Beyond Medical Informatics

This is a guest post submitted by one of the NITP trainees: Sheryl Cu-Pineda. I changed some names and items for privacy and accuracy. Some observations and events may have changed since this was last submitted. – Dr. Mike Muin

—

I turn off the alarm clock and start preparing to go to “work”. “Work”—that’s what I call it and that’s what it feels like. But its really a training program.

The Medical City, under its CIO Dr. Mike Muin, initiated a training program called NITP which stands for Nurse Informatics Training Program. And this is what’s been keeping me busy for the past two months now.

I and my two other trainee-mates are helping the Clinical Applications team create the Nursing Module that will be incorporated into the Health Information System. We’re currently working on digitizing the Medication Treatment Record, I and O sheet and the Vital signs monitoring sheet.

Going back to my story, on my way to work I think of the things that I need to accomplish for the day.
Yesterday it was about the MTR or the Medication Treatment Record for TMC PRIME. TMC PRIME (Patient Records and Integrated Medical Exchange) is TMC’s Health Information System.

• Project Overview Statement—Done
• Process workflow—Done
• User Stories—Done
• Presentation—Done

Everything has been emailed to our supervisor who uploaded it to Asana, a project tracking tool. We also had a meeting with our outsourced development team. It’s one of the weekly meetings we have regarding project updates. Later in the day I had to log onto Google Docs and answer some clarification questions from the developers about MTR. I’m happy be exposed to the wonderful world of Google’s tools: Google Calendar, Google docs, Gmail.

Today, we will be meeting with NSO personnel and gather requirements that needs to be incorporated into the Nursing Module of TMC PRIME. It’s important that we consult with them so that they actually get a system that they would want to use!

Coordination is key. It’s our role to get user requirements and to relay them accurately to the development team. Hence the documents, presentations and meetings. Not that I’m complaining. It’s really just the way things are.

For next week, I hope that we’ll get to work on the Laboratory Information System (LIS). We get exposed to the different systems hospitals use, and the main goal is to integrate all of these into one Healthcare Information System—TMC PRIME!

It’s so cool and exciting. With LIS, we get exposed to the process of choosing vendors/suppliers and dealing with maintenance agreements—and of course HL7 compatibility. For LIS, there’s the migration and version upgrade. We’re sort of late on this project.

Doc Mike also gave us lectures about Electronic Medical Records and Project Management. But the most interesting lecture was about HL7.  The concept is just so simple and yet it can accomplish so much data sharing among different systems. Let’s just not get into the technical part. My poor brain just won’t be able to take how it’s all coded!

Of course, it’s not just us nurse trainees doing all the work with regards to Nursing Module, LIS, e-Kardex data migration and other projects. We work under project managers who guide us and who can address our questions. Its a really nice experience all in all.

If someone would ask me if I’d recommend NITP to others, I’d say YES. The exposure that you’ll get here can’t be found anywhere else. The exposure to the Health IT world is fascinating. Its just so valuable because as I see it, health IT is just beginning to grow in the Philippines and the NITP is a good push to get that head start in this growing industry.

—

Comments welcome! – Dr. Mike Muin

We are doing Round 2 of Nursing Informatics Training Program at The Medical City.

Target start date is June 18, 2012. Applicant interviews will start as soon as possible. Training program will take 14-16 weeks to complete depending on the projects assigned.

New projects added to the ones in the original post include:

• Nursing module
• Medication Treatment Record
• Vital Signs Monitoring Sheet
• Input/Output Monitoring

Interested nurses should review original post and submit their Letters of Interest (short essay on why they want to join) and CVs to mbmuin(at)medicalcity.com.ph. Letters of interest can be placed in the body of the email.

Thanks!

This is a guest post submitted by one of the NITP trainees: Tereska S. Quisao. I changed some names and items for privacy and accuracy. Some observations and events may have changed since this was last submitted. – Dr. Mike Muin

—

It’s already been a month since I became part of the Nursing Informatics Training Program (NITP) under the IT Department of The Medical City. The work environment is very dynamic and there are a multitude of projects going on at the same time. It’s just as busy as a nursing unit, and I have to say that I’m enjoying myself. Working in IT is very different from what I’m used to since my background is purely bedside nursing. The information coming in can be technical and a little overwhelming, but I see that as a challenge.

Right now, I am working with the Clinical IT team on the Cathlab results and Tumor Registry automation. For the Cathlab, TMC PRIME will become a platform in which physicians can enter the results of different procedures with a uniform format and more speed and accessibility. We have met with the Cathlab staff and they seemed enthusiastic about the project and have been very accommodating. We made a Project Overview Statement (POS) and process flow diagrams. One of the senior nurses familiar with the workflow at the Cathlab has already seen and approved both documents. I have also written a separate POS for the migration of existing Cathlab results. Our concern right now is that we do not have any input from the doctors who will be the end-users for this project. We plan to meet with them to present what we have accomplished, gather feedback, and find a possible physician champion for the project.

We are also working on the Tumor Registry for Cancer Research. There is a lot of statistical data to be dealt with and an improved automation of its registry seems necessary. I was present at a meeting with one of the doctors of the center wherein the forms to be used were discussed. I have also talked to the staff several times regarding their workflow process. We made a POS and a process flow diagram and sent a copy of the POS to the doctor who said that it looks aligned with their goals. (However, we need more specific input with regards to the success criteria.)

After the workflow was laid out into a diagram, it became obvious that data collection was taking up a large amount of time which could be allotted for other tasks (such as the actual input of data into their existing registry). This made me realize how much more effective work would be with the use of technology.  It would help to automate many parts of their workflow but it might not be cost-effective. Another obstacle that we identified is the lack of manpower, as only two people make up the staff for cancer research.

What I am very excited about right now is the possibility of electronic nursing documentation. It gave me a lot of ideas. Nurses need to fill out more and more forms as hospitals continue to seek improvement in care by better documentation, legal protection, and compliance with JCI requirements. I used to dream of having one big Trodat stamp with a template of what is commonly written down in nurses’ notes. This is probably the closest thing to it.

Charting can be very time-consuming and anything that will make it quicker and easier will help, especially since it must be done for each patient. Small things (such as calculating your patients’ BMI, manually filling up patient’s name and PIN number on headings of each page, or computing their 24-hour input and output) can accumulate and take a big bite out of our time—and time is very important for a nurse. Imagine how much weight would be lifted off our shoulders if we had a nursing documentation system when we go on duty for 2 straight shifts with 8 patients assigned to you.

If done correctly, computerization of nurses’ notes can lighten our workload and allow us to allot more time for accomplishing other tasks. TMC can serve as the pioneer in electronic nursing documentation and as a model for other hospitals. I think it would make a good impact on the nursing community here in the Philippines not only because it will be the first of its kind in the country, but because there are so many advantages to be had with its implementation.

—

More notes to come (I hope!) from the other 2 trainees. Comments welcome. Thanks! – Dr. Mike Muin

Last March 7, 2012, we started our first Nursing Informatics Training Program (NITP) in the IT Department (ITD) of The Medical City (TMC).

We have 3 trainees. All nurses with clinical experiences. 2 of them have both IT degrees and RN degrees.

Last week was all orientation. We gave them an overview of all Health IT projects.

This week, I gave a lecture on the following topics:

• Fundamental Concepts in Health Informatics
• Overview of Healthcare Information Systems
• Telemedicine and other areas of biomedical informatics
• Lessons learned in Health IT practice
• Introduction to Project Management Concepts

The discussions during the lecture was very lively. I appreciated all the questions. I gave them an assignment to do the Project Overview for each of their assigned projects.

We will start assigning them soon to these projects:

• ICARUS/Medication Management/Barcoding
• PRIME – Cath Lab, Cancer Center
• PRIME – Eye Center
• Ophtha Telemedicine
• PRIME Phase 2 Planning
• LIS and MUSE HL7 Integration Planning
• MID OMRI and PRIME Integration Planning
• Telemedicine

2 weeks almost done. 12 weeks more to go. I’m excited. I think this is going to be fun!

3rd SEMINAR ON HEALTH INFORMATICS — UPM-NThC

College of Dentistry Auditorium, University of the Philippines Manila Pedro Gil St. Cor. Taft Avenue, Manila June 26 2010 8:00 AM – 5:00 PM.

Coming from the widely successful first (April and second (May 21) Seminars on Health Informatics, the UP Manila National Telehealth Center is inviting more health and IT professionals and students to participate in the third offering at the UP College of Dentistry Auditorium on June 26th, 2010.

This third seminar aims to offer the same content as the first but with additional talks by professionals working in health IT. It also promises to provide participants with concrete action items that they can pursue to further sharpen their knowledge and skills in health informatics.

WHAT: 2nd SEMINAR ON HEALTH INFORMATICS
WHERE: College of Dentistry Auditorium, UP Manila, Pedro Gil St. Cor. Taft Avenue, Manila
WHEN: 21 May 2010 8:00 AM – 5:00 PM

Coming from the widely successful first Seminar on Health Informatics last April 8, the UP Manila National Telehealth Center is inviting more health and IT professionals and students to participate in the second offering at the UP College of Dentistry Auditorium on May 21st, 2010.

This second seminar aims to offer the same content as the first but with additional talks by professionals working in health IT. It also promises to provide participants with concrete action items that they can pursue to further sharpen their knowledge and skills in health informatics.

More information here.

I got this through the Philippine Medical Informatics Society (PMIS) mailing list—a new online Wikibook entitled ‘Handbook of Biomedical Informatics’.

http://en.wikipedia.org/wiki/Book:Biomedicalnformatics

The sender was Instituto Edumed. Here’s an excerpt of the email.:

In another striking innovation in the world of electronic publications  and Web 2.0, the online encyclopedia Wikipedia, in its English version,  has published today a new online Wikibook entitled "Handbook of  Biomedical Informatics", version 1.0, after more than 5 months of  organization work. The book is based on articles published on the  subject by Wikipedia.

The book has 276 pages in its PDF version, and gathers, organizes and  classifies all the knowledge amassed by the Wikipedia articles on topics  in health informatics, telehealth, standards and classifications in  health informatics, and related topics, organized into 21 sections and  more than 250 entries. Thus, it is considered one of the most  comprehensive and complete books in the area.

Head on to the site and see for yourself!

I will give a review or update once I’ve time to run through the contents.

Just a quick observation: In the Wikipedia link, is it really Biomedicalnformatics? In all caps, this is how the namespace would look: BIOMEDICALNFORMATICS. There’s no I in Informatics.

People ask me often about what I do. Medical informatics can be a difficult concept.

At the start of my career, even my parents were confused. (Both my parents are lawyers, by the way.) My mother called my field "Medical Informatech", while I once heard my father describe my job as "Medical Robotics". My son told his cousins that his father "is a doctor but now he fixes computers for hospitals".

So, what is it exactly that I do as a Medical Informatics Consultant?

Let me go through what I did in the past 7 years to give you a better idea:

When I was with eHealthline, I had my first taste of project management. I managed timelines, gathered requirements and maintained project scope for a Hospital Information System (HIS) implementation for a Philippine hospital. I did requirements gathering and clinical systems analysis for an HIS implementation in Vietnam. I was part of the development team for a Pharmacy Management System for a Malaysian company.

When I worked with a Health NGO, I recommended e-learning and Web-based technologies for consumer health applications. I also developed Web-based systems. During this time, I also taught medical students on the use of computers and online resources for medical education.

When I did my Postdoctoral Research Fellowship in Medical Informatics, I did researches for Web-based medical applications, mobile technologies, information search and retrieval and human-computer interaction. I also developed Web-based medical applications in PHP, MySQL and Ajax methods.

For my current work, I do combinations of many of these previously mentioned tasks along with strategic planning, vendor evaluation and implementation reviews.

Here’s the short list of what I do for the hospitals and organizations I work with:

• Project Management
• Clinical Systems Analysis
• Technology and Software Evaluation and Recommendation
• Healthcare IT Education and Advocacy
• Software Design and Development
• Strategic Planning

After explaining all these, my mother said, "I think I now get what it is exactly that you do—you solve problems in hospitals and in healthcare mainly through the use of computers and IT."

Exactly.

—

If you’re a Healthcare IT professional, how do you describe your job? What kind of work do you do?

Here’s a list of news, links and articles about Medical Informatics, Healthcare and IT that I found interesting this past week (May 10 – 16, 2009).

The Healthcare IT field is growing—and in the process of organizing itself.

A stimulus to define informatics and health information technology
A BMC Medical Informatics and Decision Making article, it proposes a standard (or consesus) for definitions and terms of usage for Medical Informatics terminologies, including the difference between Clinical Informatics and Health Information Management. Formatted as a debate piece, it should spark discussions and interest among different Healthcare IT groups.

The Drive for More HIM Professionals
First there was AMIA 10×10 (10,000 trained by 2010). It later moved forward as 20/20—an international effort to educate 20,000 healthcare informaticists in other countries by 2020. Now, this article states that AHIMA “has developed Vision 2016 to help supply appropriately trained HIM professionals to meet the existing and growing demand.” Obviously, there is a growing need for more Healthcare IT professionals worldwide. We probably need to initiate something similar here in the Philippines.

Health IT players form EHR Stimulus Alliance for physician education
Vendors are making a collective effort to educate physicians in the use of electronic health records. This is part of a growing movement to increase adoption of Healthcare IT, collaboration between different parties and awareness of benefits of computerization.

What do these activities mean for Philippine Medical Informatics? What’s our next move?

—

Is there an interesting Healthcare IT-related link you’d like to share? Please post them below. Thanks!