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Transition of face-to-face care to telecare in a homecare organisation: a new way of caring
Transition of face-to-face care to telecare in a homecare organisation: a new way of caring
Transition of face-to-face care to telecare in a homecare organisation: a new way of caring
Transition of face-to-face care to telecare in a homecare organisation: a new way of caring
Transition of face-to-face care to telecare in a homecare organisation: a new way of caring
Transition of face-to-face care to telecare in a homecare organisation: a new way of caring
Transition of face-to-face care to telecare in a homecare organisation: a new way of caring
Transition of face-to-face care to telecare in a homecare organisation: a new way of caring
Transition of face-to-face care to telecare in a homecare organisation: a new way of caring
Transition of face-to-face care to telecare in a homecare organisation: a new way of caring
Transition of face-to-face care to telecare in a homecare organisation: a new way of caring
Transition of face-to-face care to telecare in a homecare organisation: a new way of caring
Transition of face-to-face care to telecare in a homecare organisation: a new way of caring
Transition of face-to-face care to telecare in a homecare organisation: a new way of caring
Transition of face-to-face care to telecare in a homecare organisation: a new way of caring
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Transition of face-to-face care to telecare in a homecare organisation: a new way of caring

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The transition of face-to-face care to telecare (care at distance using videoconferencing) requires new skills and knowledge for nurses and other health care professionals: eHealth competencies and …

The transition of face-to-face care to telecare (care at distance using videoconferencing) requires new skills and knowledge for nurses and other health care professionals: eHealth competencies and also competencies on self-management support.

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  • 1. Transition of face-to-face care to telecare in a homecare organisation A new way of caring Thijs van Houwelingen MSc, Ansam Barakat MSc, Prof. Dr. Helianthe Kort, Holder Faculty Chair Demand Driven Care 05/11/13 This project is part of the strategic area „Healthcare & Technology‟ , University of Applied Sciences Utrecht
  • 2. Background Matter of transition • Growing number of older adults & decreasing number of care professionals • Telehomecare can offer a potential solution by supporting older adults to agein-place [Pountney, 2009] by substituting more efficient e-visits for in-person • Some Dutch homecare organisations are dealing with the question: how can we integrate telecare in our care pathways? • Homecare organisations experience barriers to implementation (Kort, Van Hoof, 2012). Research Centre for Innovations in Health Care www.kenniscentrumivz.hu.nl Background Background Project Goals Phase 1 Method Phase 1 Results Phase 1 (a) Results Phase 1 (b) Goals Phase 2 Method Phase 2 Objective of project: Obtain insight into telecare possibilities for homecare organisations that did not yet implement telecare Results Phase 2 (a) Results Phase 2 (b) Discussion Self-manag. Discussion Nursing pract. Conclusion
  • 3. Background Project – partners involved Collaboration between Research Centre Innovations in Health Care [coordination] “Which telecare providers do we have to select for our pilot?” “Which nursing tasks can be substituted by telecare?” Practice - Health Care Organisation Rivas Zorggroep [facilitator] Education - Students, Bachelor of Nursing & Students Management in Health Care [carried out the research] Research Centre for Innovations in Health Care www.kenniscentrumivz.hu.nl Background Background Project Goals Phase 1 Method Phase 1 Results Phase 1 (a) Results Phase 1 (b) Goals Phase 2 Method Phase 2 Results Phase 2 (a) Results Phase 2 (b) Discussion Self-manag. Discussion Nursing pract. Conclusion
  • 4. Goals Project • Phase 1: Comparison of four telecare providers, aiming to advice Rivas which two telecare providers to include in their pilot Research Centre for Innovations in Health Care www.kenniscentrumivz.hu.nl Background Background Project Goals Phase 1 Method Phase 1 Results Phase 1 (a) Results Phase 1 (b) Goals Phase 2 Method Phase 2 Results Phase 2 (a) Results Phase 2 (b) Discussion Self-manag. Discussion Nursing pract. Conclusion
  • 5. Method Phase 1 – Comparison of telecare devices • 1. Exploration of vision and values of healthcare organisation and demands with regard to telecare 2. Exploration of possibilities of four different telecare devices 3. Scoring of telecare providers • Assesment of devices: Comparison of demands of organisation with possibilities devices, resulting in a scoring list Interviews • Nurses • Managers • Project manager Analyses of • Outcome of workshops • Vision of organisation Interviews with telecare providers Research Centre for Innovations in Health Care www.kenniscentrumivz.hu.nl Background Background Project Goals Phase 1 Method Phase 1 Results Phase 1 (a) Results Phase 1 (b) Goals Phase 2 Method Phase 2 Results Phase 2 (a) Results Phase 2 (b) Discussion Self-manag. Discussion Nursing pract. Conclusion
  • 6. Results Phase 1 – Comparison of telecare devices (a) Examples of demands of homecare organisation with regard to telecare Application of device • Possibility to monitor • Puff inhalation COPD patients • Wound care • Medication intake • Communication with dietician at distance Offer of education Completeness of the course Functions • Connection with other platforms • Additional possibilities, non-care related, such as: gaming, grocery shopping service Service • Security criteria (requirement of Dutch health insurance) • Service desk, in case of emergency Research Centre for Innovations in Health Care www.kenniscentrumivz.hu.nl Background Background Project Goals Phase 1 Method Phase 1 Results Phase 1 (a) Results Phase 1 (b) Goals Phase 2 Method Phase 2 Results Phase 2 (a) Results Phase 2 (b) Discussion Self-manag. Discussion Nursing pract. Conclusion
  • 7. Results Phase 1 – Comparison of telecare devices (b) Table 1. Comparison of (a) demands and (b) possibilities of devices Demands and requirem ents / Telecare supplier Applicati on of device(m aximum score = 56 points) Function s of device (maximu m score = 21 points) Service of device (maximu m score = 42 points) Offer of training (maximu m score 14) Total score (maximu m score133 points) Device a ++ (55) ++ (19) +/- (25) ++ (13) 112 Device b ++ (53) ++ (20) +/- (28) ++ (12) 112 Device c ++ (55) ++ (20) - (24) + (11) 110 Device d +/- (38) +/- (14) -- (14) + (10) 76 Goals Phase 2 Method Phase 2 Conclusion (phase 1) • Three of the four telecare providers showed a comparable level of quality • One telecare providers failed in particular on „functions‟ and „service‟ Research Centre for Innovations in Health Care www.kenniscentrumivz.hu.nl Background Background Project Goals Phase 1 Method Phase 1 Results Phase 1 (a) Results Phase 1 (b) Results Phase 2 (a) Results Phase 2 (b) Discussion Self-manag. Discussion Nursing pract. Conclusion
  • 8. Goals Project • Phase 2: Exploration of care tasks that can be substituted by telecare Research Centre for Innovations in Health Care www.kenniscentrumivz.hu.nl Background Background Project Goals Phase 1 Method Phase 1 Results Phase 1 (a) Results Phase 1 (b) Goals Phase 2 Method Phase 2 Results Phase 2 (a) Results Phase 2 (b) Discussion Self-manag. Discussion Nursing pract. Conclusion
  • 9. Method Phase 2 – Exploration of telecare tasks 1. Development of a complete list of care tasks, provides by the homecare organisation Interviews with district nurses of Rivas 2. Estimation of time required for each task Based on experience of nurses and their managers 3. Assessment of care tasks: which tasks can be provided via telecare? 4. Estimation of time for each possible telecare task 5. Reach consensus of tasks that can be substituted and times that can be saved in this particular organisation According to: • Representatives of the two selected devices • Homecare organistions that already use telecare In collaboration with district nurses of Rivas Research Centre for Innovations in Health Care www.kenniscentrumivz.hu.nl Background Background Project Goals Phase 1 Method Phase 1 Results Phase 1 (a) Results Phase 1 (b) Goals Phase 2 Method Phase 2 Results Phase 2 (a) Results Phase 2 (b) Discussion Self-manag. Discussion Nursing pract. Conclusion
  • 10. Results Phase 2 – Exploration of telecare tasks (a) Care tasks that can be substituted by telecare /e-visits • • • • • • • • Inhalation with nebuliser Subcutaneous injection Stoma care Medication intake monitoring Structuring conversations Blood pressure measurement Glucose value measurement Et cetera In total 55% of the 97 care tasks can be done trough telecare… Research Centre for Innovations in Health Care www.kenniscentrumivz.hu.nl Background Background Project Goals Phase 1 Method Phase 1 Results Phase 1 (a) Results Phase 1 (b) Goals Phase 2 Method Phase 2 Results Phase 2 (a) Results Phase 2 (b) Discussion Self-manag. Discussion Nursing pract. Conclusion
  • 11. Results Phase 2 – Exploration of telecare tasks (b) and 67% when combining telecare and family carers However… Managing 55% of the care tasks instead of providing them directly, sets high demands on older adults‟ willingness to play an active role in their care process Research Centre for Innovations in Health Care www.kenniscentrumivz.hu.nl Background Background Project Goals Phase 1 Method Phase 1 Results Phase 1 (a) Results Phase 1 (b) Goals Phase 2 Method Phase 2 Results Phase 2 (a) Results Phase 2 (b) Discussion Self-manag. Discussion Nursing pract. Conclusion
  • 12. Discussion Implications for self-management So, the transition of face-to-face care to telecare has great implications for self-management of patients At the same time, recently (2013) a Dutch survey observed that “few Dutch older adults choose to use self-management tools” [Krijgsman et al., 2013] On of the reasons that UUAS in 2011 already started the PETZ-project: Predictors for the Use of eHealth by Older Adults and Professionals (www.petz.hu.nl) Research Centre for Innovations in Health Care www.kenniscentrumivz.hu.nl Background Background Project Goals Phase 1 Method Phase 1 Results Phase 1 (a) Results Phase 1 (b) Goals Phase 2 Method Phase 2 Results Phase 2 (a) Results Phase 2 (b) Discussion Self-manag. Discussion Nursing pract. Conclusion
  • 13. Discussion Implications for nursing practice New eHealth competencies are required [Barakat et al., 2013], for example • Have basic skills for using technology and hardware • Ability to treat and diagnose effectively at a distance • Know and be able to translate the benifits of eHealth technologies to end users (http://www.medicine20.com/2013/2/e10/) A changing role: less providing care directly, more coaching Coordinating care, carried out by the patient himself or his family carers (self-management) Barakat et al., (2013). eHealth Technology Competencies for Health Professionals Working in Home Care to Support Older Adults to Age in Place: Outcomes of a Two-Day Collaborative Workshop. Medicine 2.0. Research Centre for Innovations in Health Care www.kenniscentrumivz.hu.nl Background Background Project Goals Phase 1 Method Phase 1 Results Phase 1 (a) Results Phase 1 (b) Goals Phase 2 Method Phase 2 Results Phase 2 (a) Results Phase 2 (b) Discussion Self-manag. Discussion Nursing pract. Conclusion
  • 14. Conclusion Future challenges for research and nursing education Future research – More evidence on competencies required for telecare / eHealth [Van Houwelingen et al., 2013] – More evidence on competencies required for selfmanagement support Nursing education Nursing schools should take the responsibility to offer an adequate preparation for the rapidly changing health care sector: • Education on eHealth • Education on self-management Van Houwelingen et al., (2013). Using the Unified Theory of Acceptance and Use of Technology to Explore Predictors for the Use of Telehomecare by Care Professional. Assistive Technology Research Series, 33: Assistive Technology: From Research to Practice. Research Centre for Innovations in Health Care www.kenniscentrumivz.hu.nl Background Background Project Goals Phase 1 Method Phase 1 Results Phase 1 (a) Results Phase 1 (b) Goals Phase 2 Method Phase 2 Results Phase 2 (a) Results Phase 2 (b) Discussion Self-manag. Discussion Nursing pract. Conclusion
  • 15. Thank you for your attention! Thijs van Houwelingen thijs.vanhouwelingen@hu.nl / www.innovationsinhealthcare.research.hu.nl A special acknowledgment goes to Angela van Ark, Maartje van Oorschot, students Management in Healthcare, and Maria-Lotte Haagsman, Romy van Ruitenbeek, Sharron Jalimsing, Conny van Ruitenbeek, students Bachelor Studies of Nursing, University of Applied Sciences Utrecht. We are thankful for the effort they have put into this research. References [1] Pountney, D. (2009). Telecare and telehealth: enabling independent living. Nursing & Residential Care, vol. 11, p. 158. [2] Krijgsman, Johan, Jolanda de Bie, Arina Burghouts, Judith de Jong, Geert-Jan Cath, Lies van Gennip, Roland Friele. eHealth, verder dan je denkt: eHealth-monitor 2013. Den Haag: Nictiz en NIVEL, 2013. url https://www.zorgkennis.net/downloads/kennisbank/ZK-kennisbank-eHealth-monitor-2013-1928.pdf [3] Barakat A., R.D. Woolrych, A. Sixsmith, W.D. Kearns, H.S.M. Kort. eHealth Technology Competencies for Health Professionals Working in Home Care to Support Older Adults to Age in Place: Outcomes of a Two-Day Collaborative Workshop. Medicine 2.0, 2013, 2, e10. doi:10.2196/med20.2711. [4] Houwelingen, T. van, A. Barakat, A. Antonietti & H. Kort (2013). Using the Unified Theory of Acceptance and Use of Technology to Explore Predictors for the Use of Telehomecare by Care Professionals. In: P. Encarnação et al. (Eds.), Assistive Technology Research Series, 33: Assistive Technology: From Research to Practice (pp. 1223 - 1228). IOS Press, Amsterdam. doi: 10.3233/978-1-61499-304-9-1223 [5] Kort, H.S.M., J. van Hoof (2012). Telehomecare in The Netherlands: Barriers to Implementation. International Journal of Ambient Computing and Intelligence, 4(2), 64-73. doi: 10.4018/jaci.2012040105 Research Centre for Innovations in Health Care www.kenniscentrumivz.hu.nl Transition of face-to-face care to telecare in a homecare organization A new way of caring date 05/11/13

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