When does healthcare start?

If I were to ask you the question, “when does healthcare start?”, what comes to mind?

I have asked this question many times to different audiences of nurses and healthcare professionals. I typically will get a silent pause to start.

That silent pause is an indication that thought is going into the answer (and perhaps there is some unknown as this may not be a common question).

Several years ago, when I first started asking this question, the most common answer was with one’s insurance card or at the hospital.

I know that I had that thought as well for the first decade or more of my career. As a registered nurse, I am considered a healthcare professional. Hospitals were the primary place of employment for registered nurses when I graduated from my undergraduate program at Georgetown. Hospitals are also the primary place of employment for registered nurses today.

However, one day I was listening to a presentation about healthcare that shifted my perspective. I am a person before I am a healthcare professional. As a person, I will have healthcare needs. I also have some agency around decisions I make each day regarding my health.

This agency is around what is called, modifiable risk factors. Modifiable risk factors are choices we can make each day that can impact our health in the short or long term. Examples include whether or not one smokes tobacco, drinks alcohol, is active or sedentary, and to some degree food choices. Non-modifiable risk factors also affect our overall health. Examples of non-modifiable risk factors include our genetic composition (e.g., inherited diseases and/or carriers for diseases), age, race and ethnicity.

As humans and people, our daily choices can influence our modifiable risk factors. Thus, our daily choices can influence parts of our health but not all of it.

In areas where we do not have the ability to modify our risk factors, healthcare expertise, diagnosis, treatment, care and intervention can be of great value. There are three levels of care: primary, secondary and tertiary care.

Often, when someone needs to go to the hospital, that is seeking out tertiary level care. Primary care is preventative in nature. The goal of primary care is to prevent or identify any potential health issues before the need for greater intervention.

Therefore, as you navigate your day to day, consider if there may be one action you take today, tomorrow or the day after that you think about as it relates to your short and long term health.

~ Dr. Kelley

Reflections on the GenAI Divide Report from MIT

In Episode 7 of KnowMyVoice®, I reflect on the recent report from MIT: The GenAI Divide: State of AI in Business 2025 that was highlighted in a recent Fortune’s article. I examined key findings from the report and reflect on the findings in the context of innovative change in healthcare delivery.

Take a listen and if you have an idea for a podcast episode topics to cover or questions of curiosity, send us an email at either contact@nightingaleapps.com or contactus@icarenursingsolutions.com.

Enjoy your start to September. Be well and take care, ~ Dr. Kelley

The GenAI Divide Business Report 2025

Earlier last week, I saw several reports on the Fortune article, “MIT Report: 95% generative AI pilots at companies failing. I wanted to explore what the report uncovered to further understand how the overwhelming hype of AI in the media around what AI can do and what it will replace, could be so disconnected from the reality of what is happening in the daily operations of business.

I am a daily user of generative artificial intelligence (e.g., GenAI). I find myself turning to ChatGPT (my current GenAI product of choice) over the traditional ‘Google Search’ often, but not always. Some of this effort, is to be sure that I am moving along with the pace of the product’s (e.g., ChatGPT) development. While some of the effort is because I do find the responses to be a faster aggregation of available data and information on the internet than I could aggregate on my own from what we have been using over the last decade and more, commonly referred to as a ‘Google Search’.

In the traditional ‘Google Search’, we might put a word or phrase in the search bar and in return, a few sponsored ads would be at the top. Then, you would see a list of ranked items that may or may not be the most reputable, reliable and valid sources. As a user, you need to be able to decipher which are the reputable, reliable, and valid sources. You may read through a few links to get a sense of what the selected page says about the entry to determine where to search next. This could go on for as long as you would like to ‘dig in’ to the topic.

Now, with ChatGPT, and similar GenAI platforms, the large language model or “LLM”, performs that aggregation for the user and presents an answer. In the paid version, I often will have links associated with the returned response. I will not take the response seriously without a corresponding link that I will check for reliability and validity. However, this is my own personal principle, and could vary user by user.

I have found that ChatGPT can aggregate and present me with enough preliminary information that can take me to the next step in my knowledge development process to answer the question I have in mind. Whether it is to determine where to go for dinner or how many nurses there are in the world, I treat the responses as a preliminary start and not the end point.

Now, I have a PhD in nursing informatics where I studied the use of data, information, knowledge and wisdom in the context of nursing and healthcare delivery. I have worked in and studied health information technology for over 20 years now. So, my mind is automatically primed for this type of behavior. Yet not everyone will have these tendencies. Therefore, it is important to note there will be potential vulnerabilities where the data and information presented could misinform the user(s).

I share this because while AI is becoming increasingly more prevalent, it is a tool. Tools have specific purposes and use cases. We know what the stethoscope can and cannot do in helping to assess the human body. We know what calculators can and cannot do to help in preparing medications for administration. We know what the pulse ox probe can and cannot tell us to help in managing the respiratory system. The stethoscope, calculator, and pulse ox probe are technologies. They are technologies we have accepted into standards of practice. They have specific use cases and have reliability and validity to allow for standardization across care providers to offer data and information that can be used to generate knowledge about the patient’s condition.

We are in the early stages of discovering the use cases for generative artificial intelligence (GenAI) in healthcare. The report from MIT further demonstrates how the technology alone is not the transformative agent. Technology also requires the identified use case for the intended people and associated processes. This is no different than any other technology that has been adopted into healthcare. I say that to reduce the intimidation factor of the term and unknowns.

Nurses are experts in knowing how to give nursing care. They know what they need to do for their patients. The same is true for every other healthcare professional role group. Thus, this means that you have the opportunity to assist in determining the best use cases for GenAI in collaboration with others.

More to come on this topic as I review the MIT report in the next post….

Have a great week,

~ Dr. Kelley

KnowMyVoice®  Episode 6: Nursing Care is Complex

Nursing Care IS Complex. It is the nature of the work. The work requires flexibility and adaptability in ways that one cannot predict. Yes, we depend on an incredible amount of data, information, and knowledge to give evidence based informed care. However, the work is complex – not linear. As a result, the potential for AI is present, but surrounding specific use cases that nurses will be best able to identify.

In Episode 6 of KnowMyVoice®, I reflect on the continued conversation of artificial intelligence (AI) and it’s potential influence on healthcare delivery in tandem with the complexity and lack of predictability of a nurse’s shift. I describe how AI is a tool to facilitate the use of information that does have value in nursing. However, care also depends on the human connection. Take a listen and if you have an idea for a podcast episode topics to cover or questions of curiosity, send us an email at either contact@nightingaleapps.com or contactus@icarenursingsolutions.com.

Enjoy your day. Be well and take care, ~ Dr. Kelley

You cannot force creativity.

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New and novel ideas cannot be forced but rather must bubble up on their own.

For me, it is almost always a result of getting away from my computer.

Whether it is driving, walking or running, my mind has more freedom to wander and explore…

Tonight, the views definitely were a great addition to what came to me.

Creativity needs room to breathe and if you are too structured or limited in what you believe can be possible, the ideas will be stifled…. and so will your excitement for them.

Episode 5: User Needs for Change

In Episode 5 of KnowMyVoice®, I reflect on a recent interaction with the self checkout machine at CVS and relates it to the user experience nurses often face in working to integrate the technology into their daily information needs for care delivery.

In my research, I witnessed (and often experienced) the struggle with matching workflow needs with health IT solutions. Yet, what can you do? Is there someone you can call? The short answer is yes. Tune in here to learn more.

Be well and take care,

~ Dr. Kelley