I personally would love to see medications listed as a hyperlink in the EHR that would take you directly to the side effects and suggested management of those side effects.  I am a clinic oncology nurse and we deal with many medication side effects on a daily basis.  Although we do have access to drug books and also online resources, it takes time to look up the drug and then find the side effects.  Many times, you then have to go to another area to find management of those side effects.  When you do this for multiple patients a day, it becomes very time consuming.  These links could also alert you to potential drug interactions.  In the hospital setting, this could also check IV compatibility.  These links could also be accessible to the patient through their “my chart” access.  The patient could click on the hyperlink and answer a list of questions that would then either trigger possible home remedies or, alternatively, send the nurse and physician an alert to potential serious complications.  Anytime the patient accessed one of these links and answered questions, this would create an automatic progress note in the chart with the questions and the patient answers so the side effects could be tracked to see if the patient was responding to management techniques.  This would allow the patient to feel like they are more involved in their care and had more control.  This would be especially wonderful in the field of oncology nursing where almost every medication you give to your patient, be it oral or IV, will cause side effects, some harmless and some life threatening.

So ask yourself, where do you see the future of health care headed and is there anything that you can to do help implement those advances?

Asthma is a chronic disease of the lungs that causes the airways to become inflammed and narrow.  This causes symptoms of wheezing, shortness of breath, tightness of the chest and coughing.  An Asthma attack can present with any one of these symptoms or combination of symptoms.  Reactive Airway Disease is often used interchangeably with Asthma although it is really just a general term and is not a true diagnosis.

I happen to fall into the category of a parent with an Asthmatic child.  My daughter who is now 8 years old was officially diagnosed at the age of one year but this was a suspected diagnosis from the time she was 9 months old.  It is a very frightening thing to have a child who has episodes of extreme shortness of breath with wheezing and use of accessory muscles to breathe.  My husband and I have spent countless hours without sleep due to her difficulty breathing, made several trips to the emergency room, and have administered more breathing treatments than I could count over the last 7 years.  However, for her, it has become a natural, if inconvenient, way of life.   We have graduated to an inhaler and she only has to use the nebulizer for severe attacks.  She has learned to recognize when she is about to have an attack and will go get her inhaler so that we can help her use it or go to the school nurse for help.   We have learned that if she gets an upper respiratory virus or infection, we must get it treated promptly as her asthma will flare up very quickly.  I have witnessed her go from a slight runny nose to being in the emergency room with uncontrollable wheezing within a 24 hour time frame, even with the use of the nebulizer at home.  My personal experience as a parent of a child with Asthma is why I chose this topic for my Webliography.

I have spent many hours researching Asthma and its causes.  Following is a list of reputable, reliable resources with regard to the causes, symptoms and management of Asthma that I hope you will find as useful as I have.

National Heart Lung and Blood Institute

http://www.nhlbi.nih.gov/health/dci/Diseases/Asthma/Asthma_Causes.html

This site is part of the U.S. Department of Health and Human Services of the National Institutes of Health.  It provides an overview of diagnosis, signs & symptoms, causes, treatments, preventions and how to live daily with asthma.

Mayo Clinic

http://www.mayoclinic.com/health/asthma

The Mayo Clinic website is a wonderful tool to use for many different diseases.  The information contained on this site dealing with Asthma includes the definition, symptoms, causes, risk factors, diagnosis, treatments and also when to call a physician for help with management of symptoms.

WebMD

www.webmd.com/asthma

This site provides a great deal of information on Asthma symptoms and treatments and also contains links to even more articles about natural remedies, links between certain other diseases and Asthma and even the best and worst cities to live in when you suffer from Asthma.

Asthma.Com

http://www.asthma.com/?rotation=30490751&banner=208373882&src=1asthma&kw=p31158483&247SEM

How much more self-explanatory could a site be for Asthma than Asthma.com.  This site has been one of the ones that I have used the most often.  It is filled with valuable information for both the patient and the parents.  It has updates on current medications available, what type of Asthma you may be suffering from and assessments to determine if your Asthma Action Plan is working.  It also contains links to many other sites for individuals with Asthma.

Centers for Disease Control and Prevention

http://www.cdc.gov/asthma/

The Centers for Disease Control and Prevention site is filled with useful information much like the other sites listed but it also has specific information depending on how you are affected by Asthma.  It contains links for the healthcare professional, patient, parent and even school educators and gives specific information based on your needs.  It also contains links to related diseases and triggers.

American Academy of Allergy Asthma and Immunology

www.aaaai.org/

This is a site that you can either view most of the information for free or choose to become a member and have unlimited access.  It not only contains information about signs and symptoms and disease management but also contains links to the Journal of Allergy and Clinical Immunology.  Also found on this site is a very neat feature that is a “virtual allergist”.  Here you can check your current symptoms according to body system and then find possible causes and interventions.  It also has an area “just for kids” that has interactive games, puzzles and projects for the child suffering from Asthma.

What is Health Care Informatics?

According to our textbook Nursing Informatics and the Foundation of Knowledge, Health Care Informatics is the “. . .combination of health care science, information science, and computer science”.  So what does that really mean?  It encompasses the Electronic Health Record (EHR) and the Clinical Information System (CIS) which give us programs that allow for electronic medical records.  This is the up and coming technology in the health care industry and provides convenience and continuity of care for the patient.  The EHR allows all health care workers within a system to view the patient’s medical records at a moments notice.  This is a wonderful tool to allow different health care workers involved in the patient care to compare therapies and medications so that the chance for unwanted interactions in medications or contraindicated therapies are lessened.  The CIS then incorporates the other areas of the patient care such as labs, imaging, coding, billing, etc. into the patient’s chart. These systems communicate with the “Legacy” systems (or those systems already in place for labs and xrays) and incorporate them into one record.  Then, as is noted above, all of this information is available on the computer and is accessible to those using the various health care systems, such as EPIC used at St. John’s. I believe that in the future this information will become accessible to all health care systems through use of the internet and secure websites.

What I have learned my first week. . .

In this first week of class I have expanded my knowledge of just exactly what is involved with the EHR and have learned to look at it in a new (and hopefully better) way.  I see it as a complete picture of the patient including symptoms, management, testing, outcomes, evaluations and billing.  This allows for all aspects of the patient’s care to be incorporated into one common site.  I have also learned to blog and have created a Twitter account and am hoping that as time goes on, I will become more comfortable with both of those as they are new to me.  I am excited about this course and what it will do for me in expanding my knowledge of the technology that is available to me as an individual but also as a professional nurse.  Twitter and this blog will give me a platform that is accessible to more people and fellow professionals than I would otherwise be able to reach.  On that same note, it will give me a way to connect with other nurses and health care professionals and allow me to learn from their expertise and knowledge.  Looking more in depth into the health care informatics will broaden my view of the electronic health system and will hopefully make me more effective in using the tools which are available to me and to my patients.  I am expecting great things from this class and am excited, and a little scared, about diving into the technology.