So what does the Future of Food have to do with informatics? So many times I find myself in the odd position of explaining why I am present at something that does not have informatics or health IT in the name. Frequently, I have to dig a bit to explain the relevance of nutrition informatics (defined by the Academy as the “intersection of information, nutrition and technology”. Although it’s been a full year since I attended the first event at Washington Post Live, hosted by Editor Mary Jordan, this time around the relevance of informatics was so easy. The Academy continues to sponsor this event, which serves as a real-life “mash-up” of everyone involved in food and hunger; Secretary of Agriculture Tom Vilsack—a favorite of many-- rounded out the morning.

Now back to the informatics thread.

• When registering for the event, participants were encouraged to donate via a “virtual food drive”for the Capital Area Food Bank.
• @PostLive Twitter followers and hashtag: #thinkfood, as always shared so many new points.
• Per Secretary Vilsack: Vilsack: “In the next 40 yrs we have to have the same level of productivity innovation as we had in the previous 10,000 yrs.” This kind of statistic comes from analysis of “big data” across multiple sources.
• Check out the Midwest Dairy Association’s Infographic!
• Multiple discussions on the use of technology to evaluate soil and determine how many plants should be planted as the machine is planting them, robots to milk cows, and determine how the milk should be collected.
• And of course, the usual—Facebook “like” options.
• The event was—true to it’s name—streaming “live”and highlights are available afterwards on the website.
• And finally, a quote from Grocery Manufacturer’s Association Executive Vice President, Government Affairs, Louis
  Finkle: “People look less and less to labels and more to smart phones and tablets.”

Who knew? Informatics is everywhere!

The U.S.
Department of Health and Human Services (HHS) Office for Civil Rights (OCR) has developed an array of new tools to educate consumers and health care providers about the Health Insurance Portability and Accountability Act (HIPAA) Privacy and Security Rules. 

For Patients/Consumers:

Seven consumer-facing videos are available on the HHS OCR
YouTube Channel at http://www.youtube.com/user/USGovHHSOCR.

Fact sheets (available in eight languages) on the HIPAA Privacy
Rule:  http://www.hhs.gov/ocr/privacy/hipaa/understanding/consumers. 

For Health Care Providers: (Continuing Education credit
available)

OCR has also launched three modules for health care providers on compliance with various aspects of the HIPAA Privacy and Security Rules, available at Medscape.org:

1.   Patient Privacy: A Guide for Providers

http://www.medscape.org/viewarticle/781892?src=ocr2 

2. HIPAA and You: Building a Culture of Compliance

http://www.medscape.org/viewarticle/762170?src=ocr2 

3.  Examining Compliance with the HIPAA Privacy Rule

http://www.medscape.org/viewarticle/763251?src=ocr2

 The fourth offering of the AMIA/Academy 10x10 Informatics Education Program (with a focus on nutrition informatics)
begins on May 8, 2013, provides 54.5 CPEU and costs $2,195.  This online
program culminates with an “In Person” session on October 19, 2013 at FNCE in
Houston Texas.  Registration: http://www.amia.org/education/academic-and-training-programs/10x10-academy-nutrition-and-dietetics 

For questions, contact: Lindsey Hoggle at lhoggle@eatright.org. 

Partial scholarships are available for those who will be taking the AMIA/Academy 10x10 Course in Informatics –with a focus on
nutrition.  Complete the scholarship application by April 19, 2013: http://www.surveymonkey.com/s/9R9HKDV

Post by Cathy Welsh MS, RD
If you are documenting in the electronic medical record (EMR), chances are your information is stored, not directly, but in a land far, far away! More and more businesses are deciding to hire other companies to buy equipment and host applications, such as your EMR, over the Internet. I am most familiar with the software vendor, Cerner®, so let me explain “remote hosting” by quoting from its Web site.

• Predictability—service level, budget, and resources
• Operations excellence—client productivity
• Disaster recovery prevention and protection
• Client focus on core business of providing quality health care
• Affordability

Because of the sensitivity of private health care information and the need to avoid downtime, more and more facilities are considering remote-hosting options. Is this process truly “transparent” to you? Or if your EMR is remote hosted, does this affect you every day?

In this scenario, when you use an EMR program such as Cerner’s PowerChart®, you are likely to use a program like CITRIX®. CITRIX makes software products that companies use to make sure that they can keep their information secure and control which applications users can access.

Here are some tips on how to work in a remote-hosting environment.

Passwords

Your passwords will change every 3–6 months. Come up with a system to help keep it easier to remember your passwords, so you do not write them down. I use a word and then add a string of numbers at the end, which I increment each time my password changes. I also select passwords by first typing a series of numbers and letters that are easy on the fingers. Considering the number of times you will enter these keystrokes, it is something to consider!

Lost Work

The EMR is a dynamic system. When you log on to the EMR to do your work, my advice is to start your documentation, finish it, and then log off the system. Many things are going on in the system when you are doing your work. Other users may look at the same chart you are using. Sometimes software upgrades are running in the background. Many people have complained that they have lost their work when they stepped away from their computer. Do not let this happen to you.

Monday morning blues

Everyone jumps on the system first thing Monday morning, so realize that speed may remain slow for a while first thing on Mondays.

Smart Searching

Learn how to search smart. Even a few people running searches for a wide range of data from a long time ago really can impact the system. I once got a call from a medical student looking for documentation from 2008. I recommended that he go to Medical Records, because the kind of charting he was looking for was still on paper. In other words, do not become a “resource hog” (someone who uses more system resources than necessary).

Learn how to use flow sheets and filters, so that your searches are more direct, allowing you to pinpoint the information that you need. As the EMR matures and more and more data is input hourly, this will become even more important.

Access from anywhere

Depending on your facility, you may even have the ability to access the EMR from your home computer. This is a real benefit if you are on call over the weekend. Ask your Information Technology Department if you qualify for a device or if you can get added to the list of users who can have home access.

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Submitted by Jan Greer-Carney, MS, MBA, RD, LD

The Nutrition Care Process is a wonderful tool for nutrition professionals. It allows us to organize our assessment, nutrition diagnosis, intervention, and monitoring/evaluation in a standardized fashion. If this information is entered into the electronic health record as structured data, then we can mine our data and begin to show the value of our interventions. This can only mean greater respect for our field, which will hopefully translate into better salaries too. It is a shame that it is not such a simple process.

A nutrition module is not included in the electronic health record package, so we get to design our own nutrition documentation screens. That sounds kind of nice, like we will actually get what we want, rather than what someone thinks we want (even though the designer does not even know what we do).

However, the reality is that we each create a documentation process that the system we are using allows us to create. We enter our data, checking the appropriate boxes and free-texting information without a desired box. When we go to look at the charted information, it looks nothing like what we think we entered. It is easy to see why the provider does not read our notes.

Oh, for the day when we get a nutrition documentation process that is standardized, one that results in charted information that is actually meaningful. Then we can appreciate meaningful use!

By now, many members realize the non-profit relationship with the Healthcare Information Management and Systems Society (HIMSS)—perhaps most recently from the HIMSS/Academy Nutrition Informatics Town Hall Series (you can still register for the third and final in the series: Meaningful Use in Action: Exploring the Possibilities of Nutrition Informatics)

This year, we have multiple dietitians in attendance at the HIMSS 2013 Conference in New Orleans (NO), La. For the more than 35,000 in attendance, they can participate in multiple nutrition related sessions. These include one on the TIGER (Technology Information Guiding Education Reform) Initiative, one with the Academy’s Chief Science Officer on Malnutritionand an open discussion on digital nutrition. Why does this matter? Because we need open, transparent discussions on how and what to document with digital nutrition data to improve health care.

So this is likely a most impressive aspect of HIMSS2013? Absolutely! However, what renewed me most was the story of New Orleans Mayor Mitchell Landrieu, who provided real numbers of improved education, improved healthcare, rebuilding and revitalization in the city since Hurricane Katrina devastated NO in 2005. While “advocacy” for nutrition is at times challenging, his story was what I needed--that perseverance in difficult times, can be overcome and indeed can make you better, stronger and more positive. It was worth the trip on day one.

Submitted by Amy Buehrle Light, RD, LDN: I have been aware of HL7 (Health Level 7) for 20 years or so, having worked with nutrition and food-service management systems that use HL7 standards to interface to electronic health records. During the past couple of years, I have learned much more about it while serving on the Academy of Nutrition and Dietetics’ Nutrition Informatics Subcommittee for Interoperability and Standards. But only now, as I finish up my first HL7 Working Group meeting, can I say that “I’ve drunk the HL7 Kool-Aid.”

A quick introduction to HL7

HL7 is an international organization (55 countries and growing) that develops consensus-driven standards for how to exchange data in health care. If two or more electronic health systems “talk to” each other, HL7 is the likely standard or format used to share data.

Why should RDs care about what HL7 is doing?

HL7 is the gold standard for how health care data is handled, including data that we enter and use to care for our patients. Diet orders, supplements, allergies, snacks, preferences, nutrition consults, care plans, quality measures, and transition of care documents are all affected by HL7.

Hard work is paying off

Thanks to a core group of very determined and hard-working informatics RDs that have gone before me, along with the support of the Academy, we are making significant inroads in shaping HL7 standards. As I have witnessed this week, this has not gone unnoticed in the HL7 community. It is very amazing to sit side by side with health professionals and information technology specialists from Australia, the UK, Canada, the Netherlands, and many other countries to sort out the best way to share nutrition-related information.

The value of our involvement was more formally acknowledged this week, with Elaine Ayres presenting our contributions to the newly formed Mobile Health Work Group at the “Birds of a Feather” Open Space session. How gratifying it was to see our profession get some well-deserved kudos!

Having a seat at the HL7 table is making a difference. Does your organization utilize HL7? If so, pull up a chair.