Are nurses threatening the success of telehealth?

Research suggests nurses are reluctant to embrace technology

The widespread rollout of innovative telehealth systems is being threatened by nurses, who find the technology disruptive, a new report is claiming.

Researchers Urvashi Sharma and Malcolm Clarke of the department of computer science at Brunel University in Middlesex interviewed community support workers and clinicians, including nurses who specialise in congestive heart failure and chronic obstructive pulmonary disease (COPD) – to find out what they thought before and after the implementation of telehealth in Nottingham.

And their findings, published in BMC Health Services Research, show that some healthcare professionals view telehealth as threatening and, as a result, organisations are being urged to work to minimise potential disruptions.

The research states: “Three main factors add to the experience of threat and affect the decision to use the technology: Change in clinical routines and increased workload; change in interactions with patients and fundamentals of face-to-face nursing work; and change in skills required with marginalisation of clinical expertise.”

Nurses, in particular, complained of unnecessary workload demands due to duplicate processes, such as the need to enter the same information in two data systems, the study found.

Also, they felt that telehealth should be used for monitoring and not to replace human interaction with patients. They were apprehensive that lack of face-to-face- interaction would result in poor diagnosis and missed clues to illness.

If adequate steps are not taken, and the concerns of users are not addressed in a timely manner, results can be detrimental to service integration

One nurse said, “I think the sort of thing one wonders with is lack of the face-to-face contact. And although you are asking questions and doing specifics, there is always a chance there could be something that you are only going to see if you are face-to-face with somebody.”

However, another healthcare worker noted that a year after the implementation, even though telehealth increased her workload and daily practices, she recognised the positive outcomes as the result of the technology, such as a reduction in hospital readmissions.

"If somebody is unwell, traditionally a patient may well sit there, at home, feeling unwell. But they would not necessarily call us," she told the researchers.

"They would leave it a few days until they get worse, and then call us. However, with the monitoring, we are able to call them because their oxygen level is low on that day.”

To lessen the stress involved with the introduction of telehealth, the researchers suggest providers consider user experience - especially non-technical users, such as nurses and community support workers - when implementing the technology.

Effective strategies include offering users timely, appropriate and context specific training; adequate technical support; and procedures that allow a balance between the use of telehealth and a personal visit by nurses delivering care to their patients.

"If adequate steps are not taken, and the concerns of users are not addressed in a timely manner, results can be detrimental to service integration," the researchers state.

“Since the introduction of telehealth can be experienced as threatening, managers and service providers should aim at minimising the disruption caused by taking the above factors on board. This can be achieved by employing simple-yet-effective measures.”

Click here to read the research in full.