Kathy Johnson, R.N., M.S., Project HealthDesign Ph.D. Candidate in Nursing, University of Wisconsin-Madison
The American Medical Informatics Association (AMIA) recently held its fall symposium in Washington, D.C. This was the fifth symposium I’ve attended as a nursing doctoral student. The past five years have seen significant changes in symposium foci. This year, meaningful use, the amazing power of Watson, and the impending volume of patient-sourced data were major topics. In fact, during his keynote address, NIH Director Frances Collins, M.D., Ph.D., noted that the amount of data coming from patients directly will soon far outweigh clinically generated data. This year, it was very clear to me that this expanding horizon of patient-sourced data brings new opportunities for nurses and greater recognition of their role in patient care.
Seasoned nurses will remember “SOAP” charting: documentation of the subjective (S-patient reports and complaints), objective (O – clinical measurements at time of presentation) elements of the patient’s presentation, followed by a nursing assessment (A) and plan (P). Nursing informaticists have developed standard nursing terminologies and languages and demonstrated their key role in telehealth. Today’s technologies, particularly mobile health applications and their integration with a patient’s health and health care, demonstrate that there is a key role for nurses in this frontier.
Nurses know that the patient experience of health and illness that occurs outside of the clinical visit is essential to understanding the patient. In the past, documenting the patient reports, the “S”, has been limited by what our medical knowledge tries to read into a patient subjective report. The current Project HealthDesign teams’ work expands both what subjective experiences are (S) and how they can be measured (O). The inclusion of patient-sourced data into the EHR or, at minimum, clinical conversation, validates the patient’s participation in their care.
In my view, over the past five years, the AMIA symposiums have showcased an amazingly fast progression of technology and computing power. These advancements have moved from biomedical ontologies, imaging capabilities, and genomic mapping to solid advancements that have a tangible influence on the way patients can manage their own health.