Virtualizing care from hospital to community: Mobile health, telehealth, and digital patient care
Editor-in-Chief: Elizabeth Borycki RN, PhD, FIAHIS, FACMI, FCAHS
Elizabeth Borycki RN, PhD, FIAHIS, FACMI, FCAHS
JMIR Nursing (JN, Editor-in-Chief: Elizabeth Borycki, RN PhD, FIAHIS, FACMI, FCAHS) is a peer-reviewed journal for nursing in the 21st century. This journal is indexed in PMC and PubMed. The focus of this journal is original research related to the paradigm change in nursing due to information technology and the shift towards preventative, predictive, personal medicine:
"In the 21st century the whole foundations of health care are being shaken. Technology is taking service to new heights of portability: less invasive, short-term, and with greater impact on both the length and quality of life. (...)
Time-based nursing care with the activities of bathing, treating, changing, feeding, intervening, drugging, and discharging are quickly becoming historic references to an age of practice that no longer exists. Now the challenge for nursing practice skills relates more to taking on the activities of accessing, informing, guiding, teaching, counseling, typing, and linking. "
(Tim Porter-O'Brady, Nurs Outlook 2001;49:182-6)
Reports on the impact of electronic medical record (EMR) systems on clinicians are mixed. Currently, nurses’ experiences of adopting a large-scale, multisite EMR system have not been investigated. Nurses are the largest health care workforce; therefore, the impact of EMR implementation must be investigated and understood to ensure that patient care quality, changes to nurses’ work, and nurses themselves are not negatively impacted.
Around 1800 pediatric transplantations were performed in 2021, which is approximately 5% of the annual rate of solid organ transplantations carried out in the United States. Effective family self-management in the transition from hospital to home-based recovery promotes successful outcomes of transplantation. The use of mHealth to deliver self-management interventions is a strategy that can be used to support family self-management for transplantation recipients and their families.
At the workplace, health care workers face multiple challenges in maintaining healthy dietary behaviors, which is the major factor behind obesity. A hospital-wide mass health screening exercise showed an increasing trend in the prevalence of obesity and median BMI from 2004 to 2019, as well as a higher crude obesity rate among shift workers.
Nursing education has increasingly focused on critical thinking among nursing students, as critical thinking is a desired outcome of nursing education. Particular attention is given to the potential of technological tools in guiding nursing students to stimulate the development of critical thinking; however, the general landscape, facilitators, and challenges of these guidance models remain unexplored, and no previous mixed methods systematic review on the subject has been identified.
Treatment for pancreatic cancer entails symptom distress and a high burden of self-care. Patient-reported outcomes, collected with the support of mobile health (mHealth), have shown positive effects on symptom management, patient satisfaction, and quality of life for patients with cancer. For mHealth tools to become an integral part of clinical routine, experiences from health care professionals are needed.
The COVID-19 pandemic has prompted an interest in whole-person health and emotional well-being. Informatics solutions through user-friendly tools such as mobile health apps offer immense value. Prior research developed a consumer-facing app MyStrengths + MyHealth using Simplified Omaha System Terms (SOST) to assess whole-person health. The MyStrengths + MyHealth app assesses strengths, challenges, and needs (SCN) for 42 concepts across four domains (My Living, My Mind and Networks, My Body, My Self-care; eg, Income, Emotions, Pain, and Nutrition, respectively). Given that emotional well-being was a predominant concern during the COVID-19 pandemic, we sought to understand whole-person health for participants with/without Emotions challenges.
The implementation of telemonitoring (TM) has been successful in terms of the overall feasibility and adoption in single disease care models. However, a lack of available research focused on nurse-led implementations of TM that targets patients with multiple and complex chronic conditions (CCC) hinders the scale and spread to these patient populations. In particular, little is known about the clinical perspective on the implementation of TM for patients with CCC in outpatient care.
Workplace health interventions can produce beneficial health- and business-related outcomes. However, such interventions have traditionally focused on lifestyle behaviors of individuals, mostly not considering the role of working conditions. The wecoach intervention is an internet-based tool that combines both a digital and a participatory team development approach aimed at addressing critical job demands and resources as key aspects of health-promoting working conditions. Nursing staff are particularly affected by challenging working conditions and could potentially benefit greatly. Understanding the acceptance of novel workplace health promotion approaches is a critical precursor to their successful implementation and use.
eHealth is considered by policy makers as a prerequisite for meeting the demands of health care from the growing proportion of older people worldwide. The expectation about what the efficiency of eHealth can bring is particularly high in the municipal home health care sector, which is facing pressure regarding resources because of, for example, earlier discharges from hospitals and a growing number of patients receiving medications and treatments at home. Common eHealth services in home health care are electronic medication administration records (eMARs) that aim to communicate delegated tasks between professionals. However, there is an extensive gap in the research on how technology affects and is experienced by home health care professionals.
Canadian nurses are at the forefront of patient care delivery. Although the use of digital health technologies for care delivery is gaining momentum in Canada, nurses are encouraged to integrate virtual care into their practice. In early 2020, more Canadian nurses delivered care virtually compared with 3 years ago.