By Katherine Gombay
“Fishermen on boats, they eat all kinds of stuff,” says Nursing Professor Antonia Arnaert. She is voluble in her excitement about her most recent telenursing research project, which had patients with uncontrolled diabetes using smartphones and the Internet to communicate with the nurses responsible for monitoring their health.
Telehealth is getting increasing attention as a cost effective means of delivering health care to patients in remote locations or for those whose health needs long-term monitoring.
“Patients with chronic diseases like diabetes, or who have gone through surgery, often have lots of questions and the doctors and nurses don’t always have the time to answer them,” says Arnaert. “My work is all about trying to develop a new model of health-care delivery, and telenursing has a big role to play in it.”
Arnaert has spent the last 20 years researching and designing telehealth nursing services for different groups of patients based on technology that ranges from smartphones to the Internet and video-conferencing. In the past, she has worked with cancer patients in the final stages of their lives, with the elderly who are housebound, as well as with those who are coping with chronic diseases such as diabetes, depression or hypertension. Arnaert believes that telenursing has an important role to play, both in monitoring the health of patients, but also in teaching them how to care for themselves.
During Arnaert’s recent diabetes pilot project for the Public Health Agency of Canada, patients in five regions of Quebec – the Lower North Shore, Gaspésie, Îles de la Madeleine, and in two different areas in Montreal – were responsible for checking their own vital signs. They then went to a secure web site where they answered a series of questions about things like exercise, diet and food care.
Their nurses, who were some distance away, were then able to monitor their responses to make sure their patients were in good health. “With telenursing, it’s true that the nurse will never be able to be there to give their patient a cup of coffee. But patients say they feel they get lots of attention from their nurses, because they know that they have their full attention for an hour. Some of them even dress up for it,” says Arnaert.
“The nurse plays a crucial role as the care co-ordinator,” she adds. “Their work is focused on giving the patients the knowledge to manage their own disease, as well as giving them the support and advice they need. The nurse needs to know the technology and the diseases, but they also need to know how to motivate people to develop new routines. A lot of their work is education.”
Arnaert’s research has led to the development of software for an integrated interactive telehealth platform, which is currently being commercialized by McGill in a joint venture with Magellan Global Health. Thanks to a well-defined series of questions that Arnaert has developed for a number of common diseases, the software is able to alert care nurses to the need to check in on a patient.
Initially, some nurses Arnaert worked with worried about potential technical problems with the new systems they are being asked to use. But she has also found that when they see the benefits in terms of the way their time is spent, and are convinced that telenursing can benefit their patients, they are much more ready to accept it. As for the students currently studying nursing at McGill, Arnaert says they’re so excited about telenursing that every time she asks for help with one of her research projects, there are more volunteers than she can cope with. Arnaert hopes eventually to be able to set up a lab to train nurses in telenursing techniques.
And the patients? Arnaert laughs. “They’re as proud as peacocks about learning to use these systems to manage their health. When they meet with their doctors they show off and say ‘see what I’ve learned to do!’ ”