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Making Connected Health Work for Patients and Practice
Kay KaneSenior Professional Development Officer eHealth
RCN & European Centre for Connected Health
Karen McGurkCase Manager, Northern HSC Trust
Terminology
eHealth characterizes not only a technical development, but also a state-of-mind, a way of thinking, an attitude, and a commitment for networked, global thinking, to improve health care locally, regionally, and worldwide by using information and communication technology.
Connected Health is a term used to describe a model for healthcare delivery that uses technology to provide healthcare remotely.
ExamplesPatient Information/Service Portals• Health information on the web• NHS Direct• Map of Medicine• Choose & Book
Patient Care Systems• Telemedicine consultations• Picture Archiving• ECR & Summary Care Record
Telehealth : Remote monitoring• blood pressure monitoring • blood glucose monitoring • cardiac arrhythmia monitoring• medication reminder systems.
Context • Strategic
– National, Regional, Local• Advances in technology
– Less expensive– Widespread use
• Demographic– Ageing Population– Working population reducing
• Public demand– Access to information– Feedback on health indicators
Transformation from Industrial Age Medicine to Information Age Healthcare
Person
Family &Community
Primary Care
Secondary Care
Tertiary Care
Person
Family & Community
Professionals as Facilitators
Professionals as Authorities
Doing Supporting
Professionals as Partners
Use of Information & Communication Technologies
Adapted from Malaysian Telemedicine Blueprint
Patient with Clinical Problem
Gains information via internet, own health record, networks
Patient with Clinical Problem
Visit Clinical Team Gains information
Visits clinical team to gain understanding and
discuss options
Before
Now and in the future
Information Age Healthcare Impact on Nursing
• No longer defined by dispensing knowledge and solving problems
• Will become a broker in the patient’s decision process
- educative- interpretive- facilitation- analysis
• Using technology to give direct nursing care
eHealth : Local Context
• Joint working ECCH & RCN- Appointment of eHealth Officer
• Engaging the Nursing Workforce
eHealth: the voice of nurses in NI
AimTo communicate and market new developments in nursing practice emerging from a technology driven healthcare system to nurses in Northern Ireland
Progress to Date
• Workshops for Nurses and 85 Nurses attended • Survey using a questionnaire (n=80) to gather
information on Nurses awareness of eHealth, their access to IT, and their attitudes towards eHealth
• Focus groups • Consensus Seminar for Strategic Nurses Leaders• RCN – Nursing Informatics Forum • Report
Non Trust StaffSouthern TrustWestern TrustNorthern TrustBelfast TrustSE Trust
Trust
40
30
20
10
0
Co
un
t
71% Community Nurses86% Degree Level81.4% more than 15 years experience24.3% more than 30 years experience
Other Specialist Nurse
Service Manager
Practice Nurse Sister/Charge Nurse
Staff Nurse
Which of the following best describes your job?
20
15
10
5
0
Co
un
t
Demographics
Attitudes and PerceptionsRate Statements – positive & consistent
• Impact on relationship Somewhat bene/beneficial = 80.8%
• Confidentiality No effect/beneficial = 80.8%
• Improve Safety Yes/Partly = 88.1%
• Improve Patient Care Strongly agree/agree = 65.7%
Previous Knowledge of eHealth
0.00%
10.00%
20.00%
30.00%
40.00%
50.00%
60.00%
70.00%
80.00%
H&C ECR RTNI ePresc ICTStrategy
ECCH Emer CareRec
eReferral PictureArchiving
75% had heard of eHealth 45% had heard at work
Current Practice in NI
• Remote telemonitoring – over 800 patients COPDDiabetesHeart FailureCardiac
• Teledermatology –over 300 patients• Electronic Pen for TVS• eCat• Virtual Ward• eRostering
Connected Health - Rationale
• Healthcare is a safety critical industry• Good safety practice requires proactive work – systems
as safe as design and forethought will allow• Understanding of benefit and risks of using technology
is essential for safe care
Preparing for the future• Guidance and resources to support nurses’ use of
information and engagement in modernisation through connected health
• Nurses are adequately trained and supported to use new systems and to ensure that connected health is integrated into nursing curricula at all levels.
• Integrating connected health into career and competency frameworks and leadership programmes
Learning to Manage Health Information (2009)
Taking Nursing Informatics seriously !
Nursing Informatics is a specialty that integrates nursing science, computer science, and information science to manage and communicate data, information, knowledge and wisdom in nursing practice.
American Nurses Association's Scope and Standards for Nursing Informatics Practice (2008)
Developing an eHealth culture
• Strategy/Structure – lead and support
• Education - meet the need
• Service – encourage innovation ‘free thinkers’
• Professional bodies - forums/conferences
Your role………what you can do?• Look out for ways you can use technology in your practice -
be a ‘pioneer’
• Develop Nursing Informatics as an ‘extra string to your bow’ a special interest
• Use your knowledge of nursing and patient care to influence design and implementation
• Join the on-line community, sign up for a mailing list
• Volunteer to take a proactive role- join forums- working groups- keep colleagues up to date
YOUR HEALTH, YOUR CARE AT HOME
Aim of Project
• To support the management of people with long term conditions at home.
• To prevent unnecessary admissions to hospital and residential care.
• To facilitate early discharge when hospital admission is necessary.
Long Term Conditions
• Diabetes
• COPD
• Heart Failure
Assistive Technology
• Remote monitoring of vital signs including:-• Blood pressure• Pulse• Oxygen saturation• Weight• Blood Glucose• Peak Flow
Levels of Support
• Level 1 – Supported Self Care
• Levels 2- Disease Specific Care
• Level 3 – Case Managed
Staff Involved
• Continuing Care Nurses
• Acute Care at Home Team
• Specialist Nurses
Benefits for Patients
• Support people with long term conditions to live independently at home for as long as possible
• Support for carers of people with long term conditions
• Early identification of Exacerbations of L.T.C• Nursing staff can initiate early intervention• Maximise use of professional time and
responses to patients needs
Benefits for Patients (… cont)
• Reduce home visits from nursing staff.• Delivery of flexible, person centred packages of
care.• Help reduce fear and isolation and improve
quality of life.• Contribute to developing alternatives to long-
term care in residential/nursing homes.• Prevent unnecessary admissions to hospital or
residential care.
Patients Views
Promotes:
• self management
• continuous monitoring
• Independence