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eHealth for Patients and Information for Nursing

eHealth for Patients and Information for Nursing. Royal College of Nursing European Centre for Connected Health. eHealth for Patients and Information for Nursing. CONCEPT The Vision CONTEXT What is happening, where and why IMPACT What does this mean for your nursing practice? WAY FORWARD

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eHealth for Patients and Information for Nursing

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  1. eHealth for Patients and Information for Nursing Royal College of Nursing European Centre for Connected Health

  2. eHealth for Patients and Information for Nursing • CONCEPT • The Vision • CONTEXT • What is happening, where and why • IMPACT • What does this mean for your nursing practice? • WAY FORWARD • What you can do

  3. Patient Research • NHS Choices • NHS National Library for Health • Map of Medicine • Other consumer health websites • Pubmed

  4. 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

  5. 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

  6. Context : Drivers • 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

  7. Terminology : Telenursing/Telemedicine Telenursing: the use of telecommunications technology in nursing to enhance patient care.  It involves the use of electromagnetic channels (e.g. wire, radio and optical) to transmit voice, data and video communications signals.  Skiba, D.J: (1998) Health-oriented Telecommunications in Nursing Informatics.  Where Caring and Technology meet. M:J: Ball , et al., Editors. Springer: New York. P40-53 Telemedicine: the use of audio, video, and other telecommunications and electronic information processing technologies to provide health services or assist health care personnel at distant sites. (American College of Physicians online, http://www.acponline.org)

  8. Terminology : Telecare • Telecare is the remote or enhanced delivery of health and social services to people in their own home by means of telecommunications and computerised systems. • Telecare usually refers to equipment and detectors that provide continuous, automatic and remote monitoring of care needs emergencies and lifestyle changes, using information and communication technology (ICT) to trigger human responses, or shut down equipment to prevent hazards. http://www.jitscotland.org.uk/action-areas/telecare-in-scotland

  9. Examples Telecare • equipment to assist in reducing accidents and incidents in the home motion, falls, fire & gas • community (social) alarms Telehealth • blood pressure monitoring • blood glucose monitoring • cardiac arrhythmia monitoring • medication reminder systems.

  10. Telehealth : Telemonitoring • Home telemonitoring: a patient management approach combining various information technologies for monitoring patients at distance. Guy, P; Mirou, J; Claude, S; (2007) Systematic Review of Home Telemonitoring for Chronic Diseases: The Evidence Base J Am. Med. Inform. Assoc. Vol 14 : No 3. pp 269-277 • Remote Telemonitoring Northern Ireland (RTNI) 2011: 5000 people with long term condition -Diabetes -Heart Failure -COPD • Monitoring vital signs and transmitted to a response centre where it is monitored against parameters set by the patient’s clinical team.

  11. Terminology - eHealth ehealth is an emerging field in the intersection of medical informatics, public health and business, referring to health services and information delivered or enhanced through the Internet and related technologies. In a broader sense, the term 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. (J Med Internet Res 2001;3(2):e20)

  12. Terminology – Connected Health • Connected Health is a term used to describe a model for healthcare delivery that uses technology to provide healthcare remotely. • Connected Health aims to maximize healthcare resources and provide increased, flexible opportunities for patients to engage with clinicians and better self-manage their care. • Connected Health encompasses programs in telehealth, remote care (such as home care) and disease and lifestyle management, and is associated with efforts to improve chronic care.

  13. Terminolgy –Nursing Informatics • 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) • Nursing informatics is using technology, research, and professional experience to manage nursing data, information, and knowledge to improve practice and deliver better health care. Simpson, Roy (2006). In H. A. Park, P. Murray,& C. Delaney, C. (Eds.). Consumer-Centered Computer Supported Care for Healthy People. Amsterdam, Netherlands: IOS Press, p 5 

  14. ‘Times-they are a changing….. Bob Dylan Are you …… a bystander a participant a leader ……..

  15. In the past we’ve given knowledge to clinicians who have passed it on to patients, now our principles are that we give knowledge to patients and give them the opportunity to discuss it with clinicians Sir Muir Gray –NHS Chief Knowledge Officer

  16. Information Age HealthcareImpact 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

  17. Education The Way Forward Patient Nursing Practice Service

  18. 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)

  19. Getting Involved • 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

  20. Your role………what you can do? • Share with your colleagues the knowledge you gain today • Look out for ways you can use technology in your practice - be a ‘pioneer’ • Develop Connected Health/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

  21. What you can do….. • Be informed • 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

  22. What Nursing can do for you? • Strategy/Structure – lead and support • Education - meet the need • Service – encourage innovation ‘free thinkers’ • Professional bodies - forums/conferences

  23. RCN Survey (2008) • Mapping e-health competencies for clinical practice has identified gaps in learning provision around clinical information management (as distinct from IT skills) • Myths and misconceptions around such areas as information sharing and electronic records.

  24. WWW…….progress When I took office, only high energy physicists had ever heard of what is called the Worldwide Web.... Now even my cat has its own page. President WM. CLINTON, during announcement of Next Generation Internet initiative, 1996.

  25. Some alternative terminology ! • Curser : Term applied to computer users who get abusive to their machines • Booting the Computer : applying a size 16 Doc Martens to the system box after it keeps telling you there’s not enough memory to run the application • Hard Drive : a car with no engine • Windows: Point, press and panic • Spreadsheet: telling lies in columns Exley. H. 1995

  26. ‘Times-they are a changing….. Bob Dylan Don’tbe a bystander bea participant striveto be a leader …….. eHealth Connected Health Nursing Informatics

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