Using Wireless Technologies in Health Care

GROUP C

DEBORAH MACINNES
JENNIFER LADESMA
LAURA LIEBROCK

Instructor: Dr. Jack Yensen
Course: MHST 602 Transforming Health Care through Informatics
Date: November 17, 2008

Warm Up . . .

As a warm up please enjoy reading these articles.

Gladman, A., S. & Lapinsky, S., E. (2007).
Wireless Technology in the ICU: boon or ban?
Critical Care 2007, 11:165. Link to article

Greenfield, S.(2007). Medication Error Reduction and the Use of PDA technology. The Journal of Nursing Education, 46,(3).
127-131. Link to article


What are your thoughts as you read these articles?

What is down the road in Health Care?

Has the video offered you new information on the possibilities of wireless technologies?

Presentation Outline

Goal and Objectives

Definition of "Wireless Technologies"

History of Wireless Technologies

Advantages of Wireless Technologies

Disadvantages of Wireless Technologies

Future Trends

Survey

Recommendations and Summary

Goal

UNDERSTANDING THE ADVANTAGES AND DISADVANTAGES TO HEALTH CARE WORKERS USING WIRELESS COMMUNICATION TECHNOLOGIES.

Objectives of our Presentation

• To provide a framework of our history with wireless technologies as a manner in which to understand its present use.

• To describe the advantages of using wireless technologies in health care.

• To analyze the disadvantages of employing wireless technologies in health care.

• To offer insight and possibilities related to future trends with wireless technologies.

• To highlight recommendations of the effect of using wireless technologies in health care based on the summary of our research findings.

What are "Wireless Technologies"?

Wireless technologies can be defined as any device that creates or stores data which can be communicated over radio waves (Cavoukian, 2007).

Some examples of wireless technologies are personal digital assistants, internet home care devices, home-based sensor monitoring systems and other patient monitoring devices.

There are both advantages and disadvantages derived from their usages.

Wireless Technology

Click to enlarge picture

History of Wireless Technology

How do we encourage "protestors" against new technology to try these new devices?

History of Wireless Technology

In 1865, James Clark Maxwell published his theory of electromagnetic radiation.




In 1887, Heinrich Hertz carried out a famous set of experiments that proved Maxwell's theory - and in 1894, the British scientist Oliver Lodge succeeded in transmitting wireless signals 150 yards.

In June 1896, an Italian physicist named Guglielmo Marconi began experimenting with radio waves to send messages.

On December 12, 1901, the first wireless transatlantic radio message was sent from Cornwall, England to Signal Hill, St. John's, Newfoundland by Marconi.

Historical Perspectives of Healthcare and Wireless Technology

1950's use of computers in healthcare industry growing. Initial use was for basic business office functions.

1960's conducted studies on how computer technology could be utilized effectively in healthcare industry.



1970's nursing recognized potential for improving documentation, quality of patient care.





1980's personal computer (PC) emerged. PC's brought computing power to workplace and point of care. Informatics field emerged.

1990's technology became integral part of healthcare settings. Smaller and faster computers, laptops, notebooks used at point-of-care settings. Internet being used for high performance computing and communication or the "information superhighway" (Saba & McCormick, 2006).

Post-2000 continued with hardware and software development such as wireless point-of-care, wireless tablet computers, personal digital assistants (PDA's), and smart cell phone. Internet continues to provide a means for development of clinical applications.

Wireless Technologies Used in Health Care

Click for Computational Sensor Monitoring



Click for Personal Digital Assistants



Click for Global Positioning Systems



Click for Radio Frequency Identification Tags



Click for Bluetooth Technology



Click for Wi-Fi Technology



Click for Wireless Nurse Call System



Click for eMAR



Click for Wi-Max Technology



Nortel™ Wi-Max Infomercial

Journal Articles of Interest

A Simply Wireless Home Care Management System


Wireless technology in the ICU: boon or ban?


Linking Home Care and the Workplace through Innovative Wireless Technology: The Worker Interactive Networking (WIN) Project

Wireless Technology Empowers Physicians


Wireless For All

Increased Portability?

The Advantages of Wireless Technologies

• Can reduce costs i.e. cables do not need to be installed; wireless media is essentially free.

• Increase efficiencies: hospitals are routinely applying wireless solutions for patient monitoring, data collection and enhanced communication.

• Health professionals can automate functions and shift their practice into other areas of increased complexity, responsibility and caring which will have positive impact in the nature of the work.

• Makes important information more readily and widely available. ie) Paramedics can send cardiac images and data directly to cardiologists, reducing wait time to treatment.

• More mobile and portable.

• Allows for employee flexibility and represents a cost savings for the employer (less overhead, travel time, vehicle emissions).

• Promotes self-care, shared care and wellness which ultimately reduces demands our the health care system (Hamilton & Rupp, 2007).

What do you think are other advantages?

Disadvantages of Wireless Technologies

Physical:

• Studies have shown that Radio Frequency Radiation (exposure from cell phones, antennas, cordless phones wireless routers) may have biological and health effects such as cancer, disruptions to cell functions, neurological, psychological and behavioral effects (Fawcett, 2008).

Communications in a Virtual Office:

• Intangible rewards such as praise and recognition cannot be given as casually, especially for internally motivated employees.

• Organizations will need new ways to socialize new employees due to less face to face communication and reduced opportunities to develop natural camaraderie.

• Management of virtual teams can be complex and chaotic. As with virtual monitoring, employees may feel loss of independence, loss of freedom of mobility and a feeling that "someone is always looking over my shoulder".

• Continuous connectivity to work leads to employee burnout.

• Informal communications are not possible, ie) conversations at the water cooler.

• Discussions on difficult or controversial topics may be curtailed and resolution of conflicts which require confronting and negotiating would be difficult (Hamilton & Rupp, 2007).

Other:

• Home monitoring and workplace interventions require close attention to issues of privacy and confidentiality.

• Poor design of wireless technologies can detract from features such as mobile messaging, automated documentation and decision support systems.

• Staff resources: who is responsible for broken or lost equipment, who will provide ongoing training, how will the system interface with current information systems, how will this affect workflow?

Can you think of any other disadvantages?

Future Trends and Wireless Technologies

Computational sensor monitoring in the home to monitor the functional health patterns of clients and informs the caregiver when dysfunctional patterns occur.

Clinicians able to access a patient's entire EHR at the point of care.

Wireless technologies used to better manage the dual demands of employment and caring for older family members.

Nurse facilitated Internet support group available to employees who have health concerns about their relative.

A Case Study

Connie is an Emergency Nurse with 7 years of experience. On her days off, she logs onto her Facebook page as she finds this is the easiest way to keep in touch with her colleagues in her graduating class.

One day Connie logged on and noted that one of her colleagues who works in a hospital in the same province, was seeking the group's advice. He had posted concerns about his frustrations with staff shortages at his work and how a patient had developed severe pressure ulcers as a result. Her colleague did not mention the patient's name but posted pictures of the pressure ulcers which he had taken with his phone camera.

Questions ???

1. What, if anything, do you think Connie should communicate to her colleague?

2. Do you believe Connie's colleague was correct in posting patient pictures?

3. Considering the information was shared only with other health professionals and that the patient name was not shared, do you believe there was a breech in confidentiality?

Please take our Survey!

Please click on the link below to complete our survey. You will have until November 22nd, 2008 to complete the survey. A summary of your responses will follow. Thank you for your input!

Wireless Technology Survey

Recommendations and Summary

Thank you for your participation and discussions on our blog.
Here is a summary of our survey results and recommendations for the future.

Total number of survey responses, (8). Total questions (10).


Question #1 - How often do you use wireless technology?
25% sometimes(2), 50% often(4), 25% always(2).

Question #2 - Is using wireless technology in health care important to you?
87.5% Yes(7), 12.5% No(1).

Comments:

• Efficiency, saves time and money, portability, flexibility, quality of care improves.
• No reason given for not being important.

Question #3 - What type or types of wireless technology are used in your place of employment?
PDA’s 50%(4), Pagers 100%(8),cell phones 100%(8), Subnotebook computer 25%(2), Bluetooth 0% and monitoring devices 37.5%(3). Other: Central Monitoring, Laptop.

Question #4- Are you satisfied with the overall usability of your workplace technology?
Yes 50%(4), No 50%(4).

Comments :

• Need wireless laptops for medication cart so meds may be signed off at point-of-care.
• Systems are often down difficult to encourage wireless when this happens.
• Need continuous IT support, technician on site 24/7 that understands health care.

Question #5 - Do you think wireless technology can contribute to employee stress and burnout?
Yes 87.5%(7), No 12.5%(1).

Comments:

• It creates a 24/7 working environment that is not healthy. Healthcare will pay for this if boundaries are not set up soon.
• Some who have not grown up with the technology may find it stressful. I find it is second nature to younger staff.
• I think it will reduce employee stress and burnout.
• Employees available 24/7.

Question #6-Have you ever noticed "work-related" information on social networking sites like facebook or MySpace?
Yes 37.5%(3), No 62.5%(5).

Comments:

• Have not noticed as yet but if did would let them know infringing on someone's privacy.
• Have noticed work complaints. Have not been involved myself.
• Talked with staff member.

Question #7 - In your opinion, what do you feel is the most positive result of wireless technology as it relates to health care?
Improved quality of patient care 62.5%(5), Improved patient data collection 50%(4), Employee flexibility 25%(2), Mobility and portability of patient information 75%(6), Improved sense of employee time management 65.5%(5), Improved access to health care providers 62.5%(5).

Question #8 - Are you “connected” to work-related wireless technologies even on
your days “away” from your health care environment?
Yes 62.5%(5), No 37.5%(3).

Question #9 - If you were to wave a magic wand, what recommendations would you make towards proceeding with wireless technologies and healthcare?
6 answered question and 2 skipped question

Comments:

• Keep in mind principles of security and friendliness during development.
• All documentation at bedside.
• Ensure safety, confidentiality and security are legislated. Need appropriate training for using technology and importance of privacy and confidentiality.
• Link all physicians offices with healthcare centres.
• EHR must be a priority especially with aging population.

Question #10-Did our blog site offer you anything “new” in terms of further understanding wireless technologies?
Yes 85.5%(7), No 12.5%(1).

Comments:
If yes what have you learned?

• Learning history and evolution of wireless technology.
• What will be used in the future.
• Review on some information other parts were new.
• Different types and applications of wireless technology.
• Did not realize how much technology has expanded in short time.
• Just touched the tip of the ice berg when it comes to what will be available in the future.

Recommendations:

1) Although most of us view wireless technologies as important, our satisfaction with these devices remain low.

Therefore, 

• Proper training on the use of wireless technologies in health care needs to be offered to employees including knowing how problem solve these devices when errors occur. 

2) We view wireless technologies as important, however, we also suspect that too much usage and availability contributes to employee stress and burnout. 

Therefore, 

• Signs of burnout, coping strategies on dealing with these technologies and setting boundaries needs to be discussed with employees.
• No Blackberry Zones or Leave the Laptop at Work Days

3) More than half of our group reported not viewing work-related information on social networking sites such as facebook, myspace, etc, however, about 1/3 of us have witnessed such postings.

Therefore, 

• Employers should ensure there are clearer policies against the broadcasting of confidential information so that staff at all levels understands the definition of breaching confidentiality and the consequences that follow.
• Organizations should implement internet policies that clearly set out limitations on the use of social networking and personal websites, personal use of computers and internet while at work.
  
• Employees need reminders, education and training on appropriate discussions on sites that are not considered private. Patient information, pictures, and descriptions should never be shared on these sites.

4) Organizations need to make more effort to ensure employees feel like part of the organization thus participate in its values.

Therefore: 

• With the awareness of the diminishing face to face contact in today's wireless world, organizations should arrange for more social events, (ie potlucks, golf tournaments, etc.,) that encourage interpersonal communication, direct contact and increased moral amongst all employees.

References

Connected Earth. (2008). How communication shapes the world. Retreived November 1st, 2008 from http://www.connected-earth.com/Galleries/Telecommunicationsage/Awirelessworld/Theoriginsofradio/index.htm

Fawcett, J. (2008). Health risks of wireless technologies. Alive: Canadian Journal of Health Nutrition. April (306). 154-157.

Garrett, B.M. & Jackson, C. (Gladman, A. S., & Lapinsky, S.E. (2007). Wireless Technology in the ICU: boon or ban? Critical Care, 2007, 11:15.

Greenfield, S, (2007). Medication Error Reduction and the use of PDA technology. The Journal of Nursing Education, 46 (3). 127-131.

Hamilton, R.H., & Rupp, W. T. (2007). Opportunities and challenges in the wireless world. Journal of Internet Commerce, 6(3), 29-33.

Knox, C. & Smith, A. (2007). Handhelds and HIPPA: Does instant access and availability jeopardize patient privacy? Nursing Management, June 38(6). 38-40.

Saba, V.K. & McCormick, K.A. (2006). Essentials of nursing informatics, (4th ed.). New York, NY: McGraw-Hill.

Strople, B. & Ottani, P. (2007). Can technology improve the intershift report? What technology reveals. Journal of Professional Nursing, 22(3), 197-204.