Technology is part of everyday life. Most people have
mobile phones, use the internet, and have gadgets
around the house. Many people are used to booking
travel or holidays online, communicating with friends
and family by text, taking their child’s temperature at
home, or monitoring their household’s energy usage.
Activities that once required an expert intermediary, or a piece of equipment only available to
specially-skilled workers, are now possible for everyone. In healthcare, however, the picture is
very mixed.
There are many instances where technological developments have transformed care. New
diagnostic and treatment methods have reduced the need for invasive surgery; or where surgery
is necessary, have made it less traumatic. The use of telephone, video and web technology has
allowed expertise to be shared over great distances, and clinicians and patients to talk directly to
one another, even when they cannot be together. The reduction in size, complexity and price of
medical equipment has made it possible for individual patients to have their own equipment at
home. Changes in Government policy, public expectations and health economics have supported
the move towards home or community-based care, and away from the habit of admitting people
to hospital routinely for investigations or treatment. As a result, entire services that would once
have been ward-based are now delivered by community teams.
Yet there are still many instances of the health care system being remarkably resistant to the
potential of technology to make care more effective, convenient or personalised for patients.
There are times when important information still travels slowly and unreliably by letter or fax.
There are places where multiple written records are used by a variety of different professionals
about the same patient during the same episode of care. There are practitioners who refuse to
use information technology; and decline to offer their patients home monitoring equipment on
the assumption that they won’t be able to manage it.
Healthcare provided in the community is the most exciting and essential place for new technologies
to be exploited to the full1
. People’s homes are all different, individuals are each unique, and their
circumstances can change from day to day. If ever there was a setting that demanded tailored
care, flexible solutions to problems, and a partnership of knowledge and practical management
between the individual and their health team, it is in the patient’s home. This report highlights
some of the many examples of how technology can give patients a new sense of control and
involvement in their care, and give nurses new ways to deploy their expertise. It aims to:
Review the status of technology and ‘eHealth’ in community nursing practice
Identify some of the reasons why professionals find it difficult to embrace new ways of
working in the community, and to signpost to some guidance that will help them
Begin a debate on what is needed to transform attitudes to technology and embed it in
modern practice
Set out some challenges for individual community nurses to consider as part of their own
professional development
Technology will never replace the expert nurse; both are needed to deliver high quality care
to patients. Neither will the nurse, however expert, be able to substitute entirely for the use
of technology in modern health care. That would be as unfair as denying a patient modern
medicines. Now is the time for the intelligent, comprehensive and creative use of every possible
technological aid to deliver nursing in the community. It is no longer a fictional long-term vision;
we are already in the Smart New World.
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