Drive to encourage district nurses to embrace telehealth

New report suggests a reluctance to give up old ways of working

The telehealth industry was given a major boost this week when the Queen’s Nursing Institute launched a drive to encourage more district nurses to recognise the role of assistive technologies.

A report from the organisation revealed that some community nursing teams had already made significant changes to the way they practice as a result of telehealth equipment, but said others were stalling and missing out on potential new ways of helping patients.

It is claimed those who are yet to embrace the technology are concerned devices that allow remote monitoring or consultations could harm the relationships they build up with patients, or increase the feelings of isolation, particularly among patients living in remote areas.

There are still many instances of the healthcare system being remarkably resistant to the potential of technology to make care more effective, convenient or personalised for patients

The report, entitled Smart New World – using technology to help patients in the home , states: “The first, and possibly the biggest, issue, is the attitudes of professionals to the adoption of new technologies, and their readiness to embrace such changes in practice.

“There are still many instances of the healthcare system being remarkably resistant to the potential of technology to make care more effective, convenient or personalised for patients. There are practitioners who refuse to use information technology, and decline to offer their patients home monitoring equipment on the assumption that they won’t be able to manage it.

“Healthcare provided in the community is the most exciting and essential place for new technologies to be exploited to the full. Now is the time for the intelligent, comprehensive and creative use of every possible technological aid to deliver nursing in the community.”

In 2010, a Royal College of Nursing survey showed 20% of respondents thought an electronic patient record could be a ‘threat’ to the relationship nurses have with patients. But this week’s report says communications technology is now becoming part of the mainstream community nursing provision.

Now is the time for the intelligent, comprehensive and creative use of every possible technological aid to deliver nursing in the community

Rosemary Cook, director of the Queen’s Nursing Institute, said attitudes now had to move on in the same way for telehealth, particularly with a growing elderly population and a huge number of people living with long-term health conditions.

She said: “Technology is transforming the way that care is delivered, as well as the relationship between the patient and the professional.

“It doesn’t replace the nurse, or the need for a high level of both clinical skills and interpersonal skills in community nurses. Technology only works for patients when it is combined with expert, relationship-based care.”

Dr Susan Hamer, national director for nursing, midwifery and the allied health professionals in the Informatics Directorate at the Department of Heath, said the introduction of telehealth would require new ways of working, but claimed nurses were used to having to change and the need to constantly acquire fresh skills. She added: “Already we have examples of community nurses successfully deploying a range of mobile solutions for themselves and for patients. What we know from these sites is that when new ways of working are well planned, the use of new technologies is both popular and realises real benefits, both anticipated and unanticipated.

The cultural change required to move forward technology as a key aspect of our community services is our biggest challenge. The technology in many ways is the easy bit, but as many a writer would say, the key to culture change rests within our own behaviour

“The challenge for us is to develop an active vision which sees technology as a key enabler to our goals. Yes, there will be disruption to our old ways of thinking and delivering services, but change has always been our constant. There definitely will be new skills to acquire for ourselves and others, but that too has always been the case.

“The cultural change required to move forward technology as a key aspect of our community services is our biggest challenge. The technology in many ways is the easy bit, but as many a writer would say, the key to culture change rests within our own behaviour.”

The report highlights a pilot scheme in Kent, involving 250 COPD patients in the community. The introduction of assistive technologies led to a 50% reduction in hospital admissions and an 80% reduction in home visits. A scheme in Scotland, which involved giving district nurses laptops, was estimated to have saved £500,000 a year in travel costs alone.

In order to help with the transition, the Queen’s Nursing Institute is to run a number of sessions looking at technology in community healthcare and will fund nurse-led projects in the field.

Click here for the full report

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