonitoring, etc. Telenursing is achieving significant growth rates in many countries due to several factors: the preoccupation in reducing the costs of health care, an increase in the number of aging and chronically ill population, and the increase in coverage of health care to distant, rural, small or sparsely populated regions. Among its benefits, telenursing may help solve increasing shortages of nurses; to reduce distances and save travel time, and to keep patients out of hospital. A greater degree of job satisfaction has been registered among telenurses. Telepharmacy Telepharmacy is the delivery of pharmaceutical care via telecommunications to patients in locations where they may not have direct contact with a pharmacist. It is an instance of the wider phenomenon of telemedicine, as implemented in the field of pharmacy. Telepharmacy services include drug therapy monitoring, patient counseling, prior authorization and refill authorization for prescription drugs, and monitoring of formulary compliance with the aid of teleconferencing or videoconferencing. Remote dispensing of medications by automated packaging and labeling systems can also be thought of as an instance of telepharmacy. Telepharmacy services can be delivered at retail pharmacy sites or through hospitals, nursing homes, or other medical care facilities. The term can also refer to the use of videoconferencing in pharmacy for other purposes, such as providing education, training, and management services to pharmacists and pharmacy staff remotely. Teledentistry Teledentistry is the use of information technology and telecommunications for dental care, consultation, education, and public awareness in the same manner as telehealth and telemedicine. Teleaudiology Tele-audiology is the utilization of telehealth to provide audiological services and may include the full scope of audiological practice. This term was first used by Dr Gregg Givens in 1999 in reference to a system being developed at East Carolina University in North Carolina, USA. Teleneurology 13 NCM 110- Nursing Informatics | Prepared by: Reymar John I. Jordan MSN RN 2023-2024  Southern Luzon State University College of Allied Medicine Teleneurology describes the use of mobile technology to provide neurological care remotely, including care for stroke, movement disorders like Parkinson's disease, seizure disorders (e.g., epilepsy), etc. The use of teleneurology gives us the opportunity to improve health care access for billions around the globe, from those living in urban locations to those in remote, rural locations. Teleneuropsychology Teleneuropsychology (Cullum et al., 2014) is the use of telehealth/videoconference technology for the remote administration of neuropsychological tests. Neuropsychological tests are used to evaluate the cognitive status of individuals with known or suspected brain disorders and provide a profile of cognitive strengths and weaknesses. Through a series of studies, there is growing support in the literature showing that remote videoconference-based administration of many standard neuropsychological tests results in test findings that are similar to traditional in- person evaluations, thereby establishing the basis for the reliability and validity of teleneuropsychological assessment. Telerehabilitation Telerehabilitation is the delivery of rehabilitation services over telecommunication networks and the Internet. Most types of services fall into two categories: clinical assessment (the patient's functional abilities in his or her environment), and clinical therapy. Some fields of rehabilitation practice that have explored telerehabilitation are: neuropsychology, speech- language pathology, audiology, occupational therapy, and physical therapy. Telerehabilitation can deliver therapy to people who cannot travel to a clinic because the patient has a disability or because of travel time. Telerehabilitation also allows experts in rehabilitation to engage in a clinical consultation at a distance. Teletrauma care Telemedicine can be utilized to improve the efficiency and effectiveness of the delivery of care in a trauma environment. Examples include: Telemedicine for trauma triage: using telemedicine, trauma specialists can interact with personnel on the scene of a mass casualty or disaster situation, via the internet using mobile devices, to determine the severity of injuries. They can provide clinical assessments and determine whether those injured must be evacuated for necessary care. Remote trauma specialists can provide the same quality of clinical assessment and plan of care as a trauma specialist located physically with the patient. Telemedicine for intensive care unit (ICU) rounds: Telemedicine is also being used in some trauma ICUs to reduce the spread of infections. Rounds are usually conducted at hospitals across the country by a team of approximately ten or more people to include attending physicians, fellows, residents and other clinicians. This group usually moves from bed to bed in a unit discussing each patient. This aids in the transition of care for patients from the night shift to the morning shift, but also serves as an educational experience for new residents to the team. A new approach features the team conducting rounds from a conference room using a video- conferencing system. The trauma attending, residents, fellows, nurses, nurse practitioners, and pharmacists are able to watch a live video stream from the patient's bedside. They can see the vital signs on the monitor, view the settings on the respiratory ventilator, and/or view the patient's 14 NCM 110- Nursing Informatics | Prepared by: Reymar John I. Jordan MSN RN 2023-2024  Southern Luzon State University College of Allied Medicine wounds. Video-conferencing allows the remote viewers two-way communication with clinicians at the bedside. Telemedicine for trauma education: some trauma centers are delivering trauma education lectures to hospitals and health care providers worldwide using video conferencing technology. Each lecture provides fundamental principles, firsthand knowledge and evidenced-based methods for critical analysis of established clinical practice standards, and comparisons to newer advanced alternatives. The various sites collaborate and share their perspective based on location, available staff, and available resources. Telemedicine in the trauma operating room: trauma surgeons are able to observe and consult on cases from a remote location using video conferencing. This capability allows the attending to view the residents in real time. The remote surgeon has the capability to control the camera (pan, tilt and zoom) to get the best angle of the procedure while at the same time providing expertise in order to provide the best possible care to the patient. Telecardiology ECGs, or electrocardiographs, can be transmitted using telephone and wireless. Telepsychiatry Telepsychiatry, another aspect of telemedicine, also utilizes videoconferencing for patients residing in underserved areas to access psychiatric services. It offers wide range of services to the patients and providers, such as consultation between the psychiatrists, educational clinical programs, diagnosis and assessment, medication therapy management, and routine follow-up meetings. Teleradiology Teleradiology is the ability to send radiographic images (x-rays, CT, MR, PET/CT, and SPECT/CT) from one location to another. For this process to be implemented, three essential components are required, an image sending station, a transmission network, and a receiving- image review station. The most typical implementation are two computers connected via the Internet. The computer at the receiving end will need to have a high-quality display screen that has been tested and cleared for clinical purposes. Sometimes the receiving computer will have a printer so that images can be printed for convenience. The teleradiology process begins at the image sending station. The radiographic image and a modem or other connection are required for this first step. The image is scanned and then sent via the network connection to the receiving computer. Telepathology Telepathology is the practice of pathology at a distance. It uses telecommunications technology to facilitate the transfer of image-rich pathology data between distant locations for the purposes of diagnosis, education, and research. Performance of telepathology requires that a pathologist selects the video images for analysis and the rendering diagnoses. The use of "television microscopy", the forerunner of telepathology, did not require that a pathologist have physical or virtual "hands-on" involvement is the selection of microscopic fields-of-view for analysis and diagnosis. 15 NCM 110- Nursing Informatics | Prepared by: Reymar John I. Jordan MSN RN 2023-2024  Southern Luzon State University College of Allied Medicine Teledermatology Teledermatology allows dermatology consultations over a distance using audio, visual and data communication, and has been found to improve efficiency, access to specialty care, and patient satisfaction. Applications comprise health care management such as diagnoses, consultation and treatment as well as (continuing medical) education. Teleophthalmology Teleophthalmology is a branch of telemedicine that delivers eye care through digital medical equipment and telecommunications technology. Today, applications of teleophthalmology encompass access to eye specialists for patients in remote areas, ophthalmic disease screening, diagnosis and monitoring; as well as distant learning. Teleophthalmology may help reduce disparities by providing remote, low-cost screening tests such as diabetic retinopathy screening to low-income and uninsured patients. Telesurgery Remote surgery (also known as telesurgery) is the ability for a doctor to perform surgery on a patient even though they are not physically in the same location. It is a form of telepresence. Remote surgery combines elements of robotics, cutting edge communication technology such as high-speed data connections, haptics and elements of management information systems. While the field of robotic surgery is fairly well established, most of these robots are controlled by surgeons at the location of the surgery. Remote surgery is essentially advanced telecommuting for surgeons, where the physical distance between the surgeon and the patient is immaterial. It promises to allow the expertise of specialized surgeons to be available to patients worldwide, without the need for patients to travel beyond their local hospital. Remote surgery or telesurgery is performance of surgical procedures where the surgeon is not physically in the same location as the patient, using a robotic teleoperator system controlled by the surgeon. The remote operator may give tactile feedback to the user. Remote surgery combines elements of robotics and high-speed data connections. A critical limiting factor is the speed, latency and reliability of the communication system between the surgeon and the patient, though trans-Atlantic surgeries have been demonstrated. Congratulations you have finished the module. I hope you understand our topics for this module. For any inquiries you may contact me thru txt or call message at 09477882797 or PM me on my messenger every Fridays; 1- 5 pm. Are you ready for your evaluation? EVALUATION Self- Assessment In on your own word, summarize the different types of information 16 NCM 110- Nursing Informatics | Prepared by: Reymar John I. Jordan MSN RN 2023-2024  Southern Luzon State University College of Allied Medicine technology system used in nursing practice. Discuss the role and importance of the information systems used in nursing practice. REFERENCES Carolyn Sipes, “Application of Nursing Informatics- Competencies, Skills, Decision-making”, 2019 Springer Publishing Company, LLC Jeanne Sewell, “Informatics and Nursing- Opportunities and challenges”, 5th edition, 2016 Wolters Kluwer http://nursingcrib.com/nursing-informatics/community-health-information-system/ http://nursingcrib.com/nursing-informatics/nursing-informatics-in-ambulatory-care-information- system/ https://en.wikipedia.org/wiki/Telehealth https://abbetarmos.wordpress.com/nursing-informatics-critical-care-application/ 17 NCM 110- Nursing Informatics | Prepared by: Reymar John I. Jordan MSN RN 2023-2024