By: Francella Smoker, Ph.D., RN
Published: 22 August 2018
Present Day
America spends more than $2 trillion annually on healthcare and, despite spending more on healthcare than any other nation, the United States only ranks 43rd in the world in life expectancy.
MiNurse: The year 2040: Hypothetical Scenario
Eight years ago, 2032, six major organizations came together to advance the health and welfare of the nation. These organizations, collectively known as the Association of Medical Boards, Experts, and Researchers [AMBER] developed a new proprietary technology affectionately known as MiNurse; Medical Interactive Networking Unification and Resource Scanning Equipment. The AMBER venture funded the research and development that directly led to the engineering of the MiNurse system which was successfully piloted in a variety of healthcare settings in twenty States and five countries. Today, 2040, MiNurse plays a vital role in ensuring that the healthcare system provides seamless, affordable, quality care with improved health outcomes for individuals, groups, and communities.
Prior to the advent of MiNurse, several barriers prevented nurses from being able to effectively respond to changing health care settings in an evolving healthcare system. Registered Nurses (RN), regardless of specialty or work setting, were expected to be flexible, resilient, and to operate in a complex, fast-paced healthcare environment requiring an extraordinary range of skills and talents. Demands for healthcare reforms, evidenced-based practice data that captures nursing care and interventions to improve nursing practices, nursing shortages, an aging nurse force, inadequacy of educational preparation as reflected in the lack of skills and knowledge applied in nursing practice, bullying, unethical practices, lack of training and preceptorship placed nurses at a disadvantage in taking a stance as leaders in a revolutionary healthcare market. MiNurse removed these barriers allowing nurses to be full partners with physicians and other healthcare professionals in redesigning healthcare in the United States.
The MiNurse database is shared between hospitals locally, State-wide, nationally, and internationally through the internet. This shared database allows access to thousands of research journals, medical research, medication databases, as well as a myriad of other diagnostic tools, all at the disposal of the nurse or any other medical staff by using voice commands. This shared database removes the gap of 20th-century nursing practice, where nurses relied on colleagues and on the job experiences to care for patients, as opposed to evidence-based practice and technology. MiNurse drastically changed the way in which healthcare providers (HCP), medical facilities, and support industries do business by sharing patient information in real-time.
A Shared System for Better Patient Care
The technology of MiNurse allowed for the seamless integration of updated information and has proven to be the most beneficial advancement in the field of nursing in recorded history. The MiNurse system is essentially a series of interlinked computers which have drastically changed the way in which nursing interventions are conducted. By integrating MiNurse with all healthcare practitioners, hospital staff, non-hospital medical personnel such as Emergency Medical Services members in ambulances, and Medical Evacuation members in planes and helicopters; allows for the quick transmission, recording, and retrieval of patient and other medical information through an interactive device which is worn like a set of glasses. These glasses, a descendant of Project Glass, has built-in wireless communication, display, camera, and microphone with attached earbud so communications, either from the system or other users, remains confidential.
MiNurse interlinks with medical monitoring devices attached to the patient which constantly tracks the patient’s vital statistics. Since the MiNurse device is mobile, a monitoring device is attached to the patient when he/she enters the care facility and remains with the patient until discharged; thus, a seamless record of the patient’s encounter, from check-in to discharge, is recorded. This all-in-one device came about as an attempt to save money, lessen the equipment required in hospital rooms, promote freedom of patient movement, and create an uninterrupted record. MiNurse ultimately changed the care facility matrix from the stressful hospital environment of the 2020’s to a calm atmosphere of positive energy. The care facility matrix is now a healing, restful place to recover from illnesses.
The wireless connectivity for the MiNurse system takes advantage of the infrastructure in facilities and communication systems. This wireless connectivity allows the nurse to link their MiNurse into any patients monitoring equipment and download or upload data for patient trends such as heart rate, temperature, and oxygen saturation. All of this information is displayed on the lens of the glasses. In other words, a graph of the patient’s vital statistics is displayed in a heads-up display style, allowing the nurse to identify areas of concern. This networking capability also allows the nurse to upload data to other medical staff for on-the-spot feedback, reducing phone calls, pages, and minimizing the amount of direct communication with interprofessional team members caring for the patient at all times. Furthermore, MiNurse allows doctors and other healthcare providers to transmit scripts and authorize refills from almost any location.
MiNurse allows all health care providers to share real-time information as situations are happening. For example, given the scenario of a 24-year-old patient involved in a traffic accident who sustained multiple lesions and requires a blood transfusion. Through MiNurse, EMS crew members are able to transmit vital information in real-time to the destination hospital. The information transmitted is both visual and telemetric allowing doctors to diagnose the patient’s condition. Thanks to the transmitted information, doctors at the destination hospital are able to identify a more serious condition the EMS staff missed, allowing the ambulance to be diverted to a hospital with the required equipment and appropriately trained medical staff. Additionally, MiNurse was able to identify the patient as having blood type AB, thanks to programming which accessed the patient’s historical medical records, and alert staff of this rare blood type while running a supply check of local facilities. If MiNurse identifies low on-hand stock of blood type AB at the re-routed hospital, it will search out and notify the closest facility with the required blood type on hand and place an emergency order for delivery. When the patient arrives, the hospital will have everything set up to save this patient’s life.
The ability to quickly retrieve information on a patient from a common database has helped to decrease the number of medical misdiagnoses and errors since MiNurse was introduced in 2132. All of this has culminated into better health care, with fewer mistakes, timely diagnoses, quicker treatment, less paperwork, fewer lawsuits, a reduction in erroneous charges, and lower overall health care costs for the patient. All thanks to a constant video, audio, and information log collected and recorded by MiNurse.
Evidenced Based Practice Real Time
Evidenced-based research shows that health care informatics incorporating information technology [IT] will enhance patient safety by standardizing, flagging errors, and eliminating handwritten data. As such, the incorporation of MiNurse technology eliminated redundancies and duplication of documentation, reduced errors, eliminated interruptions for missing supplies, equipment, and medications, and eased access to data thereby allowing the nurse time to care for patients. In addition, the MiNurse smart device closed the gap in the number of errors which occurred but was not being reported. Medical personnel once feared to report errors because of retributions or being used as a scapegoat. Thus, many errors would not be reported which created a sizable gap in achieving high-quality care. Furthermore, MiNurse provides a large pool of patient data for clinical research allowing for more practical evidence-based treatments.
Since the installation of the MiNurse smart device, evidenced-based practice from real-time data has shown much of the care delivered in the healthcare system is direct nursing care. This realization of the value nurses adds to the healthcare system thrust nurses into the forefront of healthcare. This shift necessitated the nursing process be changed from traditional thinking, that viewed patients as a collection of parts, to view patients as a holistic being. Data collected and analyzed from MiNurse captured real-time data of nurses’ actions which lead to developing new continuing education and training programs for nurses.
In the past, nurse’s used a clipboard then went to a computer to input information. This practice changed to electronic medical records as was mandated by law. Today, MiNurse allows the nurse to remain with the patient with very little distraction from the environment, including having to document on a computer. The phrase; if it was not documented it was not done, is obsolete as MiNurse records the patient encounter from the time of registration at a care matric facility to the time of discharge. The detailed data generated from the MiNurse report of nurses’ usage in the system, allows for continuous education; as opposed to annual mandatory training via a computer-based program or from organizations. MiNurse made it easy and accessible for RN’s to continue as lifelong learners by having available appropriate and developmental continuing education to maintain and advance their practice in a fast-paced dynamic healthcare environment.
Interprofessional, or team-based care, is now the standard of practice thanks to MiNurse. This came about because MiNurse allowed providers to be connected with updates and reviews of patients assigned to them. With nurses being full partners to physicians and other healthcare professionals, redesigning healthcare in the United States had far-reaching implications for the safety and quality of healthcare provided around the globe. This improvement in safety and quality of health care, including nursing care, as evidenced by marginal errors recorded on MiNurse fact sheets of error reporting. Due to the improved educational accessibility and capability, nurses have the ability to replay nurse-patient interactions flagged for improvement. This, in turn, drove the evidenced-based practice research engine which today continuously infuses better ways of caring for patients; thus, improving patient outcomes significantly. More autonomy, job satisfaction, and a higher value placed on the nursing profession became factors which facilitated closing the gap in the nursing shortage experienced in prior years. Other areas which were positively impacted were the development and use of nursing evidence, as well as evidence produced by other disciplines, with relevance to nursing practice. Nurses have a substantive and essential role in improving the quality of health and have made significant strides in providing high-quality care.
The Economic Impact of MiNurse
From an economic standpoint, America spends more than $2 trillion annually on healthcare and, despite spending more than any other nation, the United States ranks poorly in the world in life expectancy. With the introduction of the Obama Care package, Americans could be covered by insurance for medical care, dental care, and medications. The restructuring of the health care system, the addition of MiNurse, and the new standard of providing care placed America in a stronger position as one of the healthiest nations in the world.
Additionally, healthcare spending has been reduced significantly due to the reduction in malpractice awards, buying into technology, pharmaceutical control, and better education and training of staff. Money saved from these expenditures was redirected to research into the use of nanotechnology, cancer, Alzheimer’s, and other diseases. Greater funding was dedicated to teenage pregnancy, sexually transmitted infections, closing the gap in health disparities among different populations, and creating incentives for nurses to work closely with communities to improve the quality of people’s lives. Additionally, a paradigm shift from moving health care from fragmented care and treating people after they became sick, to keeping them well through preventive measures and education was implemented. Thus, millions of people have been spared from suffering and illness, eliminating billions of dollars of unnecessary healthcare costs.
MiNurse has impacted positively at the healthcare organizational level. The media, in a one-hour documentary, detailed the advantages and limitations of the MiNurse smart device. Among the advantages, MiNurse has proved to be one of the most beneficial advancements in the field of nursing and indeed all medical professions. The use of the MiNurse device has reduced costly medical errors, improved quality of care provided by interprofessional care teams, and thus has improved patient outcomes and satisfaction. The disadvantage is the sizable startup cost of MiNurse for facilities which lack the required infrastructure. Implementing MiNurse at a facility can be costly due to purchasing the equipment, installing the MiNurse system, and training personnel on its use. This is especially difficult for facilities in third world nations. The one-hour documentary called upon policymakers to fund programs in order to exert a greater influence by using their positions to garner support and share information about the influences and changes driving the healthcare revolution with other major stakeholders, to include the media, business leaders, and civic leaders. The use of the MiNurse smart device in the year 2040 and beyond will continue to remain a strong force, driving down the cost of health care for consumers, improving health, and promote healthier lifestyles.
References
Central Intelligence Agency. (2018). Country comparison: Life expectancy at birth. Retrieved from https://www.cia.gov/library/publications/the-world-factbook/rankorder/2102rank.html
Trust for America’s Health. (2018). Ten Top Priorities for Prevention. Retrieved from http://www.healthyamericans.org/pages/?id=126