According to Spyglass Consulting Group research, nurses are spending upwards of 50 percent of their time documenting patient care.

Quoted in an article in the upcoming July print edition of ADVANCE, Spyglass' Managing Director Gregg Malkary said the amount of time nurses spend documenting patient care has increased 250 percent since 2004.

These days, an HIM director is an important part of the management team at any hospital or health system. The CIO has earned his or her place at the executive table, but needs to work closely with other executive leaders throughout the health care enterprise.

The HIM director is more than just an overseer of the medical records. He or she is a bridge between the organization's paper records and its long-term strategy of electronic medical records (EMR). As many hospitals transition from paper-based medical record keeping to electronic information, these two managers (HIM director and CIO) must work together for the betterment of the entire organization.

When the IT department and HIM department work together and maintain mutual respect, the benefits are widespread. Not only is each party more productive, but the organization's IT and information management is better planned, managed and synchronized.

With nearly 30 percent of organizations reporting a fully EMR, perhaps the time has come for HIM (health information services) and IT to work closer together. In fact, many are already doing so.

We want to know how closely the CIO and HIM director are working together. We've created a survey that will provide an industry snapshot of reporting relationships between HIM and IT. With the move to EMRs, are these two departments working closer together, and if so, how has the relationship kept pace with technology?

Take our survey and then come back and comment on the HIM director and CIO relationship at your facility.

I took my daughter to the hospital for some X-rays the other day, registering at the imaging center's front desk, then proceeding to a registration desk to continue the process.

We were at the end of the registration process when the registrar handed me a wireless device to complete the registration and health insurance verification process.

No training, just a hand extended in my direction with a device in it.

The woman said that I needed to verify my insurance information and my daughter's demographic information.

The more screens that I tapped with the stylus, the more difficult the seemingly simple task became. I clicked on a date field and the stylus clicked off September instead of October for my daughter's birth month. The woman helped me scroll backwards on the screen, so I could re-enter the correct month.

I even commented to the woman that I write about technology for a health care IT magazine, but was finding the process difficult.

"Someone wanted it," was her off-handed response.

Is that where we are with technology today? Someone wanted it, so it's implemented? It sounds simple, so I'm guessing that it's more complex than that.

I clicked another field incorrectly and had to get assistance to scroll back to the previous screen. Here I was with a device whose screen was smaller than a legal pad, and I was having difficulty using a stylus.

I couldn't imagine someone trying to use this device for the first time. I wondered how an elderly patient would fare when faced with such a task.

Older patients actually have an easier time of it than us "young folks," the woman said. She must have been laughing inside, thinking that this guy who writes about technology could not grasp the nuances of modern technology. She attributed the elderly patients' adaptation in using the technology more easily because they have to use it in their everyday lives.

That's probably true, because the last time I was at this particular hospital was when my daughter was born 10 years earlier.

So, I came away from this experience with two things to remember as technology is implemented at your hospital: (1) Someone wanted it -- the technology, that is, and (2) it's for the "older folks."

At a news conference June 9 in Harrisburg, Pa., State Rep. John Payne (Dauphin County) and the Pennsylvania Patient Safety Authority announced a pilot project in which 11 hospitals will use a standardized color-coding system for patient wristbands.

The system specifies color-coded wristbands to designate allergies, fall risks, do-not-resuscitate orders, and other critical patient-specific information that physicians and nurses must be aware of at all times.

In 2005, the Patient Safety Authority issued an advisory, based on reports submitted by hospitals, about the potential risks of color-coded wristbands being misinterpreted by health care providers due to the lack of standardization. The advisory led to the pilot project among northeastern and southcentral Pennsylvania hospitals to create a standardized color-coding system.

"[This] event marks the next logical step in the effort to standardize patient wristbands statewide," said Carolyn F. Scanlan, president and CEO of The Hospital & Healthsystem Association of Pennsylvania (HAP). "Following the groundbreaking work of the Patient Safety Authority and the Color of Safety Task Force, we have updated the Pennsylvania Wristband Standardization Project "Banding Together for Patient Safety" toolkit and resources, and we will be providing them to hospitals in the coming weeks. Pennsylvania's hospitals appreciate Representative Payne's efforts to call attention to this important voluntary initiative."

Pennsylvania's hospitals have a long history of implementing quality and patient safety programs to improve care, HAP noted. In recent years, Pennsylvania's hospitals have worked with the Partnership for Patient Care, the Institute for Healthcare Improvement, the Pittsburgh Regional Health Initiative, the Patient Safety Authority, the Pennsylvania Health Care Cost Containment Council, and others to enhance patient safety, reduce errors and prevent infections, the group said.

"Pennsylvania's hospitals are about healing, health and hope," Scanlan said. "This initiative furthers our ability to deliver on that promise."

The thought of interacting with artificial intelligence (AI) is chilling and one I have difficulty grasping.

While I'm fascinated by the work of inventor and futurist Ray Kurzweil and what he has to say about the role AI will play in our society, I'm not so sure it's a place I want to go. Kurzweil says that by 2029 (20 years from now, when I'll be in my mid-60s), sufficient computations to simulate the entire human brain, which he estimates at about 1016 (10 million billion) calculations per second, will cost about a dollar.

"By that time, intelligent machines will combine the subtle and supple skills that humans now excel in (essentially our powers of pattern recognition) with ways in which machines are already superior, such as remembering trillions of facts accurately, searching quickly through vast databases, and downloading skills and knowledge," Kurzweil wrote.

What got me thinking about computers, machines and AI issues? A story that I read this weekend about an AI avatar that interacts in a controlled computer environment.

I wondered about eventual congenial interactions with AI inside a three-dimensional projected world, such as one with virtual subway stations or city streets, and much like the computer-generated world of Liberty City in Grand Theft Auto IV (GTA IV).

What might AI be like if it were introduced in a game such as GTA? It'd be like AI meets GTA, literally with a one-two punch, high-kick and a couple of shotgun blasts for good measure. Do you want to engage in hand-to-hand combat with your AI avatar in a virtual city?

GTA IV, which collected more than $500 million in global receipts after its first week on the market in early May, has sold more than 6 million copies to become the highest grossing entertainment launch in history, according to Reuters. Initial sales topped $300 million for last year's violent "Halo 3" video game from Microsoft. Sales of GTA exceeded Hollywood's film debut of "Pirates of the Caribbean: At World's End," with its share of swashbuckling, high-seas violence; the film garnered more than $406 million in its first six days on the big screen. In the latest GTA escapade, the main character Niko, an avatar, is cast as an Eastern European immigrant who runs drugs, shoots at police officers and kills rivals. Critics hailed the game as a brutal and satirical masterpiece, Reuters reported.

According to published reports, the story features two possible finale scenarios. The player can choose to have Niko get revenge on a character named Dimitri or make a deal with him which looks to spare a life.

If the player chooses to seek revenge, Niko ambushes Dimitri on his ship while he is supervising a delivery. Think about it. In an AI environment, you could fight alongside Niko as he kills Dimitri after a firefight in the hull of the ship. Or, you could participate in a drive-by shooting, killing character Kate McReary outside of a church. Nice touch. Ah, the virtual world is such a pleasant place to exist...

With AI technology, instead of sitting at the game console, you might be able to literally transport inside the game's confines, but without the reality of pain, suffering, punishment or any other ill-effects of battle. Virtual fighting, killing and death could become even more entertaining than it is today.

And don't forget about the kiddies. They too can participate in virtual warfare. Think of a virtual Chronicles of Narnia. (After this weekend's successful showing at the box office, with its share of epic battles, I had to write about it, and I'm sure the video game is already in development.) With AI, you (or your 9-year-old, for that matter) could be in a three-dimensional, computer-generated world charging on horseback, wielding your sword toward King Miraz's army. You could be screaming expletives at King Miraz, the AI, and he might even "kill" you on the battlefield.

Sound interesting?

Maybe it's farfetched, but the thought of an avatar or AI putting an "end" to my life, even if only in cyberspace is chilling.

According to Carestream, the $500,000 in donated medical imaging equipment consists of "three KODAK Point-of-Care computed radiography [CR] systems, including two KODAK Point-of-Care CR-ITX 550 Systems, that integrate a powerful CR reader with a portable X-ray unit to create a self-contained mobile imaging package."

These compact CR systems can be rolled to each patient's bedside to perform imaging exams. Radiographic X-ray images are captured onto re-usable phosphor plates. CR readers download and process the images, which are stored as digital files, and the plates are then used for the next patient, the company reported. These medical images can be reviewed immediately at the site or sent to remote hospitals and other health care facilities via wired or wireless communications. 

The company noted that mobile CR systems offer excellent image quality, rapid image capture and are designed for a wide variety of environments, including temporary medical facilities that are set up to treat patients in disaster areas and battlefields.

Are you aware of similar donations to the China relief effort by companies in the health care IT field?

As the Health Insurance Portability and Accountability Act of 1996 (HIPAA) got in full swing a few years ago, I received several press releases from software vendors or consultants who touted that they were there to help health care organizations with their HIPPA work.

Did you catch that? The letters typed were HIPPA. What does that stand for? Health Insurance Portability and P-Accountability Act? Health Insurance Portability and Portability Act? For those vendors who sent those press releases to me, they ended up in my e-mail trash bin or the circular file under my desk.

I read this interesting story in the Albany Times-Union the other day about a wordsmith Jeff Deck who is making a cross-continent tour to rid the misspellings on billboards, signs and elsewhere in public view.

Here's a sign that Mr. Deck might want to correct. It's posted as an image in Flickr.

Did you spot the typographical error?

Have you seen any other typos or misspellings in your work in health care?

My husband writes for a music Web site, so I was surprised when he informed me that he had just written a post about some very big (or should I say, very tiny) technology news that I had not seen on any of the usual tech sites I peruse.

Researchers at the University of Glasgow have used nanotechnology to exponentially expand chip capacity (and even eliminate the need for silicon) for MP3 players, without increasing the size of the device itself.

"Professor Lee Cronin and Dr. Malcolm Kadodwala's work would see 500,000 gigabytes squeezed onto one square inch. The researchers believe that their development could see the number of transistors per chip rising from today's limit of 200 million to well over one billion," according to a press release on the University's Web site.

"We have been able to assemble a functional nanocluster that incorporates two electron donating groups, and position them precisely 0.32 nm apart so that they can form a totally new type of molecular switching device," said Cronin.
 
 "By taking these nano-scale clusters, just a nanometer in size, and placing them onto a gold or carbon, we can control the switching ability. Not only is this a new type of switchable molecule, but by grafting the molecule onto metal (gold) or carbon means that we can potentially bridge the gap between traditional semiconductor devices and components for nanoscale plastic electronics."

The research is published in the April issue of Nature Nanotechnology. I'm betting that chip makers and medical device manufacturers will be very interested in learning more about this ground-breaking research. While the research focuses on MP3 players, the implications of the knowledge gained could have a tremendous impact on the future of medical information storage.

I remember not too long ago when observing Earth Day usually meant one day of planting a couple seeds, maybe eating lunch outside and paying a little closer attention to lights being left on. Similar to how some react to all the good cheer surrounding Christmas by wondering why people can't be as warm and generous all year, I sometimes wished that the extra attention could last longer than 24 hours. That's not to suggest I'm Captain Planet or anything. I certainly have my bad habits and can't quite afford a hybrid vehicle yet, but I try to be mindful.

For whatever reason, either an increased concern over global warming or a recognized financial value in conservation, energy consumption and output has become a full-time topic in almost every industry, including politics, business, technology and health care. Consumer products such as light bulbs are constantly improved, environmental policy is a major presidential platform and businesses seek to reduce their footprints. As more leadership emerges from all sectors, people can become more optimistic that the planet can be saved.

Chest compressions alone, or hands-only cardiopulmonary resuscitation (CPR), can save lives and can be used to help an adult who suddenly collapses, according to a new American Heart Association scientific statement. The statement, from the association's Emergency Cardiovascular Care committee, is published in Circulation: Journal of the American Heart Association.

Hands-only CPR consists of hard, rapid chest compressions in the middle of the victim's chest, until emergency medical responders arrive. The method can be used by people not trained in conventional CPR or those who are unsure of their ability to give the combination of chest compressions and mouth-to-mouth breathing it requires. I would imagine that hands-only CPR is also attractive to people who worry about catching a communicable disease from a stranger who collapses in their vicinity.

The new recommendation is an update to the 2005 American Heart Association Guidelines for CPR and ECC, which puts hands-only CPR on par with conventional CPR when used for an adult who has suddenly collapsed. The change was supported by evidence published from three separate, large-scale studies in 2007, each describing the outcomes of hundreds of instances of bystanders performing CPR on cardiac arrest victims.

Perhaps the new guideline will encourage people who previously would've been too scared to attempt CPR to provide life-saving compressions in an emergency situation. The result could be more patients making it into your ERs with hope for revival.

"Anyone who has filed their taxes this way and has their personally identifiable information stored unprotected in their computer is vulnerable to the ever-growing threat of electronic identity theft," noted a statement issued today by Identity Finder, a maker of software that prevents identity theft.

Identity Finder cited a recent Associated Press report that stated, "Fraudulent tax returns filed as a result of identity theft jumped more than six-fold over the past five years." 

The company provided the following list of tips to prevent identity theft post-April 15.

1) When storing a copy of your tax return on your computer, make sure you secure it with a password so that your Social Security Number cannot be read if the file is lost.

2) Securely delete all electronic, financial documents used to prepare your tax returns so any personal information is safe.

3) Ignore all refund/ rebate/ warning e-mails claiming to come from the IRS and never click on links within those e-mails (most likely a phishing attack).

4) Do not provide personal information to anyone calling you claiming to be from the IRS; the IRS already has your information and the caller is likely to be an identity thief.

5) Check your credit report with one of the three credit bureaus for free every four months to make sure your identity hasn't already been stolen.

6) Install the latest updates to your operating system so known Windows or Mac vulnerabilities can't be exploited by hackers.

7) Don't save your password in your Web browser when accessing banks and other institutions that keep your personal information because it could be leaked if you ever get a virus, Trojan, or are hacked.

8) If you provided your bank account and routing information to the IRS for payment or refunds, check your bank accounts to ensure the proper transfer occurred. 

9) Visit your bank account online and set up alerts on your accounts to monitor when high amounts of cash are withdrawn.

10) Make sure you do not receive incorrect payment liability or refund information; a thief could have filed a tax return on your behalf fraudulently. If you suspect tax preparation fraud, call your state tax department toll-free at 1-888-675-9437.

So here's the deal, I work in a creative environment, but I have to disagree with the recent announcement that viewing Apple's logo makes one more creative than IBM's logo does.

Come on, they're just logos. They're nothing but a company's brand. I like Merion Publications' logo better than the two I stared at the other day (Apple and IBM). If you open a copy of your recent print issue of ADVANCE for Health Information Executives, you will see our logo at the bottom of page 4, next to the words "Merion Publications, Inc." It kind of looks like a tree with branches. What do you see? Does our logo make you more creative?

I used to work for a workers' compensation administrator in Valley Forge, Pa. Rumor had it that the company's logo was designed by the CEO's daughter on a spirograph toy one sunny summer afternoon.

Last month, researchers at Duke University's Fuqua School of Business and Canada's University of Waterloo announced results of a study that determined that Apple's logo can make you more creative than IBM's logo can.

Professors Gavan J. Fitzsimons and Tanya L. Chartrand at Duke examined whether brand exposure elicits automatic behavioral effects as does exposure to social primes. Results from the research supposedly support the translation of these effects. Participants in the research showed more creative behavior after viewing the Apple rainbow logo than the IBM logo, after just 30 milliseconds of exposure. Also, participants in the research study who looked at Disney's branding and logo were more honest than when they viewed E! logo.

The hypothesis for the professor's research was that exposure to goal-relevant brands (i.e., representing a positive value characteristic) elicits behaviors that are goal-directed in nature.

According to a report in InformationWeek, the findings may stir up the debate about subliminal advertising, something that until recently was viewed as nothing more than a hoax.

Professor Chartrand told the technology magazine that, "what we found is that people who were subliminally primed to the Apple logo were more creative than people who had been subliminally primed to the IBM logo. The Apple logo was the old rainbow logo, not the current logo.

I have to tell you, I stared at the IBM and Apple logos, and I like IBM's better. I like how the lines run through the letters I, B and M. I was drawn to the IBM logo. I immediately thought of Big Blue, and felt like the company IBM had a strong corporate entity, because of its logo. In contrast, Apple's earlier rainbow logo made me feel like I wanted to kick back and take the rest of the afternoon off.

Do you feel more creative after looking at Apple's rainbow logo than after looking at IBM's logo? What about Merion Publications logo? Does ours make you feel more creative?

Take a look at them and tell me what you think.

The bad news is that nearly 6,000 people died while waiting for a transplant last year, according to the United Network for Organ Sharing (UNOS).

Donate Life America and UNOS are using the month of April to educate Americans about the number of lives that could be saved and improved through organ, eye and tissue transplants.

According to Donate Life America, each day in the U.S., about 79 organ transplants take place while an average of 132 people are added to the nation's organ transplant waiting list.

The number of patients on the U.S. waiting list for organ transplants reached a record high of 97,670 as of Dec. 31, 2007. In comparison, 80,790 patients were on the waiting list as of Dec. 31, 2002. And 53,167 patients were on the waiting list as of Dec. 31, 1997. That's an increase of nearly 84 percent in 10 years.

UNOS reported that the longest organ-specific waiting list is for kidney donations, with more than 75,000 people currently waiting for an organ transplant.

So please note that April is a special month for encouraging donation signup. Many states provide simple methods for designating organ donation on drivers' licenses or state identification cards. Donate Life America offers a directory with details by state online at http://www.donatelife.net.

"State donor registries play an essential role in the donation process by enabling an individual to make a decision that gives procurement agencies full authority to procure their organs and/or tissues upon their death," said Sara Pace Jones, Donate Life America chairman. "These legally binding donation decisions are critical for the nearly 100,000 people who are on the National Waiting List for organ transplants and the many more awaiting cornea and tissue transplants to restore their lives and health."

One misconception about organ transplants is that most recipients survive only a few years. According to Donate Life America, long-term survival is becoming more common. For example, a number of kidney recipients are living 30 years or longer after transplant. Recipients of other organs have survived more than 20 years after transplant.

You may have missed the celebration this week, but 50 years ago then-President Dwight D. Eisenhower created the Defense Advanced Research Projects Agency (DARPA) in response to Russia's surprise launch of the first man-made satellite, Sputnik. At the time, President Eisenhower's guidance was clear: Find and quickly develop advanced technologies for the Armed Forces so that the United States would never again suffer a technological surprise from another nation.

While a Russian threat is not prevalent today, DARPA continues its work with advanced technologies and systems that give advantages to the U.S. military, according to the American Forces Press Service.

When first formed, DARPA made no reference to "defense" in its name, focusing instead on accelerating the development of the space program. DARPA concentrated on space projects and developed the Saturn V rocket, which launched the United States' Apollo mission to the moon and created the first surveillance satellites for intelligence-gathering on Russia's missile program and activities.

In addition to its military work, DARPA formed an entity, ARPANET, which led to today's Internet. The system began by interconnecting computers at four university research centers in the 1960s. By 1972, the number of computers had grown to 37. Now there are more than 1 billion computers connected to the Internet, according to DARPA's Web site.

DARPA changed the face of warfare, as well, by developing stealth aircraft, advanced precision munitions and the Predator and Global Hawk unmanned aircraft.

A conference held last week at the Washington Hilton in Washington, D.C., included presentations by Anthony J. Tether, the agency's director since 2001.

Do you think we are better off for having DARPA? I look forward to your thoughts.

"Nurses who work at night are four more times likely to experience a drowsy-driving episode," said Linda Scott, director of Grand Valley State University's nursing program. "In addition, the risk of crashes almost doubles for drivers working night shifts that exceed 12.5 hours in length."

According to ASRN, there are two main causes of drowsy driving:

1) Sleep restriction. Persons getting less than the recommended seven-to-eight hours of sleep each night are more likely to feel tired the following day, which can ultimately affect their cognizance behind the wheel. Not getting enough sleep on a consistent basis can create "sleep debt" and lead to chronic sleepiness over time.

While some factors, including working at a job that requires long hours and familial responsibilities, are beyond a person's control, other reasons for sleep restriction represent lifestyle choices. This includes sleeping less to have more time to work, study, socialize or participate in other activities.

2) Sleep fragmentation, which causes an inadequate amount of sleep and can negatively affect a person's functioning during the daytime. Sleep fragmentation can have internal and external causes. The primary internal cause is sickness, including untreated sleep disorders. External factors that can prevent a person's ability to have a full, refreshing night of sleep include noise, children, bright lights and a restless bed partner.

Eight to nine hours of sleep is optimal and sufficient sleep benefits alertness, memory and problem-solving, and overall health, the ASRN report noted. Sufficient sleep also reduces the risk of accidents, according to the National Sleep Foundation. A 2003 study performed at the University Of Pennsylvania School Of Medicine demonstrated that cognitive performance declines with fewer than eight hours of sleep.

For nurses who work mandatory overtime, double shifts or simply do not get off until after midnight or sometimes morning, it is nearly impossible to ensure seven to eight hours of sleep.

Nationwide, drowsy driving is the direct cause of approximately 100,000 police-reported crashes annually, resulting in an estimated 1,550 deaths, 71,000 injuries and $12.5 billion in monetary losses, according to the National Highway Traffic Safety Administration.

So how can nurses avoid drowsy driving? Post your comments here, or visit the HIT Insider Forum for a list of suggestions and further discussion.