Using technology to support better workforce deployment to improve

care for long term conditions

Dr Guy Dewsbury

Professor Alison While

The Florence Nightingale School of Nursing and Midwifery

King's College London

Managing Long Term Conditions – Assistive Technology theme 16th April 2010, Harrogate

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The main themes of this presentation are:

1. The role of technology in supporting long term

conditions (LTC)

2. ICT practice and role changes

3. The impact upon nursing practice

4. The advantages and disadvantages of

technology deployment within LTC

Managing Long Term Conditions – Assistive Technology theme 16th April 2010, Harrogate

1. The role of technology in supporting long term conditions

• Evidence suggests that technology can

support people and their carers with LTC

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Managing Long Term Conditions – Assistive Technology theme 16th April 2010, Harrogate

Technology and LTC

Technology

Cancer

Heart and Cardiac

Respiratory Conditions

Mental Health Neurological Conditions

Diabetes

Musculoskeletal Conditions

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Managing Long Term Conditions – Assistive Technology theme 16th April 2010, Harrogate

These include:

• COPD

• CHF

• Diabetes

• Parkinson’s Disease

• MS

• MND

• Dementia

• Other chronic

conditions etc.

Technological support for LTC

Remote monitoring of conditions

Teleconsultations

Remote medication

management

Remote carer support

Shared patient information

Signposting

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Managing Long Term Conditions – Assistive Technology theme 16th April 2010, Harrogate

Patients with LTC will have

a range of technological

support for them from

health and social care.

• New technologies can

• enable collaborative working

• provide better data collection

• provide secure data systems

• enable electronic ordering

• increase auditing capabilities

ICT implementation

2. ICT practice and role changes • ICT will enable health professionals to

develop new ways of working both remotely

and virtually.

• ICT facilitates improved monitoring of

patient status to which health care

providers can respond.

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The development of health technology

Direct face to face contact

Telephone communication

Remote Internet communications

Remote activity monitoring

mHealth portable wireless communications

ICT

usage

Time Managing Long Term Conditions – Assistive Technology theme 16th April 2010, Harrogate

3. The impact upon nursing practice • The nurse plays a pivotal role in LTC

management

• Improved patient monitoring enables timely

healthcare interventions to support self-care

capabilities

• Fits with Darzi Report (DoH 2008) ambitions of

high quality care for all

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Managing Long Term Conditions – Assistive Technology theme 16th April 2010, Harrogate

Key areas where change will occur

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Nurses will have a

wider repertoire of

communication

with patients.

Managing Long Term Conditions – Assistive Technology theme 16th April 2010, Harrogate

Contributions to areas of nursing practice

Managing Long Term Conditions – Assistive Technology theme 16th April 2010, Harrogate

Differential use of Technology by different nurses

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Managing Long Term Conditions – Assistive Technology theme 16th April 2010, Harrogate

5. The advantages and diadvantages of technology deployment within LTC

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Managing Long Term Conditions – Assistive Technology theme 16th April 2010, Harrogate

Advantages

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Managing Long Term Conditions – Assistive Technology theme 16th April 2010, Harrogate

• One nurse can interact with many patients

remotely.

• One nurse can manage a larger caseload

through remote monitoring.

• Less chance of cross-infection through

virtual interaction.

Other advantages

• Less travel time.

• Doctors and nurses can hold joint remote

consultations with the patient and their

family.

• Fewer costly face-to-face healthcare

interventions with enhanced patient self-

care.

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Managing Long Term Conditions – Assistive Technology theme 16th April 2010, Harrogate

Further advantages

• Virtual titration of current medication and

virtual prescription changes will save time

and money.

• Efficient signposting to other services to

maximize health resources.

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Managing Long Term Conditions – Assistive Technology theme 16th April 2010, Harrogate

Disadvantages

• Reduced personal contact between professionals

and patients.

• Formulaic approach may constrain practice and

override professional judgment.

• Significant investment will needed to ensure all

practitioners are “masters” of ICT.

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Managing Long Term Conditions – Assistive Technology theme 16th April 2010, Harrogate

Other disadvantages

• Patient expectations might be

unattainable/unmet.

• Challenge of controlling virtual information.

• Compatibility of issues across different ICT

systems.

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Managing Long Term Conditions – Assistive Technology theme 16th April 2010, Harrogate

Unanswered Questions

• Acceptability of different ICT for different

people.

• Most evidence relates to chronic disease

management to the neglect of health

promotion.

• ICT use by informal carers and unqualified

care workers not researched

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Managing Long Term Conditions – Assistive Technology theme 16th April 2010, Harrogate

Conclusion • Health services can stand to benefit considerably

through the use of technology but there are

limitations and appropriate use.

• Technology cannot substitute for face to face

contact in all cases.

• Successful implementation will require staff

acceptance of new ways of working and good

training ICT.

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Managing Long Term Conditions – Assistive Technology theme 16th April 2010, Harrogate

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Thank You

Guy Dewsbury

guy.dewsbury@kcl.ac.uk

Alison While

alison.while@kcl.ac.uk

http://mykcl.com/schools/nursing/

Managing Long Term Conditions – Assistive Technology theme 16th April 2010, Harrogate