Health IT Module Content for NURS 220Y

What is it’s role in healthcare?

 Term coined by Clayton Christensen in his book: The Innovator’s Dilemma “a process by which a product or service takes root initially in simple applications at the bottom of a market and then relentlessly moves up market, eventually displacing established competitors.”  What does that mean in healthcare? 

Dr. Jason Hwang an internal medicine physician:  “The transference of skills from highly trained but also expensive personnel to more affordable providers, including technology- based care.  The shift away from traditional health care venues like hospitals into clinics and office settings, and, in some cases, into patients’ own homes.”  Townsend, John C. (April 23, 2013) Disruptive Innovation: A Prescription for Better Health Care. Forbes. Retrived August 14, 2013 from

Emerging technologies

 Subset of eHealth  Practice of medicine or healthcare supported by a mobile device  Phones, tablet, iPad, laptop, other mobile (wireless) monitoring devices  Used to:  Collect data (community/public/home health)  Deliver healthcare information (at point of care)  Monitor (vitals, labs, activity)  Communicate (messaging, )  CDSS  Disease surveillance

 Providing direct care via long distance  As simple as a phone consult  Video interactions  Home monitoring of patients  May use mobile devices

 MEANINGFUL USE  improve understanding of their health  take a more active role in their health care.  involvement of their families Examples: ent/7-e-health-tools-to-get-patients- engaged/ ?pgno=1 Do these tools provide “meaningful use” to patients? 

 FDA- How to regulate a mobile device ?  EX: Mobile phone that does a urinalysis  What type of medical device is it?  How is it regulated for safety, accuracy, etc?  Guidance in development

Digital Natives and Digital Immigrants- Which one are YOU?

 91% of U.S. adults own a cell phone; 56% of U.S. adults own a smartphone (May 2013 survey)  31% of cell phone owners, and 52% of smartphone owners, have used their phone to look up health or medical information.  19% of smartphone owners have downloaded an app specifically to track or manage health.

NOTE: Ages are as of 2011 Millennials (18-34) Gen X (35-46) Younger Boomers (47-56) Older Boomers (57-65) Silent Generation (66-74) G.I. Generation (75+) % of American adults in each generation who go online wirelessly (with a cell phone or laptop computer) 82%71%55%46%33%9% PEW How well will mobile health technology improve healthcare if the majority of the healthcare consumers do not embrace the technology? What can be done to improve access to or use of technology?

 Chronic Disease Management  Independent Aging  Health and Wellness  Smart Homes 

Improving care delivery

 What type of app is it?  Reference  Diagnostic tool  CDSS  Networking resource  Cost effective?  Free or subscription?  Equipment requirements  Hardware or on a mobile platform  Security  HIPAA compliant? Where is data stored?

Care centered on patients

 Self monitoring  Weight  Activity  Calories  Blood sugars  Sleep tracking  Stress management  Symptoms of chronic disease  Observations of daily living   Medical reference  Health information  Health care guidance  Community

 Seven in ten (69%) U.S. adults track a health indicator for themselves or a loved one and many say this activity has changed their overall approach to health  Project Health Design  personal health records (PHRs) as springboards for action and improved health decision-making  HealthTap (  From web or mobile device  Tailored medical advice with the input of doctors who are site members.

The future of nursing

 ess_future_of_medicine.html ess_future_of_medicine.html  Watch this video and discuss in class  Does this technology replace the nurse?  Why or why not?  How will the nurses’ role and responsibilities change with this kind of technology?

 User  Educator  Innovator  Protector  Role Model  Super User  Data Analyst

Mobile health technology and telehealth

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POWERPOINT REFERENCES Department of Health and Human Services (no date) Health IT Adoption Toolbox: Meaningful use: Patient engagement. Retrieved August 14, 2013 from Christensen, C. Information on Disruptive Technology: Centers for medicare and Medicaid services (August 2012) Stage 2 Overview Tipsheet. Retrived August 14, 2013 from Guidance/Legislation/EHRIncentivePrograms/Downloads/Stage2Overview_Tipsheet.pdfhttps:// Guidance/Legislation/EHRIncentivePrograms/Downloads/Stage2Overview_Tipsheet.pdf Hansen, Turton, T (December 2010). A Disruptive Innovation in Care Delivery: Nurse Practitioners Fill the Primary Care Gap: Fierce Mobile Healthcare Mobile Health Downloads:a Fierce Mobile Healthcare, Embedded Health Monitoring: Fox, S. (July 1, 2013) Pew Internet: Health. Retreived August 14,2013, from Health Tap: Kellerman, G.R. (December 10, 2012) Mobile Health Tech: From Novel Startups to Global Industry. The Atlantic retrieved August from

Medical technology for the older adult: National Institutes of Health, life time distribution of healthcare costs data: National Science Foundation video about Smart Home Technology: Quantified Self: Pew Internet Tracking for Health: Topol, E. Ted TALK The Wireless Future of Medicine: Townsend, John C. (April 23, 2013) Disruptive Innovation: A Prescription for Better Health Care. Forbes. Retrived August 14, 2013 from Wikipedia entry Digital Native: updated July 30, 2013 Wikipedia entry Disruptive Innovation: Updated July 23, 2013http://en.wikipedia.org/wiki/Disruptive_innovation Wikipedia entry mHealth: Updated August 4,2013http://en.wikipedia.org/wiki/MHealth Updated August 4,2013 Why mobile technology may well define the future of healthcare. You Tube Video: Zickuhr, K. (Dec 16, 2010) Pew Internet Report Generations 2010:

Led by Bellevue College, the Health eWorkforce Consortium was formed to elevate Health Information Technology workforce development locally and nationally and provide career paths into this promising field for veterans and others. The nine-college consortium includes Bellevue College, Bellingham Technical College, Clark College, Clover Park Technical College, Northern Virginia Community College, Pierce College, Renton Technical College, Spokane Community College, and Whatcom Community College. The Health Information and Management Systems Society (HIMSS) is also a primary partner. This workforce solution is 100% funded by an $11.7m grant awarded by the U.S. Department of Labor's Employment and Training Administration. The solution was created by the grantee and does not necessarily reflect the official position of the U.S. Department of Labor. The Department of Labor makes no guarantees, warranties, or assurances of any kind, express or implied, with respect to such information, including any information on linked sites and including, but not limited to, accuracy of the information or its completeness, timeliness, usefulness, adequacy, continued availability or ownership. This work is licensed under a Creative Commons Attribution 4.0 International License. Exceptions: 1) Materials identified as copyrighted or derived from another source. 2) Materials extracted from the Office of the National Coordinator (ONC) Health Information Technology Workforce Curriculum, which carries a more limited CC-BY SA license.CC-BY SA license