What is the biggest technology barrier to launch virtual nursing?

[Mitchell Fong]

When I think about technology in Healthcare, I am always focused on making sure the technology has the intended impact and drives value for all users (patients, caregivers, etc.). As virtual nursing evolves, it is imperative that technology is an enabler of enhanced care and NOT A BARRIER for care. The technology must always support the clinical workflow to drive value. I have seen workflow integration and appropriate data to be huge barriers of technology innovation in healthcare. When I say “appropriate data ” I am referring to the right amount of data (not too much or too little) and presented in a fashion that is meaningful and usable by the end users. What are your thoughts and how have you addressed these issues?

Topic

[Ami O’Grady]

I found this article, Health System Approach to Implementing Technology-Facilitated Care to resonate with our challenges. My company is over ten years old and not a product of the pandemic. We have seen the challenges outlined in the article and made some gains in overcoming the patient-facing technology challenges. But what I see is those patients that are sicker have far less tolerance for learning technology. They often “shut down” and will disenroll from the program due to another overwhelming task of managing their health needs. I’m more than willing to share the steps we have taken to overcome the challenges- such as purchasing pulse oximeters with different color results, one color for the pulse and another for O2. I also found blood pressure cuffs with larger buttons for easy use in the older population or those with physical limitations. Consideration of the patients’ technology experience is crucial to launching a successful VN program.

[Dr. Bonnie Clipper]

@Ami these are all great points. We need to establish frameworks to educate patients – as well as staff- while patients are being admitted, through intake or even in clinic visits. I am not aware of any system doing a great job of this year. I think we are all running to catch up. This is a great point that deserves more focus.

[Ami O’Grady]

I agree with the comments here. I am fortunate, in my current role, to see the outputs of a technology team working with the clinical team to build the software/ platform needed to provide virtual services. We are building a robust platform for clinician efficiency and seamless patient data integration. But this is not a practical model for other settings and larger systems.

An area I’ve experienced as a barrier to virtual nursing is the patients’ digital literacy. It can be time-consuming for nurses to teach patients to monitor their blood pressure remotely. Time-consuming and often a source of frustration as a patient acclimates to the associated in-home technology. Similar challenges and frustrations occur when internet access is a barrier. Whether it’s a rural location or lack of home internet, the challenge is there and can lead to disengagement by the patient.  There would be wider adoption of virtual nursing services with policy changes specific to reimbursement for digital health literacy support. Designated nonclinical support personnel to spend the time to train and provide help early on could make a significant impact on the virtual nursing service provided and the outcomes for patients effectively participating in a service inclusive of VN.

[Dr. Bonnie Clipper]

i think that some of this stems from the fact that IT has to be viewed as a partner, and at the same time shouldn’t be the reason to not explore or implement new care models. I am seeing this in an organization that I am working with now–IT is “not able to prioritize this work due to staffing and workloads”- yet ironically this is exactly why the VN model is being implemented although from a patient care/clinical staffing perspective. I think we will find better ways to grapple with this over the next year that make everyone feel as though they are on the same team again.

[Rhonda Manns]

Hi all! I think that there should be considerations for technological support for the VN. Yes, the technology infrastructure could be a heavy lift at first, but we need to consider the staff needed for troubleshooting/maintaining it.

The build is one thing, but the IT support staff is another. And, let’s be honest, the internal Hospital IT staff lacks the layers to focus on this element. Even today, I’m finding that hospital/health systems are just beginning to expand their PMO and IT offices to include a “product” mindset and roles to bridge the gap between the clinical need, the tech builds and the system/setup.

While internet/IOT infrastructure, cybersecurity, and data mapping are all top of mind for executives – as an Snr. Capability (clinical software integration product) Lead and RN, I see this as a blindspot and additional need. Good chat!

[Cynthia Russell, DNP, RN-BC]

I wonder about the technology infrastructure and the cost to support the bandwidth needed.  Community hospitals may struggle to have a robust network infrastructure.

[Mitchell Fong]

Bea – I agree with your thoughts completely. The experience is vital to ensure the experience and value derived is appropriate. The lack of coordination and interoperability across various systems is a huge barrier/risk when implementing technology today. The people, process, and technology need to be working together in alignment to create a seamless workflow and good experience to avoid those unintended consequences.

I am curious, are there any processes in place that your organization has been successful as using to help mitigate this risk?

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