International Projects Coordinator, Assuta Medical Centers, Tel Aviv, Israel.
Nurse Navigator, Oncology Institute, Assuta Medical Centers, Tel Aviv, Israel.
Semin Oncol Nurs. 2020 Dec;36(6):151091. doi: 10.1016/j.soncn.2020.151091. Epub 2020 Nov 19.
Digital Technology has become a pervasive, even ubiquitous part of our daily lives, affecting almost every aspect of our lives. Although the uptake of digital technology in health care has lagged behind other sectors, today, digital health is already becoming a cornerstone of developed health systems all over the world. Hence, the question is not whether we should adopt digital technology in health care, but how to do it most effectively. Digitally enabled remote care, or telemedicine has been available for many years but large-scale adoption has been slow. COVID-19 has caused a quantum leap in this area and particularly in the area of chronic disease and cancer care. The objective of this article is to briefly review the literature on the use of digitally enabled remote health care, in general and in cancer care specifically, with a focus on nursing practice, and to define the questions that need to be asked to guide effective implementation.
Review of the literature and the experience of the authors.
There is increasing uptake of digitally enabled remote care. A growing body of evidence suggests that care delivered via telemedicine can be both safe and effective, in some cases with better outcomes than conventional face-to-face care. However, tele-oncology has not yet become standard practice. Digital health solutions need to be integrated into the patient pathway and in health care team practices for optimal supportive care in oncology in line with appropriate guidelines. Training education and formative evaluation are required to guide effective implementation. Formulating the right questions to ask is a critical starting point.
There is very little debate today about the centrality of the role of the oncology nurse in coordinating care, guiding the patient, and providing ongoing support. Mobile technology provides an opportunity for monitoring and support through a minimally burdensome, maximally accessible approach. Moreover, smartphones and applications allow for repeated evaluation of adherence and symptoms in real time, ideally enhancing care for patients. However, even with the growing acceptance of "nursing telepractice", there are challenges and barriers to overcome to mainstream digital health into oncology nursing practice. Telemedicine services go much further than simply digitizing traditionally analogue health care processes and services, they fundamentally reorganize processes, procedures, and services. Thus, in addition to training and education, nursing tele-oncology demands a service transformation.
数字技术已经成为我们日常生活中无处不在的一部分,几乎影响到我们生活的方方面面。尽管数字技术在医疗保健领域的应用落后于其他领域,但如今,数字健康已经成为世界各地发达医疗系统的基石。因此,问题不是我们是否应该在医疗保健中采用数字技术,而是如何最有效地采用。远程医疗或远程医疗已经存在多年,但大规模采用速度缓慢。COVID-19 在这一领域,特别是在慢性病和癌症护理领域,引发了一场量子飞跃。本文的目的是简要回顾数字远程医疗的文献,一般来说,特别是在癌症护理方面,重点是护理实践,并确定需要提出的问题,以指导有效实施。
文献回顾和作者的经验。
数字远程护理的应用正在增加。越来越多的证据表明,通过远程医疗提供的护理既安全又有效,在某些情况下,比传统的面对面护理效果更好。然而,远程肿瘤学尚未成为标准做法。需要将数字健康解决方案整合到患者路径和医疗团队实践中,以根据适当的指南为肿瘤学提供最佳的支持性护理。需要培训教育和形成性评估来指导有效实施。提出正确的问题是一个关键的起点。
如今,关于肿瘤护士在协调护理、指导患者和提供持续支持方面的核心作用,几乎没有什么争议。移动技术提供了通过最小负担、最大可访问性的方式进行监测和支持的机会。此外,智能手机和应用程序允许实时重复评估依从性和症状,理想情况下可以改善患者的护理。然而,即使“护理远程实践”越来越被接受,将数字健康纳入肿瘤护理实践仍存在挑战和障碍。远程医疗服务不仅仅是数字化传统模拟医疗流程和服务,它们从根本上重新组织了流程、程序和服务。因此,除了培训和教育,护理远程肿瘤学还需要服务转型。