Could you please tell us a little bit about yourself and your work pre-COVID-19?
My interest in informatics goes back to my computer and programming classes in high school. I’ve worked as a Registered Nurse for 10 years and have decided to re-engage my interest in data and technology in a way that utilises my clinical knowledge and skills. My curiosity has evolved from attending health informatics conferences to landing a research internship, exploring redundancy in documentation, and diving into postgraduate studies in Health Data Science shortly after. That evolution continues and I’m very excited about where it can take me next!
I’ve gravitated towards digital health in recent years and got involved in projects relating to the use of data in practice. Currently I am working as the Essential Clinical Dataset Coordinator for Sydney Local Health District to rationalise and optimise nursing admission data and to support meaningful documentation for nurses. I am also a Paediatric Intensive Care Nurse at Sydney Children’s Hospitals Network-Westmead, currently working on a study to measure text similarity in our electronic progress notes. I am curious and passionate about how we can use data efficiently, meaningfully, and dynamically for clinical decision making, quality improvement, and research.
In five words or less, what was your reaction when you heard of the restrictions put in place?
Confused, concerned, and challenged.
I’m a healthcare worker so the reaction was centred around how we will face the pandemic. What came to mind often was how do I/we do this without compromising safety, quality, and efficiency despite the largely unfamiliar and rapidly changing circumstances of COVID-19.
How did you overcome the challenges of COVID-19?
It was a great time of uncertainty so communication was definitely key for me. Articulating thoughts and ideas was largely helpful- I always believe in its power to clarify and limit, if not remove, the abstraction of the unknown. I asked questions, had difficult conversations, listened. I observed how people reacted, and framed the challenges as opportunities to help and learn as we all had to step up. Laughter, debrief, and encouragement from colleagues at work were crucial. I also journalled, facetimed with family and friends, enjoyed running more, and took my banana muffins to the next level by baking a flourless version! Essentially, I focused on what can be done, and what I can do to keep moving–work and out.
Did you find many positive aspects/outcomes?
Yes. It’s great to see the dedication and passion of colleagues in the face of adversity and the big unknown. I’ve met and learned from people I otherwise wouldn’t have come across–it’s fascinating how a common goal can bring people together despite varying backgrounds and experiences. Service has many faces–whether it’s through direct patient care, or getting involved with behind the scenes support. That’s what I love about working in healthcare–feedback and results may not be always tangible but you definitely know you’re making a difference. The entire experience was humbling and I learned a lot about people and leadership.
What surprised you about your work during the pandemic?
How older members of our community can feel left out and be put off by the technology. I observed this from both sides of the fence–from colleagues I worked with, and from patients I cared for virtually. Briefing about the new models of care and tools that came with were rapidly done to sustain care delivery. While most were able to follow reasonably well, others struggled despite their wealth of professional experience because the technology wasn’t as intuitive for them. Similarly, patients communicated well but found it challenging to follow the steps to download and use a completely unknown app, as some of them may have never used their phones beyond calling and texting. I realised that while technology can be an enabler of care, it can also be a huge barrier. Though there have been exciting innovations in technology and automation, healthcare thrives on its human capital. Different generations have different strengths and challenges and we should find ways to leverage the expertise of our mentors and older colleagues. They hold valuable contextual knowledge and skills that may never be replaced nor replicated.
If you had to build a health service from scratch knowing what you know now, what would that look like?
Ensure more involvement and consultation with end-users of technologies. COVID-19 fast-tracked innovation and everybody adapted as a reactive response. Now that the world knows more compared to earlier this year, there should be more time to look back and evaluate- learn from what worked or failed, and be honest with what should stay or go, taking quality, sustainability, and usability into account. I’d also dedicate a team for analysing trends and finding insights from data relating to the virtual technologies being deployed. Have them communicate with leadership/executive teams and provide feedback for planning, implementation, and evaluation of the technologies/interventions. Not everybody would have a chance to read a detailed report, so short and sharp but consistent updates of key observations in the data (e.g. patterns, irregularities) and how this relates to the current context would be useful. This could dynamically guide the right questions, ideas, and investigations in rapidly changing situations.
Is there anything that you would like to add?
Now that people have seen and experienced the value of digital health, the momentum should be reinforced with ongoing evaluation. Focus should not be limited to service delivery but should also include the quality of care and the digital footprints made along the way. We now have the advantage of using AI, data science, and machine learning to learn and deploy tools that help us make sense of the vast information around us. Having said that, the true potentials of these technologies can be truly maximised only if we have data of good quality. COVID-19 has demonstrated how important it is to rapidly communicate accurate, relevant, and reliable information. For instance, documentation in the eMR from our frontliners finds meaning beyond one episode of care as information is pulled together for iterative analysis and modelling by experts for population-level recommendations. From the bedside to wider groups such as treating teams, infectious disease experts, government agencies, and researchers, every piece of information has helped experts form the pieces of a dynamic puzzle. Point-of-care documentation goes beyond the here and now of clinical areas–it is the articulation of a health professional’s meaningful contribution to caring for one person and the entire population.
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A very big thank you to Danielle for telling her wonderful story!
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