Health IT-enabled Care for Underserved Rural Populations: The Role of Nursing

The University of Arizona College of Nursing, Tucson, AZ, USA.
Journal of the American Medical Informatics Association (Impact Factor: 3.5). 04/2009; 16(4):439-45. DOI: 10.1197/jamia.M2971
Source: PubMed


This white paper explains the strong roles that nursing can play in using information technology (IT) to improve healthcare delivery in rural areas. The authors describe current challenges to providing care in rural areas, and how technology innovations can help rural communities to improve their health and health care. To maximize benefits, rural stakeholders (as individuals and groups) must collaborate to effect change. Because nonphysician providers deliver much of the health care in rural communities, this paper focuses on the critical roles of nurses on IT-enabled caremanagement teams. The authors propose changes in nursing practice, policy, and education to better prepare, encourage, and enable nurses to assume leadership roles in IT-enabled health care management in rural communities.

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Available from: Patricia A Abbott, Nov 13, 2014
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    • "Findings of a recent literature review we conducted indicated that individual interventions using mobile technology can positively impact outcomes of chronic illness while at the same time reduce the cost and burden to patients However, no approach to date has combined the individual interventions as an integrated system to deliver healthcare at a distance within existing rural health clinics. The ability of such interventions to improve care and reduce strain on rural healthcare practices will depend on the effective use of technology (Effken and Abbott 2009). Our team of experienced rural healthcare clinicians, researchers, a technology developer, project manager, and a statistician is uniquely suited to develop, implement, and evaluate a healthcare delivery model that includes mHealth technologies in a rural population. "
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    ABSTRACT: There are 62 million Americans currently residing in rural areas who are more likely to have multiple chronic conditions and be economically disadvantaged, and in poor health, receive less recommended preventive services and attend fewer visits to health care providers. Recent advances in mobile healthcare (mHealth) offer a promising new approach to solving health disparities and improving chronic illness care. It is now possible and affordable to transmit health information, including values from glucometers, automated blood pressure monitors, and scales, through Bluetooth-enabled devices. Additionally, audio and video communications technologies can allow healthcare providers to conduct many parts of a physical exam remotely from varied settings. These technologies could remove geographical distance as a barrier to care and diminish the access to care issues faced by patients who live rurally. However, currently there is lack of studies that provide evidence of feasibility, acceptability, and effectiveness of mHealth initiatives on improved outcomes of care, a needed step to make the translation to implementation studies in healthcare systems. The purpose of this paper is to present the protocol for the first study of mI SMART (mobile Improvement of Self-Management Ability through Rural Technology), a new integrated mHealth intervention. Our objective is to provide evidence of feasibility and acceptability for the use of mI SMART in an underserved population and establish evidence for the refinement of mI SMART. The proposed study will take place at Milan Puskar Health Right, a free primary care clinic in the state of West Virginia. The clinic provides health care at no cost to uninsured, low income; adults aged 18-64 living in West Virginia. We will enroll 30 participants into this feasibility study with plans of implementing a longitudinal randomized, comparative effectiveness design in the future. Data collection will include tracking of barriers and facilitators to using mI SMART on patient and provider feedback surveys, tracking of patient-provider communications, self-reports from patients on quality of life, adherence, and self-management ability, and capture of health record data on chronic illness measures. We expect that the mI SMART intervention, refined from participant and provider feedback, will be acceptable and feasible. We anticipate high patient-provider satisfaction, enhanced patient-provider communication, and improved health related quality of life, adherence to treatment, and self-management ability. In addition, we hypothesize that patients who use mI SMART will demonstrate improved physical outcomes such as blood glucose, blood pressure, and weight.
    SpringerPlus 08/2015; 4(1). DOI:10.1186/s40064-015-1209-y
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    • "This long-distance care uses telecommunication equipment to transmit real-time patient data from the rural site to eICU Ò caregivers, who communicate with on-site caregivers through dedicated telephone lines. Nursing education programs that prepare graduates for employment in rural settings must provide learning opportunities reflecting the unique issues and challenges faced by rural nurses (Booth, 2006; Effken & Abbott, 2009; Sevean, Dampier, Spadoni, Strickland, & Pilatzke, 2008). Table 1 provides a summary of these rural challenges and unique issues. "
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    ABSTRACT: Innovative educational approaches are needed to meet the growing technology demands of our health care system and the expectation for integration of Quality and Safety Education for Nurses (QSEN) competencies in undergraduate curricula. Preparing baccalaureate nursing students to deliver health care services in rural environments requires awareness of multiple factors, including rural nursing practice challenges and rural culture. Nursing faculty at a Midwestern public university located in a predominantly rural state designed an integrated approach to address these needs through technology-focused and QSEN-based simulation scenarios. This manuscript presents the activities and outcomes from the 1st year of the project.
    Clinical Simulation in Nursing 10/2013; 9(10):e469–e475. DOI:10.1016/j.ecns.2012.09.005
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    • "Many strategies have proposed for reducing attrition among healthcare professionals [3]-[6], [10],[11]. Another important study was conducted in UK for establishing health informatics as a recognized and respected profession in UK National Health Services [12]. Healthcare professionals trained in health informatics are able to work in alternative healthcare facilities like Ambulatory care centres, Rehabilitation centres, Public Health Facilities, Home Health Agencies, Insurance Companies etc. "
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    ABSTRACT: Management of Knowledge workers in healthcare is one of the key challenges being tackled for delivering quality healthcare services . Faced with a global shortage of skilled health workers, even developed countries are struggling to build and maintain an optimum Knowledge workforce in healthcare. India too has been experiencing acute shortage particularly so in rural areas. This paper attempts to describe about the study undertaken to analyze the prime reasons for attrition of Knowledge Workforce in Healthcare in Northern parts of India that have a wide gradient of rural and urban belt , taking into account both public and private healthcare organizations. Further the paper focuses on three categories of health workers: Doctors, Nurses & Paramedics and Administrators. The present work analyzes the pattern of attrition based on socio demographic differentials among the healthcare professionals. The objective of the study has been to analyze the strategies adopted by the healthcare organizations to retain the employees and suggest measures in lowering attrition. Simplification of processes using Healthcare Information Technology (HIT) tools is a suggested as a significant strategy to reduce stress at work , time spent on administrative work and focus on core competence by knowledge workers in healthcare thereby reducing rate of attrition.
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