Can and should nurses push the boundaries in healthcare with digital technology?
According to Professor Natasha Phillips, a former UK Chief Nursing Officer and the founder of Future Nurses, it is critical to meet future healthcare needs.
Professor Phillips, who spoke at the recent International Nurses Congress held in Montreal, Canada, said historically, the focus on the digital transformation of healthcare has been on electronic health records.
“While these are essential for information sharing, they’re not themselves transformative. In fact, what we have too often seen is the translation of old ways working into digital systems.”
“This has led to overburdened nurses spending considerable time documenting care and actually adversely effective critical thinking of some.”
But Professor Phillips argues that technology is evolving rapidly, including mobile health applications and ambient monitoring providing care closer to home. It has also allowed people to manage their health with targeted information, including big data and genomics support.
“Having access to this data, healthcare teams can now see a global view of populations.
“They can really start to target road population health in this way. And we need to do this because we’ve got some really big challenges,“ she said.
These challenges include chronic diseases and multi-morbidities that increase the burden of long-term care along with inequity and poverty.
To tackle these issues, Professor Phillips believes digital technologies can help by supporting the move from a paradigm of managing illness to a paradigm of promoting health.
“So, whilst it’s daunting, we have to embrace this.”
However, embracing technology comes with its own set of challenges.
These include the need for interoperability and data sharing to improve the fragmented nature of our healthcare systems and realise the practical benefits of information flows and big data for practice and research.
“Additionally, our global workforce challenge cannot be ignored. Delivering change of scale required in systems to an already overburdened workforce due to nursing shortages and low morale is indeed a challenge.”
Yet Professor Phillips believes these challenges are not insurmountable and that the goals of health systems can be addressed by purposeful digital transformation where people, process and technology are considered together holistically.
Further, she said nurses were well-placed to lead this charge.
“This will need system leadership, data governance policies which enable data sharing, home with a focus on personalised nursing care, informed by great data, telemedicine, virtual wards, and ambient monitoring,” Professor Phillips said.
“To get there, it has to start with a unified vision of how we want to practice our nursing in a world that is digitised, connected, and transformed.
“We need to dream our future. We need a shared understanding of what good leadership looks like in this space of the opportunities to improve and make care safer on how we want to work with people we serve and empower them.”
Ultimately Professor Phillips said nurses needed to be supported with the education that enabled them to harness the use of technologies by engaging with non-nursing colleagues to inform the laying of smart foundations such as technologies that work for nurses.
“This requires us to do more to develop specialist nurse leaders with a deep understanding of technology and data science at the interface of technology development and nursing practice.
“We have some of those people today, but we need to support them and amplify their voice. We are a global profession. Our vision should be global. It should not only address the challenges we face now but be future-focused.
“Reimaging how we will practice in ten, twenty years and beyond as Florence Nightingale reimagined and redefined nursing over 150 years ago. So must we reimagine and redefine nursing for the digital age.”
Professor Phillips pointed out that nurses have limited experience with technology to make their work lives more manageable. This starkly contrasts their experience of technology in their personal lives.
“After 30 years of working on standardised nursing terminologies like the international classification of nursing practice, we have failed to see these used at scale. Our documentation burden has, in fact, increased, and nursing is all too often reduced to a series of tasks commanded on a computer screen.”
Professor Phillips said the lack of structured data in electronic health records has meant that nurses have not reaped the rewards of rich data about nursing interventions and outcomes to demonstrate impact.
“Arguably and understandably, this affects our willingness to change. This means we are mostly still in the substitution phase. So we are mostly there where we are doing a direct substitute with no actual function of change in how we deliver care. So how do we move from there to redefinition where there will be new ways of working ways we have not yet imagined and new roles developed in response to these changes?”
Professor Phillips said that change must start with nurses. She argued that if nursing does not radically change education, it will fall further behind as a profession.
“This is not good for nurses, it’s not good for patients, and it’s certainly not good for populations.”
Professor Phillips said not only do learners feel well prepared for digital healthcare systems, but nurse educators feel ill-equipped to prepare them.
Changing the way nursing views technology comes back to vision.
“It starts with recognising that digital is every nurse’s business. We must mobilise ourselves as a social movement, a force for global health enabled by digital technology and data, but without a shared purpose. The innovators and future-thinking nurses are lost; their voices are diluted.
“We must work together to ensure the nurses of the future leave their training with the knowledge and skills to confidently work with innovative technologies, genomics and artificial intelligence, using big data to evidence and evolve their contribution to healthy people and healthy populations. With this knowledge, the nurse of the future is a digital innovator and an entrepreneur.”