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Does telehealth threaten the nurse/patient relationship?

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6 February, 2012

Does telehealth threaten the nurse/patient relationship? What do you think?

The Queen’s Nursing Institute has launched a new drive to encourage district nurses to make the best use of new communications technology such as telehealth systems. A report published by the institute said some district nursing teams had already made significant changes to their practice as a result of new technology but others lagged behind.

The report said: “The first, and possibly the biggest issue is the attitudes of professionals to the adoption of new technologies, and their readiness to embrace such changes to practice.”

It cited a Royal College of Nursing survey from 2010 in which 20% of 1,300 respondents thought an electronic patient record could be a “threat” to the nurse-patient relationship.

But the report said communications technology was becoming part of “mainstream” community nursing provision and was “no longer just a series of interesting pilot projects”.

QNI director Rosemary Cook said: “Technology is transforming the way that care is delivered, as well as the relationship between the patient and the professional.

“It doesn’t replace the nurse, or the need for a high level of both clinical skills and interpersonal skills in community nurses. Technology only works for patients when it is combined with expert, relationship-based care.”

Readers' comments (12)

  • With an ageing population we all have to work smarter and use the technology available to us to communicate with our patients. Technology is a part of Nearly everyone's life and I am sure that any patient would be pleased that their nurse was able to communicate with them swiftly and efficiently whatever the medium. Of course there will always be the need for face to face communication and interaction and each patient would always need to be assessed case by case. but on the whole I think this is a great step forward and well done QNI for promoting it.

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  • "Technology only works for patients when it is combined with expert, relationship-based care.”"

    with cut backs in staff and heavier workloads I can see this in many cases replacing 'relationship-based care'. It is happening in all other services, healthcare and otherwise, right across society. it is just the way systems, resources and attitudes have developed.

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  • "Technology only works for patients when it is combined with expert, relationship-based care.”"

    with cut backs in staff and heavier workloads I can see this in many cases replacing 'relationship-based care'. It is happening in all other services, healthcare and otherwise, right across society. it is just the way systems, resources and attitudes have developed.

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  • "Relationship based care" - isn't this what telehealth is all about ? Using technology to engage with patients is no more or less valuable than face to face ... Just different !

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  • teresa chinn | 6-Feb-2012 12:09 pm

    not everybody will share your view and also need be respected.

    not everybody has the same attitude towards modern technology which is often perceived as replacing face to face contact and is cold and uncaring, especially the elderly.

    good change management skills may be needed with some to persuade them of its value.

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  • I absolutely agree with the comments from Rosemary Cook at the QNI - telehealth should be viewed as an adjunct to, not replacement for, the nursing care that we give patients.

    However, others have rightly pointed out that care must be taken when introducing technology. Telehealth is not for everyone, and the wishes of patients must come first. Having said that, there are many examples of patients (and staff) who were initially wary of telehealth but who very quickly come to love it!

    As with most nursing interventions, the key to using telehealth correctly is to identify - through a holistic, individualised assessment - those patients in whom it can support self-care, enhance quality of life and improve clinical outcomes.

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  • Before starting an interesting and important discussion, please define what you mean by 'telehealth'.

    It has several distinct meanings depending on who is using it, from:
    • remote monitoring of the vital signs of patients in their own homes, to
    • visits via Skype or other videoconferencing, to
    • the kind of phone/internet-based advice provided by NHS Direct (ref: Ontario Telehealth)
    In the article Eileen also threw 'electronic patient records' into the mix!

    Without defining your terms your commenters will end up talking at cross purposes.

    Steve Hards
    Editor, Telecare Aware (telecare and telehealth news website)

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  • michael stone

    When I glanced over this one, my brain 'read' the much more interesting:

    'Does telepathy threaten the nurse/patient relationship ?'.

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  • good point Steve; Eileen needs to clear what she means by telehealth..the model used in my organisation is monitoring of vital signs for respiratory patients; the teams still visit the patients though/ they attend outpt appts...

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  • good point Steve; Eileen needs to clear what she means by telehealth..the model used in my organisation is monitoring of vital signs for respiratory patients; the teams still visit the patients though/ they attend outpt appts...

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  • michael stone

    Steve Hards | 6-Feb-2012 7:17 pm

    tiritega mawaka | 12-Feb-2012 7:48 pm

    It is a general point that different groups of people use the same words to mean different things - it is always something which can cause confusion.

    Within the NHS the terms 'DNACPR' and 'DNACPR Order' have several different meaning, which become conflated and confused.

    But the most interesting one is the phrase:

    'patient-centred care'

    which can mean very different things to different people.

    Problems arising from the lack of tightly-defined words, are all over the place, both inside healthcare and in the wider world. It is entirley possible for the two parties of a discussion to be effectively 'talking about different things' without eithe rparty realising that !

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  • In society it would seem to me individuals are dependent upon one another for help and support. This is being eroded by modern technology especially in the elderly on their own who need human contact and not being faced with more and more machines and technology which they really do not understand and which can not offer them human warmth, empathy and reassurance for the anxieties. It is enough to make anybody curl up their toes and die. Those involved in operating this tech. could eventually loose all the skills of empathy, compassion, anticipating the needs of others and face to face communication and increase social isolation and all its negative psychological consequences.

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