NURS FPX 4900 Assessment 3

NURS FPX 4900 Assessment 3

Assessing the Problem: Technology, Care Coordination, and Community Resources Considerations

Client’s Name

Capella University

FPX4900: Capstone Project

Instructor’s Name

August 2024

Technology, Care Coordination, and Community Resources Consideration

Technology has become important in modern healthcare, especially in managing patients’ conditions such as heart disease. Since heart disease is still a significant cause of death globally, the proper implementation of health technology is crucial in terms of advanced patient outcomes, efficiency in care management, and cost-effectiveness of healthcare systems (Senbekov et al., 2020). These technologies include telemedicine applications, enhanced EHRs, daily monitoring devices, and decision-making support systems allowing constant care and specific care plans. Recent research by Wasilewski et al. (2024) shows that wearable cardiac monitors, telehealth, and AI-assisted diagnostic devices have enhanced the possibility of managing heart disease by offering opportunities for constant monitoring and early detection. 

Impact of Healthcare Technologies 

In my capacity as a baccalaureate-prepared nurse, I use health information and technology to provide high-quality care and management for patients with heart disease. This includes efficient monitoring and timely use of interventions for patients with heart disease. The use of technology like remote monitoring devices, electronic health records EHRs, and telehealth platforms has immensely transformed the management of heart disease. Mobile telehealth technologies such as implantable cardioverter-defibrillators (ICDs) and wearable devices like the Apple Watch offer real-time patient data on heart rhythm that can help identify potential arrhythmias and prevent adverse outcomes (Ojha, 2022). EHR as an integrated point of record allows for care coordination between healthcare providers, increasing care plans’ accuracy and decreasing prescription medication errors. Furthermore, telehealth platforms have improved care delivery to heart disease patients where escalated follow-ups and patient education have been facilitated amid the COVID-19 pandemic (Shah et al., 2021). These technologies help nurses to carry out their interventions more effectively and more quickly which in turn benefits the patient and organization. 

Advantages of Specific Technologies

Numerous benefits are associated with the application of healthcare technologies in the management of heart diseases. Devices like the CardioMEMS HF System have greatly lowered readmissions for heart failure cases because these devices constantly monitor pulmonary artery pressure to signal any deterioration before symptoms are observable (Vyas et al., 2023). In a study by Urbich et al., (2020) was carried out, the application of this advanced technology reduced heart failure hospitalization by 58%. In the same way, EHRs have also played a significant role in improving coordination and decision-making as they give immediate information about patient medical records, and laboratory, and imaging data (Vos et al., 2020). The decrease in length and repetition of health information lowers the risks of unnecessary testing and mistakes, contributing to increased patient protection and reduced healthcare expenses. Furthermore, the use of telehealth has increased the availability of Cardiology-related services for rural and other underserved communities where cardiologists may be scarce. According to the American Heart Association (2021), telehealth interventions have enhanced compliance with medical prescriptions and other self-care practices in heart disease patients, which have in turn resulted in better clinical and financial related outcomes.

Disadvantages of Specific Technologies

Like any healthcare-related technology that proves beneficial in improving the healthcare system, some drawbacks are associated with these technologies. Even though remote monitoring devices are efficient, they are expensive and may lead to financial strain on healthcare facilities and patients, especially from low socioeconomic backgrounds. For instance, the CardioMEMS HF System is expensive to acquire even though its outcomes are very positive among patients who apply it. Moreover, EHRs are critical components of modern, patient-centered care but these records can present numerous technological challenges, including compatibility problems that limit the smooth sharing of data across multiple providers (Jaleel et al., 2020). This fragmentation causes delays in patient care and increases the possibility of errors and frustration among patients doctors, nurses, and other healthcare professionals. Moreover, telehealth services are beneficial, but they depend on the internet connection, which is not always accessible for elderly heart disease patients, especially those living in areas with poor connectivity, and patients with low digital literacy. These challenges support the stance that risks and limitations must be considered before incorporating healthcare technologies in heart disease management.

Recent Technology Use in Professional Practice and Potential Barriers

Today,  healthcare devices such as telemonitoring, telehealth, and imaging modalities are increasingly integrated into the professional practice of treating heart diseases. However, several challenges may prevent the effective utilization of these technologies. The high cost of implementation persists, this is because some technology devices such as implantable cardiac monitors and advanced EHR systems cannot be implemented without a relatively big investment (Rudin et al., 2020). Additionally, the concern arising from data protection and cyber security is a risk since healthcare institutions are increasingly adopting digital monitoring data systems, resulting in vulnerabilities to breaches. Furthermore, some healthcare providers refuse to implement new technologies because they are difficult to adapt, such as mastering new software, like EHRs, and using remote monitoring systems. To enable healthcare providers and patients to utilize technology seamlessly, it is important to organize awareness campaigns and training workshops for learning the use of technology in healthcare. 

Care Coordination and Use of Resources

Due to the complexity and chronicity of heart disease, focusing on the organization of comprehensive care and rational utilization of community resources is critical for the effective management of the condition. Applying models in clinical practice helps in reducing the readmission rates of patients. Such as Transitional Care Model (TMC) allows healthcare providers to plan discharge care properly to reduce hospitalization rate. Heart disease is a complex chronic disease that requires collaboration with community resources including cardigan rehabilitation and patient awareness resources. Community providers work directly with patients which is why they are more attached to culturally relevant practices. Thus, collaboration with community providers will allow healthcare providers to increase medication adherence and help them learn more about healthy lifestyle behavior for heart disease management. 

Evidence Supporting Benefits of Care Coordination and Use of Community Resources

The critical issue of heart disease can be treated efficiently using community resources and evidence-based care coordination. Research by Dev et al. (2021) shows the success of care coordination programs to reduce readmission rates. A care-coordinated plan such as clinics run by nurses proved to improve heart failure management by 25% in 30 days. Furthermore, the chronic care model is also beneficial in improving medical adherence and healthy lifestyle changes in patients’ lives. It is because this model prioritizes the collaboration of healthcare providers and patient education about their condition. A study by Wray et al. (2021) showed increased health outcomes and satisfaction levels in patients who received care from community resources. This strategy was also appreciated by patients because it was cost-effective. Moreover, incorporating technologies such as the KardiaMobile EKG device enables the tracking of patient data in real time. This is beneficial in preventing readmission rates and also critical cardigan situations. These strategies also help in improving patient’s medical and social requirements.

Current Use in Nursing Practice

Advanced Practice Nurses (APNs) help nurses improve care coordination according to ethical guidelines. Care Coordination and Management Platform (CCMP) is a technological advancement in healthcare that helps in improving medication adherence and follow-ups. Electronic health records (EHR) is also a technological advancement that helps healthcare provers in record keeping and protecting patient data. It also allows healthcare providers to provide patients with financial assistance programs, psychologists, and nutrition counseling. Community partnerships are commonly utilized in rehabilitation programs to support recovery and decrease rates of relapse. However,  these practices are gaining popularity but their implementation varies across regions and healthcare systems.

Barriers to The Use of Resources and Care Coordination

Several challenges exist in incorporating care coordination and community resources in managing heart diseases. The availability of funding especially in underserved healthcare systems remains a barrier in ensuring that individuals gain access to more innovative applications to manage their care coordination platforms and incorporate the community services in patient plans. Also, a lack of coordination between the various caregivers and other related community-based agencies results in a lot of gaps in care, especially in rural settings where resources are scarce. Older patients and healthcare practitioners also present another challenge as they are usually reluctant to embrace new technologies. For instance, patients may be scared of using RPM devices such as wearable EKG monitors, or clinicians may not possess adequate skills to use digital solutions. Furthermore, differences in reimbursement for non-conventional services like CHW work or telemedicine appointments limit the likelihood that they will be delivered to those who could benefit from them most, widening health disparities for cardiovascular disease.

Nursing Practice Standards and Organizational or Governmental Policies

State board nursing standards and policies play a crucial role in organizing health technologies, care coordination, and community resources in the management of heart disease. ANA and state boards support coordinated care strategies of embracing technological advancements such as telehealth and remote monitoring of patients with heart disease. The CMS has enforced policies such as Chronic Care Management (CCM) whereby patients are monitored continuously through technological gadgets like the KardiaMobile and smart EKGs. They are useful when it comes to diagnosing arrhythmias from an early stage and enhancing the quality of care hence decreasing the rate of hospitalization. Furthermore, initiatives such as the Hospital Readmissions Reduction Program (HRRP) promote the application of unified electronic health records (EHR) that facilitate adequate communication between care teams. Through encouraging the adoption of these technologies, and advocating for such community-oriented programs, these standards and policies thus ensure that patients receive optimum results and within overall cost-effective care pathways across all stages of healthcare. 

Ethical Implications of Standards and Policies in Heart Disease Management

Implementation of practice standards and policies of nursing in heart disease management gives rise to crucial ethical questions such as the provision of heart disease management technologies and community services. Telemedicine and remote monitoring regulations give rise to inequalities among vulnerable groups with little access to technology or stable connections. From an ethical perspective, the nurses have to support the initiatives that will close this gap and make sure all the patients are equal in terms of the opportunities they have to access quality care services. Furthermore, ethical practice entails conformity to patient autonomy and personalized care even in situations where technology is applied. The ANA’s ethical guidelines provide opportunities where nurses are supposed to make appropriate use of technology, while at the same time maintaining, both, a technical and human touch approach with the clients, particularly those from the communities who may not trust the use of technology in any health care activities, technological or otherwise. Thus, engaging with these policies necessitates ethical reasoning since nurses are not only bound by professional guidelines but also by patients’ rights and the social justice concerns of health care disparities (ANA, 2021). 

Conclusion

Coordinating care, using health information technology, and incorporating community services are crucial in the management of heart disease for value, safety, and improved patient experience. The State Board of Nursing Practice Acts (NPA) supports the application of evidence-based interventions that include technologies such as telehealth, remote monitoring, and e-records to allow efficient communication. However, an ethical dilemma becomes apparent, especially in terms of the equitable distribution of these resources to the less privileged in society. That is why, nurses must act as change agents to mainstream patient-centered approaches to care delivery that will provide access to hi-tech tools without compromising on cultural sensitivity.

References

Jaleel, A., Mahmood, T., Hassan, M. A., Bano, G., & Khurshid, S. K. (2020). Towards medical data interoperability through collaboration of healthcare devices. IEEE Access, 8, 132302-132319. http://dx.doi.org/10.1109/ACCESS.2020.3009783 

Ojha, S. (2022). Recent advancements in artificial intelligence assisted monitoring of heart abnormalities and cardiovascular diseases: A review. Letters in Applied. NanoBioScience, 12(3), 89. https://doi.org/10.33263/LIANBS123.089 

Rudin, R. S., Fischer, S. H., Damberg, C. L., Shi, Y., Shekelle, P. G., Xenakis, L., … & Ridgely, M. S. (2020). Optimizing health IT to improve health system performance: a work in progress. Healthcare 8(4) 100483 Elsevier. https://doi.org/10.1016/j.hjdsi.2020.100483 

Shah, A., Guessi, M., Wali, S., Ware, P., McDonald, M., O’Sullivan, M., & Seto, E. (2021). The resilience of cardiac care through virtualized services during the COVID-19 pandemic: a case study of a heart function clinic. JMIR Cardio, 5(1), https://preprints.jmir.org/preprint/25277? 

Senbekov, M., Saliev, T., Bukeyeva, Z., Almabayeva, A., Zhanaliyeva, M., Aitenova, N., & Fakhradiyev, I. (2020). The recent progress and applications of digital technologies in healthcare: a review. International Journal of Telemedicine and Applications, 20(1), 8830200. https://doi.org/10.1155/2020/8830200 

Urbich, M., Globe, G., Pantiri, K., Heisen, M., Bennison, C., Wirtz, H. S., & Di Tanna, G. L. (2020). A systematic review of medical costs associated with heart failure in the USA (2014–2020). Pharmacoeconomics, 38, 1219-1236. https://doi.org/10.1007/s40273-020-00952-0 

Vos, J. F., Boonstra, A., Kooistra, A., Seelen, M., & Van Offenbeek, M. (2020). The influence of electronic health record use on collaboration among medical specialties. BMC Health Services Research, 20, 1-11. https://doi.org/10.1186/s12913-020-05542-6 

Vyas, R., Patel, M., Khouri, S. J., & Moukarbel, G. V. (2023). A profile on the CardioMEMS HF system in the management of patients with early stages of heart failure: An update. Expert Review of Medical Devices, 20(8), 621-631. https://doi.org/10.1080/17434440.2023.2228683 

Wasilewski, T., Kamysz, W., & Gębicki, J. (2024). AI-Assisted detection of biomarkers by sensors and biosensors for early diagnosis and monitoring. Biosensors, 14(7). https://doi.org/10.3390%2Fbios14070356 

Wray, C. M., Khare, M., & Keyhani, S. (2021). Access to care, cost of care, and satisfaction with care among adults with private and public health insurance in the US. JAMA Network Open, 4(6).  https://doi.org/10.1186/s12913-021-06717-5