Newsweek Article Post

Looking forward to reading the article Dr. Yellowlees cited in his latest post; "fascinating parallels", just made me think how interesting to be a psychiatrist and an informatics professor and the perspective that allows...also fascinating!

Introduction to Moi

Very late in the game I am realizing that Dr. Yellowlees wanted us to post an Introduction on our blogspot and I've neglected to do so, so here goes:

I'm part of the NW contingent of nurses in the Health Informatics Certificate Program, returning to school for the first time since dinosaurs roamed the planet, and actually loving it, especially this class. I'm not just saying that for "credit", more than other class in the program this one has really made me think about where healthcare is going in the future and what my role might be there. Just incredible and wonderful to think that environments like SecondLife will play a vital role in mental health treatment, training, and so many other applications that will work synergistically to improve and maintain health.

You can look at my profile to find out more about my "pasa tiempos" i.e. hobbies and interests, but professionally I am a PACU RN, and proud Kaiser employee of almost 30 years (yes, I started when I was 12!). I've had various and sundry roles in the organization including a nine year stint in Quality Management, but have always maintained a practice as a "real nurse" in the PACU. I am a veteran of 6 pediatric urology trips to San Pedro Sula, Honduras, sadly the murder capital of the world, but absolutely the sweetest children ever. And for almost the last two years I've been a Clinical Informatics Specialist, my favorite job in the organization, with the best boss and the best team I've ever experienced. I can say with great enthusiasm that I truly love my job and don't want it to ever go away; we're just concerned that with changes in the organization and financial restrictions, that might be a possibility.

I'm so grateful for the opportunity to return to school with the support of the Hudnall Trust, another wonderful benefit of being a Kaiser employee and union member.

So there you have it, I'm writing from the PACU right now, where we're waiting for an appendectomy to close in the OR, I've been here since 8 this morning and no end in sight, a great way to make some extra money and get just a little homework finished on a rainy Sunday in Portland!

Now I'm Sold...

After attending Thursdays seminar on Davis Island, I'm sold on Second Life as an educational tool.

Thanks to Ben's help and patience I was able to find my way to the group, although I got pretty lost at the end of the hour and wandered around looking for my class! Also had difficulty with the volume on my headset, and even turned to low it was apparently too loud so I was hesitant to speak, but was able to hear and see everything just fine. Some of the avatars were pretty amazing, and many appear to be expert users, I however am unable to stop walking backwards!

I was disheartened by James Cooks comments about the waning popularity of SL. My sincere hope is that academia as well as the lay public will continue to find new ways to use the SL experience for education and training. While I still think there's probably a "shady" side to SL, when it's use is controlled and guided as it was in the seminar many can reap the benefits of this amazing technology and environment.

More than any previous class in the Health Informatics program, this class has opened my mind to many new concepts, and that is the real beauty and joy of education (in my humble opinion!).

Second Life in Physician Patient Relationships

In Dr. Yellowlees excellent paper regarding ethical considerations in mental health treatment in virtual environments he notes that the same laws and regulations must apply to the care or interaction, no matter what "environment" the care occurs in.

Dr. Yellowlees also finds there is very little difference clinically between telemedicine practice and virtual world therapy, but I have to say that in my limited time in the Second Life (SL) world I noticed several items that made me ponder that point.

To be "proficient" in SL at an Advanced level, I'm presupposing a long learning curve, which the patient must be able to accomplish. This requires intermediate computer skills at least, which obviously not all patients have. Are these less than intermediate level patients then exempt from therapy in a virtual environment? Telemedicine patients have only to respond to a human voice and image on a screen, an environment that requires minimal skill on the part of the patient as many are familiar with Skype, or certainly at the most basic level, television. Additionally I assume patients would need to be able to download the program, an ostensibly simple task that has caused me hours of frustration and necessitated the help of my hospital’s IT department (and it’s still not 100%, which causes me great consternation and makes me want to seek therapy in any environment I can get to!).

HIPAA considerations are a top priority in any patient interaction, and as Dr. Yellowlees notes in an “unprotected” environment like SL extra precaution must be taken. In my short time in SL I was amazed, impressed and ultimately kind of creeped out by the expertise of the SL residents I chatted with. All manner of acronyms and extremely creative visual images were displayed on the chat screen, using only the tools available on a regular keyboard. If they have the time, desire, and intelligence to format these images, imagine what they could do if they turned their talents to hacking the program and intruding on a private island.

Adding to the creepy factor, all of the avatars dancing in the blues bar I visited were…without clothing! Which led me to wonder… why? My avatar apparently was the only one who found it appropriate to dress for the occasion. I’m not sure but I don’t believe there are restrictions on language use (i.e. profanity), although surely there must a way to report inappropriate users.

All of the above was enough to make me somewhat uneasy with the physician/patient interaction in the environment, even though VOIP is used and no session records are kept in the application. I’m confident my opinion will change if I’m able to hold on to my connection and participate in the seminar tomorrow evening.

Record Sales Predicted for iPhones? Harrrummppph!

While I respect the opinions and choices of all who choose an iPhone or other iProduct as their means of communication or acquiring information, I'm about to blaspheme and admit to all that I will never have an "i" anything, and here's why:

I had $150 of iTunes charged to my debit card by some unknown entity, called the 800 # on the charge which referred me to the iTunes website, which referred me to the 800#. At no time was there ever an option to speak to a human being. Needless to say, I was out $150.

If you have problems with your "i" product you must make an appointment to speak to a (I've heard) usually surly employee at one of their inconveniently located retail sites. Seriously? In this information age we make an appointment and drive to a location to fix our issue?

Let's move on to the quality of sound on an iPhone-which ranges from bad to worse. Many of my friends and family insist on attempting to communicate via these devices. I don't have any hearing issues and have a perfectly serviceable LG Verizon phone that has served me well for four years and I am forced to ask the caller to repeat themselves frequently during the course of a conversation. They can hear me just fine and admit that they have this problem with all calls...an issue they didn't have until they took the plunge and invested in this product (which also requires a paid internet connection to function, purchasing the dreaded iTunes, etc. just to get going).

I could go on but won't bore you any further. The lack of customer service, the expense, and the holy eclectic atmosphere that surrounds this product add to it's non-desirability for me. Sure those apps are fun and I appreciate what they can do for healthcare, but they can be accomplished just as well via a "lower end" droid without all the cachet of an iPhone.

All in my humble opinion of course!!

it remains to be seen...

exactly what we'll use this blog for, but I'll bet Dr. Yellowlees has some thoughts on the subject!

more to follow...