Until professor Yellowlees, M.D., introduced Second Life into our Health Informatics curriculum, I had never heard of Second Life. In short, Second Life allows computer participants, in the form of avatars, to interact with each other via the Internet. An avatar is an electronic image that looks like a human. It represents, and is created and manipulated by, a computer user. The avatar can be anything the user would want it to be; there's no limitation to size, image, appearance, sex or race, et cetera, as is physically imposed upon us in human form. If an avatar is too tall to get through a door, it can be resized instantly to walk through the entrance gallantly. The avatar can fly, walk, drive, run, sit, stand, talk and so forth.
Professor Yellowlees led our class as avatars to visit a Virtual Hallucinations & Mass Prophylaxis training environment on a private "Davis Island" on Second Life. In this virtual hallucination environment our avatars moved around the island, and we heard simulated voices mimicking what a schizophrenia patient might have heard. Among other places on "Davis Island", our avatars flew to the virtual Sacramento County Disaster Clinic for Bio-terrorism Exercises where our avatars interacted with, and helped each other. Meanwhile, we (as humans), communicated via VoIP (Voice over Internet Protocol) and IM (Instant Messaging).
Next day, my avatar was a solo visitor in Second Life's "Second Health Hospital London" where I visited the Well Being Building, which promotes healthy living practices for the local community and health practitioners. It also has a centre which promotes health education and holds conferences for patient and professional learning. Inside the Well Being Building, there's a large swimming pool, gym, drop-in clinic to help people with weight loss, stopping smoking, and cholesterol tests. Another place my avatar visited was the Resuscitaton Council (UK). It has many helpful education posters, such as accessing stroke symptoms. One of its posters states: "Suspect a stroke? Act FAST. Call 999." FAST stands for Facial weakness, Arm weakness, Speech problems, and Test these symptoms. These places were vast and empty when visited solo.
How could Second Life be used in a doctor-patient relationship? I believe it would be very useful for engaging in interactive education or for communicating with a patient in a secured Internet environment. An interesting article, "Can Second Life Help Teach Doctors to Treat Patients?" can be found at http://www.cnn.com/2009/TECH/03/30/doctors.second.life/index.html.
At the present moment, the Second Life doctor-patient model, I believe, has its down side. In order to maximize the interactive experience, the patient would need a high speed Internet connection, secured online access, and would have to be comfortable with using the computer to communicate with his or her doctor in the form of an avatar; this is something not everybody could or would like to do. Would this model work well with older adult patients? Could it be effective in rural areas where the Internet might not be readily available to everyone in the community (lecture 4 Telemedicine)? What about the probable breach of Internet security? On the other hand, this model could work well among younger generations as many of them have mastered the skills of collaborating via the Internet.
Will Second Life and Telemedicine (lecture 4 Telemedicine) become a part of our routine healthcare visits? If so, when might that be?
Friday, September 11, 2009
Wednesday, August 12, 2009
Hello all,
This is my first Blog, and my first class in Health Care Informatics. I am learning about this subject from the ground up. After listening to the Health Informatics lectures and reading my text book, I realized that Health Care Informatics Systems has a very close relationship with Information Technology, in both software and hardware.
My background is in software system design, development, user suppport, network engineering and systems administration. Therefore, in this blog, I would like to address some challenges in the Electronic Health Record system from the perspectives of Information Technology that I've leanred from my professional experience.
I have learned that a digital application does not function by itself; many human dedications are involved to make it work the way it should. Because we are human, we make mistakes; and they may become expensive challenges in the life cycle of the application.
The following addreses some of these challenges and perhaps ways to avoid them.
Faulty System Design and Application User-Abondoment:
When an application fails to meet the stake holder's needs, it is not unusual for users to adondon the application. Therefore, it is vital to have a clear understanding of user requirements from the beginning, during the PMP Project Integration Management phase. This is similar to the "Online Consultations," mentioned in professor Yellowlee's text book (Peter Yellowlees, MD, Your Health in the Information Age (2008), p.59). With the exception that data collection, data analysis and project management in the E-Health record system is about the application itself; not the patient.
User Training and Support:
The application has to be developed from the user's perspective: speak the user's language, think like a user, and make it easy for user to utilize it. The support personnel must realize that any questions about the application usage is an important question; bear in mind that it may be this user's first time ever to come in contact with that little weird icon that the support personnel might have explained a hundred time of its usage to other users.
E-Health Record, Real Time Access - Contingency Planning and Recovery:
As the healthcare communicty (doctors, nurses, administrators, and other personnel) begins to enter every bit of patient information, in every stage of the treatment process, into the E-Health record, assuming that paper records will no longer be kept, what would happen to a patient during ER where the system is down due to system malfunction or natural disaster? How could the negative consequences of such a scenario be eliminated or reduced, and at what cost?
Technology does sometime die, no matter how much redundancy and recovery planning have been done. To mitigate the negative impact of such a scenario, do we implement an identical real-time system (a backup system), which run concurrently with this application? At what cost are we willing to invest?
Interface Accuracy
Currently we have paper based and computer based records tha are not linked together (Module I, Webcast lecture.) suppose the E-Health Record application does link these 2 together, what auditing procedure will be put in place, to be followed religiously, to make sure that the records have an absolute accurate link, patient A to patient A, for the entire U.S. population?
In my systems development career, I have worked on countless applications that have misrepresented information (garbage) between application interfaces, such as a customer transaction was posted to the wrong General Ledger ID. In this scenario, it was just a business loss. What if the data mistake contributes to the loss of many human lives?
These are just a few examples of the many challenges that the electronic health record may encounter.
In the quest to understand more about the challenges on the development and support of the electronic health record, I've found the information posted on the HealthIT.hhs.gov website to be extremely informative. On this site, there is useful information on privacy and security, antifraud measures, medical identity theft, federal laws and regualtions, standards and certification, National Health Information Network (NHIN), Health IT Tools, et cetera.
In addition, I have attended an informative Webcast Live Meeting offered via this site to address some questions in providing "Funding opportunity to furnish assistance, defined as education, outreach, and technical assistance, to help providers in their geographic service areas select, successfully implement, and meaningfully use certified EHR technology to improve the quality and value of health care." The total amount of funding opportunity is $598,000,000. You can locate more information about this topic on their website.
Just like the evolution of the Information age and the Internet, I believe that the electronic health record system will become a part of our lives in the near future.
Thank you, class, for your critics. All comments are welcomed.
This is my first Blog, and my first class in Health Care Informatics. I am learning about this subject from the ground up. After listening to the Health Informatics lectures and reading my text book, I realized that Health Care Informatics Systems has a very close relationship with Information Technology, in both software and hardware.
My background is in software system design, development, user suppport, network engineering and systems administration. Therefore, in this blog, I would like to address some challenges in the Electronic Health Record system from the perspectives of Information Technology that I've leanred from my professional experience.
I have learned that a digital application does not function by itself; many human dedications are involved to make it work the way it should. Because we are human, we make mistakes; and they may become expensive challenges in the life cycle of the application.
The following addreses some of these challenges and perhaps ways to avoid them.
Faulty System Design and Application User-Abondoment:
When an application fails to meet the stake holder's needs, it is not unusual for users to adondon the application. Therefore, it is vital to have a clear understanding of user requirements from the beginning, during the PMP Project Integration Management phase. This is similar to the "Online Consultations," mentioned in professor Yellowlee's text book (Peter Yellowlees, MD, Your Health in the Information Age (2008), p.59). With the exception that data collection, data analysis and project management in the E-Health record system is about the application itself; not the patient.
User Training and Support:
The application has to be developed from the user's perspective: speak the user's language, think like a user, and make it easy for user to utilize it. The support personnel must realize that any questions about the application usage is an important question; bear in mind that it may be this user's first time ever to come in contact with that little weird icon that the support personnel might have explained a hundred time of its usage to other users.
E-Health Record, Real Time Access - Contingency Planning and Recovery:
As the healthcare communicty (doctors, nurses, administrators, and other personnel) begins to enter every bit of patient information, in every stage of the treatment process, into the E-Health record, assuming that paper records will no longer be kept, what would happen to a patient during ER where the system is down due to system malfunction or natural disaster? How could the negative consequences of such a scenario be eliminated or reduced, and at what cost?
Technology does sometime die, no matter how much redundancy and recovery planning have been done. To mitigate the negative impact of such a scenario, do we implement an identical real-time system (a backup system), which run concurrently with this application? At what cost are we willing to invest?
Interface Accuracy
Currently we have paper based and computer based records tha are not linked together (Module I, Webcast lecture.) suppose the E-Health Record application does link these 2 together, what auditing procedure will be put in place, to be followed religiously, to make sure that the records have an absolute accurate link, patient A to patient A, for the entire U.S. population?
In my systems development career, I have worked on countless applications that have misrepresented information (garbage) between application interfaces, such as a customer transaction was posted to the wrong General Ledger ID. In this scenario, it was just a business loss. What if the data mistake contributes to the loss of many human lives?
These are just a few examples of the many challenges that the electronic health record may encounter.
In the quest to understand more about the challenges on the development and support of the electronic health record, I've found the information posted on the HealthIT.hhs.gov website to be extremely informative. On this site, there is useful information on privacy and security, antifraud measures, medical identity theft, federal laws and regualtions, standards and certification, National Health Information Network (NHIN), Health IT Tools, et cetera.
In addition, I have attended an informative Webcast Live Meeting offered via this site to address some questions in providing "Funding opportunity to furnish assistance, defined as education, outreach, and technical assistance, to help providers in their geographic service areas select, successfully implement, and meaningfully use certified EHR technology to improve the quality and value of health care." The total amount of funding opportunity is $598,000,000. You can locate more information about this topic on their website.
Just like the evolution of the Information age and the Internet, I believe that the electronic health record system will become a part of our lives in the near future.
Thank you, class, for your critics. All comments are welcomed.
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