S2 EPISODE 11: TechNurse - Transforming Healthcare Through Informatics with Tristan Pahuyo.

This is Chito and welcome to the Ner Sohage podcast season two. Greetings everyone. Thank you for our loyal listeners. Again, we're live and again today we have a very special guest. He is one of my colleagues when I own view where in university and he is employed in one of the biggest trust in London. Before I start this podcast, I would just like to thank everyone who subscribed and liked our previous episode. That was on how to be a nurse in Norway. And again, me and Champ would like to thank our special guest, Mr. R.J. Missina. Thank you so much for that very enjoyable and very entertaining episode. And today again, we have a very special guest and we will be talking about a very interesting topic today which will be revolving around being a tech nurse, transforming healthcare through informatics. Let me introduce you guys to Mr. Tristan and we're just not colleagues in university but we're actually friends. Please downplay it. Please be a good friend. This is a very special episode today because it's the first time that we will be conversing in Bissaya which is our mother. I'm so so excited to see you again. I'm so excited to see you again. Oh, right? First time to listen to English. So English is a big thing. English is a big thing. But if we will be having a problem with certain kinds of, we will be speaking in Bissaya which is so fun. How are you? So Chito, I've been very good. How was life being a nurse outside the Philippines? How's your job right now? How's everything? How's life? How is it all? How's everything? General. So everything's been very good actually. It's been almost 10 years since we finished university. 10 years? Yeah, it has been. I graduated 2012. I want to say that every five years, one inch of my life is in my life. Okay, continue. But, strict, okay, continue. Anyways. But anyways, it's been great. It's been almost 10 years. I'm finished university. I've been practicing as a nurse for, well, nurse. I say I've been registered for more than 10 years as well. I think it's been good. As you know, as Chito said earlier, I've just been in, I'm in, I'm Basin London and today is very sunny. So I was in the park. Everything's good. How about yourself, Chito? I've not seen you seeing some, well, I'm a good Chito. Chito doesn't usually come every time I invite him to catch me. I went to the, when we were in the park, I was like, I didn't want to be an alcoholic park because, you know, I changed my name. Actually, me and Tristan had been together for university, didn't quite very, yes, it's 2008. Yeah, yeah, we first on each other 2008. And we'll talk about your journey, Tan. How's your journey in nursing? Why did you take up nursing in the first place? So I think that's a very, you know, it's a good way to start this kind of role, role conversation. Journey, how did I end up going into nursing? So first is I wanted to, initially I wanted to become a doctor, but then it was, it's very expensive. So the next thing that you choose, obviously, is nursing. And also in the Philippines, as everyone would be, you know, as you're already aware, you need to do pre-med course. And I think I've been told that nursing was a good, good pre-med course. However, that is one bit to it, probably 20% of the reason why I wanted to do nursing. Eight of us I wanted to do nursing was I know a lot of people in high school doing nursing. And also it's the idea of moving out of the country. I'm not going to lie to you. It's, it's you, it's finding like brainer pastures. I'm only getting that at the we were, I think personally, I was primed to think about that. They brought me a customer abroad. I want to go abroad that's why I'm doing that. And you know what, you were one of the, how do you call that? What do you think? I think I'm the one who's going to be a botched. That's what you're going to be. So that's what you're going to be. Like it's what you're going to be. Okay, I'm desperate. But, but when you were in, you were, you were practicing nursing in, in back home. What was your specialty? Did you specialize or something or were you just in the world? No, I didn't, I didn't specialize. I was quite lucky because when I started my practice, you know, you don't normally go to a specialized area. But then when I started working, I didn't even get paid at that time. So I was picked to, in a big hospital in, where, where, where, from, to go to ICU because they had, they had a need. And I was very lucky because, you know, they don't normally go straight to ICU. You'd either go towards or some other area. So I've been, I see, I've worked in ICU since 2013, January 2013 until December 2015 in the Philippines. And that's been my, my bread and butter since, yeah, I'm just only ICU. So, so, so 2016, yeah, you from, from the Philippines to the UK, yes, from 2016 is one I had. Where are you directly? How do you call that? Where are you directly employed in the ICU or ICU? Yeah, so I was recruited. I was recruited for a, for heart centers. So they, they went home, they went to the Philippines in 2015 to recruit for ICU staff that's going to be working in heart center that's not been built. So we were very lucky, it was, it was in the center of London. Is it, is it the Royal Brompton or? No, I worked at the Barnes, oh yeah, Barnes, yeah, a part, heart center. And so, yeah, so I've been, I've been recruited as an IT nurse, which again, I feel very, you know, very fortunate about having been, transition from the Philippines to the UK and directly working in the specialist area. But yeah, that's, that's, and from 2016 to 2019, mid 2019, I have been an IT nurse. Wow, so three years, yeah, so three years, well, for us, yeah. So how was the, how was your transition from the, the setting in the Philippines to, to the UK? How was it? I see you wise, I see you wise, it was, it was very different, you know, I'm very used. I've not, I've not been used to having, I didn't come from a cardiac center. So I didn't use central lines to give medications. I didn't monitor central, like CVPs, central immune pressures. I didn't, I didn't know how to use arterial lines. So it's quite a transition because a special DSA in my previous, like my hospital in the Philippines was more like trauma, stroke patients. But, you know, Filipinos, we, we carry on, we, we like the challenge. So it wasn't, it wasn't that difficult of a transition, because we are very experienced in general. And I think we get very good training back home, right? So, yeah, it wasn't, it wasn't particularly difficult. I think the most difficult thing for me was the, the language, like the jargons, you know, how they say, "Frucimide, one time I asked a doctor to change a prescription, because the doctor wrote "Frucimide, F-R-U instead of furocimide," which is still acceptable, but that's fruity bias, like, no, it's furocimide. So, one, one shot, that's like, so different. So different, okay. I go to the Philippines, get Western, I want to get American, yeah, very Americanized. So, so, so, then, um, You said that you said that you changed my question. Did you just thought about going somewhere other than the UK, going to the Middle East, going to the US, Australia or anywhere? Or it was just like very how do you call that? Tanana or very. Tanana, yes. It's a really lovely life. Can you tell me what you're going to do? I'm going to be a bit nervous. Alright, so what are you thinking about going to the US, Canada or anywhere? No, not really. Actually, my initial plan, well, as I'm not talking to have for a real now, when I studied nursing, there's always this idea about having the American dream, going to the States. That was the only thing that I knew of where I can work as a nurse. So whilst I was studying, we listened to people who were in abroad and they said, "Oh, you should work in America." Our training, we're primed to go to the States. When I made a decision to go to the UK to London specifically, I said, "Yeah, three years would be fine just to get there." So you're really thought of going? Yes, I thought of going because I had the American dream. I've always wanted to do that. And then I ended up not pursuing it because of that. That's how I ended up in nursing informatics. So I, yeah, it's three years after three years since after arrived in the UK, I transitioned into nursing informatics and once I got embedded into nursing informatics, and then I completely forgot about America because it's not transferable. Extensions aren't transferable to America. You know what? I was just wondering if I could be honest with everyone. I almost failed nursing informatics and I was in university for a city. And if there was someone, if there was someone who would do informatics, it would be Cheeto. I mean, it would be a no-brainer for him to do informatics. I don't know how I ended up in the informatics. But I'm going to tell you how. And I'm going to tell you the differences later. So, you know, back because I soon, you know, I'm nursing informatics before when we were still studying. It was really, you know, I was really thinking about how to do it. It was very high level. Yeah, because it was the first time that I think they introduced that curriculum, the BSN curriculum, and it included nursing informatics. And I think we had that, like, red book as I could remember. Yeah. No, it was really hard. It was very technical. Remember, it was all that important. I remember it was HTML. It was HTML. So they taught us how to code. And that is proper. Well, that is what I knew of nursing informatics. But there are several, you know, sorry, sorry, sorry, sorry. Sorry, Cheeto. So, yeah. So, good to you, Ten. We're seeing that. Yeah, so that's why I knew of nursing informatics is very analytical. You need to code. But there are several tranches to it when I've just experienced when I arrived, well, when I transitioned here in the UK. And I can talk more about that later. But it's not just about, like, the analytics, the how, how, how digit, how digitally capable you are, the individual. There's a lot more to it. But yeah. All right. So, yeah. So, so we've talked about your journey, Ten, no? And your nursing journey, rather. Yeah. So let's talk about nursing informatics proper now. Like, yeah, our, the title of the podcast is called "Back Nurse, Transforming Healthcare Through Informatics." So, yes. Can you, can you take me through nursing informatics prop, you know, what is nursing informatics? Just for our listeners to know what is really nursing informatics. Because, you know, we have a lot of listeners been messaging me about, you know, how, if you can make nursing informatics a topic of one of your episodes, we're really interested, especially the students. Yeah. So, I, and I think, and one of the, one of the, the thing that, you know, it's, um, remaining in my mind was to contact you because you're the only person I knew about, you know, is really, um, well versed with nursing informatics. So, Tan, can you take me through or take us through nursing informatics? So, okay, cool. So, I've got a nursing informatics of what I know of nursing informatics, of what I studied nursing informatics, and I can give you an idea of what that is. And I can give you what that looks like in the UK healthcare system as well. So, nursing informatics, in general, as a specialty is, you know, it combines nursing sciences, information sciences, or IT, and computer sciences, to manage and communicate, um, healthcare information effectively. So, it mostly focuses on, um, the use of technology and data to support and improve, um, nursing practice, patient outcomes, and healthcare outcomes in, in general. Um, so, in nursing informatics, we use various information systems. Those are what we call as, um, electronic healthcare records, and another, um, data storage mechanisms, that would allow to collect, store, analyze, and, um, disseminate patient data, so that they wouldn't be visible, and they will be able to, um, be used for, um, research, for quality improvement purposes, or just generally to improve, um, to, to improve practice and promote, to promote evidence-based practices. Um, so, yeah, that is, like, a very high level of what, what nursing informatics is, and, you know, it plays a crucial role in bridging the gap. The nursing informatics is, um, playing crucial role in bridging the gap between clinical care and technology, because they use their expertise as a subject matter expert in clinical care, and they're, uh, know how in, and technology to inform and make, um, and make, uh, decisions, like, um, quality improvement programs or processes. Um, and just to talk, I'm going to break nursing informatics down from what I know, and from, you know, what we've discussed, Cheetone, um, so, you know, we've got data management, we've got, um, workflow optimization, um, we've got clinical decision support, we've got, um, system implementation, um, work, um, workflow and process improvement, um, education, training and research. I can talk more in detail about that, but I'm not going to bore you with the details, it's quite technical. So that is why I know of nursing informatics, as is. Um, but in the UK healthcare system, there isn't as, nursing informatics is quite different, um, and it's constantly changing on what that is. Um, when I moved into my nursing informatics role, it was more of a, um, sort of cut you down. Did you pioneer this role? So I was a pioneer at BARTs. Oh, wow. Yeah. So I was the first one who, uh, I was the first nursing in informatics. So, so how do you call the individual nursing informatics? Uh, I wouldn't really call myself that because I'm not very good with data. I didn't, I didn't crunch in data a lot. So normally that's what they would do. And they analyze data, they look at data, um, but my, my role was like nursing information, um, and lead in informatics nurse was, um, more of like transformation. How do we implement systems? And how do we, once we implement the systems and look at the data that we've collected, how are we going to use it to improve practice? And I don't have an experience of that. So I didn't. So you, you guys are the ones who, um, how do you call that, um, analyze the, or maintain the electronic health record? Am I, no, so we've got the IT, we've got the IT team. So I'm going to, I'm now going to talk about transition now in what nursing informatics, what lead informatics nurse in the UK does. So what we normally do is, um, well, what we do is, there is this movement called like a, you know, digital movement, um, within the NHS. And, as lead nurses who focus on digital, focus on informatics, we're trying to, um, utilize the system in the best way possible, and look at how we can, um, improve nursing practice and improve care that we provide to patients. But first we need to implement the system. I was brought into my role because I didn't have someone who's going to, um, lead it from the nursing side. And then, and nursing is going to be a great job. going to be impacted a lot when you implement systems. Majority of the projects, among our IT projects, you know, implement Nila in the healthcare setting does not involve clinician. It was only then that realize that there is a gap because when they implement it, they don't have any idea how it would impact. - Back to the practice, they back to the work. - That's why I'm there. - I'm there to let them know this is how it's going to impact the practice there for these are the things, these are the steps that we need to do. So nursing, nursing in the healthcare is transformation, change management, which includes communication, how you communicate to clinicians, how you communicate the change, how you, you know, change is disruptive. So how do you mitigate the disruptive impact of change in clinicians workflow? - So one of my projects was I implemented, you know, digital observations. So I wrote down the code we see device. - Yeah, so no more, no more news storming. - No more news storming. - Oh yeah. - Yeah, so no more news. So we've got devices, we rolled out devices in the wards. - Was it the phone size? - No, it was a rolling one. It was a Welsh Allen one. - All right, okay. So it's like a dynamap, but the results of the dynamap will automatically get translated into the electronic healthcare record. So one click and then it just gets pushed through the EHR. So it will tell you the news too. So you don't have, do there's no writing? - So paper less. - So paper less? - Yes. - Really workflow optimization, no? - Yes, yeah, workflow optimization, reducing time. Yeah, automating tasks, producing software tasks, improving communication and collaboration. - Yes, yeah. - Probably, no? It's really amazing, Stan, actually. - Charlanc. (laughing) - And Stan. - I'm breakers at the big serious guy. - No, I'm not. - Charlanc. - So now you have got a change topic. - I don't know about the dramatic thing. (laughing) - All right. So, Stan, you've said about a quick bird's eye view on nursing informatics. And can you give us like, what's a daily life of being a nursing informatics? What do you do? Just to give them a very nice idea. - An idea, yeah. - So I just wanna give everyone just a bit of an FY. So I don't do nursing informatics now. - All right. - Yes, I do change management a much more specific bit in an implementation VHR. So I'm gonna be talking in retrospect. So what I did for two years, as a nurse, working in nursing informatics. So my day to day, so I was implemented from nursing side, and electronic healthcare record. So mainly, you know, assessments and the basic, basic assessments and digitized it. So what I did on a day to day basis, before we implemented the system, was go around the world, speak to world managers, make sure that all the digital link nurses know what the brief is. So we established a very good digital link network, wherein I, as lead, would focus on one topic, let's say false assessment, and how it would look like in an electronic format. So this keeps them ready, right? So that clinicians or nurses will be aware how it looks like in the new system. So I go around the words, make sure, that they've got their materials, the digital link have got their materials, and make sure that they included it in their huddle. Let's say I focus on false. So we do a presentation, they say, this is false assessment, this is how we do it currently on paper, and this is how we're going to transform it in an electronic format. So it's just that, it's just making sure that that communication lands well with staff, so that when we implement it, they wouldn't be surprised. - So you are the one who is like, from scratch, makes the format from the paper to the computer. - I'm a great. - So we've got a system already that's built. What we do is configure. So the system is built, the data set is there, but what we do is propose or suggest, make recommendations based on what the workflow is, to tailor it to the workflow. - So you're not the one who codes. - No, all right. - You just need to recommend these. - Yeah, so I give recommendations, I give, so I work alongside analysts and change leads to make sure that what nursing wants is reflected into the system. So this is why I was telling you. - You're really the difference. - Yeah, it's very nice, okay. This is now that I don't really know what's the role of the nursing format before. Now it's really a bridge between nursing practice and the digital side of healthcare, healthcare system, making everything, like making the computer's work for us and improving patient care, helping the nurses as well. Less time, more time for patient care, that's really nice. - Yeah, it's all about the benefits. But yeah, it's quite a different thing. And again, I'm just speaking exclusively for the UK practice 'cause nursing informatics, as we know of Cheeto, what we were taught of, they code. So in the States, in America, what I know is they do the coding, they do the configuration. But here we don't do any. - Oh, so there is nursing informatics, so there is nurses in informatics in the US as well. - Yes, and they do a very, they have very different specialty. - Well, different training as well. - But they've got different trainings that, I think you need to do your masters, about the, you need to know how to code, essentially. And you need to be well versed with how the system works and part of your role would be data analysis. I don't do any data analysis. So it's more of understanding what the data is, getting working alongside, 'cause we have analysts, working alongside the analysts. So yeah, it's more like a liason kind of role rather. - Yeah, I know. So aside from the US and the UK, then do you have any idea of other healthcare systems in the world that has this kind of specialty in nursing? - I think, I think all of the, I think majority of like the countries that I know, like you know, like in Europe, yeah, develop countries have got this kind of role, albeit called differently. And you know, I know there's one in Middle East as well, but they're called differently, but there is the discipline. I mean, the discipline exists. I don't know what it's called. - But are they nurses as well? - Yeah, and they have to be. 'Cause otherwise you won't be able to understand what you're going to propose, right? You're not able to empathize. And you're not, otherwise they wouldn't be a subject matter expert. - So did you, in the first place then, where your experience from the ITU helped you progress to being, or having that role, the nursing informatics? - No. (laughing) Well, the thing is, it was a very new role. I was quite lucky that I was given the opportunity. You know what I leveraged when I applied for the role? It's my nursing informatics background. - Oh, wow. - Yeah, when I studied. - Oh, oh, oh, oh, oh. - And the thing is, it's just about how you package it, right? So yeah, I leveraged heavily in my informatics experience, and also what's helpful, especially in the UK setting, is, you know, when you're a band-six or a band-seven. If you get yourself into quality improvement projects, because nursing informatics is, you know, you work alongside quality improvement. And there are methodologies in the quality improvement space that you can use, so that you will be able to do your job effectively as a lead nurse's informatics. - All right. - Yeah. - So what? - Yeah. - Go. - No, you go. (laughing) - So time for growth, I was going to say. - So yeah, so. So what about nursing informatics, Karun? - No, no, no. - You're not in a discipline, all right? - No, no. - When did you leave? - When, when. - Two years ago, I left, I lived. I lived. (laughing) I left, I left 2021, I lived. - That is, yeah. - Why did you leave 2021? - All right. Why did you decided to move on to the discipline? - Well, because there was an opportunity for me to work with something that I'm quite interested in, so what my role now is like a change agent in an electronic healthcare record, delivery program, so it's like an additional transformation program. that covers two major trusts in London. - Bart, St Thomas? - No, St Thomas and Kings. - Oh wow. - Yeah, so I worked with that. - What healthcare system do you have done? - I think, oh it's a new one. - Yeah, it's a new one. - It's an epic. So I used a user, I invented a server in. - Miner's magic system. - Actually, yeah, yeah. I've touched a server and Ebro and Ice. - Which is quite different. But, you know, how different is it epic from other healthcare system or record system? - I can only compare epic to Cerner. Those are the only two main ones that I've worked with. So Cerner and Epic are two enterprise systems. What enterprise means is that it cages end to end from outpatients, inpatients to community. It's not just specific to like ICU or specific to patient tracking. So there are some of the systems up. There are probably some of them that you've mentioned that are specific to like specialties. But with Epic and Cerner, they're both enterprise. So the good thing about it with an enterprise system is that you get visibility of everything. So if the patient came from an outpatient clinic and was admitted to an E and then blood, then you can see that whole journey. And that seamless transition between hospital spaces can be easily documented and visualized in these systems. Which makes it a lot easier for us to buy. Because if you've got multiple systems, very hard. If you log in to the server, then you log in to that. And with Epic and Cerner as well, they've got inbuilt. I think there's another one. And I hope Cerner and Epic pays me for championing this. (laughing) So Tan, Epic and Cerner, EPR are like go hand in hand. - No, no, no, no, no, no, no, no, no, no. no, no, no, no, no, no, no, no. They're two separate, they're two separate. - Separate competitors actually. So yeah, and they're both from America. So they provide the same type of product. But they offer different things. - Different, yeah. - All right, quite interesting, no? So Epic is really nice, very nice. - So Epic as well, just a very quick one on this. 'Cause this might be something that people will be interested in terms of roles. Epic allows clinicians to configure it. Therefore, we've got roles where we call system analysts. So, and those are our clinicians. So those are nurses. So they're the ones who can figure this system. They've got a textbook already of codes that they can apply, like a library. But it's the closest thing to what I think what nursing informatics do in the state. Yeah, it's an analyst role if you know an organization. - So edition. - Yeah, if you know an organization, it's very nice. - Yeah. - You can apply as an analyst. - So I think it's my healthcare background. - So I think it's more user friendly than a certainer. That's what you're thinking. - Yes. - And it's more, how do you call that flexible? Because you can alter the interface, isn't it? And make it more, how do you call that? - Yeah, make it more clinician- - Clinician-based. - Clinician focus. - Because sometimes when you, because sometimes when you work on systems, there is like a lag, if you're lag of, how can I translate this one? - There's kind of, - I can translate. (laughing) - It's like repetitive task. - Yes, yeah, yeah. - I don't, and then when we do repetitive task, that's where the, you know, - So the way it's used is a bit cumbersome why is it not automated? - Yes, yes. - Yes, and then what I'm going to do is why is it not able to do that? I think that's what I'm going to do. - That's what I'm going to do. - So, it's very nice. - So I think CERNOR is able to do that. I've not worked with an organization who's, you know, who has implemented it that way. Whereas with Epic, they encourage clinicians to apply for the analyst role. Because, you know, they've got an understanding of what the clinical workflow is. They can configure it themselves. - Is it general, general analyst, or like, for example, specialist specific? - It's specialist specific, all right. So they're specialists in, all right, in the other virtual, - There's the other virtual, - Oh, yeah, what? - Theatrist, clinical documentation. There's one in endoscopy. - So it's really like how they go that separate like a department. - Yes, yeah, yeah. Which is quite good. Because then you can have people there who knows the system very well. Yeah, it's good. It's a good brawl if you're interested in that. (laughing) Yeah, the system analyst. There's a couple in the hospitals in London. It does that UCLH, Roy Marston, Gosh and Guy Stommer's. - Guy St. Thomas. - All right, wow. Let's watch the space. Watch NHSJobs.com for an analyst role. - All right, that was quite interesting topics about their nursing. Thank you for that, Tan. Really appreciate that. - You're very welcome. - And Tan, you just want to ask, during your stint with nursing informatics, is there any, what's your greatest achievement that you had ever accomplished? - What do you think? - Is this a trick question? (laughing) No, just joking. I think one of my greatest achievements when we went live with the electronic healthcare record, it was a very successful goal live. And came the back of the goal live was, because I wanted to improve how we document, how I wanted to improve the compliance. And it's a good thing about implementing systems, right? 'Cause then you'd know if people are compliant to their assessments. So you can have visibility. You can have reports generated and you can see which it's not a punitive thing, but you can see where the gap is. You can see an improvement opportunity to say, let's say, or X-Word has got low-false assessment. And then if you see in the audit, they've actually got more, like they got a lot of false, like this year, and then you can put two and two together. And then you can create a quality improvement project out of it. So what I've done was I created a minimum data set. Just a standard data set that nurses will have to complete at a minimum within their shift. So this is a word-based minimum data set. And it's been implemented. It's been picked up quite well. We used the data set during COVID, 'cause it's just a slicker way. This is what you said earlier, Tito. I wish there was one page that you can just fill everything in and that's it. So this is the page and there's like a level of auto population as well. So I used this. I worked with analysts to create this data set. And I used this to apply for a digital health fellowship, which I got accepted. And yeah, it's been picked up since. So that led to overall improvement and compliance of nursing assessment documentation within FireSausmetals and within my organization. So I was really happy. (laughing) (laughing) (laughing) Tito and I used to drink a lot. (laughing) Shout out to all our HNH fans. (laughing) I think you should post this and everyone should listen to this 'cause our HNH is there. (laughing) And you know what, well, I got our classmate's already already, you know. I know. (laughing) Everywhere. You know, in 10 years, you know, it's everyone's like. (laughing) (laughing) (laughing) (laughing) Getting excited. So I heard about, you know, when we spoke about, when we met like two years ago, you spoke about, with a conversation about, you started the system during, you know, the Nightingale Hospital. Yes. You remember the COVID pandemic, the government, you know created this COVID hospital in the heart of London and you were the one of the you know the backbone of the Olympics. I wouldn't go that far. All right. I mean you were one. Yeah I did I did work there yeah. How so how was the experience then? Like, um, do you want me to be honest? Well it was it was it was such an amazing experience actually. So we were our organization hosted the electronic healthcare record system in the night in a hospital. That was the so the so they they did you sooner. Yes they used sooner. Yeah. So parts and hosted that. We were called in one day. Essentially is it's to do the same thing. Transformation. How do we implement it and scale and with a specific time frame because you know we need to train a we need to. Yes. The comments out we need to train people we need to understand what the minimum data set is that people should fill in given that they will but nurses in the night in girl will have a lot more patients than they normally would have and use the system than they're not familiar with. So it's just creating that whole strategy and it was quite it was it was really it was really good and I was very glad that I worked with there. However our work got cut short because as everyone is aware you know the number of patients dramatically dropped in open within within a week's time frame. So yeah it was it was such a good experience I met a bit lovely people but then again I didn't get to implement what I didn't get to do the work as much as I'd want to if you know what I mean okay well that we got cut short because but I know we thought the notion of what a girl is. I know I'm very proud and I still got my badge. So you were guys given badges? Yes I just got my ID badge from Nightingale Hospital nursing infirmatics. Yeah wow yeah it was very good. It was it was again one of my proudest moments and then a month after that I was sent to IC. Which was rather overwhelming. So you've we've touched about the nursing. So time I'm going back now I forgot about this one. Is there any regrets like you know transitioning from from the ITU to the digital world of nursing? No. Is there like what could have been things and everything like that? No. There's a lot of things I you know I could have done that would have prepared me to be a bit more a tune to the role. Obviously I didn't have a project management background. I've only been involved in a very minor quality improvement project and there the initials that when I started the nursing infirmatics role I really struggled because you know and I worked and I see you I had a very structured way of doing things and is almost like I'm very familiar with it. It's you know my I can close my eyes and do my job but with nursing infirmatics there's a lot of there there's still there's still structure within in a very different way because it's almost like project management and change management and I wish that I could have involved myself in QI before I joined or like yeah just involve myself a bit more in projects and that would be my advice to people who want to transition to these types of roles because these are project management based roles. If you've involved yourself in clinical projects that will stand you in good stead and and you probably do better. By in terms of regret I don't regret anything you know I am very fortunate to be in my current role now. Now moving roles again. So yeah and yeah if if anyone's interested and wants to talk about it and how they want to you know how to position themselves to be able to pivot into these types of roles and you know very happy to get in touch with me on LinkedIn. I charge. I charge. I don't clap. Wait did I say you're not indoors? Very nice and lovely episode today with you Tan and I guess it you know nursing and hermatics in the future will like transform healthcare and you know not only in the in the Western world but hopefully in you know across across all across the developing countries as well. Because that is my dream. Yeah because you know it would it would really help the not only the nurses but also the patient yeah. It's mostly it's mostly for the patients you know it's mostly for the patient outcomes healthcare outcomes how do we improve now if we don't have visibility of data how can we do research how it cope. Yeah it is really crucial. It will be like very how do you go that very beneficial for everyone. Yes definitely discipline discipline wise like research. Yeah I know what you do it's it's very cost effective as well. Well yes initially isn't you know there is there is this curve and investment wherein you've only read the benefits of your investment in in the next five ten years. But it's you know it's very cost it will save the and a healthcare organization so much money. And I can talk it. Yeah I know and it also transcends to not only you know the data management and everything like this but also to job satisfaction. Yes exactly. Nurse you know retaining their jobs for quite long because you know they're happy with the job. Yeah I know make it more like easier for them to swivel in a toxic shift. It's you know hopefully hopefully soon we they would realize this and you know and are you happy than if you know one of the hospitals and one of the disciplines in the in the Philippines will like contact you and give a lecture give a something like that. No I'm very very happy to do that. All right I think it is my it is my passion it is I hope as a country we develop a national strategy and what that digital that what digital health looks I think it's about time isn't it? It is yeah and because you know there is there is it is really promising and yeah and we've seen or we've seen about we've seen already the results. Yeah we have yeah and you know they can be very experienced to it and you know the the results of the systems are quite effective and seeing the healthcare systems around the world who implements it you know. Yeah it's just like you know I've been so I went to and Wisconsin for an epic conference last year and how I saw how transmission of these systems are in terms of improving my healthcare delivers healthcare provision and I just hope it gets picked up I hope someone from the Philippine government is listening right now. Actually yeah actually you know the the podcast is quite you know it's quite trendy at the moment and you know everyone listens to it and hopefully you know it's it's a stepping stone or stepping episode for anyone who are interested you know contact piston and in the link. Yeah you know nursing and and I think I just want to get a point across here because in nursing informatics especially in the UK is a rapidly growing field and you know it is essential to like a digital future in healthcare and don't be scared in terms of branching out to to various to to this type of discipline within nursing like digital nursing we've got you know I've got my colleague dang dang Trinidad I can link you in with her she's part of like a decision digital decision making group in London she's a lead and actually in terms of what that what that looks like in in in nursing you know what this what digital looks like given the gaps in the data literacy and technology enabled care and stuff so yeah if you want because dang is much more tuned to like the whole nursing in thematic space because I'm quite far out now having the transition into a bit more a different yeah different side of systems implementation but yeah all right okay then thank you for thank you so much for your contributions contribution to this episode I'm waiting for my bottle of champagne to a rock in two weeks time all right so here address yeah Charad the joke so so tan you know any before we end this episode you want to shout out? Do you want to greet someone from the Philippines? Because you know we are really global. Oh Charolang, I don't want to because if I think if I mention names people will be upset. If I miss them so I'm just say hi to everyone that I know. Keep in touch or message me if you've listened to the podcast. I'm also very happy to say hi to you. I'm very happy to say hi to you. But I can't say hi to you. Joking is like a joke. I think there's too many to mention Cheeto. I don't want to upset anyone. It's quite. you know. I don't have any time to do the podcast. Who would have thought that the podcast would not understand one or two things. Who would have thought that we would be here sitting and conversing and everything. About informatics especially me. Fail! Don't even know how to coach. So, and this podcast again this is Cheeto. And Tristan. Bye! I love you! Thank you everyone!