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Harnessing Big Data to Help The Elderly, with Becca Nock

6/12/2015

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by Megan Sperry

Becca Nock is a graduate student at Penn working towards her PhD in Nursing and Healthcare Administration. She received her Bachelors in Nursing from the University of Pittsburgh in 2013, where she first became interested in the intersection of community healthcare and technology.

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As a bioengineer, I spend a lot of time thinking about and justifying the translatability of my research to the clinic. How will physicians and patients benefit from my work? Will it be helpful? Does it make sense and fit within the context of current issues in healthcare?

However, I don’t spend a lot of time thinking about how other healthcare providers will benefit from advances in healthcare technologies, namely the people on the front lines of healthcare: nurses, physical therapists, aids, and many more. Additionally, I find that research scientists do not tend to involve these professions in the process of designing and constructing research aims. This is unfortunate, because they have so much expertise to offer. Many bioengineers collaborate with doctors, yet I know fewer researchers that are collaborating with nurses.

When I met Becca earlier this year, I was immediately interested in her research and unique perspective on the intersection between nursing and technology. She is someone I kept running into all around Philadelphia! I met her at Penn Apps in January and then again at the Philly Women in Tech Summit in April. She is incredibly friendly and the passion she has for her work shines through when talking with her.

Becca is interested in the use of technology for improvement of healthcare in the community setting, specifically for older adults. However, when she first entered nursing school, none of these avenues were remotely on her radar!

Becca always thought she wanted to be a pediatric nurse. She volunteered at the Children’s Hospital in Houston while growing up and at a summer camp for children with severe disabilities. However, “…slowly throughout nursing school, [I realized that] you can like kids and love working with kids and not be a great pediatric nurse.” In pediatrics, “You have to be so high energy that whenever you walk into someone’s room, you are just lit up and excited, even if you have to do a procedure. And working with families is a very specific dynamic.”

[Patients with dementia] reacted to emotion. They may not know where they are, but to someone sitting next to them, holding their hands, they reacted to that.”
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“Then, I had a clinical in geriatric psychology—people with Alzheimer’s [disease] and very severe dementia. Geriatrics was something I never thought I wanted to do! Going in, I thought geriatrics and psych were two things I didn’t want to do. One day [while working there] I knew I wanted to do that.” Becca found she loved working with the older adults on that unit because, “They reacted to emotion. They may not know where they are, but to someone sitting next to them, holding their hands, they reacted to that.”

As a researcher at the University of Pittsburgh, Becca also started working with technology that allows people with tracheal or breathing tubes to communicate. For her research, Rebecca was doing a lot of interview-based research and spending time talking to older adult patients in the hospital. She loved talking to patients and decided to spend more time with patients by working in the community with Bridging the Gaps program. Bridging the Gaps, a Philadelphia-based program, has a mission to, ‘Combine health-related service in economically disadvantaged communities with the education of future health and social service professionals’. Becca said that she really enjoyed working deeply within high-need neighborhoods within Pittsburgh. “I liked that I could sit there and talk to them for two hours!” At the time, Becca was doing a lot of health education work and fell in love with taking her time with people. “It wasn’t a rush to get something done or find out specific information.”

In addition to working in the community, “I was interested in the bigger picture of hospitals and how they work.” At the beginning, Becca said that, “…in the hospital, all the technology…I never really paid attention to it. You just kind of used it. And the attitude around charting as a nurse is, ‘If you didn’t chart it, it wasn’t done,’ from a liability perspective. But, [there was] almost no focus on where the data is going or what could be done with the data later.”

As Becca began working in nursing technology, the biggest surprise was seeing the data on the ‘other side’.  “We were pulling data from the electronic medical record and it was a huge process to clean the data. As a nurse I was like, ‘I’m just charting what I did today.’” But Becca never thought of herself as having the skill set (or interest!) in coding. “The technology aspect of it, and how things are built, is just so fascinating. It was something I was starting to become very interested in [at the end of undergrad]. And something I’m much better at than I thought I might be!” Becca learned a lot about technology and coding through taking classes with organizations such as Girl Develop It Philly.

I was interested in the bigger picture of hospitals and how they work.”
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Becca and her teammates won the Grand Prize at Philly Codefest this year for the development of an app for use with the Indego Bike Share in Philly!

This summer, she is doing her Masters practicum with Independence-Blue Cross. “They have a whole informatics department! They are doing fabulous work. It’s an aspect of healthcare I never thought about taking part in or knew was really there.”

One aspect of healthcare that Independence-Blue Cross cares about is the quality of care that patients are receiving, particularly in regards to their Medicare Advantage Plan. “They want their patients to be healthy, but also the higher the quality of care, the better the reimbursements are from Medicare.” This is where data analysts come in—to measure and quantify the quality of care that patients are receiving. Also, “How can we provide physicians with the highest quality information? What patients are at highest risk for getting different diseases? [For example], this patient is at high risk for diabetes, how can I counsel them about that now to avoid this disease in the future?”

A second interesting aspect about insurance company data is that no matter what hospital or practice you go to, the information goes back to the insurance company. Although patient information does not yet transfer seamlessly from location to location, it is possible to achieve more complete stories from insurance company data. “What’s a little different is that electronic medical records for a hospital are actual nurse and physician charting, versus insurance companies using claim statements.”

“Basically there is a ton of data out there right now! We just need to figure out how to use it best.”

Driven by her continued interest in developing technologies to aid older adults living at home, Becca will be focusing her PhD dissertation research around the question of, “What technology do older adults actually use?” We started talking about our own grandparents, in their 80s and 90s, who use Facebook, iPads, email, cell phones, and even read Beta Pleated Chic. (Hi grandma!) This is great news for the future of technologies to help older adults. Secondly, she is curious if the technology can be seamlessly integrated into their lives to remind them to do things such as get more exercise, get enough sleep, or take essential medications.

I am excited to see where Becca’s research takes her and what type of impact these shifts in nursing technologies can make on healthcare overall.

Are you a nurse? What do you think about the future of technologies in nursing? Comment below or drop us a line at megan@betapleatedchic.com.
Basically there is a ton of data out there right now! We just need to figure out how to use it best.”
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