Making Connected Health Work for Patients and Practice

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

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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.

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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.

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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

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Transformation from Industrial Age Medicine to
Information Age Healthcare
Person
Person
Family Community
Family Community
Use of Information Communication Technologies
Primary Care
Professionals as Facilitators
Secondary Care
Professionals as Partners
Tertiary Care
Professionals as Authorities
Doing
Supporting
Adapted from Malaysian Telemedicine Blueprint
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Before
Patient with Clinical Problem
Visit Clinical Team
Gains information
Now and in the future
Gains information via internet, own health
record, networks
Patient with Clinical Problem
Visits clinical team to gain understanding and
discuss options
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Information Age Healthcare Impact on Nursing

• No longer defined by dispensing knowledge and
  solving problems
• Will become a broker in the patients decision
  process
• - educative
• - interpretive
• - facilitation
• - analysis
• Using technology to give direct nursing care

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eHealth Local Context

• Joint working ECCH RCN
• - Appointment of eHealth Officer
• Engaging the Nursing Workforce

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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

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Progress to Date

• Workshops for Nurses and 85 Nurses attended
• Survey using a questionnaire (n80) 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

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Demographics
71 Community Nurses 86 Degree Level 81.4 more
than 15 years experience 24.3 more than 30 years
experience
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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

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75 had heard of eHealth 45 had heard at work
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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

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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

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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)

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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)

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Developing an eHealth culture

• Strategy/Structure lead and support
• Education - meet the need
• Service encourage innovation free thinkers
• Professional bodies - forums/conferences

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Your rolewhat 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

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YOUR HEALTH, YOUR CARE AT HOME
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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.

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Long Term Conditions

• Diabetes
• COPD
• Heart Failure

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Assistive Technology

• Remote monitoring of vital signs including-
• Blood pressure
• Pulse
• Oxygen saturation
• Weight
• Blood Glucose
• Peak Flow

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Levels of Support

• Level 1 Supported Self Care
• Levels 2- Disease Specific Care
• Level 3 Case Managed

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Staff Involved

• Continuing Care Nurses
• Acute Care at Home Team
• Specialist Nurses

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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

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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.

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Patients Views

• Promotes
• self management
• continuous monitoring
• Independence