Improving Archaic Medicine

[sunspotmia]

As it stands today, computers have become so integrated into society, that it would be difficult for some to conceive of implementing methods of functioning that were practiced as little as ten years ago, without them. Business, architecture, education and even the arts have been profoundly affected by the efficiency and ever improving speed and organization that computerized programs provide. It is as if these machines have become an extra appendage for people as we continue to evolve into the future. So, why is it that when it comes to the care of our own bodies, we have not yet come to fully recognize the potential of this remarkably powerful tool?

The answer to this question is three fold. The first reply to be given is of course the most practical one, cost. Advanced technology cost a pretty penny. For many hospitals the cost of implementing computerized options like Motion C5 while managing a budget may not seem practical. But, when one considers the shortage of nursing staff and the stressors associated with the archaic nature of medicine today, can these devices really be put on the back burner for much longer?

In considering the reasons why medicine is so slow in integrating more advanced technology, the medical personnel who are expected to use this new equipment, though they are the backbone of the hospital care team, stand to impede advancement. Hospital staff workers who have been in the health care profession for decades are used to paper written orders and bulky charts because well, that’s the way they’ve always done it. Resistance to change is to be expected, but if change can positively impact the hospital system as a whole, while making it run more efficiently, the old must eventually succumb to the new.

The final answer to the question of the resistance in integrating advanced computer technology into the healthcare system is that, some hospitals have already taken this jump into the future. Imagine for a second working in a hospital ten to fifteen years into the future. Most of your surroundings are made of a clean durable non-staining white plastic polymer. You are walking into the nursing station where noise has been reduced up to 20%. There are no bulky coffee stained charts with chicken scratch scribbled illegibly between the margins of a worn torn stack of papers. There are instead efficient compact machines lined up concurrently, placed on small white computer ports.

You look into one of the hospital rooms and see a nurse with a patient. She has a small flat lightweight box with her. She lifts the computer up, and you watch a red light from the side of the white box upload the patient’s identification bracelet, bringing to the nurses fingertips any information about the patient that she might need.

You see her lifting the box and pointing the back of it at a wound on the patient’s foot. Instantaneously you see on the screen a clear 300 mega pixel picture of the patient’s foot.

With a few flicks of the nurse’s wrist she uses a pencil shaped wand, and is able to document her assessment of the patient. The nurse then takes the computer and places it into a machine which has recorded the client’s vital signs. The nurse removes the blood pressure cuff from the patient’s arm and on the screen appears the patient’s vitals, along with all other data that the nurse has documented.

You watch the nurse as she takes pictures, reviews orders, educates the patient about their condition, reviews medication interactions, and documents all of her work in real time. Before moving on to the next patient the nurse places her thumb on the computer screen and she has instantly signed her name to the assessment she had completed.

Finally she returns with the white box to the nurse’s station, where she places it onto a port. In seconds everything that this nurse had just done is accessible to every other hospital staff member and doctor caring for her patients. The exact time and date of all orders, lab tests, assessments, diagnostics, nursing interventions and reference medical information is in clear black and white on an economical white box. The hospital as a system has been revolutionized.

Ok so I’ve painted a pretty picture for the reader about the future of healthcare, but what does this all mean in practical terms, and who does it impact? The simple answer… everyone. Patient care is paramount in the healthcare industry. The effects of a more efficient form of providing hospital based care increase the success rate in providing the maximum standard of patient care. Doctors and nurses who need immediate access to patient information, may not access pertinent information from standard bulky stationary computers in current use today, for an average of two hours. In a setting where minutes and seconds can stack up for or against the patient, the efficiency of new technology can greatly improve the hospital environment.

Is this all some futuristic dribble, or is it really possible? It is possible. Humans are evolving, and making things smarter, better, faster, and stronger. The present can be confounding to some, and change can seem costly and overly complicated. But, without visionaries who look to the future and plan how the next decades will transform society, progress cannot be made. All types of people are necessary to building the future, whether it is the technically minded smarties, the caring dutiful healthcare providers, the revolutionary enthusiasts, or the practically based traditionalist, everyone’s contribution is worthwhile, and essential to making the future better.

To view a video news report on the advancement of medical technology visit: http://cbs5.com/video/[email protected]

So what do YOU guys think? What will the future be like?

[RNperdiem, RN]

As long as we can still have the skills to provide patient care when the power goes out, when the computers are down, and machinery malfunctions, fine.

Computer charting, Pyxis machines, and better bed tracking have improved many aspects of patient care.

[llg, PhD, RN]

I have a question for the OP. What is your stake in this thread? What is your level of experience with existing technology? Are you an employee of the company whose product you mention? Is this an advertisement?

I did my doctoral dissertation on information technology and nursing. While computers can help us in many ways, they are not "magic." They break. They malfunction. They come with their own sets of problems. We are very far away from having any type of utopian world that some people like to imagine. Some of us prefer to deal with reality.

[sunspotmia]

I have a question for the OP. What is your stake in this thread? What is your level of experience with existing technology? Are you an employee of the company whose product you mention? Is this an advertisement?

I did my doctoral dissertation on information technology and nursing. While computers can help us in many ways, they are not "magic." They break. They malfunction. They come with their own sets of problems. We are very far away from having any type of utopian world that some people like to imagine. Some of us prefer to deal with reality.

I'm a nursing student. I wrote this paper for class. I just wondered what more experienced nurses thought of these ideas. You're very suspicious. lol.

[Halinja, BSN, RN]

If we don't dream it, it won't happen. Change is often greeted with deep suspicion, and it is difficult for some people to adapt. yes, we're busy, and learning new things seems to take up a lot of time we could be using 'more constructively'.

But look at cell phones and how ubiquitous they have become. Yet, those are a very new invention. There is a hospital in LA that has robots that beam pictures of patients to the doctors, sometimes in different buildings from the patients. Our doctors can see the Fetal Heart tone strips of our patients from their offices off campus. Things can change for the better, but they won't unless we are willing to consider new ideas, and take a chance that, yes, like everything in life, there will be flaws, and times where things fail. That's why we have generators. And paper always works until the lights come back on...so what have we lost?

How many of us know that Bush and our congress has passed legislation REQUIRING electronic record keeping? It's coming...

[nyapa, RN]

oh how I love computers. But I have seen the other side of them when they "go down" in the health professions. Our medication programme went down for two hours in the morning, therefore mane meds couldn't be given. Neither could pain relief. That is technically a drug error.

We now rely on them for lab results. But backup systems are definitely needed. At least with lab results there is always the telephone. But our drug administration programme has no real backup...

[llg, PhD, RN]

I'm a nursing student. I wrote this paper for class. I just wondered what more experienced nurses thought of these ideas. You're very suspicious. lol.

That's OK then. I thought it was a joke account by the company trying to sneak an advertisement for its product onto the board.

For the record, I am not against computerization. I bought my first home computer back in 1986 ... had an uncle who worked for IBM back in the 60's ... had a crush on a programer back in the 70's. It's just that I have been around long enough to know that the claims of technology designers and sales people are usually pretty inflated. And those people rarely consider all the down sides that come hand-in-hand with their products. They tend to only look at the positive aspects and leave it to the bedside nurses (or "end-users") to have to figure out how to deal with the problems.

I've seen two different hospital computer systems crash and have to be brought down. I've seen a schools computer system crash and lots of work lost as a result.

I realize that technology will continue to evolve -- but I think we should be focusing more attention on developing the wisdom to deal it than we do now. Now, in most hospitals all the money and attention goes to developing and buying the technology -- and the human needs are often given very little attention.

[sunspotmia]

That's OK then. I thought it was a joke account by the company trying to sneak an advertisement for its product onto the board.

For the record, I am not against computerization. I bought my first home computer back in 1986 ... had an uncle who worked for IBM back in the 60's ... had a crush on a programer back in the 70's. It's just that I have been around long enough to know that the claims of technology designers and sales people are usually pretty inflated. And those people rarely consider all the down sides that come hand-in-hand with their products. They tend to only look at the positive aspects and leave it to the bedside nurses (or "end-users") to have to figure out how to deal with the problems.

I've seen two different hospital computer systems crash and have to be brought down. I've seen a schools computer system crash and lots of work lost as a result.

I realize that technology will continue to evolve -- but I think we should be focusing more attention on developing the wisdom to deal it than we do now. Now, in most hospitals all the money and attention goes to developing and buying the technology -- and the human needs are often given very little attention.

No, I don't think you're anti-computer. I just thought that my paper probably sounded too, well, not sophisticated to be mistake for an ad, that's all.

Thanks for your input it's an interesting point of view. Nurses input should be considered more often, because we have the most interaction with clients. We know what is going on, and we are the ones that have to deal with the changes. So I wondered how most nurses felt about new technology. I like computers and I was thrilled to see that some of the ideas I'd been thinking about were already out there. Although, I do think the device is a bit bulky looking. I think something closer to a palm would be easier to carry.

[sunspotmia]

If we don't dream it, it won't happen. Change is often greeted with deep suspicion, and it is difficult for some people to adapt. yes, we're busy, and learning new things seems to take up a lot of time we could be using 'more constructively'.

But look at cell phones and how ubiquitous they have become. Yet, those are a very new invention. There is a hospital in LA that has robots that beam pictures of patients to the doctors, sometimes in different buildings from the patients. Our doctors can see the Fetal Heart tone strips of our patients from their offices off campus. Things can change for the better, but they won't unless we are willing to consider new ideas, and take a chance that, yes, like everything in life, there will be flaws, and times where things fail. That's why we have generators. And paper always works until the lights come back on...so what have we lost?

How many of us know that Bush and our congress has passed legislation REQUIRING electronic record keeping? It's coming...

I'm not really worried about Bush, but I couldn't have put it better. Thanks for the input.

[Indy, LPN, LVN]

I think the device looks pretty nifty. In my experience, fingerprint ID's work about 75% of the time on the first or second try. So I'd like to be able to scan my badge or log in manually if the thing happens to not like my fingers.

We have computer charting where I work. The thing is okay, but there are 2 computers available among 6 beds in an ICU where if all 6 are filled, that means they're all pretty sick and it makes getting to the computer to actually sit down and chart, very difficult.

Our charting involves menu type stuff and a "to do" list that's sort of redundant. So I'm interested not only in the actual device, but also the programming that goes into it. Software that's time-consuming to use, isn't necessarily better just because it's at the bedside and portable. If you spend too long typing at the bedside then a difficult patient or talkative family will distract you and that can be annoying. I'd like to see a point-and-click assessment with free text comment fields available for each abnormality, but enough clickable abnormals that you don't spend all day on the assessment of a critical patient.

I noticed in the video that the nurse has the thing facing the patient. I so would not do that! I don't ever show a patient or the family what I'm charting, even if I'm standing in the room doing paper charting.

Oh, and the little stands for the patient rooms... ports or whatever... each port needs to double as a recharger, no matter where it is. Period. That way if one nurse spends her whole shift taking one tablet around with her to all her patients' rooms, it'll recharge some each time she plugs it into anything. And the facilities that use these need to have a few on standby in case a tablet's battery does run dry.

All in all, it's a nice little thing. But hospitals have found out the hard way that backup systems are everything, like having paper flowsheets for when the computer's down, having backup power for the pyxis or omnicell so meds can be given, etc. If your hospital still functions halfway decent when the crap hits the fan then you're doing okay.

[nightmare, RN]

Yes it's looks good on the video as long as nurses remember to communicate with the patient(which she was doing in the video)sometimes there is a tendency to get so caught up with the machinery you forget that there is a living ,breathing person lying there! Are these things secure from hackers etc?.How do you register your fingerprints to access them? and is there backup if the lights go out?!

I love computers but you still need the human touch and nothing beats the experienced eye of a doctor or nurse.

[MB37]

I'm a student too, and I really like the idea of moving to a more computerized system. The hospital I do my clincals at is in "transition," so charting is still by hand but labs and orders (eventually) are in the computer. You still have to check the chart for everything, since it takes a while for stuff to get entered. There always needs to be some type of manual override and paper backup system - I'm from New Orleans, and I know people who were working as nurses during Katrina when the power was out for 6 or more weeks. I've also seen patients not be able to get their meds for several hours, because the order hasn't been put into the Pyxis yet. Hopefully once everything is computerized and synched, this problem will be eliminated - as long as you can still get meds when the lights go out.