Q&A with Today’s Nursing Leaders
By Christina Orlovsky, contributor
Feb. 26, 2010 - With the future of health care filled with uncertainty, questions about how funding - or the lack thereof - will affect health information technology (IT) loom large on the minds of informatics experts and those eager to implement electronic health records and integrated health care systems. NurseZone recently spoke to health IT expert Lillee Gelinas, RN, MSN, vice president and chief nursing officer of VHA, Inc., an alliance of health care systems designed to provide members with best-practice solutions and services, who offers her insight on current trends, the effect of reform measures on health IT and how nurses can help shape the future.
Lillee Gelinas, RN, MSN, vice president and chief nursing officer of VHA, Inc., discusses current trends in health IT with NurseZone
Q. Is health care reform financing tied to the development of health information technology, or are stimulus funds separate?
A. It's separate. More than $750 million in awards have been made to state and local governments and community organizations to help prepare for widespread, meaningful use of health IT. The awards will help make health IT available to hospitals and primary care physicians by 2014 and grow an emerging industry expected to support tens of thousands of jobs.
Q. Will those funds continue?
A. Yes, but our crystal balls are cloudy!
Q. Where is health IT headed, with or without health care reform?
A. It doesn't matter about health reform with this one. Modernizing our health care system with health IT is critical to an efficient and cost-effective system in the future. We must replace the clipboard with the keyboard. The White House health care summit begins February 25 and most Americans will watch it on television, by webcast or even on their cell phone. We've come to depend on these communication strategies so much now they are the norm, but our health care system is anything but "modern" in comparison. Our health care system is outdated with clipboards, handwritten records, paper and one hand not knowing what the other is doing.
Read the book Paper Kills 2.0: How Health IT Can Help Save Your Life and Your Money. Wow!
Q. In addition to reform uncertainty, what are some of the other key barriers or challenges facing health IT today?
A. The AHIC Electronic Health Records Workgroup, which I co-chaired with HCA's (Hospital Corporation of America's) CMO, John Perlin, M.D., dealt with this "barriers" issue a great deal.
For one, the economic issue looms large. Modernizing hospitals and physician practices will take a huge investment, and hospitals don't have those dollars sitting in their banks.
Second is interoperability. We have to get this done quickly, and right.
Finally, workforce issues: Training, use and long-term adoption of technology requires attention to the human factors.
Q. What are the benefits of integrated health IT systems for nurses and their patients?
A. For patients, the benefits include:
• Fewer errors
• Fewer malpractice issues/lawsuits
• Highly reliable safety
• Consistent quality of care
• Less duplication of effort and rework - For instance, how many times have you given a health care provider your drug allergies?
• Better patient compliance to treatment protocols and regimens
• Better self-management of disease states and illness
• Better satisfaction with health care
For nurses, the benefits include:
• Better work environment with less "hunting and gathering" of information
• Better retention
• Better job satisfaction and less frustration
• Better ability to practice consistently and confidently
Q. In addition to electronic medical records, what are some other key health care technologies affecting nurses in their daily job responsibilities?
A. Technology solutions can make nursing care safer and more efficient. Nurses believe it is essential to have smart, portable, point-of-care solutions for capturing and transmitting data, as well as routine communications.
Some examples include: equipment and patient tracking, bar coding, robots, radio frequency identification (RFID), medical administration records (MARs), PDA devices, smart beds, smart pumps, wireless computers on wheels, laptop/tablet, smart cards, tube system, kiosks, active clinical decision support, GPS, cameras and data warehouses.
Nurses want functionalities that make technology faster, more convenient, compact and easier to use. The need for interoperability and integration of technology are important, as are technologies with hands-free features (voice activation) and portability (hand-held) for devices requiring user interface.
Q. How can nurses make health IT systems more effective, or impact those currently under development in their own facilities?
A. Nurses need to be part of teams involved in planning, design and implementation.
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