By Megan M. Krischke, contributor
It is no secret that the United States is facing a serious shortage of nurses in the coming years. According to the executive director of the American Association of Colleges of Nursing (AACN), Geraldine Bednash, RN, Ph.D., “The problem will not be solved by making a million more nurses, but by better educating fewer nurses and using them differently and more effectively.”
According to industry experts, technology is going to need to play a key role in making nurses more efficient, especially in light of the growing nursing shortage.
Shelly Martin, RN, MHSA, couldn’t agree more.
“As we face the nursing shortage, technology is going to need to play a key role in making nursing more efficient. Focusing on wellness, not just disease management, will also ease both the nursing shortage and health care costs,” said Martin, who is the director of clinical development at WorldDoc, Inc., a national provider of consumer care management systems.
Martin has worked in managed care nearly all of the 12 years she has been a nurse and is passionate about how technology, including health care management systems in particular, can serve both patients and nurses.
The management system developed by WorldDoc incorporates both a patient and nurse portal.
“When a member takes a health risk assessment (HRA) they find out in what areas they are doing well and what they need to improve upon. The assessment assigns them a health age. For instance, my health age is 28, but I am almost 35,” Martin explained. “Health age is a very engaging measurement for people. Employers who use our system report that talk around the water cooler is often people asking each other’s health ages and discussing what they can do to decrease their health age.”
The HRA also offers patients advice and information on their areas of risk and allows them to enter new information from doctor visits and screenings. In addition, the system utilizes medical and pharmacy claims to assist the user in reporting information. The addition of this imported data allows the user to store their medical data in one location.
On the nurses’ portal, the health management system allows them to identify individuals among a large population who have the greatest risk factors and for whom immediate contact with a nurse, or other health professional, would be most beneficial. Because the patient is entering information directly into their portal, the nurse can instantaneously have access to that information rather than waiting for a medical claim to come through, which could take weeks or months. This allows gaps in care to be identified and remedied much more quickly, moving the patient toward greater wellness.
The system was originally designed for patients dealing with chronic diseases such as diabetes, coronary artery disease and congestive heart failure. Using the system enabled a managed care nurse to quickly see who was delinquent in receiving screenings and routine care related to their illness, or who was reporting numbers outside of acceptable ranges. The nurse could then contact the patient by phone or electronically via the portal.
The first add-on to the system was an element of preventive care. For instance, the system would remind a female patient who just turned 40 that she needs to start scheduling yearly mammograms... Eventually, the system was expanded to meet the needs of any individual who had an interest in maintaining or improving their overall health.
The system is currently used by a variety of health plans, third party administrators and employers, and has generated verifiable results.
The original user of the two-interface (portal) system conducted a baseline review in 2004, 2005, and 2006. The population of that particular health plan was primarily Medicare patients, many of whom suffered from chronic diseases. The study focused particularly on the closure of preventive care gaps and found:
•The percentage of users receiving a pneumonia vaccine increased from 16.5 percent in 2004 to 46.5 percent in 2006.
•Recipients of flu vaccinations increased from 50 percent in 2004 to 66 percent in 2006.
•Males undergoing an annual prostate screening increased from less than 23 percent in 2004 to 72 percent in 2006, allowing early diagnoses of prostate cancer.
In a separate study, 51 percent of patient users said they felt using the interface helped them to control health care costs and reduced unnecessary doctor visits.
“Health care, in general, has been focused on managing the costs for people who are already sick,” Martin said. “The nursing community needs to realize that if we are going to make a difference in controlling those costs and in improving people’s health, we’ve got to focus on wellness and preventive measures such as screenings and lifestyle changes.”
Because she sees technology playing such a key role in the future of nursing and patient care, Martin urges nurses to not be wary of technology and to ask for training.
“I think senior management would offer training, but nurses need to ask,” Martin remarked. “Additionally, applications today are really much more user-friendly than they used to be—if you can get around the Internet you can use most of these programs.”
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