Using technology to support better workforce deployment to improve care for long term conditions- Managing Long Term Conditions 2010

1. 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

2. 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
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3. 1. The role of technology in
supporting long term
conditions
• Evidence suggests that technology can
support people and their carers with LTC
Managing Long Term Conditions – Assistive Technology theme 16th April 2010, Harrogate
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4. Technology and LTC
Cancer
These include:
• COPD
• CHF
• Diabetes
• Parkinson’s Disease
• MS
• MND
• Dementia
• Other chronic
conditions etc.
Musculoskeletal
Conditions
Heart and
Cardiac
Technology
Respiratory
Conditions
Diabetes
Neurological
Conditions
Managing Long Term Conditions – Assistive Technology theme 16th April 2010, Harrogate
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Mental Health

5. Technological support for
LTC
Remote monitoring
of conditions
Patients with LTC will have
a range of technological
support for them from
health and social care.
Signposting
Teleconsultations
Shared patient
information
Remote
medication
management
Remote carer
support
Managing Long Term Conditions – Assistive Technology theme 16th April 2010, Harrogate
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6. ICT implementation
• New technologies can
• enable collaborative working
• provide better data collection
• provide secure data systems
• enable electronic ordering
• increase auditing capabilities

7. 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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8. The development of health
technology
Remote activity
monitoring
ICT
usage
Remote Internet
communications
Telephone
communication
Direct face to
face contact
Time
Managing Long Term Conditions – Assistive Technology theme 16th April 2010, Harrogate
mHealth portable
wireless
communications

9. 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
Managing Long Term Conditions – Assistive Technology theme 16th April 2010, Harrogate
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10. Key areas where change
will occur
Nurses will have a
wider repertoire of
communication
with patients.
Managing Long Term Conditions – Assistive Technology theme 16th April 2010, Harrogate
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11. Contributions to areas of nursing
practice
Managing Long Term Conditions – Assistive Technology theme 16th April 2010, Harrogate

12. Differential use of Technology by
different nurses
Managing Long Term Conditions – Assistive Technology theme 16th April 2010, Harrogate
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13. 5. The advantages and
diadvantages of technology
deployment within LTC
Managing Long Term Conditions – Assistive Technology theme 16th April 2010, Harrogate
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14. Advantages
• 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.
Managing Long Term Conditions – Assistive Technology theme 16th April 2010, Harrogate
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15. 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 selfcare.
Managing Long Term Conditions – Assistive Technology theme 16th April 2010, Harrogate
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16. 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.
Managing Long Term Conditions – Assistive Technology theme 16th April 2010, Harrogate
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17. 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.
Managing Long Term Conditions – Assistive Technology theme 16th April 2010, Harrogate
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18. Other disadvantages
• Patient expectations might be
unattainable/unmet.
• Challenge of controlling virtual information.
• Compatibility of issues across different ICT
systems.
Managing Long Term Conditions – Assistive Technology theme 16th April 2010, Harrogate
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19. 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
Managing Long Term Conditions – Assistive Technology theme 16th April 2010, Harrogate
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20. 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.
Managing Long Term Conditions – Assistive Technology theme 16th April 2010, Harrogate
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21. 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
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