EMR – Digital Divide

What’s the Digital Divide all about? And why the need for Cloud Computing? 

The digital divide is based upon the fact that doctors store EMR data about their patients, for the same consult, more than once. They may see them first at the point of care system (in the hospital or office) and second, in their billing system. When they enter data into these systems TWICE, there is double the risk of error. As a result, the physician may fail to bill for many of the billable services they provide.

Cloud computing can alleviate these hurdles as the doctor can store patient data on the same server – despite which facility he or she is entering the data from be it in-patient or out-patient. The use of different servers and different databases is risky, both in terms of information security and patient safety.

The benefits of cloud computing are many. Just a list of the top three:

  1. Cross facility patient census list management
  2. A personal patient database for physicians which is not currently available across facilities
  3. Physician sign-out reports for improved safety during patient hand-offs to the on-call physician.
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UX + Educational Design in the Mobile World

In order to deliver an effective learning experience (whether in the present or the future, in third-world nations or first-world), the following UX capabilities are required:
1) Capability to extract a good understanding of the culture of the learners
2) Strong ability to architect information is There will forever be a need and even more so for eLearning.
3) Sharp eye for designing a solution utilizing the appropriate educational tools

Yesterday after attending the Moodle Moobile (or as I like to call it MooBile) webinar, it became more apparent how UX will play a role in educational design for the medium of Tablets and smartphones.

a phone inside a book

MooBile allows users to apply an appropriate Mobile-friendly Theme to a course – all aspects of responsive design considered!
MooBile has strengths and flaws like any web application that must adapt to the restricted screen size of a Smart Phone and the interactions that follow. For instance, using quiz technology, glossaries, instant messaging, user forums, folder structures, etc. All aspects have their limitations when it comes to being deployed on a mobile device.

It is apparent that the user experience and educational design fields will be more closely linked in the next few years. Very exciting times!!

Following the seminar, we were also given access to a free open course on mLearning best practices! Accessible on a mobile phone!!

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TED Eastside Prep

I am so excited to attend this year’s TED EastsidePrep event in Seattle, WA. The theme for this year is The Evolution of Instruction.

The speakers will consist of a diverse of group of leaders, stakeholders and entrepreneurs in the worlds of education, business, technology and cognitive science.

The following question will be explored:

What could education look like in the next 5-20 years? What can be done to optimally craft an engaging, consuming, educational experience?

  • What components are essential to a well-designed human experience?  (in education?, in work?, in life?)
  • How could the educational experience (in school and outside of school) of young people be reimagined to be a more engaging, immersive experience that leads to a desire for lifetime learning? What can schools learn from other areas (business, research, arts, craftsmen, writers, etc.)  to improve their product?

My thoughts:

  • Will online education systems for post-secondary learning, adult learning and the corporate professional learning domain ever replace the instructor-led systems? To what extent could they be streamlined and merged to provide learning? Will the accreditation process be more rigorous or lax?
  • How can collaboration between individuals in a course be supported by evolving social media technologies?
  • How is task-based/action-oriented learning psychology changing the landscape of education systems – how can eLearning support these changes without sacrificing the value of traditional education?
  • Is open courseware the way of the future? Who is leading in this domain?
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How many doctors have your doctor seen lately?

When asking my doctor husband when the last time he saw a doctor was – he simply laughed and made reference to the fact that all of  his colleagues would have the same answer – an eye roll and a groan. They don’t see doctors. No physicals. No check-ups. In fact, my husband who’s dad was also a doctor, grew up never even having a designated family doctor! Crazy, right?

I’m honestly baffled by this as I think if anyone should care the most of their own health, it should be those providing healthcare, no? Maybe I have it wrong. After all, doctors are some of the most unhealthy group of people I know. They don’t sleep properly. Coffee and chocolate bars are considered a meal. They never see daylight. They don’t have time to exercise. They may actually be carriers of all sorts of diseases to which, by now, they are immune. They are exposed to excessive amounts of radiation. Did I mention they don’t sleep?

Coming from a computer science background with some engineering and business chops, I find it extremely useful to see what it’s like on the other side. Being a user of technology helps me as a UX designer design. It gives me a fresh outlook on how to address technical barriers and make the human-computer interaction an even more enjoyable experience!

As a wife, I would probably push my husband to see a doctor anyway! But as CEO of a hospital…would I mandate for all doctors to have a doctor? Does an architect design his own home? Or perhaps a chef cook his own meal?

Either way, I still believe that the more opportunities we have to see things on the other side of the fence, the better we will perform!

(however, it does make me nervous to know that my mortgage broker still rents)

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Best Resources for eLearning!

To keep your head above water in every training design problem: SIMPLE IS EASIEST!

Here is a short list of links that I refer to constantly for advice in the realm of eLearning design.

ANALYSIS

All the theory you ever needed for designing ANY type of Learning strategy

DESIGN

Modern tips about designing eLearning

DEVELOPMENT

Many options… here is a list of LMS vendors

IMPLEMENTATION

Some examples:

EVALUATION

Trends in eLearning

More trends in Ontario

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Telehealth and the use of Texting in Medicine

Today I had the delight of pondering about Texting as a supplement or even replacement of the Paging system within the medical workflow.

Pager

Current workflow: Doctor* carries pager > Nurse* (or some person from department X) pages Doctor > Doctor returns page with Phone call > The person accountable for the Page must be near the phone to receive the call > Communication ensues…

*This “Doctor” and “Nurse” could easily be swapped with other hospital staff or personnel: “Technician”, “Physicist”, “Nurse manager”, etc.

Scenarios: Could happen anytime of day (dinner, weekend, middle of the night!) in any location (cafeteria, bathroom, on top of Doctors head as he/she is sleeping)

Pagers, an obsolete technology in today’s smart-phone saturated world, is used only by doctors, lawyers and possibly drug dealers – not that I know too much about this 🙂

In terms of Pager types, there are all sorts of pagers: Numeric, Alpha numeric, Two way pagers. Will these soon be replaced by Text messaging? Not without some real consideration of the human factors involved in this Current Workflow.

The Human Factors

Physical – pagers are cheap, easily to carry, difficult to lose – they have a tendency to stick out like an ugly thumb. They scream, vibrate and do all sorts of alarming things to instil fear in the beholder.

Psychology – “This is the way it’s done”. But let me ask the question: How was it done before the Pager was invented? And once the pager was invented, how long did it take for the hospital system to adopt that technology?

Safety-critical psychology – Pagers offer a safe-guard in that the messaging system must be two way. If the proper protocol is followed. There will be someone to answer the page. Both parties are now talking to each other and we know who is liable for what.

Team behaviour – Currently this is the two-way communication mentioned above. The returned phone call will likely reduce miscommunication that could easily occur with a one-way or even two-way text message.

Organizational Issues – Again, using pagers is the way it’s currently being done – so why fix something that isn’t broken? It’s not really about fixing as much as it is about improving! If text messaging was employed, think how easily data from the SMS (simple messaging service) can be tracked! The hospital organization can benefit from the added data (who is texting who, who answers the message, how are messages being sent/received, etc). Furthermore, imagine what could be revealed (errors & behaviours) from the collected data! That being said, a well-thought out policy or organization would have to be put in place to regulate that reporting information.

Political Issues – The IT policy around use of cellphones and other mobile devices is currently being laid out in the US at a federal level. For this top down regulation to take effect, it could be tricky to enforce the idea of text messaging as a replacement for paging. Canadians are slower to implement solid IT policies around the use of mobile devices in healthcare. From my perspective, it seems like the residents and staff already text each other instead of speaking on the phone. Less intrusive, more informative and collegial. Although texting is not accepted formally but it appears that it is common and frequent!

So inarguably, humans have evolved to include texting as an accepted form of communication. As an Human Factors/IxD/UX enthusiast, I feel this could be a task for us user experience designers. Organize this evolved “texting” behaviour, adapt it to the hospital folk and workflow and come up with a solution on how to structure an SMS paging system that can address all levels of human factors…not an easy design or change-management battle to say the least!

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“Yelp” for Healthcare?

Recently I posted a link to Health Tap – A new interactive social network that aims to connect doctors to patients – or rather the general public waiting to become patients.

HealthTap screenshot

“HealthTap’s free web and mobile applications enable 24/7 access to personalized, relevant and trusted health information from thousands of leading doctors, helping people find the best care and make better decisions about their health and well-being.”

Immediately this raised all sorts of red flags for me. As someone who is not directly working in the Healthcare industry but personally related to several critics in this domain, I could already sense a negative response.

Why the negative response?

1. Legal issues
If medical advice is exchanged between a medical professional and person (non-relative or even close acquaintance), there is potential risk for legal ramification. Doctors in our country are trained to exchange medical information in the appropriate legal confines of a hospital or medical office – this way there is some face-to-face interaction between doctor and patient and there is legal documentation that exchange of advice took place.

2. Work load
Giving advice – especially if serious medical advice – is MORE work for doctors. Billing this type of work would create new kinds of havoc in the world of medical billing. Perhaps it is different across the border, but in Canada, doctors do not have extra time to even go online fishing for vulnerable people to divulge advice to.

3. More Legal Issues (and inter professional relations)
How does this affect the relationship between physicians? Does it promote collegiality or competition? Imagine a scenario where one doctor recommends another specialist online! In an online social forum like HealthTap, there is going to be an imbalance of responsibility (again touching on point 1). Physicians will be putting their careers on the line and patients will get to “take shots” at them anonymously.

4. Patient selection
Let’s be honest, doctors don’t want to attract all sorts of super-neurotic, annoying patients to their practice. The more active the physician is on HealthTap, the higher the chance of them being at the helm of these irrational and often sensationalistic attackers.

The Positives

Bearing in mind the opinion of a few doctors and my own instinct, there seems to be a lot of sensitive issues tied to HealthTap’s social network for healthcare. While I do agree that the concept of a curated participatory healthcare online forum would be very helpful to all of us in the Dr. Google era, it is a very difficult model to maintain. Especially given the different policies on healthcare around the globe. While I did mention the negatives of HealthTap, it’s idealistic positive features include:

1. A way to build a reputation online among other doctors.  

2. A method of attracting new patients (keeping in mind the negatives). This is probably more suitable for the US folks.

3. Saves time for patients as they can access YOUR medical knowledge online. Note, this does not save YOU time as a physician and in fact, may cause more work down the road.

4. Better serve existing patients. Your knowledge is available 24/7 — but are YOU (the physician) available?

5. Achieve awards and recognition for helping others. Hmm… should online credibility be something that doctors strive for? This I am not so sure. I would like to know my doctor is healthy and happy and balanced in his or her life. Not someone who is tweeting medical knowledge. This may hurt the rep of a doctor if they don’t do it right…

6. Maintain peace of mind with the offered “insurance” that covers all Medical Experts for participation – Perhaps this is the golden ticket for all the participating doctors!

All in all, HealthTap is an idealistic concept. I foresee that it will be very difficult to implement as policies in Healthcare are already a sensitive subject and even more so the use of online forums as a means to offer health advice.

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