I keep telling everyone – I’m too darn old for this stuff! My brain agrees, my bod agrees … my poor tired memory agrees … but my kids and my friends are completely without sympathy, and keep telling me: “Aw Moofie, you can do it!”

Sometimes, I’m not so sure …

I just finished a course that taught me more about computers than I ever wanted to know … and it was so complicated for my poor little brain that I’m starting it over from scratch now that it’s over, with my in house expert, Dougie, as my professor. I got a decent grade in the course, and won’t need to repeat it as far as school is concerned – but I know how much I’ve actually retained of what I was taught. Liquids – I retain … computer trivia – I don’t! I need to figure out a way to do that in reverse! ;o)

Seriously though, that last course was like something out of a bad dream. The online “autograders” would mark our quizzes wrong, even when we cut/pasted the information directly from our notes. There was a problem with the course design, and because of the hue and cry we raised in the classroom, DeVry is going to revamp the course before they give it again. It was hard enough already without marking our right answers wrong!

About half way through the 3 1/2 hour final, I knew I wasn’t going to get the high score I’d gotten on all of other courses up until then. I had that sinking feeling … there were things on there I know I’d never seen before …

Our professor, good hearted as he is, knowing that the course had some serious issues, graded the final on a curve. I came out of the course with a decent grade, and to my amazement, would have even if he hadn’t graded on a curve. The reason –> I take really good notes!

This session, we’re having Logic and Design. Much easier … as you can see, since I have more time to blog. It’s a pre-programming course, intended to teach us to design pretty, accurate flow charts, and write nice, clean, logical computer code. Each week, the course includes two live lectures, completing and passing in a multi-sectioned lab, reading and studying the assignments in our text book, reading and studying a written “lecture,” posting to our two classroom subject threads at least three times during the week, and taking a quiz on the material we’ve learned before the week is over. I don’t expect a lot of trouble from this course. It’s actually leaving me time to catch my breath. The last course didn’t leave me enough hours in a week to do much besides study … even though I was using voice recognition software to help with my notes.

So, what’s next? Maybe my grandsons and I will get to sit side by side, and do our homework together? I’ve seen stranger! The son I homeschooled is now homeschooling me! Today we reviewed SATA drives, various types of cables and ports, and the raison d’être behind all of those prickly pin connectors sticking out of a nice new motherboard … and put a Grub bootloader onto my Linux machine. I was a grateful, if somewhat slow, student …

Maybe it’s like a second childhood … I’m getting the chance to actually go to school all over again as I regress back into my infancy. You’d think I might have been able to skip that part, eh? Dig right into the candy bowl, grab a jump rope, and run outside to play! Nope, not for me! I’m going to go from Connectivity with Lab to Dick and Jane … and from there into diapers …

Tomorrow morning, I meet with my Red Hat ladies. I’ve only seen them once since last June, so it will be a happy get together for me. We’ll sit and dine together, laugh and be silly like a bunch of little girls on a school outing. We’ll all pretend that none of us see the extra white hair, the deeper wrinkles … the hand that shakes just a bit more than it did last time. We’ll mention those who are absent due to illness in hushed tones, never daring to wonder aloud if they’ll ever grace our meetings again …

… And then I’ll come home, pull out my lap top, and go to my class room. I’ll read about IF statements and WHILE loops, do my homework and study for my quizzes, and I’ll discuss the concerns of youth with my classmates.

What different worlds! Is it truly possible to belong to both? I wonder if I’ll ever find out …

The first time I ever saw my nephrologist, he told me: “No potato chips!” He also told me a lot of other “No’s!” Like – “No Chinese food!” … “No more than 12 ozs of coffee!” … “No … ” well, you get the idea!

Of course … I was always very careful to pay close attention to everything I was told. *cough* Until recently, that is …

Lately, I’ve been gobbling chips like there’s no tomorrow! (Actually, if I really were, that would be more likely than I’d like to consider! *LOL*) I’ve been crunching down info on BIOS chips, CMOS chips, North Bridge Chips and South Bridge Chips … CPU chips … and all of their little buddies, too – like IDEs, SCSIs, SATAs … PCIs and ISAs … and I’ve even had to learn about pins and volts and amps and … *pant pant* …

Well, to say the least, I’m far more knowledgeable about the difference in one type of chips (BBQ, Salt and Vinegar, Dill, Sour Cream and Onion, Ranch … *drool*) than and I am about BIOS and CMOS …

I remember when I took my first purely HIT course, and I had to memorize all of the acronyms – from HIPAA to AHIMA to AMRA and the AAMRL … I thought that I’d never seen so darn many acronyms! Little did I know! I now know that the CPU can have an L1, L2 and even L3 cache onboard – or discrete, and that it can reside on an AT or an ATX form factor, which comes complete with ISA slots (if it’s old) and PCI and USB ports if it’s new! Not only that, it also has IDE, SATA and/or SCSI connectors …

… if I have to get any more deeply involved in this, I’m going to have to get a six pack of THIS to go with my CHIPS!

Seriously though … I’m really enjoying this course. When I first looked at the text book and saw how technical it gets, I panicked … but as it turns out, it’s actually beginning to sink in, and is far more interesting than I expected it would be. My only idea was getting to Medical Informatics – by whatever route necessary … even if it meant meandering through ‘Puter Anatomy 101. Now I’m beginning to think that I’m actually going to enjoy the trip itself.

The only downside is that this isn’t coming intuitively for me. The anatomy, medical terminology … psych … and even a great deal of the HIT specific stuff (records, etc.,) was relatively simple. Much of it was a repeat of things I’d learned years ago. But this intensive computer system information is not intuitive for me. I’m having to apply myself to my studies in ways I’ve never done before! (Ack! Did I admit that out loud??? *blink!*) I’m going to be able to do this, but it’s going to take some serious time and attention.

I’m not going to stop blogging … but I’m going to have to stick to week ends until I’m more familiar with my course material. When I no longer have to struggle with what CMOS stands for … (Complementary Metal Oxide Semiconductor, by the way) … you’ll see me in here and on your blogs more often. This is some pretty hairy stuff for an old lady like me … I’m trying to wrap my menopausal, short-circuiting brain around circuit boards and DIMM memory chips … and all I’m coming up with is a DIMMer brain with barely any memory at all! ;o)

So please bear with me! I’m not gone! I’ve just been KIDNAPPED by a ROM chip and I can find my way to the I/O port!

Well, this is it! I have to make posts on two of my classroom threads, and take a final this coming week, and then I’m all done until January 8th!

Earlier today, I finished the second large personal project required by the class I’m taking. I intend to look it over again tomorrow, and then pass it in. I’ll try to do my material review on Monday – and take my final on Tuesday, so that I can spend the rest of the week doing Christmas things. I haven’t done a single bit of Christmas anything yet. We will have our annual Reveillon on Christmas Eve … and we haven’t even begun planning our menu.

I intend to take photos and share our reveillon with all of you. I also hope to get caught up on my blogging and blogruns before the New Year! ;o)

I bet you’ve all got me beat when it comes to getting ready for Christmas … anyone feel like decorating my tree? *innocent blink*

Read more about Reveillon on Wikipedia

Although I’m sure it must seem that way, I’m not playing hide-and-seek, honest! I thought I would write a post and let you know what has been going on, before you all give up on me.

Less than a month ago, we moved home from camp. The weekend that we moved home, I had a final to take in my Health Information Processes class, and a new class to begin – Advanced PC Applications with Lab. The first week of the course, we were told that we had until this Sunday (Nov. 26) to complete a rather involved project in Excel. We also had something I haven’t had to deal with up until now – live online classes two nights per week. I chose my project theme, received permission to use it, and tackled it with enthusiasm. The graphic you see on this post is the graphic I designed for enhancing the Documentation sheet. I chose “Dietary Values for the Renally Impaired.” I worked on it every available minute, and I’m ready to pass in my “chef d’Å“vre” tomorrow.

Meanwhile, I had to the get the house up to speed for Thanksgiving – not an easy task. As it turned out, my son Dougie and I worked feverishly the last week before Thanksgiving trying to finish unpacking and cleaning. We made it – by a squeak! We had a quiet Thanksgiving celebration this year – only 7 of us. My daughter, son-in-law, and grandbabies were not with us, and neither were Daein and Sarah. They were all missed!

Those were the major things. Concurrently … there were (are) other goings-on …

Dougie has accepted a job, and is working with a fellow from church … so it looks as if I’ve lost my chef. I guess my poor husband is going to have to put up with my cooking again … ;o)

Daein has been job hunting since he got out of college, and may be signing on with an Israeli company which could use his Molecular Biology skills … it would involve a lot of travel. We’ll see if he goes with that one or not …

I’ve been staying in touch with my dear friend, Dr. Engel … who is recovering from his stroke. He’s making great strides, although I’m not sure that he realizes how much better he’s doing. He’s had a nightmarish few months. I hope that he comes back to his blogging soon.

And for myself – I still can’t believe I actually did this – but this past Tuesday, I changed my major. The two consecutive classes, which I took just before the class I’m taking now, were my first two “HIT specific” classes – all of the other classes had either been “Gen Eds,” or courses which support the major (medical terminology, anatomy, etc.) … so I finally got a good taste of what HIT’s do on a day by day basis. It caused me to realize that, although Health Information Technology is a health informatics course, it’s not what I’m looking for. A degree in this course would have sent me into the back room of some hospital or other medical facility, where I would have scrutinized patient’s charts for errors and omissions, entered diagnostic and procedure codes for insurance companies, and gone slowly, but surely, mad. This wasn’t what I thought I was buying into.

After speaking with a course advisor last Tuesday, I was directed toward CIS – Computer Information Systems. Once I have a BS in CIS, I can take a certificate course for Medical Informatics, and arrive at my destination in that manner. Roundabout – but at least, going this route, I will get there! Once the course I’m taking at the moment is over, I’ll begin with “Architecture and Operating Systems with Lab.” This course delves into the workings of Windows, Unix and Linux. I guess I have a bit to learn, because in my mind, Unix and Linux are basically the same systems …

And now, home from camp, the initial unpacking and cleaning for the holidays over and done with, settling into my new major, kids starting new jobs … it looks as if I’m just about ready to settle back into my regular blogging schedule.

And how have all of you been??? :o)

One of my required courses for HIT is “Health Services and Information Systems.” This week, we’re going to be engaging in a discussion on “current trends in the development of health information systems.” Our professor introduced the subject with a question: “What is CPOE and why do you think it has become such a growing trend?”

For those who aren’t familiar with the acronym CPOE, it stands for “Computerized Physician Order Entry,” and claims to be able to reduce the incidence of serious medication errors by over 50%. This calls to mind similar claims made by the proponents of “Computerized Patient Records,” for example:

“Computerized patient record systems can help improve the quality of care provided, for example, by providing real-time patient status reports, test results as soon as they are available, and graphs and flowsheets of test trends. They can help reduce costs by eliminating many manual functions and the supply and staff expenses associated with these functions. Finally, they can provide practices the data necessary to attract and negotiate favorable managed care contracts.”

From: Computerized patient records benefit physician offices

Since the term “CPOE” isn’t mentioned anywhere in our text or lectures, I decided to Google it. I was able to come up with quite a bit of information. One particular web site, The Commonwealth Fund, which describes itself as “A private foundation working toward a high performance Health System.” had an article entitled: “Overcoming Barriers to CPOE.”

Following is how they described the “barriers:”

Barriers and Strategies to Overcome Them

Physician and organizational resistance was one of the top barriers cited in the interviews. Physicians seemed to believe that CPOE systems would create more work and that the traditional paper-based ordering method was faster. Some hospitals abandoned implementation plans, fearing that physician resistance could escalate to a point of “physician rebellion.” The interviewers also noted low levels of computer literacy among some physicians and a lack of user involvement in implementation processes. [...] (emphasis mine)

From: Overcoming Barriers to CPOE

To their credit, after they proposed “Involving younger, computer-savvy physicians in the implementation process” as a stragegy to overcome the barriers, they also metioned cost, and the immaturity of the systems themselves.

An earlier article in “ACP Online” entitled “Doctors are the main barrier to computerizing records” states: “the primary barrier to adopting EMR technology [...] is physician resistance.”

I find this a bit odd, since most of the physicians I know are computer savvy, and some, like Dr. Bob, have even written their own EMR software … and Dr. Greg P. from Information is Free even builds/rebuilds his lap top!

So then, what’s the problem? Is it as The Commonwealth Fund intimates … that much of the resistance is due to older, technologically challenged physicians? I’m not sure I fully buy that. Without too much effort, I can think of three retired physicians who are computer savvy enough to blog: Dr. Hans Engel of “In a Doc’s Mind,” Dr. James Gaulte from Retired Doc’s Thoughts, and Dr. Maurice Bernstein from the Bioethics Discussion Blog. Perhaps these are rare individuals, but I’m certain that if I applied myself a bit, I wouldn’t be too hard put to find other such “rare individuals.”

So … what is it, really?

Sometime in the not too distant future, I hope to work on writing and implementing biomedical databases. Although many of my fellow students will probably settle comfortably into an HIT transcriptionist’s job, that’s not where I intend to go. I’d like to know why you would, or would not, choose to use electronic media, such as EMR’s and CPOE’s in your own practice. If you don’t use them now, what would cause you to consider upgrading? If you do use them, are you satisfied with them? Why or why not?

Your opinions and ideas will be passed on to my fellow students, and we can carry the information with us when we enter our respective Health Informatics fields. Who knows how far your voice could carry?