We can integrate technology to enhance humanity in healthcare. 

October 24, 2026

Technology is a tool. People can use technology to support cognitive needs. At a basic level, people need access to data and information to make decisions. However, those decisions must also be based on knowledge for the most effective outcomes. 

For example, consider something as simple as the name of an over-the-counter medication. While many are familiar with the brand name of Tylenol, fewer are familiar that the active ingredient in the brand Tylenol, is acetaminophen. Acetaminophen is the generic name of the medication. Acetaminophen can be purchased over the counter as well as a generic brand, often located right next to the Tylenol. They both have the same active ingredient. However, the prices are often different. While not everyone is exposed to this knowledge, every nurse, pharmacist, doctor learns it as part of their educational preparation. 

Now, what if there was a way to bridge this knowledge gap for patients and people who could use this insight while deciding about what medication to buy at CVS or Walgreens? This is a place where technology could be helpful to other humans by being a knowledge resource as it is unlikely the pharmacist could answer every over-the-counter medication question that comes through each day. In this example, the direct beneficiary would be the person (who may or may not be considered a patient at that time). Healthcare or the care of health is a daily ongoing event, not just when one needs to see a doctor or go to the hospital.

A second example where additional knowledge would be beneficial is in the hospital setting. In the example I am about to share, the direct beneficiary of the additional knowledge is the nurse. What you may or may not know is that nurses often are looking for equipment around the unit to assist with administering medications. Many intravenous medications require a piece of equipment called a syringe pump. Syringe pumps are notoriously hard to find on a patient care unit. 

So, sometimes nurses, who know they will need a syringe pump will proactively seek one out ahead of the scheduled medication time. They may search supply rooms, empty rooms,and/or other places where there may be a syringe pump. There is no systematic way to identify this essential piece of equipment to deliver meds. The patient may never know the struggle the nurse is facing trying to make sure the medication is delivered on time. 

If one is found, the nurse may opt to hide it somewhere for later. However, what if this did not have to happen? What if there was a way to tag the equipment and link it to a find my equipment search tool available for nurses across the hospital? We know the technology exists. We know there is a need. The benefit would be to the nurses directly and indirectly to the patients. 

I just offered two very simple examples of how humans could benefit from more knowledge to make informed decisions. The additional knowledge can come through technology solutions that would benefit the person or user seeking out answers. While these two examples are relatively simple in terms of the problem, they do represent the approach that offers a human need for an answer that can be supported through technology. We must keep this perspective in mind as new technologies are presented that may or may not be solving a problem faced by a human. 

Healthcare Innovation: It takes the time that it takes.

August 19, 2018    |   , ,

While clinicians (e.g., nurses, doctors, CNAs, etc.). are the users of new health care technologies, they are often not the purchasers. This complicates the diffusion of innovation in healthcare. However, it doesn’t mean it can’t be done. It does mean it will likely take longer than diffusing innovation at the consumer level.

Article originally appeared on Linkedin here: Healthcare Innovation: It takes the time that it takes on October 2nd, 2017.

If we aren’t yet connected on LinkedIn, send me a connection request at: Dr. Tiffany Kelley RN

Nightingale’s Innovative Nurses Campaign

May 14, 2018    |   , , , , , ,

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In September, we kicked off our Nightingale’s Innovative Nurses campaign! At Nightingale Apps, we believe in innovation, compassion, and serving others. That’s why we’ve decided to highlight nurses that use ingenuity to solve problems at the bedside. If you’d like to nominate a nurse or even yourself please reach out to us at contact@nightingaleapps.com.

We’ve shared their stories through our email list communications and also on social channels. To connect all of the Innovative Nurses we’ve featured, I’ll be providing those stories in a series of blog posts here on Know My Voice. I look forward to your thoughts!

Best,

Dr. Tiffany Kelley RN

I didn’t know my lab results nor that I would be asked about them.

February 01, 2018

This week I visited an acupuncturist for the first time. The acupuncturist asked me about my past medical history as well as my current health. She asked me about when I last had labs drawn and if I knew the results.

I knew I had labs drawn recently, however I had no recollection of what was drawn during my last physical nor what those lab values were as a result.

I had to tell her, ‘I don’t know.’ (I also didn’t know I would be asked about them).

Read more

Where do I start?

November 05, 2017

Earlier this week I spent some time speaking to a group of graduate nursing students at a college in Boston Massachusetts. We talked about the foundations of nursing informatics, electronic health records (EHRs), apps, and problem solving in the field.

Each student mentioned something that could be improved with regard to their current health IT environment. I mentioned that each one of them had an opportunity to help solve those problems. The question from one student was, “where do I start? How do I help solve some of these problems?”

Her question was the BEST question of the night. Where or how do I start is usually the first barrier toward moving anything forward.

To start, KNOW that you don’t need to have a technical background to provide a suggestion for improvement. What you do need, YOU ALREADY HAVE and that is your clinical expertise and knowledge of how to care for patients.

So, if you recognize a problem that has the potential to impact care delivery in your area (e.g., inpatient, ICU, ED, PACU, Ambulatory) and is a hindrance toward the delivery of quality patient care, take a closer look.

Take a closer look beyond the technology to see why it may be a problem. What is the issue? Is it a process issue (e.g., workflow)? Is it a people issue (e.g., non-compliance)? Is it a technology issue (e.g., design/functionality)?

Then observe and ask questions. Who else is impacted? Does it bother them too? Why hasn’t anyone said anything?

Next, think about what would be the way to solve it. How could it be made better? What would be a better situation. This is where you should not focus on what you do or do not know about technology but rather how technology could support you in your delivery of care.

Finally, find someone to share your findings with and ensure that you get it to the right person.

We cannot make improvements without knowing what the issues are that are impacting care. Those in the roles of care delivery are the BEST equipped to offer suggestions to others that can evaluate and begin to implement new changes.

Joining a council, becoming a Super User or a Subject Matter Expert (SME) are three ways to get more experience and learn more about the role of technology and informatics in nursing and health care delivery.

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Healthcare Innovation: It Takes the Time that it Takes

October 02, 2017

Did you know that the first electronic health records (e.g., EHRs) were developed in the late 1960’s and early 1970’s? I did not know this when I first came to know them in the early 2000’s. I naively thought, ‘how hard can it be to take paper records and turn them into an electronic form?’.

 

Well, the answer to that question, it is very hard! Despite the efforts during my first few years with EHRs, I was unaware of the fascinating history that came alongside this new way of digitalizing patient information until I began writing my book on EHRs. EHRs are a case study for demonstrating that healthcare innovation is a different marketplace.  With so many influential factors, bringing innovation to healthcare environments takes the time that it takes.

 

Dr. Lawrence Weed conceptualized the idea for a ‘problem oriented medical record’ in 1968. His thoughts were published in the New England Journal of Medicine. He saw the opportunity to leverage technology in a way that physicians could manage patient information according to problems and understand the whole patient as a person. Dr. Weed saw the opportunity to support the clinician with information needed for decision making, and care delivery. Weed did not use the term ‘electronic health record’ or EHR, nor did any of his peers that were developing the first EHR systems. The term used at that time was ‘computerized patient record’ or CPRs.

 

During that time, several organizations began developing systems for use within their facilities: Duke, Massachusetts General Hospital, Beth Israel Deaconess Medical Center and the Department of Veterans Affairs are just a few of these pioneers. These efforts began nearly 50 years ago. However, fast forward 40 years and the United States had been at less than 2% adoption in 2009.

 

While we may not think of it now, the EHR is an innovation in healthcare. AHRQ defines healthcare innovation as, “the implementation of new or altered products, services, processes, systems, policies, organizational structures, or business models that aim to improve one or more domains of health care quality or reduce health care disparities”    (https://innovations.ahrq.gov/faq). The EHR is an example of how diffusing innovation in healthcare does not happen overnight.

 

I sometimes wonder where we, the United States, would be had the HITECH Act not made financial incentives available to accelerate the adoption of EHRs in health care organizations. I suspect the adoption rates would not be what they are today. As of the end of Q2 of this year, less than 2% of hospitals and outpatient practices were at a Stage 0 on the HIMSS EMRAM  (electronic medical record adoption model). In less than 10 years, the United States went from less than 2% adoption to less than 2% non-adoption!

 

Now, imagine you were Dr. Lawrence Weed or any of the pioneers that developed the early EHRs. Imagine the hurdles experienced to bring the idea and early concepts to life and acceptance. Imagine how many people said ‘that will never happen’ or ‘you can’t do that’ and over how long of a period of time it likely was expressed by others. Fifty years is a very long time.

 

EHRs faced financial, technical, organizational and legal barriers toward rapid adoption. The HITECH Act helped to breakdown some of the financial barriers. In general, healthcare innovation needs to overcome each of these barriers toward successful implementation and adoption.

 

In some cases, the technical environment and the organizational culture wasn’t quite ready for EHRs. Legally, the protection of electronic PHI was not defined until 2003 with the Security Rule. Thus, despite the conceptualization and recognition of the potential in the 1960’s, the healthcare innovation took the time that it needed before it could be accepted into the environment.

 

I believe this is a helpful perspective for those that are developing new innovations in healthcare. The general ecosystem of innovation tends to paint a picture that one can develop a solution and have it lead to rapid widespread adoption within a very short period of time. (For example, Instagram started in 2010 and was sold to Facebook in 2012 for 1B). Yet, the healthcare marketplace is not the same as the consumer marketplace. In many cases, the consumer of the innovation in healthcare is not the purchaser of the product. Additionally, the previously mentioned barriers become less conflated when managed at an individual (e.g., person/user) level rather than a system (e.g., health care organizational) level. Thus, the adoption of new innovations within healthcare organizations requires the time that it takes.

Best,

Dr. Tiffany Kelley RN

 

For more information about my book, Electronic Health Records for Quality Nursing and Healthcare, visit Destech Publications at: http://bit.ly/2a6pJpz.

 

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