danny

In this blog I want to focus on Stage 5 of your future health information technology HIT infrastructure: the harmonization of health information technologyand clinical design. At this point in your planning you should have a pretty comprehensive HIT strategic plan for 2013- 2015. Now you must think about harmonizing the technology plan with your clinical workforce and strategies. Many hospitals and healthcare systems have recognized the importance of this harmony by establishing the position of Chief of Medical Informatics.

In 1988 after I was fired from my job, I lost weight and ended up in the hospital, where my doctor prescribed the first SSRI (selective serotonin re-uptake inhibitor) antidepressant. He said if I did not take it, I could die. 

I have taken antidepressants on and off since, and have dealt with the side effects of weight gain, muscle spasms, extremity swelling and severe fatigue. No doctor ever seemed to think antidepressants could be making my life more difficult. 

I have lived at this facility for 20 months. It is almost half the size of my previous facility and life is more casual. 

Residents here are closer to my age and for the most part more active. I think most of them consider their rooms to be both apartment and studio. Residents use their rooms to lounge as well as to sleep. Some also use them to work on or tinker with their hobbies, which are readily visible.

It is always interesting when a building environment issue drives an operational question, which leads to a passionate, cross-functional discussion.

Last Friday was this facility's second Summer Fun Day. A cookout was held at a local park promising lots of food, pop and even a DJ. 

Since I am not much of a picnic person, and had much to do, I decided to remain behind. Despite that, many staff all but begged me to go. I kidded them by saying, "I do not want to fight the flies for my food.”

"TMI" (too much information) should be the catch phrase for dinner with any baby boomer. I have clients who will shout out their PSA levels, blood pressure and other various test results at business meetings. This has become as commonplace as a pregnant or new mother discussing breast feeding and how their delivery went. For those of us not in that current condition, the conversation is uncomfortable at best and becomes TMI.

 I hate bringing this up, but as I write this, my nose is bothering me. It feels dry inside and stuffy. Since I am quadriplegic I cannot check out my nose. I cannot reach to scratch, rub or blow it. I have to rely on the aides to help me.

In my May blog I outlined 10 HIT (health information technology) strategies to becoming a preferred provider. We had reached Stage 4: HIT Infrastructure Due Diligence. If you are following this plan you probably need more time to complete your due diligence. I will postpone covering Stage 5: HIT Clinical Design, until next month’s blog.

I cannot remember when my vitals were last taken. They used to be done once a month. But it seems to have been longer than that. 

Nurses do vitals here. Because of that I am reluctant to ask them to check them, when it is not scheduled. I have my own thermometer but I cannot use it myself. As a quadriplegic, I know it is important to keep track of my temp. Even a low-grade fever can be potentially dangerous, especially when the weather is hot.

When I first moved to a nursing home 16 years ago, I thought I would keep busy reading, writing letters to friends and talking to others. 

But with a call light cord around my hand, I was not able to turn pages to read. Instead, I read in my room in the daytime with my door open and without the call light on. Several months later the facility got me a “blow in” call light. But by that time, my arms were weaker and I no longer had the reading in bed habit.  

With the need for states to rein in healthcare budgets, we are seeing a rapid move toward managed long-term care in states across the country. These changes are forcing many LTC providers to adapt to a new healthcare environment. For some this means rapid growth; for others merging with competitors or larger healthcare systems. No matter where you sit, change is probably the order of the day.

The first nursing home I moved to 16 years ago was a cool 70 degrees during the summer months. Some days I was so cold I went outside and sat in the sun till I warmed up. I knew the coolness was necessary for residents with breathing problems and for staff who were always moving. 

Over the years the air conditioning temperature in nursing facilities, stores and businesses in general has gone up. Buildings are much warmer in the summer. There is no doubt that economics and air conditioning efficiency are the reasons.