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

2. 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.

3. 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.

4. 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

5. Transformation from Industrial Age Medicine to Information Age Healthcare Person Family & Community Primary Care Secondary Care Tertiary Care Person Family & Community Professionals as Facilitators Professionals as Authorities Doing Supporting Professionals as Partners Use of Information & Communication Technologies Adapted from Malaysian Telemedicine Blueprint

6. Patient with Clinical Problem Gains information via internet, own health record, networks Patient with Clinical Problem Visit Clinical TeamGains information Visits clinical team to gain understanding and discuss options Before Now and in the future

7. Information Age Healthcare Impact 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

8. eHealth : Local Context Joint working ECCH & RCN - Appointment of eHealth Officer Engaging the Nursing Workforce

9. 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

10. Progress to Date Workshops for Nurses and 85 Nurses attended Survey using a questionnaire (n=80) 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

11. 71% Community Nurses 86% Degree Level 81.4% more than 15 years experience 24.3% more than 30 years experience Demographics

12. Attitudes and Perceptions Rate 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%

13. 75% had heard of eHealth 45% had heard at work

14. 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

15. 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

16. 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)

17. 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)

18. Developing an eHealth culture Strategy/Structure – lead and support Education - meet the need Service – encourage innovation ‘free thinkers’ Professional bodies - forums/conferences

19. Your role………what 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

20. YOUR HEALTH, YOUR CARE AT HOME

21. 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.

22. Long Term Conditions Diabetes COPD Heart Failure

23. Assistive Technology Remote monitoring of vital signs including:- Blood pressure Pulse Oxygen saturation Weight Blood Glucose Peak Flow

24. Levels of Support Level 1 – Supported Self Care Levels 2- Disease Specific Care Level 3 – Case Managed

25. Staff Involved Continuing Care Nurses Acute Care at Home Team Specialist Nurses

26. 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

27. 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.

28. Patients Views Promotes: self management continuous monitoring Independence