ER nurse responsibilities guest post 1ab44594f658 300x217 1

Using a Mobile App for Remote Chronic Care: an RN’s Perspective

If you provide care to patients dealing with chronic conditions, you know it is not an easy job. Fortunately, with advances in technology, this doesn’t always have to be the case. More healthcare professionals and facilities than ever are using digital technology in their practices. And for good reason – a study from Ricoh Research shows that 74% of hospitals that use mobile solutions to collect and share data are more efficient than those who don’t.

Aetonix’s mobile app, aTouchAway, has been deployed in various healthcare organizations for this purpose. The app connects the entire circle of care on one platform, allowing for seamlessly sharing updates on the patients’ health in real-time. This ensures that everyone is up-to-date and actively involved in the patient’s care. The patient also has the ability to self-manage their own care. aTouchAway’s integration with home health equipment allows for the patient to monitor their own condition. For example, a physician could set up a customized protocol (workflow) that asks their patient with diabetes how they are feeling on a scale of one to ten. If their response is lower than five, the physician can instruct them to use a pulse oximeter to measure their blood oxygen levels. When set up with the proper equipment, the patient will be able to do this themselves from the comfort of their home.

Thamesview Family Health Team

The Thamesview Family Health Team is an organization based in Chatham, Ontario, who use aTouchAway with their patients. They are a family health team made up of 16 family physicians and more than 23,000 rostered patients. Other roles in the team include nurse practitioners, registered practical nurses, administrative and reception staff, social workers, and more. We sat down to speak with Laura Schauer, one of their registered nurses, about the work she does for her chronic patients using digital technology.

As a registered nurse at the Thamesview Family Health Team, she has a lot of daily tasks. “I do many regular ‘hands on’ nurse work such as injections, dressings, and blood pressures,” she says. “I also draw blood work, perform foot care, monitor our INR clinic, health and wellness checks, and am a smoking cessation counsellor and Health Links care manager.” Her role is essentially managing, supporting, and caring for their complex patients. These include people with multiple health issues, who are often elderly, isolated, or tend to end up in the hospital or emergency department more frequently than others.

Ontario Health Initiatives

Reports show that seniors with three or more chronic diseases use three times the amount of healthcare resources than those with none. “I do feel that with the number of rising seniors in our population, the number of people with ever-growing list of chronic health problems will also grow,” Laura says. As chronic diseases are on the rise, healthcare organizations must do what they can to keep these patients out of the hospital. Hospital readmissions are both costly to the system and stressful for the patients.

This family health team is part of the Health Links. Health Links is an Ontario initiative to provide better, more coordinated care to those with complex conditions. Organizations caring for patients involved in the Health Links must work to ensure that patients have a coordinated care plan (CCP) and ongoing care. The Thamesview Family Health Team is part of the Chatham-Kent Health Link. According to Laura, “In the beginning, our four RNs here actually were all involved [with Health Link patients] and we all had a designated ‘patient list’. As the Health Link role has expanded, we have found it much easier to have one main RN dedicated to the program and the rest help support the role.”

Of course, taking on the role of managing many complex care patients can come with its complications and challenges. Laura states that her biggest challenge is time. She and other nurses also have to factor in driving time for home visits and there are only so many hours in a week. They are challenged with trying to see as many patients they can with the amount of time they have.

Observing & Intervening

Fortunately, she does not always have to drive to see the patient in person. Using aTouchAway allows Laura to monitor her patients remotely. “Currently, I have a few different uses with my patients for aTouchAway,” she says. “Most notably is a patient with congestive heart failure (CHF) – they have their own blood pressure monitor and weight scale. They get their numbers for me every morning and enter them where I can then access them.” She is able to watch for trends and when she sees a sudden change, she can step in. Looking at the data, she noticed one of her patients began having low blood pressures. When she called the patient to discuss this and check in on them, they complained that they had been feeling dizzy. “I had to discuss with the patient’s physician and they ended up needing a lower dose of their blood pressure medication.” After the physician was able to remotely adjust the patient’s prescription, the patient reported feeling back to normal two weeks later. No in-person visits were required. In situations like this, it helps that multiple members of a patient’s care team can connect on the same platform.

“For someone flaring with their CHF,” she adds, “their weight may begin to climb, as might their blood pressure, and perhaps also their oxygen levels may drop as well. Having a nurse reviewing the trends of these numbers regularly gives us an idea as to what is going on, and a chance for early intervention.”

Improved Communication = Improved Outcomes

Another advantage she gets from using a mobile app for healthcare monitoring is the ability to send and receive photos. “We are also in the works of using aTouchAway for photo exchange,” she explains. “I have a patient that frequently gets cellulitis and they live far away. To have the ability for them to send a photo of the wound/potentially infected area and be able to get in touch with their physician quickly can mean an avoided hospitalization because we had a quick intervention.”

When asked about her personal experiences with the technology, she states “luckily the training to use the technology was pretty easy, which is helpful when trying to explain how to use it to others. Of our patients that currently have it, they have caught on pretty quick and are able to communicate with me, answer their reminder questions, and even upload their daily weight and blood pressures.” Of course, there are some patients who will still prefer the face-to-face visits instead. When finding the solution that fits best for your patients, ease of use is essential. Laura explains that some patients who have cognitive deficits or dementia, for example, may not remember how to use the system or operate a tablet.

Recent advances in technology may be the key to simplifying complex care. Laura Schauer has taken advantage of what mobile solutions can offer. “For patients with complex, chronic health conditions such as COPD or CHF, mobile health monitoring with vitals (blood pressure, heart-rate, oxygen, weight, etc.) is very helpful as changes to these numbers are sometimes the earliest indicators that something is amiss or an exacerbation is looming.” The ability to check-in on her patients without actually being there allows her to provide the same quality of care but in much less time. Not only does a mobile app save time for everyone involved, it allows patients to self-manage and still live independently. They are able to monitor their condition from the comfort of their home. Although chronic diseases are on the rise, with so many new technologies and programs available, there is reason to believe they can be managed easier than ever.

Featured image courtesy of eMedCert.

Keep reading
Keep reading

Leave a Reply

Your email address will not be published. Required fields are marked *