May 25, 2020
By Justin Burkett

Connected mobile nurses: virtual nursing care in the era of COVID-19

iStock.com/AJ_Watt

Take away messages:

  • Canadians want health care that is highly personalized and designed around an intuitive user experience.
  • Mobile health care is the next frontier which will allow Canadians instant access to health professionals 24-hours a day.
  • Virtual health care delivery reduces customer friction, amplifies nurses’ reach, and allows practitioners to practice to full scope.

A friend called me the other day to ask for some health advice, something she does routinely, and it got me thinking: how many other people call their friends who are nurses to ask for similar information? Given that most people either are or want to be in charge of their health and would rather call up a friend than make an appointment at a busy clinic on the other side of town, it seems only natural that we would want to find easier solutions for connecting with our health care providers.

COVID-19 is the ground-zero event that has forced society to come to an almost complete standstill; and while chaotic, it is forcing us to examine our present model and ask how well it is serving us.

Currently, there are millions of calls and online inquiries placed to central phone lines and government-run health websites across the country, designed to field questions funnelled through algorithmic processes leading to predictive outcomes. These tools, although designed for efficiency and built around a model that screens for severity of illness, are not set up to provide the comprehensive services that families need, such as chronic disease management and education, child and maternal health services, and health system navigation.

Direct connection

COVID-19 is shedding light on the need for people to be able to connect directly with qualified practitioners while they are confined to their homes and at the mercy of an unregulated Internet that offers no form of personalization or relationship. By using the text and video messaging services built into smartphone technology and software applications, registered nurses and nurse practitioners can easily and securely connect with clients to carry out many of the responsibilities needed to assist individuals and families in achieving their optimal physical, emotional, mental, and spiritual well-being (Alberta Health Professions Act, 2019).

COVID-19 is the ground-zero event that … is forcing us to examine our current model and ask how well it is serving us.

With mobile phone technology, a qualified RN or NP could be available 24 hours a day, providing service that is regulated, personalized, and integrated into the larger health system.

Indeed, virtual care models are popping up all over the place. The Ontario Telemedicine Network, for example, provides teams and self-managed services for palliative, wound care, and chronic disease management, all virtually, and supported by the Registered Nurses Association of Ontario (RNAO). Babylon, a service provided by the communications company, Telus, provides free healthcare through a mobile app that allows Alberta residents to have virtual consultations and access their health records (Telus, 2020). With these companies forming, seemingly overnight, regulatory bodies across the country are also quickly adapting to a new reality. The British Columbia College of Nursing Professionals, for example, recently published comprehensive guidelines around virtual care delivery for consultations, diagnoses, treatment, and client education (BCCNP, 2020).

Liability and security

Contemporary questions of liability and security are quickly becoming mainstream, with such companies as Amazon and Apple driving the conversation by using smartphones to connect nurses and other health care professionals directly with consumers in the United States (Amazon Care, 2020; Apple Healthcare, 2020). While regulatory agencies responsible for protecting public safety navigate how best to provide oversight in a new virtual and borderless world, it seems one way to meet the strict security requirements of data sharing, record keeping, and data integrity would be to integrate these professionals behind the firewalls of the larger health care organizations.

Not having ready access to expensive, resource-heavy telehealth services, nurses and clients alike have turned to the best available tool at their disposal: their smartphones.

Such an approach would enable teams of nurse-led virtual knowledge workers to address voluminous family health requests in people’s own homes, with the potential to reduce capacity stresses on the broader health system. The use of mobile technology would change the nature of flow from going to see the health care provider to having them come see you. It would also allow qualified nurses to work to full scope, empowering them to supply the wide-ranging health care services they are trained to provide.

Ease of access

As seen at the outset of the pandemic with the closure of specialized clinics, nurses have been compelled to find innovative ways to connect with their patients for a myriad of health-related needs, and some simply to check in. Not having ready access to the more expensive, resource-heavy telehealth services, nurses and clients alike have turned to the best available tool at their disposal: their smartphones.

Ultimately, what all Canadians want is ready access to the right health information, and the right health services, at the right time—information and services that are routinely provided by nurses. As day zero of the pandemic begins to show in our rear-view mirror, it is time for the provinces and Canada to look toward the future, one that sees nurses not only in their hospital- and clinic-based roles, but as part of the family conversation—a quick text message or video call away.

References

Alberta Health Professions Act. (2019). Revised Statutes of Alberta 2000, Chapter H-7.

Amazon Care. (2020, May 6). Healthcare built around you.

Apple Healthcare. (2020, May 6). Healthcare: the future of healthcare is in your hands.

British Columbia College of Nursing Professionals (BCCNP). 2020. Telehealth.

Telus. (2020, May 7). Babylon by Telus: Get healthcare in your home.

Justin Burkett is a registered nurse and instructor with the Faculty of Nursing at the University of Calgary with more than 10 years’ experience working in health care and education in local and global contexts. Justin is passionate about technology and the advancement of nursing practice within health systems. Justin is currently pursuing graduate studies in Leadership for Health Systems Transformation as part of the Master of Nursing Stackable Certificates program at the University of Calgary.

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