mHealth: What do we do with all the data?

Monitoring EKG rhythms with portable ambulatory monitors for 30 days improves stroke treatment, reports this month’s New England Journal of Medicine (NEJM).

Background: A leading, preventable cause of recurrent strokes is atrial fibrillation (AF), the most common abnormal heart rhythm and one that can cause clots to travel to the brain. It can be very difficult to initially diagnose AF because it tends to be paroxysmal, or “come and go.” So, it is a silent risk that easily evades detection. In recent years, continuously reported diagnostic data from implanted pacemakers and defibrillators has dramatically increased our knowledge of how prevalent AF is.

The trends are clear: Health care providers today and in the future will have unprecedented opportunities for ambulatory monitoring.

NEJM published results of a Canadian randomized clinical trial (RCT) that focused on patients who had strokes of unknown cause. It found AF was diagnosed five times as frequently in patients who wore special monitors for 30 days than for those who underwent conventional 24-hour testing. The findings led to better secondary interventions.

The ambulatory EKG monitors were attached to the chest with a non-adhesive, “dry” electrode belt. Patients were encouraged to wear it as often as possible over the course of 30 days. The study proved that this was a feasible and affordable intervention that improves care. The American Heart Association recently came out in support of prolonged EKG monitoring for “prevention of future stroke among survivors of ischemic stroke or transient ischemic attack.”

Imagine the monitoring possibilities we will have as mobile-device technology continues its exponential growth. Already, the mobile phone you carry in your pocket has more computing power than NASA did when it put the first man on the moon.

As reported in my previous post, the U.S. Food and Drug Administration has already approved a $200 case that turns your iPhone into an EKG monitor. But that’s barely the tip of the iceberg. Mobile monitoring services are the “dominant and fastest growing” segment within mobile health (mHealth) and revenues are projected to reach $49 billion by 2020. Click here to read the full report titled “mHealth Market Analysis and Segment Forecasts to 2020.”

The trends are clear: Health care providers today and in the future will have unprecedented opportunities for ambulatory monitoring. The question now becomes, “What do we do with all that data?”

“Big data may be about to overwhelm the healthcare system,” writes Lindsay Alexander of MedCity News. “A little healthcare business intelligence tip: Data by itself won’t drive value and outcomes. Smart healthcare analytics will.”

Nurse leaders today must be creative thinkers. We must design the methodology and analytics to transform practice by using these technologies in ways that will change outcomes and improve health.

Technology is always changing, and existence of a new gadget will not necessarily impact care positively. The key to actualizing real and lasting change that matters is leadership, rooted in nursing knowledge and wisdom.

What are you doing to learn more about mHealth? What are your ideas about how these tools can improve practice?

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International. Comments are moderated. Those that promote products or services will not be posted.

Let’s do this together!

Technology—it’s a term synonymous with innovation and change. Throughout my career, I have heard three consistent responses when the topic of adopting new technology in the workplace comes up.

• “I have no idea where to begin.” 
• “I have no idea how it really functions.”
• “I have no idea if there’s any way this could be used in my setting or with my patients.”

I believe solutions to overcoming these concerns lie in accessing peer communities, identifying best practices, and developing destinations that aggregate news, case studies, and insight. That’s why I’m writing this blog.

First, about me

A few words about my professional experience may help you understand this blog’s purpose and what you can expect to read in future posts. Throughout my life, I have considered myself a “tech” person and have learned to “just dive in” with new software, platforms, and digital tools. I have worked in many nursing settings: med-surg, ICU, code responder, hospice case management in both home- and long-term care, chemical dependency treatment, and informatics.

I have seen technology impact all these settings. I am also a nurse educator, and I tell new students that the first task in their nursing education is to “make your peace with change,” because this is a field where change is aggressive and never-ending. This is especially true when it comes to new digital technology and products.

Early adopters emerge from each generation. Young people enter the tech world with less baggage, anxiety, and historical expectations. They are not necessarily better at it than older generations; they just feel freer to explore and embrace new things, because of their shorter histories and less need to change previously held attitudes and expectations. Where a previous generation tends to leave off, they hit the ground running!

My philosophy

Nursing-related innovation should always be about improving patient care, and that includes both high-tech and low-tech innovation. This is not an either-or choice, and making it such creates an artificial and unhelpful dichotomy. Technology is not the answer to every question—sometimes pen and paper are best. But if we do not know what technology options exist, we can completely miss transformative opportunities to improve patient care—especially in the areas of self-care and health promotion. By using technology wisely, we have the opportunity to send patients home with a new set of tools that can revolutionize their understanding of their diseases and treatment plans, while providing more effective ways to engage in self-care.

We need to cross the divide between “techies” and nurses. The people behind digital technology reflect an immense, diverse, and rapidly expanding force that is both organized and organic. They need us to be fully engaged in spreading and creating the next generation of patient-care tools.

It can be hard for the busy practitioner to stay abreast of the latest news and trends, and this blog is one tool that will help you find and follow new developments. I hope to help you identify practical applications and demystify the tech process, so you can better share what you learn with your peers and social-media groups.

Moving forward

I want to start a conversation with you and the larger nursing community. Toward that end, I will seek to discover, aggregate, and share what is coming next. I want you to respond by asking questions and sharing your thoughts—by posting comments here and also on social networks. In today’s world, discoveries don’t come from just one source—the all-knowing expert. Each of us has a role to play. I will learn from you, and, together, we will make this blog a useful launch pad for further innovation and growth.

Please join me on the journey. I look forward to engaging with you!

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International. Comments are moderated. Those that promote products or services will not be posted.