Assessing the Problem: Technology, Care Coordination, and Community Resources Considerations
Determine how health care technology, the coordination of care, and the use of community resources can be applied to address the patient, family, or population problem you’ve defined. Plan to spend at least 2 practicum hours exploring these aspects of the problem with the patient, family, or group. During this time, you may also consult with subject matter and industry experts of your choice
Report on your experiences during the second 2 hours of your practicum.
Whom did you meet with?
What did you learn from them?
Comment on the evidence-based practice (EBP) documents or websites you reviewed.
What did you learn from that review?
Share the process and experience of exploring the effect of the problem on the quality of care, patient safety, and costs to the system and individual.
Did your plan to address the problem change, based upon your experiences?
What surprised you, or was of particular interest to you, and why?
Analyze the impact of health care technology on the patient, family, or population problem.
Cite evidence from the literature that addresses the advantages and disadvantages of specific technologies, including research studies that present opposing views.
Determine whether the evidence is consistent with technology use you see in your nursing practice.
Identify potential barriers and costs associated with the use of specific technologies and how those technologies are applied within the context of this problem
Explain how care coordination and the utilization of community resources can be used to address the patient, family, or population problem.
Cite evidence from the literature that addresses the benefits of care coordination and the utilization of community resources, including research studies that present opposing views.
Determine whether the evidence is consistent with how you see care coordination and community resources used in your nursing practice.
Identify barriers to the use of care coordination and community resources in the context of this problem.
Analyze state board nursing practice standards and/or organizational or governmental policies associated with health care technology, care coordination, and community resources and document the practicum hours spent with these individuals or group in the Core Elms Volunteer Experience Form.
Explain how these standards or policies will guide your actions in applying technology, care coordination, and community resources to address care quality, patient safety, and costs to the system and individual.
Describe the effects of local, state, and federal policies or legislation on your nursing scope of practice, within the context of technology, care coordination, and community resources.
Explain how nursing ethics will inform your approach to addressing the problem through the use of applied technology, care coordination, and community resources.
Document the time spent (your practicum hours) with these individuals or group in the Core Elms Volunteer Experience Form.
Support main points, assertions, arguments, conclusions, or recommendations with relevant and credible evidence.
Cite at least five sources of scholarly or professional evidence that support your central ideas. Resources should be no more than five years old
Topic type 2 diabetes, patient is my father
Type 2 Diabetes: Technology, Care Coordination, and Community Resources Considerations
Managing type 2 diabetes may require the use of various technological equipment. For instance, self-use glucometers can help patients monitor their blood levels remotely, allowing them to adjust their lifestyle if necessary. The devices also reduce daily travel and testing costs. Phone apps are also useful since they allow one to implement a lifestyle plan (diet and exercise) and connect with online support groups. Alongside organizational community resources such as the American Diabetes Association (ADA) and American Association of Diabetes Educators (AADE), these groups can help both patients and caregivers acquire information, skills, and moral support. Finally, care coordination is vital where the patients have a systematic disadvantage as language minority, finances, or health illiteracy. A care coordinator would assist these less-privileged patients in attaining optimal health outcomes (high-quality care and adequate patient safety) at the most efficient price.
The meeting was with my patient, a sixty-seven-year-old male relative diagnosed with type 2 diabetes seven years ago. I sought to establish his experience with healthcare technology in managing the disease. I also wanted to determine if he had been part of any care coordination program and whether he had accessed relevant community resources. He stated that he uses a glucometer to monitor his blood sugar level twice a day. The device allows him to store daily readings and send them to a paired mobile device. Thus, he can forward the health data to a healthcare practitioner if necessary. He also has a pedometer app that tracks his step count, as he aims to remain physically active. Initially, he had trouble adjusting to the new dietary requirements. Hence, his physician referred him to a dietician to develop a meal plan that was not too rigid. He stated that the coordinated effort was useful since his failed dieting approach had previously been frustrating. Finally, the respondent has read the information on the ADA website. It was particularly useful during the first year after diagnosis. Presently, he assists in a local program to raise awareness on diabetes management among low-income adults.
Reviewing the evidence-based practice documents and websites showed the impact of care coordination. For instance, Rawlins et al. (2017) established that providing a bilingual care coordinator for Hispanic and African American patients resulted in a 16% drop in A1c levels. The decline lowered the projected healthcare costs, enhancing healthcare access to patients’ quality of life. Meanwhile, Zhai & Wu (2020) found that using a blood-sugar-monitoring app to develop clinical support and instructions resulted in better A1c control and higher self-efficacy. Thus, integrating technology in diabetes management enhances clinical outcomes. Finally, community resource organizations offer more than just the information on their websites. For instance, the ADA has two publications, the Diabetes Forecast and MyFoodAdvisor, beneficial to diabetes patients (Dansinger, 2022). Such resources are available online, making them accessible to most patients.
The Practicum Experience
Exploring type 2 diabetes to determine ways to enhance patient safety and care quality and reduce costs has been insightful. Most of the information has been useful in creating a new perspective on the problem. For instance, I had previously not considered the significance of care coordination. Hence, the review has led me to revise my proposed intervention plan. I was also surprised to learn that a projected 5% of the population unknowingly lives with diabetes (Golden et al., 2017). Therefore, the current organizational and governmental interventions are severely inadequate in systematically mitigating the disease’s burden.
Impact of Technology on Care Quality, Patient Safety, and Healthcare Costs
Advantages and Disadvantages
Healthcare technology improves clinical outcomes. For instance, Rawlins et al. (2017) highlight the reduction in A1c levels. However, these benefits are only attainable if the patients have a positive attitude (Walker et al., 2021). The negativity or indifference could arise from low health literacy levels or support. Whittemore et al. (2019) also note that financial capacity can influence the effectiveness of healthcare technology in managing diabetes. Some of the devices are costly, e.g., the test strips. Most insurance companies have limited covers on these devices, meaning that the patient must purchase them out-of-pocket.
Technology is also beneficial in improving self-management. Patients learn to develop new, healthier lifestyle habits that are useful to their overall health. For instance, app-based exercise and diet programs can result in weight loss. The weight loss helps prevent cardiovascular diseases, alleviates symptoms of osteoarthritis, and improves the general quality of life. However, even the most efficient apps can attain less-than-optimal results if the patient has competing family and work demands (Whittemore et al., 2019). For instance, if one works for sixteen hours a day, they might lack time to exercise. The work or home environment may also not be conducive to implementing the lifestyle changes.
The demerits of using healthcare technology would include cybersecurity threats and poor device implementation. Security breaches can jeopardize patient safety since the apps may recommend harmful actions, while inadequate implementation lowers their effectiveness, frustrating patients. One can avoid these disadvantages by conducting a diligent market search on the most secure and reliable technological equipment before purchasing.
Consistency with Nursing Practice
The evidence on technology use is consistent with my nursing practice experience. Some patients change the apps after finding them cumbersome. Thus, they may prefer less intricate platforms as long as they allow them to perform the basic tasks. Data breaches are rare and usually originate from physically accessing the patient’s mobile device. The patients usually feel that their privacy has been violated, even if the culprit is a friend or coworker. However, most diabetes patients, including my interviewee, find the various technologies relevant to their health needs.
Barriers and Costs
Different technologies accrue various costs. For instance, a basic glucometer requires that the user periodically purchase test strips and lancets. Insurance plans may not always cover them, especially for type 2 diabetes patients, resulting in additional costs. Meanwhile, the self-management apps require internet connectivity, which may not be available to people living in rural areas. Additionally, language barriers can be a challenge when teaching patients how to use the technology. The problem is even more complex if the patient has low technology and basic literacy levels. Hence, these barriers present disparities that healthcare stakeholders should address to ensure equitable technological benefits for all.
Care Coordination and the use of Community Resources
Care coordination is beneficial since it addresses some of the systematic challenges hindering effective diabetes management. Healthcare providers can liaise with other clinical and non-clinical professionals to ensure that patients benefit from the technology. For instance, they can engage a bilingual relative or professional to translate instructions on using glucometers. Care coordination also improves self-management since patients with low health literacy receive sufficient guidance in adjusting their lifestyles. Meanwhile, community resources allow patients to customize the treatment process. One can explore a vast network of information to find interventions that are suitable for them. Thus, they assist in enhancing patient satisfaction in disease management. I can relate to these findings since my patients have narrated how they have benefitted from various care coordination efforts and community resources. Notably, these approaches have aided in creating culturally-appropriate and personally-acceptable diets.
The greatest challenge to care coordination is staff shortage. Some health facilities lack the necessary experts to provide a care continuum for diabetes patients. Moreover, individual caregivers have huge workloads that they cannot afford to engage in extensive care coordination interventions. Similarly, if community resources are inadequate, they cannot serve the population effectively. Some of the resources may not be easily accessible as they are online and may require a monetary subscription.
The Centers for Medicare and Medicaid Services (CMS) has policies regarding the use of telehealth systems. For instance, they require that caregivers use approved platforms and devices (Weigel et al., 2020). They also establish the need to educate patients on maintaining data privacy. Thus, nurses will engage in extensive patient education. They will also expand their roles to include care coordination and case management. Meanwhile, nursing ethics will require that the caregivers uphold patient confidentiality by diligently securing their electronic health devices. They must also advise patients on the best devices and apps (security and usability) but should not respect their autonomy if they prefer other platforms.
Technology, care coordination, and community resources are vital to improving diabetes patients’ outcomes. The three elements enhance care quality and patient safety through patient education and self-management. They can also make healthcare services more affordable and accessible. However, healthcare stakeholders must address the barriers and shortcomings to ensure that the disease burden declines progressively over time.
Dansinger, M. (2022, Jan. 16). Where to Find More Diabetes Resources. https://www.webmd.com/diabetes/guide/resource-support-groups
Golden, S. H., Maruthur, N., Mathioudakis, N., Spanakis, E., Rubin, D., Zilbermint, M., & Hill-Briggs, F. (2017). The Case for Diabetes Population Health Improvement: Evidence-Based Programming for Population Outcomes in Diabetes. Current diabetes reports, 17(7), 51. https://doi.org/10.1007/s11892-017-0875-2
Rawlins, W. S., Toscano-Garand, M. A., & Graham, G. (2017). Diabetes management with a care coordinator improves glucose control in African Americans and Hispanics. Journal of education and health promotion, 6, 22. https://doi.org/10.4103/jehp.jehp_27_15
Walker, A. F., Hood, K. K., Gurka, M. J., Filipp, S. L., Anez-Zabala, C., Cuttriss, N., Haller, M. J., Roque, X., Naranjo, D., Aulisio, G., Addala, A., Konopack, J., Westen, S., Yabut, K., Mercado, E., Look, S., Fitzgerald, B., Maizel, J., & Maahs, D. M. (2021). Barriers to Technology Use and Endocrinology Care for Underserved Communities With Type 1 Diabetes. Diabetes care, 44(7), 1480–1490. https://doi.org/10.2337/dc20-2753
Whittemore, R., Vilar-Compte, M., De La Cerda, S., Marron, D., Conover, R., Delvy, R., Lozano-Marrufo, A., & Perez-Escamilla, R. (2019). Challenges to diabetes self-management for adults with type 2 diabetes in low-resource settings in Mexico City: a qualitative descriptive study. International Journal of Equity in Health, 18(133). https://doi.org/10.1186/s12939-019-1035-x
Weigel, G., Ramaswamy, A., Sobel, L., Salganicoff, A., Cubanski, J., & Freed, M. (2020). Opportunities and Barriers for Telemedicine in the U.S. During the COVID-19 Emergency and Beyond. Women’s Health Policy. https://www.kff.org/womens-health-policy/issue-brief/opportunities-and-barriers-for-telemedicine-in-the-u-s-during-the-covid-19-emergency-and-beyond/