The clinical setting chosen for the model is a Community Health setting located in a rural and remote area. In this healthcare setting, nurses are striving to do more with fewer resources available. However, it is usually difficult in rural and remote Community Health settings. Thus, the issue has been on improving efficiency while delivering high-quality patient care in such locations.
Nurses in rural and remote underserved locations normally have relatively “higher workloads, large geographical areas to cover, limited access to specialists and may care for a wide range of health problems” (Effken & Abbott, 2009, p. 439). In addition, other socioeconomic barriers such as low incomes, education, poor health, language barriers, rural cultures, and lack of transportation are responsible for healthcare disparities in rural and remote settings.
Given this crisis in the rural and remote setting coupled low supply of physicians, nurses have the responsibility to develop and implement innovative nursing models for improved care delivery. The effectiveness of such a model on improved patient care would rely on the efficiency of health information technologies and communication technologies. Nurses in rural and remote settings, however, can only realize these benefits when they can create models that they understand and are cost-effective to drive care.
The rural and remote IT-based model has been proposed for this Community Health setting.
Description of the Rural and Remote IT-supported Model
The rural and remote IT-supported model will rely on mobile phone applications and other portable electronic devices to deliver health services and assist nurses to manage patient data. This model was preferred because many people in rural and remote settings have mobile phones, including sophisticated ones. These devices have presented opportunities for developing a rural and remote IT-supported model to serve community health settings.
The model will support the role of nurses in delivering effective healthcare, specifically through real-time delivery of clinical updates, reminders about medication and appointments, and learning materials. The rural and remote IT-supported model has been chosen because it can effectively serve the underserved in rural and remote locations, which generally have low incomes. In addition, it can be applied across different health scenarios for chronic conditions and other outbreak health issues.
This model would enhance healthcare outcomes through four major strategies (Braun, Caricia Catalani, & Israelski, 2013). First, it would lead to fast processes in care delivery. Second, the model will ensure the use of standards and guidelines for specific geographies. Third, it would provide learning and education materials for the target populations. Finally, the model would enhance the role of nurses as innovative care providers with leadership and management capabilities.
Nurse-led and nurse-managed health care
Nurse-led and nurse-managed health care is the future of nursing and therefore, the rural and remote IT-supported model is designed with this in mind. It is expected that nurses will be the primary users of the model in rural and remote community health settings where physicians are few. Thus, nurse leaders must support the implementation of the model. The model will focus on the patient rather than the condition and therefore, it would be possible to understand patients who can or cannot use new technologies.
Partnerships and collaboration
For patients, the rural and remote IT-supported model is more of a partnership and less prescriptive for it to work.
Nurses will rely on IT experts and nurse informatics experts to develop the model. In addition, they will also be responsible for its maintenance.
Although the community health setting may be nurse-led and nurse-managed, nurse leaders will collaborate and work with physicians on appointed days to deliver care. In addition, other care providers such as pharmacists would also be encouraged to use the model.
Continuity of care across settings
The rural and remote IT-supported model is developed to support patients with various conditions and assist nurses to manage their information, which can be transferred to other settings when required.
The model runs on IT systems and apps. Therefore, it is possible to incorporate it with other existing IT-enabled healthcare systems. This is the case with many mobile healthcare systems (Mallow, Theeke, Barnes, Whetsel, & Mallow, 2014). This model is cost-effective because many rural and remote patients already have mobile phones.
Development/Implementation Team for the Model
An IT expert is required to develop various apps and assist with their implementation. Another resource person is a nurse informatics expert who will manage all communications and capture patient data. Nurse informatics expert is expected to analyze these data, derive insights, and provide useful information for decision-making.
The model is cost-effective in terms of human resource requirements and is therefore ideal across various care settings.
Evaluation of the Model: Outcome Measurement
The rural and remote IT-supported model will be evaluated to determine its effectiveness. Data will be collected from various stakeholders, including patients. Six months after the implementation, outcome measurement will be conducted based on impacts on care delivery, promotion of learning and education among patients and leadership effectiveness, and technical challenges experienced. In addition, user preference, support availability, cost, and response time will also be evaluated (Basoglu, Daim, & Topacan, 2012). Feedback will be used to improve the model.
Basoglu, N., Daim, T. U., & Topacan, U. (2012). Determining patient preferences for remote monitoring. Journal of Medical Systems, 36(3), 1389-401.
Braun, R., Caricia Catalani, J. W., & Israelski, D. (2013). Community Health Workers and Mobile Technology: A Systematic Review of the Literature. PLoS ONE 8(6), e65772.
Effken, J. A., & Abbott, P. (2009). Health IT-enabled Care for Underserved Rural Populations: The Role of Nursing. Journal of the American Medical Informatics Association, 16(4), 439–445.
Mallow, J. A., Theeke, L. A., Barnes, E. R., Whetsel, T., & Mallow, B. K. (2014). Using mHealth Tools to Improve Rural Diabetes Care Guided by the Chronic Care Model. Online Journal of Rural Nursing and Health Care, 14(1), 43–65.