DNP 805 Topic 2 Emerging Technologies

´Technology use has intensified in health practice

´Leading use: solving clinical problems by linking patient care with information

Presentation Areas

´The clinical problem and appropriate technology

´Theory to guide presentation

´The role of the technology in resolving the clinical problem

´Potential strengths and limitations

´Patient education method for use of the technology

Welcome to this presentation on technology in clinical practice.

Health care organizations seek many interventions to advance care and enhance patient satisfaction. The role of technology is critical in these processes, and its use has intensified progressively in health care delivery. Technologies, particularly information communication technologies, play a vital role in solving clinical problems by linking patient care with information. This presentation evaluates a clinical problem that can be solved through technology. It presents the clinical problem and appropriate technology, the theory to guide the presentation, and how the technology can be used to resolve the problem. It also explains the strengths and limitations of the technology and the appropriate education method if patients were to be educated on using the technology.

Clinical Problem: Brief Description 

Clinical problem: Low patient engagement in own health management

Characteristics of Active Patient Engagement

´Cooperation with health care providers

´Desire to participate in the health care process

´Advanced patient knowledge on health conditions and management

´Improved experiences of care

´Patient-centeredness in health care delivery

The health practice faces different challenges that impede the achievement of the desired health outcomes. As a result, health care providers should continually assess clinical problems and intervene appropriately. One of the clinical problems deserving maximum attention is the low engagement of patients in managing their health. In a situation where patients are actively involved in their own health management, patients and health care professionals cooperate in health care delivery, and patients show a desire to participate in the health care process. Other defining characteristics include an informed patient population since patients can access their medical records when needed, improved care experiences and satisfaction, and patient-centeredness in health care delivery.

Barriers to Patient Engagement

´Underuse of technology

´Inadequate health care resources

´Uninformed patient population

´Attitude towards modern health practice

´Lack of encouragement and support from health care providers

Before evaluating the technology necessary to address this problem, it is crucial to examine barriers to active patient engagement in health care. A leading barrier is the underuse of technology in health practice. Patient engagement is high in health care organizations that embrace technology in care and support patients to use existing and emerging technologies (Bacchetti et al., 2020). Another typical barrier is a lowly-informed patient population. Patients should be informed on technology use and other practices that promote their engagement in health care delivery. Other barriers include negative attitudes towards modern health practice and lack of encouragement from health care providers. As a result, technologies seeking to promote engagement should address these barriers.

Technology to Improve Patient Outcomes

Appropriate Technology: Patient portals

Overview

´A secure online platform

´Provides access to health information

´Requires internet access

´Highly personalized- secure username and password

A suitable technology to address the problem of low engagement in patients’ health management is patient portals. Over time, patient portals’ use has intensified as technologies, particularly electronic health records (EHRs), dominate the health practice (Lyles et al., 2020). As a technology gaining relevance over time, patient portals include a secure online platform that patients use to connect with their health care providers. Through the platform, patients can access crucial health information that guides them in everyday decision-making regarding their health. Patient portals are among the health care technologies that work best via internet connection. They are also highly personalized since they deal with sensitive information that should only be accessed by authorized individuals.

Features

´Secure messaging

´Patient registration

´Medical history

´Education materials

´Results (lab and tests)

´Appointment requests and reminders

The effectiveness of patient portals depends on the presence and capacity of several features. Among them, secure messaging helps patients exchange information with health care providers. This requires the portal to be integrated with the EHR system. The other essential feature is the patient registration segment that allows patients to feed the system with crucial personal details before an appointment to save time in the waiting room. Other important features include medical history and medication lists, lab and test results, and appointment requests and reminders. Each feature empowers the patient differently, but the ultimate goal is to ensure that patients can access crucial health information and exchange data with health care providers as needed.

Functions/Capabilities

´Access to a provider team

´Sending messages to health care providers

´Easy access to health care data

´A platform to schedule appointments online

´Update health information e.g. insurance information

Besides the features, patient portals should be capacitated to work in various interrelated ways to actively engage patients in health management. The first capacity is providing access to a health care team all the time. From an operation viewpoint, accessing a provider team is the most basic capacity since patients need to ask questions regarding their health and update health care providers about their health for them to play an active role in health management. Also, the platforms should offer easy access to health data as long as the patients are authorized. Other essential capacities include enabling patients to book appointments and updating health information when necessary.

Theory to Guide the Presentation

Theory: Imogene King’s Theory of Goal Attainment

Basic concept: an interpersonal relationship between patients and nurses

Defining Elements of the Interpersonal Relationship

i. through sharing information

ii.Joint goal setting

iii.The nurse and patient taking actions together

´Patient needs: health information and care

The health care process is complex, and the desired outcomes cannot be achieved without an in-depth understanding of the patients’ needs. As a result, health care professionals should apply theories that encourage patient participation in the health care process to ensure that patient needs are sufficiently understood. Imogene King’s theory of goal attainment emphasizes that an interpersonal relationship between nurses and patients is crucial to enabling patients to grow and attain individual health goals (Adib-Hajbaghery & Tahmouresi, 2018). As a function that patient portals support, nurses and patients communicate information and set goals together before taking actions necessary to achieve the set goals. The theory depicts a patient as a person in need of health information and care that helps in illness prevention and enables the patient to function independently. Patient portals are valuable in sharing health information, as the theory recommends.

Applicability of the Theory

´Defines nursing as an interaction between nurses and patients

´Exchange of health information is core to the nurse-patient interaction

´Emphasizes focusing on the patient

Goals of the Nurse

i.Helping the patient to maintain health

ii.Interpret health information and develop relevant intervention plans while engaging the patient.

Imogene King’s theory of goal attainment applies to this presentation since it describes nursing as an interactive process where nurses and patients share information. Patient portals align with the goals of this theory since the nurse-patient interaction allows patients and health care providers to share relevant health information. The theory also emphasizes maximum focus on patients to help them maintain health at the desired levels and function according to their maximum capacity (Karota et al., 2020). Furthermore, which aligns with the core objectives of the patient portals, the role of nurses is interpreting information and develop appropriate plans according to the patient’s condition while engaging the patients fully in the process.

Role of Patient Portals in Addressing Low Patient Engagement

´More access to health information

´Secure patient-provider communication

´Informed decision-making

´Medication adherence

´Preventive health and services adoption

The role of patient portals in addressing the problem of low engagement in health management is critical. Dendere et al. (2019) noted that patient portals encourage participation in own health management by enabling patients to access health information when needed. The timely access to health information helps patients to understand their condition better, update health care providers appropriately, and adopt appropriate interventions to prevent their conditions from deteriorating. Patient portals also address low engagement by providing secure patient-provider communication. This tool enables patients to ask private questions regarding their health and act as advised. Other functions include improving patients’ decision-making, encouraging medication adherence, and supporting patients in adopting preventive health and related services.

Potential Strengths

´Increased ownership of personal care

´Timely access to complete and accurate health data

´Improved patient-provider communication

´Promotes patient-centered care

´Creating a more informed patient population—better understanding of a health condition.

Like many other technologies, patient portals have their strengths and limitations. One of the key strengths is increasing patients’ ownership of personal care. Through patient portals, patients understand their health conditions sufficiently and actively participate in their improvement by informing health care providers about any changes appropriately. The increased ownership promotes patient-centeredness in health care delivery since decisions directly respond to patients’ needs and preferences. Patient portals also provide patients with reliable platforms for complete and accurate health data.  Other strengths/benefits include creating a more informed patient population that can be actively involved in illness prevention and managing current and emerging health problems.

Potential Limitations

´Dependence on information communication technology and supplemental technologies

´Requires tech-savvy patients

´Security problems

´Challenges in patient buy-in

´More utilization of health care resources

Despite the strengths associated with patient portals as health technology, various limitations hamper their effectiveness and limit their use. A typical limitation is increased dependence on information communication technology, implying that health care organizations must invest heavily in this area. Supporting technologies include security enhancement technologies to protect patient portals from external, unauthorized access. Patient portals also require patients to be tech-savvy; hence, their use is limited to educated patients. Other issues include security problems as health information exchange takes place and problems with patients’ buy-in, particularly where patients are apprehensive about modern health technologies and sharing private information.

Method for Patient Education

´Preferred method: the demonstration method

Characteristics

´Performing something to make the learner understand in detail

´Preferred when showing how tools and equipment work

´Focuses on ‘how’ something works

´Saves time and it is associated with high clarity

Many patients are unfamiliar with patient portals’use, and patient education is crucial to promoting their use in health management.  Different methods can be used, including the teach-back method, presentations, and practical experiments. Demonstrations are highly suitable since they involve performing how the technology works to make patients understand their use adequately. Demonstrations are usually preferred when showing learners how tools and equipment work, such as laboratory settings. They focus on how something works, implying that they effectively show patients how to use patient portals. Demonstrations also save time since many learners (patients) can be taught as a group using the same resources.

Rationale for Demonstrations’ Effectiveness

´Enhance understanding

´Make learning enjoyable

´Combines theory with practice

´Exposes learners to the concept being studied

´High information retention rate

Instructors consider many factors before choosing a teaching method. The same applies to demonstrations for teaching patients how to use patient portals. One of the primary considerations is the method’s applicability in enhancing understanding. Unlike other techniques like lectures, demonstrations present a concept in a manner that can be understood in more detail. This is because demonstrations combine practice with theory, making the subject matter clear in areas that could have been vague if presented via other methods. Demonstrations also make learning enjoyable since it involves observation and making inferences. Exposing learners to the concepts being studied is also associated with high information retention rate.

Conclusion

Key Deductions

´Low patient engagement in own health management can be resolved via technology

´Patient portals allow patients to access health information instantly

´Patient portals improve patient-provider communication

Improving Patient Portals’ Effectiveness

´Address security issues

´Encourage use in health care delivery

´Patient education

From this presentation, it can be deduced that low patient engagement in own health management is a serious issue that requires technology intervention. Low patient engagement adversely affects health outcomes, and intervention via technology is vital to improving patient-provider communication and patient awareness of health conditions. Patient portals increase patient engagement by allowing patients to access health data and improve patient-provider communication. However, security issues and underuse in health care settings hamper their effectiveness. As a result, appropriate interventions, including addressing security issues and encouraging portal use in health care delivery, should be considered. Patient education on technology use is also a practical intervention.

References

Adib-Hajbaghery, M., & Tahmouresi, M. (2018). Nurse-patient relationship based on the Imogene King’s theory of goal attainment. Nursing and Midwifery Studies, 7(3), 141-144. doi: 10.4103/2322-1488.235636

Bacchetti, J. A., Hines, M., & SHAIKH, M. (2020). Why humanizing technology maximizes patient engagement and increases financial value for health systems. Healthcare Financial Management Association. https://www.hfma.org/topics/hfm/2020/october/why-humanizing-technology-maximizes-patient-engagement-and-incre.html

Dendere, R., Slade, C., Burton-Jones, A., Sullivan, C., Staib, A., & Janda, M. (2019). Patient portals facilitating engagement with inpatient electronic medical records: A systematic review. Journal of Medical Internet Research, 21(4), e12779. https://doi.org/10.2196/12779

Karota, E., Purba, J. M., Simamora, R. H., & Siregar, C. T. (2020). Use of King’s theory to improve diabetics’ self-care behavior. Enfermeria Clinica, 30, 95-99. https://doi.org/10.1016/j.enfcli.2019.12.035

Lyles, C. R., Nelson, E. C., Frampton, S., Dykes, P. C., Cemballi, A. G., & Sarkar, U. (2020). Using electronic health record portals to improve patient engagement: research priorities and best practices. Annals of Internal Medicine, 172(11_Supplement), S123-S129. https://doi.org/10.7326/M19-0876