Digital Health Technology in Nursing

• Nursing Informatics integrates nursing, healthcare, and technology to promote health and wellness.
• Technology influences how people access information, learn, socialize, commute, and manage behaviors related to health.
• Digital Health Technology uses technologies for health, health-related purposes, and health behaviors generally.
• Digital health technology refers to enabling technologies used in health-related applications.
• Digital Health Technology and Systems support health outcomes, promotion, disease prevention, equitable access, efficiency, reliability, costs of health systems and services, patient/worker safety, health workforce, and service delivery.
• Healthcare's digital health technologies include electronic medical records, computer Provider Order Entry Systems, patient portals, telehealth, and point of care technology.
• Digital Health Technology in Healthcare provides access, efficiency, safety, and positive outcomes.
• Drawbacks of Digital Health Technology in Healthcare include reliability issues, workflow disruption, and resource demands.

Nursing Informatics and Practice

• HIT knowledge and preparedness, skills, and competencies in nursing care impact the nurse's current and future roles.
• Nursing informatics roles encompass clinical practice, education, administration, leadership, research, policy, and the private sector.
• Nursing informatics uses technology to support person and family-centered care
• Technology use in patient care requires assessing preferences and goals, capability, motivation, literacy, willingness, availability, and cost, focusing on client/family needs.
• Patient education should cover specific technology use, privacy/security policies, confidentiality, learning styles ("Teach-back"), and available resources/supports.
• Nursing involvement is needed in change management, design, adaptation, adoption, implementation, workflow, and user experience.
• Nursing Informatics and Education offers essential knowledge regarding nursing informatics, entry-to-practice competencies/standards, digital health, evidence-informed practice, and best practices.
• Nursing Informatics and Administration/Leadership provides ongoing opportunities for staff education/training, leads change management/innovation, champions tech implementation, assesses staff needs, and fosters interdisciplinary teamwork.
• Nursing Informatics and Research uses design/evaluation strategies, considers technology, user factors, health outcomes, patient safety/care quality, and evidence to support evidence-informed practice.
• Nursing informatics influences healthcare policy, advocates for regulation, addresses emerging technologies (like social media), and promotes patient safety/quality care.
• Nursing informatics in the private sector offers opportunities to drive change from a unique perspective, integrating healthcare, technology, business, and innovative models.

Informatics Competencies

• Competency involves combining and applying knowledge/skills to specific situations.
• Informatics competencies can be developed through education programs, mentorship, clinical placements, courses, and experiential learning.
• Informatics competencies in nursing practice depend on prior education, experiences, and on-the-job training.
• Nursing informatics in undergraduate education, exposure to Digital Health Technology, hands-on learning, and professional development opportunities aid transition to digital health practice.
• Social media includes applications and websites that enable interaction between users, businesses, communities, and content.
• Social networking is a form of communication on the Internet in which users share information, ideas, personal messages, and other content.

Social Media

• Social media use in health provides access to resources and influences healthcare behaviors.
• Formal uses of social media include course assignments, content clarification, course-related sharing, and patient/exam education.
• Informal uses of social media include peer connections, skill review, interest-based learning, knowledge scaffolding, and accidental learning.
• Social media use raises accuracy, legitimacy, and professionalism concerns, alongside risks of distractions, confidentiality breaches, and reputational damage.
• Professionalism and Expectations in social media are informed by regulatory standards, professional ethics, and employer policies.
• Social media offers benefits like professional image enhancement, but risks include confidentiality, privacy, and boundary violations.
• Social media expectations emphasize integrity, accountability, and adherence to employer policies.
• The "6 Ps of social media" include being professional, positive, patient/person-free, protective, private, and pausing before posting.
• The College of Nurses of Ontario (2023) Code of Conduct requires nurses to demonstrate professionalism, respect, maintain public confidence, and be accountable on social media.
• The College of Nurses of Ontario (2024) defines professional conduct/misconduct through standards of practice.
• The National Council of State Boards of Nursing provides guidelines for social media use.
• Social Media from 2009-2010 related to nursing literature.
• In 2010-2011 Social media - Non-clarity surrounding social media and nursing
• Since 2011, policy and guideline development on social media by nurses/nursing profession began.
• "Healthy" social media provides access to information, health promotion, disease management, health behavior guidance, mobile apps, and online communities.

Week 4: Policy

• Policy is a set of principles/rules that outlines expectations and provides a basis for consistent decision-making/resource allocation.
• Health policy refers to decisions/plans undertaken to achieve specific healthcare goals.
• Health policy defines a future vision, sets targets, outlines priorities, clarifies roles, builds consensus, and informs people.
• Canadian Health Care Policy aims to protect/restore Canadians' well-being and ensure reasonable access to health services.
• The People's Health Care Act aims for a sustainable and publicly funded healthcare system.
• Ontario Health manages Ontario's health service needs regarding digital health, IT, and data management.
• The Personal Health Information Protection Act governs personal health information in Ontario by outlining client rights and requiring confidentiality.
• Information privacy is the client's right to control how their personal health information is collected, used, and disclosed.
• The Personal Health Information Protection Act permits sharing personal health information among healthcare teams for efficient care.
• Security involves processes/tools that ensure confidentiality.
• Personal Health Information is any identifying information about clients
• Personal health information belongs to the client, who can give/refuse consent.
• Nursing implications include nursing practice, education, and leadership applications.
• Commercial Health Technology includes commercial, private-sector, and federally regulated businesses.
• The Personal Information Protection and Electronic Documents Act covers the collection, use, and disclosure of personal information, security, safeguard procedures, consent, and data collection.
• Digital Determinants of Health include access to digital technologies, digital literacy, affordability, data privacy, security, and reliable health information online.
• Health equity involves fair resource/opportunity distribution to enable individuals to achieve their highest health level, addressing unfair health disparities.
• Digital health equity means equal opportunity for individuals to benefit from digital health technologies.
• Social Justice Considerations in Digital Health Technology emphasizes providing equal access, personalized experiences, addressing disparities, solving problems creatively, and including marginalized communities.

Digital Health Literacy

• Digital health literacy is the ability to manage and understand information safely/appropriately using digital technologies.
• Digital health literacy is the ability to seek, find, understand, and appraise health information from electronic sources and apply it to health issues.
• The Public Health Agency of Canada reports that 60% of Canadian adults and 88% of seniors lack health literacy, making it hard to understand/act on health information.
• 37% of Canadians seek health information online, 23% report negative outcomes, 43% experience anxiety/distress due to misinformation, and 43% are highly vulnerable to believing misinformation.
• The CMA is concerned that algorithmic mechanisms on platforms push misleading health information.
• Misinformation is verifiably false, inaccurate, or misleading news/information.
• 59% of Canadians are concerned about online misinformation and that distinguishing fact from fiction is increasingly difficult.
• Many Canadians do not know how to fact-check online information.
• Canadians who identified an interest in separating fact from fiction were more likely to verify the accuracy of news stories they encounter.
• Confirmation bias is seeking secondary sources confirming original beliefs.

Evaluating Online News

• Search engines and evaluation of online health are key aspects.
• Online health information is affected by search engine optimization, preferences, cookies, algorithms, virality/trends, and echo chambers.
• Echo chambers reinforce current beliefs, presenting similar information through algorithms and risking misinformation.
• Infodemics accelerate the spread of inaccurate information during outbreaks, causing panic/risk-taking.
• Nurses must collaborate with healthcare stakeholders for evidence-based decisions from credible sources.
• Evidence sources for nurses require clinical judgment regarding patient needs, medication practice, and practice setting.
• Examples of evidence-informed sources: practice guidelines, research, texts, healthcare teams, CNO guidelines, Health Canada.
• Nurses should support patients' health/digital literacy, understand information-seeking behavior, support online evaluation, and provide support.
• Ways to Evaluate Online Health Information: DARTS, QUEST, AACODS, and 5 Ws.
• DARTS stands for Date, Author, References, Type, Sponsor
• QUEST is the Quality Evaluation Scoring Tool, a 28-point system
• AACODS stands for Authority, Accuracy, Coverage, Objectivity, Date

Week 6: Theory

• Theory is a body of assertions, descriptions, or predictions of relationships.
• Good Theories are logical, coherent, have clear definitions, have a defined domain, describe variable relationships, include concepts, themes, principles, constructs, & include prediction.
• Frameworks provide structure informed by existing theories and guide/inform nursing practice.
• Framework Characteristics include development from literature/evidence and theoretical framework explanations
• Nursing Theory Examples: Peplau's Theory of Interpersonal Relations, Leininger's Theory of Transcultural Nursing, and Watson's Theory of Transpersonal Caring.
• The College of Nurses of Ontario (CNO) Therapeutic Nurse-Client Relationship standards are trust, respect, professional intimacy, empathy, and power.

Sociotechnical Model

• The sociotechnical model addresses health IT challenges within healthcare systems, focusing on safe implementation and use of health IT interventions within clinical contexts resulting in an eight-dimension approach to study HIT.
• The Eight Dimensions of the Sociotechnical Model are hardware/software, clinical content, interface, people, workflow and communication, internal policies, procedures, and culture, external rules and regulation, system measurement/monitoring.
• Hardware and Software involves Hardware and software required to run the applications
• Clinical Content involves all system information and content to configure software and aid clinical tool development.
• People involves all participants in HIT, emphasizing user training and knowledge/skills.
• Human-Computer Interface allows for interactions with hearing and touch, and also tensions between system interface and clinical workflow and how technology is integrated.
• Workflow and Communication recognizes healthcare's collaborative nature and practice dynamics, often leading to proposed changes.
• Internal/Organizational Policies affects all mode dimensions, including roles, budget, IT policies/procedures, and workflow.
• External Rules, Regulations, and Pressures are forces that facilitate/constrain HIT design, use, and evaluation.
• System Measurement and Monitoring involves regular evaluation of HIT's availability, usage, delivery effectiveness, impact on health, and unintended consequences.
• Implications include hardware/software, clinical content, interface, people, workflow, policies, rules/regulation, & system measurement/monitoring.
• Workarounds are methods to bypass workflow blocks, minimizing disruption.
• Factors Contributing to Workarounds: HIT delaying workflow, poor work design, time constraints, policy overrides, and technology unfamiliarity.
• Interoperability is secure/timely health information exchange with common interpretation, enabling connection, collaboration, and communication.

Interoperability

• Interoperability benefits patients through improved access, management, reduced time and reduced medication errors, and better transitions of care.
• Interoperability benefits clinicians through time savings, improved communication, confidence, and direct care time.
• Interoperability benefits health systems through increased capacity, productivity, effective planning/evaluation, research, and health data.
• Interoperability benefits researchers through marketing, time/expense savings, and innovation resources.
• Current Gaps in Interoperability are care coordination/provider burnout, poor patient access/experience, safety risks, inefficient care, high costs, disconnected care, health equity, and Indigenous data sovereignty.
• Barriers and Challenges to Achieving Interoperability include data blocking, a lack of data portability, and an inability to access data at the point of care, care coordination, and collaboration.

Explore the integration of nursing, healthcare, and technology, focusing on digital health's influence on accessing information and promoting health behaviors. Digital Health Technology and Systems supports health outcomes, promotion, disease prevention, and equitable access.