1. Michelle Trepal, RN NURS 457 September 19, 2009
Mobile e-health
Michelle Trepal, RN
NURS 457
September 19, 2009

2. Objectives Describe mobile e-health
Describe and evaluate the hardware and software utilized within mobile e-health
Describe and evaluate the information system used with mobile e-health
Assess the role and functions of the nurse informaticist when working with mobile e-health.
Examine related legal/ethical issues.
Discuss the Advantages/Disadvantages from nursing perspective.

3. Mobile e-health Often termed m-health
Includes health-related uses of mobile technologies
Mobile phones
Internet-enabled, wireless connected smartphones
Personal digital assistants (PDA’s)
Tablet computers
Subnotebook microcomputers
Remote diagnostic monitoring devices
M-health can be described in terms of the application to healthcare systems and processes of network technologies and mobile communications and devices.

4. Mobile phones This technology impacts healthcare by
Remote medical monitoring
Better accessibility to doctor’s
Uploading imaging (
Mobile phones play a really important role in the industry of medicine today. At a very basic level, it is much easier to reach doctors in case of an emergency now that we all have cell phones and there is a wide range of area for mobile phone coverage. At a more complex level, mobile phones are being used to improve medicine in third world countries, increase compliance with taking medications and even to replace standard medical resources such as ultrasound technology or the use of guide dogs for the blind.

5. Personal Digital Assistant (PDA)
Reduce’s medical errors
Patient’s lab values at your fingertips
Charting as you go
Sending prescriptions to pharmacy for patient’s
Can aid in patient-centric healthcare by providing details of patients including clinical histories, lab reports, ongoing and past treatments and so on.

6. Tablet Computers
Touch screen and pen base capability using a stylus, digital pen or fingertip
This is a relatively newer development and carries the same function as a laptop but is equipped with a touch screen and a pen based capability. This enables the user to directly write prescriptions instead of the more tedious process of printing the entire document and later writing on it.

7. Remote diagnostic monitoring devices
Intelligent walkers
Increases patient mobility
Monitor’s blood pressure
Detect’s falls
Wristwatch-monitoring device
Monitor’s pulse & respiration rates
Trigger’s alarm for abnormal readings
These include intelligent walkers, which increase patient mobility, monitor blood pressure, and detect falls.
There is also a wristwatch-monitoring device, which monitors pulse, respiration rates and so on. If any of
the readings are abnormal, this triggers an alarm once the information is transmitted to a central source. A remote-controlled monitoring system has also been developed. This involves installation of a decoder
linked to a television, a miniature camera and broadband transmission of the patient’s data.

8. Information system used within mobile e-health
LAN
Cable
DSL
Wireless LANs

9. Informatics Competencies
Basic computer skills and understanding
Ability to document information electronically
Ability to access information electronically
Search databases
Use software for charting and medications
Ability to use helpful
Main point in successful outcome is: Positive Human Flexibility and Attitude Factor
(McGonigle & Mastrian, 2009)

10. Function of the nurse informaticist
The purpose of nursing informatics is to analyze information requirements:
Design implement and evaluate information systems and data structures that support nursing
identify and apply computer technologies for nursing.
Involve clinical staff from beginning of process
Assess attitudes and concerns
Involve clinical staff in all implementation stages
Make sure systems are user-friendly
Provide adequate training prior to implementation
Provide continued education and support
The use of technology and/or a computer system to collect, store, process, display, retrieve, and communicate timely data and information in and across health care facilities that administer nursing services and resources, manage the delivery of patient and nursing care, link research resources and findings to nursing practice, and apply educational resources to nursing education.

11. Disadvantages Security concerns Lack of consolidation in the mobile
Communications
Expensive systems
Risks involved in investing in unproven technology
Inadequate data transfer speeds
Future research should deepen the understanding of these issues, especially the
organizational and social obstacles, as the technological ability to build functional
systems practically exists already.

12. Advantages Automated alerts E-diagnosis
E-patient safety and error reduction
E-patient monitoring and tracking
E-referencing
E-prescription

13. Ethical and/or Legal Issues
HIPAA: Privacy and Confidentiality
Legal Standards
Interoperability
Ownership
Security Issues: Health records and other personal information are in most countries considered very confidential, and electronic distribution of these raises a number of issues. In the U.S. there is a law known as the Health Insurance Portability and Accountability Act of 1996 (HIPAA) regulating distribution and storage of health related financial information.
(McGonigle & Mastrian, Rehab management, 2009)

14. Summary
The health care sector has a lot to gain from the new mobile technology.
The new mobile terminals enable the professionals to use electronic services more freely, making a breakthrough in electronic health care possible.
The Industry has been slow to adopt the earlier advancements in computing and electronic communications, mainly because the earlier solutions would require the user to sit by a computer terminal, which is not how the health care professionals work. The field of mobile communications is developing rapidly. There are multiple solutions for data transfer, and a number of different mobile terminals. The most likely terminals of choice for professionals are PDAs or similar devices capable of displaying multimodal information and. For the general public the most likely device would be the mobile telephones, since adoption of PDAs seems slow. These devices can connect to a network either by today’s wide-coverage cell phone
networks and wireless local area networks (WLANs) or by infrared connection. The transmission speeds of the mobile networks are constantly increasing while new network technologies are introduced (GPRS, UMTS, a WLAN).

15. References
McGonigle, D., & Mastrian, K., (2009). Nursing Informatics and the Foundation of Knowledge (1st ed.). Jones & Bartlett Publishers, Sudbury, Massachusetts.