Module 6

One definite advantage of an on-line class is the asynchronous nature of it. I did like being able to complete the modules on my own time, but I also liked the fact that there were periodic deadlines. That is helpful in not waiting until the last minute to do everything. I am less of a procrastinator now than when I was an undergrad, but I still appreciated the periodic deadlines.

The thing I dislike the most is the feeling of isolation I felt in this class. I feel I had virtually no interaction with class members and very little interaction with the faculty. For example, I only had one comment on my entire blog. I did not like the blog method of communication. I prefer the discussion board method for class discussion and participation. I tend to have a social personality and the lack of interaction with the class leaves me feeling very unfulfilled. I have taken other online classes before and not felt so isolated.

I learned a lot about ethics and decision support systems. I really enjoyed learning about different decision support systems. I had never thought of ethics as being a component of informatics, and I had never heard of decision support systems before taking this class.

The thing I would do differently about this class is I would get rid of the blogs. I really see no point to having people create their own blogs. WebCT provides a very adequate venue for class discussions and participation. I feel the blogs were not utilized in the way they were perhaps intended. I would split the class into small groups (6-10 people) and have those be the discussion groups for the blog entry topics. Maybe each instructor could lead a different group. That way, there would be a lot more interaction between students and even the instructors. This interaction would decrease the sense of isolation.

If the blog assignment and usage will be carried into future semesters, I would recommend setting a due date for creating the blogs to be early in the semester, say within the first few weeks. The reason for this is because I tried to post every one's links on my blog site, but there were so many, and people kept trickling in even 6 weeks into the semester, I couldn't keep up. It would have been nice if everyone had created their blogs within the first few weeks so that we could all post each other's links on our blogs. Also, if the blogs are to stay, I would break the class into small groups and have them comment on each other's blogs, like small discussion groups. It was way too overwhelming to try to keep up with every one's blogs, so much so, that I eventually quit trying.

All in all, I feel I learned a lot in this course. I have been on a very steep technologic learning curve since starting this program. I don't feel like I am an expert, by any means, but I do feel I know a lot more than I did.

Module 5

It seems we are bordering on the edge of sci-fi with some of these issues. And it also seems the availability of health information is a double-edged sword. I can definitely see how beneficial a national system, or even international as was brought up by Diane Rehm's guests on her show, would be. It would truly improve continuity of care and make a lot of things about patient care safer and more efficient, as in the knowing of allergies and current medications being taken. However, if we are to go to a national system, we will truly have to end the whole idea and usage of insurance. I honestly cannot see how peoples' sensitive information could be safe when it is exposed to so many systems, virtually globally. Even with HIPPA laws, I think people will find it harder and harder to get insurance because their health history, family history and possibly even genetic testing will follow them where ever they go.

I understand that there are people and organizations that are very concerned with this issue and constantly trying to fight to keep information secure, but I just think all the firewalls in the world will have a tough time protecting all of that exposed information, especially if it goes global. I really don't consider myself to be paranoid, and maybe my skepticism comes from my ignorance of technological advances, but I just think we can't see all the negative ramifications of creating a national healthcare information system.

As I was reading Hebda and Czar about the issues of information ownership, it seemed silly to me that that was even an issue. To me, it seems the client should be the owner of their own information. As I read on, I really liked the idea of a smart-card that holds all of a person's health information on it and could simply be scanned at any health care facility. That way healthcare personnel can have access to the information they need, but the facility doesn't have to store it. This way, information is truly given on a need-to-know basis. For example, my children each have an immunization card that has handwritten information on it. So why can't we take this one step further and make it digital? It could even be something as easy as a thumb drive. Starting from when you are born, a health information log is started, and whenever you go to a healthcare provider, they scan your information in order to treat you as safely and thoroughly as possible, and then any changes made can be downoaded to the card or drive, or whatever.

It seemed to me the two main issues shared by our module readings and the AHRQ website were patient safety and information sharing. The patient safety issues seem to center around medications and physician orders. We use barcoding to administer patient medications at the hospital where I work, and I quite like it. We don't, however, use a computerized provider order entry, and I wish we did. I can't think of any disasters off the top of my head that involved the misinterpretation of orders, but digitizing orders seems so much safer and more consistent.

Information sharing is a huge issue where I work. I know they do HIPPA training every year and take it very seriously. We are encouraged to do things that are mentioned in our readings such as not share passwords, log out after we are done charting and never download anything. However, I can relate to one of the issues brought up by Hebda and Czar, and that is the frequent changing of passwords and that every system has a different password. I realize it is necessary for increased security, but it is logistically difficult. I counted in my head, and I use 7 different systems that all require different passwords where I work. I have to write them down on a little cheat sheet that's taped to my badge. I don't think they are easily accessible, but I'm sure it's not ideal. But there's no way that I can remember all of my passwords, especially since they are all different and require changing at different times.

I'm not sure if our hospital privacy officer is a nurse, but the readings opened my eyes to another job possibility for nurses informaticists. A hospital would be very smart to hire an ADRN nurse informaticist because they have the nursing and technology backgrounds necessary for such a job.