AMITIAE - Tuesday 30 August 2016

Cassandra: Elsevier's Chief Professional Practice Officer, Michelle Troseth at HIMSS AsiaPac16 - Modern Healthcare and the Nurse

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By Graham K. Rogers


A few days ago I attended the HIMSS AsiaPac16 conference and exhibition at the Queen Sirikit Center, Bangkok. The main thrust of the conference was use of modern technology and systems to improve hospital management, medical services and - ultimately - patient care.

Elsevier At the event, I spent some time looking at examples of technology being developed for health care solutions and spoke to a number of people there. I spent significant time with Dr Richard Milani of Ochner Health, and with Michelle Troseth of Elsevier. The interview with Dr Milani will form the basis of my Bangkok Post column, tomorrow.

Michelle Troseth is a registered nurse (RN) who is Chief Professional Practice Officer of Elsevier. Many know this company for their vast number of academic publications, including The Lancet. With the changes that technology is bringing, especially as it is applied to medical solutions and health care, Elsevier is evolving from publisher to a clinical solutions provider. Michelle discussed with me some of there clinical issues that affect nurses.

Michelle Troseth Her enthusiasm - and a wonderfully generous laugh - made the time pass quickly indeed. While she is a strong advocate for the use of technology - particularly computer solutions - in nursing, she was adamant that we should not lose sight of the human factor. We should understand the importance of technology and how we marry this with practice for the best care possible.

We must think of the role that the nurse plays in providing excellent care and be aware of the overuse of tools. Reliance solely on some computerized systems may not provide enough information for the best decisions.

As part of the inclusion of technology solutions in health care it is important to be aware of the ways nurses think and apply this to technical solutions. There is always an interaction between the nurse and patient and technology should not take over the role of the nurse, rather it should provide consistency: evidence and support to guide the care.

Connected to the ways in which nursing staff and physicians access information, there is a growing awareness of nursing informatics: Integrating nursing science with information management and analytical sciences. She outlined some solutions that Elsevier has produced to enhance the experience, with evidence-based tools to ensure that those responsible for providing care are all looking for the same thing and evaluating patients in the same way: the tools to access what is needed, when it is needed.

As a useful illustration, she used the example of premature babies. The solutions are able to provide neonatal units with up to date information regarding risks. Again, like others I had spoken to at the show, she emphasised the consistency that such an approach was able to provide.

The risks of variability included fragmented care and the risks of repetition, missing problems, and a lack of coordination. As well as problems for patients, these shortcomings in care added to the costs. Computerizing everything, however, was not the answer. There were advantages to making everything connected, but hospitals should not rely on technology at the expense of excluding the valuable input of nursing staff.

Where such systems do score highly is in the timely provision of up to date information: new evidence, changes in procedures. There will be discoveries about new treatments, new causes and also new medicines. An example is the treatment of stomach ulcers. For years patients suffered from several processes, including dietary changes, until the discovery that bacteria was the cause. Now a course of antibiotics and other medication should clear the problem within months.

The provision of good and timely information is pushing health care forwards and, she said, a good example is the way the dialogue between clinicians has changed. Elsevier's ClinicalKey - a sort of Google for the medical profession - is currently available for medical professionals. It is already in use at Bangkok Hospital. It allows a quick search using keywords that brings up relevant information to assist doctors or other medical professionals to make more accurate decisions about a patient's condition.

An area of expansion that interests Elsevier and others at the exhibition, concerns electronic health records. This is of major importance to hospitals and health care professionals worldwide. Often, legacy systems that have been developed in-house do not have the software enhancements needed to bring them up to date and there may also be problems with efficient updating of content: hospitals need a path for that.

The management of data concerns IT professionals in many industries, but in healthcare the information is critical and needs to available in a timely fashion.

The system Michelle outlined to me married the electronic medical records (EMR) and the needs of the client with Elsevier's solution, to ensure that the entire system was maintained effectively and helping to provide the clinical solutions necessary for effective modern health care: medical professionals, nursing staff and the needs of patients.

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Graham K. Rogers teaches at the Faculty of Engineering, Mahidol University in Thailand. He wrote in the Bangkok Post, Database supplement on IT subjects. For the last seven years of Database he wrote a column on Apple and Macs. He is now continuing that in the Bangkok Post supplement, Life. He can be followed on Twitter (@extensions_th)



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