Finnish eHealth innovations in nursing care Structured electronic documentation and virtual home care as examples Health Care Education VIP day 21.08.2017, Astana Kati Peltonen, PhD (Econ.) Research, Development & Innovation (RDI) Director Wellbeing and Regenerative Growth Faculty of Social and Health Care Lahti University of Applied Sciences, Finland
eHealth and nursing informatics as new key competences in Nursing • Working environment of nurses has been changing -> Nurses as independent professionals, who have a key role in developing and implementing electronic health services as a feature of their nursing work and in reinforcing the involvement of citizens in self-care and self-management. • Nurses’ most important duty after taking care of the patients is to share information about the patients’ care and care plans • Nursing documentation as one of the key development areas • Nursing Informatics competences are required
eHealth in Finland •
Finland is very advanced in its use of IT systems within the healthcare; Finland ranks fifth in terms of the deployment of Health IT within the EU.
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eHealth policy development since 1996 along with legislation and nursing education development. The National Finnish eHealth and eSocial Strategy 2020 set by The Ministry of Social Affairs and Health in 2015.
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Smart systems: • The nationwide Kanta services (The Finnish Electronic Patient Record system) enable efficient sharing of data between residents and entire public healthcare service, pharmacies and several private healthcare providers. EHR coverage 100% (public prim and sec healthcare), 80% (private), EHR information exchange 90% (public, hospital districts), electronical referrals and discharge letters 95% (eHealth study 2011). • All healthcare professionals have their own card issued by the Population Register Centre.
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Capable Users: • The Finnish National Nursing Documentation Model and the updated Finnish Care Classification system (FinCC) • Developed through national projects since 2005 • Documentation model in line with several national laws stipulating documentation • FinCC-classification has been translated and validated fron the International Clinical Care Classification (CCC).
Structured nursing documention and its components • Structured documentation refers to systematic electronic documentation of nursing care considering several aspects of the patient’s condition. Ensio, A. 2015. Overview of the Finnish Care Classification (FinCC) system.
The impact of structured electronic documentation (Saranto et al., 2013; Mykkänen, Miettinen & Saranto, 2016)
• Enhances the quality of evidence-based nursing care and its documentation • Better described interventions, less errors and misunderstanding when standardized and commonly agreed concepts and appreviations are used • Increases patient safety and enhances continuity of care • Strenghtens multiprofessional care collaboration and reuse of patient information between health care providers -> smooth care paths for patients • Increases possibilities to assess the applied treatment methods and their effectiveness. • Standardized nursing documentation supports evidencebased nursing management.
Training to structured documentation: Insights from eNNI project • The nationwide eNNI-project (Electronic Documentation of Nursing Care – the R & D Project for Creation of Nursing Informatics Competence in Cooperation between education and working life) in 2008-2012 • Project included regional working groups, 38 social- and health care organizations and over 1400 nurses participated. • Learning by Developing (LbD)
Development cycle
1.Analysis of the current situation
2.Defining the pilot areas (eg. Ward and cases)
4.Implementi ng new practices in wider use in organization
3.Piloting structural documentatio n in practice with the help of trainers
Further development steps • Mobile documenting systems: • Documentation takes about 25-50% of nurses time in care situations. As computers are not necessarily present, there will be delays in systematic electronic documenting which may also increase errors (Gugertyn al. 2007) • There is a need to develop wireless recording systems for hospital environments, which makes structured electronic documentation even more efficient. • Kanta.fi awarded as the best mobile service for health and well-being in Finland in 2017.
Virtual home care • Virtual home care is exploited in over 25 municipalities in Finland and its use is expanding rapidly. • Virtual care complements normal home care • In virtual home care a nurse contacts patiens through video conference on a set time in order to check a patient’s condition and to make sure that a patient takes medicines or to give instructions. • Virtual care is mainly used for: • Blood sugar measurement instruction • Insulin instruction • Medication instruction; e.g. patients suffering Parkinson deseases may need several control calls/day.
Virtual home care in Lahti • The city of Lahti started virtual home care in 2016 in three areas of the city and the share of patients is increasing in this year. • Lahti University of Applied Sciences as a partner in the development project by organizing training for elderly on how to use tablets. • Results: • Virtual care increases the efficiency of home nursing care • Virtual home nursing replaces one visit/day/patient • one nurse can treat more home care patients in one work-shift without leaving the office -> More time for home care patients -> 5460 h / year = two nurses annual working hours.
Thank you for your attention! Contact details: Kati Peltonen, PhD (Econ.) Research, Development & Innovation (RDI) Director Wellbeing and Regenerative Growth Lahti University of Applied Sciences, Finland Faculty of Social and Health Care E-mail: kati.peltonen@lamk.fi, tel. +358-44-78 1041
The Kazakhstan-Finnish Education and Innovation Group, KFEIG – is the Consortium of four Finnish educational institutions: Häme University of Applied Sciences (HAMK), JAMK University of Applied Sciences, Lahti University of Applied Sciences (LAMK) and Tampere Adult Education Centre (TAKK).
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