Ready to embrace the future?

April 2016   Comments

Technology, demographics and new models of care
June 20 and 22, CNA biennial convention

Tim Porter-O’Grady
Nik Nanos

Two experts look at where health care is headed, how patients’ expectations are changing and what nurses can do to adapt and lead

Tim Porter-O’Grady’s cellphone is an essential medical tool when he is volunteering his services at an inner-city clinic. He uses apps to measure blood pressure, pulse and heart rate and to store the data in electronic medical charts.

Portable digital technology is driving a revolution in health care, says Porter-O’Grady, an associate professor at Arizona State University and a senior partner in an international health-care consulting firm. He is also a clinical nurse specialist in wound care and gerontology.

He urges nurses to take their place at the forefront of this revolution, advocating a new model of care that is mobile and flexible and that uses technology to connect with patients in communities rather than in institutions.

“With all of these transformations occurring, and with the maturation of our profession, our time has come,” Porter-O’Grady says. “The issue is, do we have the language? Do we have the courage? Do we have the political will and the strategic skill necessary to lead this transition that social, technological and economic forces are converging to create?”

Porter-O’Grady will expand on this theme as he presents the opening address at CNA’s biennial convention, taking place from June 20 to 22 in Saint John, N.B.

In his presentation at the convention, pollster Nik Nanos, president and CEO of Nanos Research, will discuss the future of nursing from a different angle. He will examine the changes the Canadian population has undergone, forecast future trends and speak about how the health system might adapt.

“When I think of forces that shape the future, I think of not just demographic forces, but societal changes in the relationship between patients and health-care providers,” Nanos says. “This change is especially critical for nurses who are, for all intents and purposes, the front line of health care in Canada.”

According to Statistics Canada, those who are 65 and older represent 15 per cent of the population and will account for about 25 per cent by 2036. This tech-savvy generation of seniors — and their adult children — will demand changes to the way health care is delivered, Nanos says. They will expect to access their medical charts online, just as they access their bank accounts, or to track the whereabouts of an ambulance on their phone, just as they locate an Uber driver.

“I’m going to say something that will probably upset people, but hospital care works on a factory model: you come in this door and you go out that door,” he says.

“I think people are going to expect a greater diversity of options. They go on a vacation and sometimes they stay in a hotel and sometimes they stay in somebody’s house, and they can connect online to get what they want. They will expect to have that same experience when they deal with the health-care system: that it’s completely transparent, agile and mobile, and that it’s a better experience.”

The baby boomers will not age in the same way as their parents did. They will live longer, remain active and want to stay in their homes rather than moving into institutions, Porter-O’Grady says. Instead of the current model of care — patients waiting until they have acute medical problems to visit a hospital or clinic — the health system will have to adapt by using portable digital technologies to connect with patients as they go about their daily lives. These technologies will allow nurses to stay in touch with a larger number of patients and to intervene when health problems begin to develop, rather than when patients are in crisis.

“Mobile devices are used to monitor how many steps you take, monitor your pulse, monitor other health indicators. The eventual integration of that, in a cost-effective way, with the health system is really where things are going,” says Nanos. “Nurses in the future may be texting or online chatting to check in with their patients: ‘How was your morning? Have you had breakfast? I notice that your sugar’s a little off.’”

This model of a health system built on prevention and community outreach is ideally suited to nurses because of their education and philosophy of practice, says Porter-O’Grady.

But there are barriers to change. Currently, nearly three-quarters of Canadian nurses work in hospitals or a nursing home/long-term care setting. And results of a 2014 Nanos Research survey showed that 40 per cent of Canadians surveyed rated the health-care system’s willingness to change as “poor” or “very poor.”

Because most nurses work in institutional settings, many may resist the coming change. But they ought to be its greatest advocates, Porter-O’Grady says, because shifting away from the existing hospital-based model will lead to lower costs, better outcomes for patients and a vastly expanded professional role for nurses.

“We have much more to offer than the current level of practice permits because of the structure of the health system,” he continues. “Technology is what frees us to be able to fully practise our profession, as we idealize it, rather than simply being functionaries in a much more limited system.”

Nurses are well-respected by the public, says Nanos, and their approval ratings will go up even more if patients see them as advocates for the kind of change that makes the system more responsive to their needs.

Kate Jaimet

Kate Jaimet is a freelance journalist in Ottawa.

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