Transcript Slide 1

Making Connected Health Work
for Patients and Practice
Kay Kane
Senior Professional Development Officer eHealth
RCN & European Centre for Connected Health
Karen McGurk
Case 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.
Examples
Patient 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
Person
Family &
Community
Primary Care
Use of Information
& Communication
Technologies
Family & Community
Professionals as Facilitators
Secondary Care
Professionals as Partners
Tertiary Care
Doing
Professionals as Authorities
Supporting
Adapted from Malaysian Telemedicine Blueprint
Before
Patient with Clinical Problem
Visit Clinical Team
Gains information
Now and in the future
Patient with Clinical Problem
Gains information via internet,
own health record, networks
Visits clinical team to gain
understanding and
discuss options
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
Aim
To 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
20
Demographics
Count
15
10
40
5
30
Count
0
Staff Nurse
Sister/Charge
Nurse
Practice Nurse
Service
Manager
Specialist
Nurse
Other
20
Which of the following best describes your job?
10
0
SE Trust
Belfast Trust
Northern Trust
Western Trust
Trust
Southern Trust
Non Trust Staff
71% Community Nurses
86% Degree Level
81.4% more than 15 years experience
24.3% more than 30 years experience
Attitudes and Perceptions
Rate 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
80.00%
70.00%
60.00%
50.00%
40.00%
30.00%
20.00%
10.00%
0.00%
H&C
ECR
RTNI
ePresc
ICT
Strategy
ECCH
Emer Care eReferral
Rec
75% had heard of eHealth
45% had heard at work
Picture
Archiving
Current Practice in NI
• Remote telemonitoring – over 800 patients
COPD
Diabetes
Heart Failure
Cardiac
•
•
•
•
•
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 longterm care in residential/nursing homes.
• Prevent unnecessary admissions to hospital or
residential care.
Patients Views
Promotes:
• self management
• continuous monitoring
• Independence