Table of Contents
Technological innovation plays a critical role in increasing accessibility and delivery of services by nurses and other health care providers. The paper will is a proposal to the grantors to finance an up-to-date technology that will see efficient monitoring and communication between the nurses and patients leading to a milestone in health care advancement. In particular, the proposal explains the need for a multipurpose m-heath application that enables nurses to monitor the progress of elderly patients suffering from hypertension in remote locations across the country. The proposed approach exemplifies innovation in its enhancement of efficiency and quality in the health care (West, 2012).
Innovation
According to Steinbul, Muse, and Topol (2013), mobile health (mHealth) is a collective term for the utilization of mobile telecommunication technologies for efficient delivery of health care and wellness services. The proposed mHealth will consist of a wearable device fitted with sensors that monitor the changes in blood glucose levels in elderly patients and a smartphone based application where the information is recorded. The information is then relayed to a central point where physiological changes are monitored by health care professional 24-hours a day. The technology will have an alert system to remind the adults to take medications at the required time. Besides the central point where the information about blood glucose will be monitored, the family nurse practitioners will an application integrated into the system and will be able to receive alerts of any anomaly while away from the office. The proposed mHealth technology will revolutionize monitoring and the timely delivery of care to the elderly population in the remote parts of the country.
The mHealth technology described above will allow for real-time management of hypertension that is implicated in limiting adversities associated with most of the chronic conditions. mHealth allows for the collection of data on the bodily functions of the patients as well as daily activities that may affect the regulation of the blood glucose levels (Lupton, 2013). Further, the technology will be fitted with GPS capabilities so that the location of the patients will be automatically detected allowing for easy navigation in times of emergency. In addition to the efficiency of the delivery of emergency care, the technology will significantly help in managing costs due to limited cases of hospital admissions (Chiarini et al., 2013). Using the technology, one FNP will be in charge of 100 elderly patients who have been diagnosed with diabetes. A team of paramedics will also be connected to the system for managing emergencies. Before a patient is enrolled in the program, a registered nurse (RN) will carry out assessments to determine eligibility and special conditions of the patient.
Problem
The risk of developing diabetes is relatively higher in adults aged 65 and above (Kirkman et al., 2013). According to Caspersen et al. (2012), up to 10.9 million of adults aged 65 and above are affected by both diagnosed and undiagnosed diabetes. By 2050, it is projected that the affected elderly in America will hit 26.7 million. Such points to the urgency with which the condition should be addressed. The proportion of diagnosed. The prevalence of diabetes in older adults is linked to increased mortality and a significant reduction in the functionality of the body. Diabetes in the elderly, if not properly managed, may lead to a chronic kidney disease and cardiovascular diseases. There is an urgent need for an effective management method for diabetic elderly.
Selected Population and Community
Elderly Aged 65 and above
As one advance in age, the functional capabilities of the body reduces. Because of an increase in life expectancy and adjustments in lifestyles, diabetes is common in adults aged 65 and above, whether insured or otherwise. Also, at 65 and above, there is a high chance of developing obesity due to the reduction in physical activities (Kirkman et al., 2012). Pertinent to old age is the reduction in the functionalities of the body. Such impairments are not limited to the processes involved in the regulation of insulin, the primary hormone in glucose regulation. The inability of the body to regulate insulin translates to diabetes.
Rural Communities
In America, people residing in the rural areas are at a high risk of developing diabetes and coronary heart disease compared to those in the urban areas. According to O’Connor and Wellenius (2012), the major driving factor is the diminished income that significantly limits the accessibility to quality health care and wellness programs. The cost of health care tends to be high preventing the members of the rural communities from accessing health care. Further, there is a general shortage of health care services especially for the chronic conditions in the countryside. Compared to the urban centers, the number of physicians and other health care providers in the rural areas is half those available in the urban centers. Such, according to O’Connor et al. (2012) extends to diabetes that requires specialized care to manage.
Qualification of the Organization and Stakeholders
Our organization can execute the proposed project. To begin with, our organization has been working closely with the rural health care facilities catering for the special populations. Therefore, the organization understands the dynamics of health care in the rural setting. The understanding of the health care needs of the rural elderly inspired the proposal for the mHealth technology. Further, the management of the organization is to professionals with experience in project management.
A major stakeholder in the project will be donor foundation. According to Steinbul, Muse, and Topol (2015), the primary barrier to the uptake of mHealth is inadequate financing. As a stakeholder, the donor will be interested in receiving information on the progress and outcomes of the project. The FNPs and RNs will be responsible for analyzing the information transmitted from the patients and be able to decide on the appropriate course of action. The program will cater for both the insured and the uninsured. The organization will work closely with the insurance providers especially Medicare to ascertain timely reimbursements for continuity in service delivery.
Other Stakeholders include the FPNs and RNs who will work collaboratively to analyze the conditions of the patients so that the appropriate measures are taken to avert any looming adversity. However, mHealth will require a reduced number of nurses, which is considerate with the supply of direct caregivers in the remote areas of the country (O’Connor et al., 2012). The RNs will be critical at the enrolment stage in the classification of the patients based on the severity of their conditions. The organization will also involve local community leaders in the region of operation to bring population that is more elderly into the program. According to a study by Sakeah et al. (2014), community leaders played a pivotal role in the success of community-based health care services. The leaders are resourceful and have the capacity to influence the adoption of the program by the rural populations.
Success of the Project
According to West et al. (2012), the main reason for the adoption of mHealth Technologies is to revolutionize the delivery of health care regarding efficiency, cost, and the patient experience. The technologies are especially instrumental in the management of chronic conditions. One of the parameters of evaluating the success of the project would be the rate of adoption of the technology by the proposed mHealth technology. Within the first year of operation, we target to hit half of the intended population coverage. The success of the program can also be defined based on the patient outcomes among the diabetic elderly. As West et al. (2012) assert, the around the clock monitoring and transfer of the patient data to FNPs accelerates the treatment of patients in need of urgent care. Considering that diabetes may lead to emergencies that may lead to mortalities, a significant reduction in the number of the adversities resulting from the conditions will translate to success. Through the mHealth technology, FNPs and RNs will be able to intervene before the conditions of the patients escalate to dangerous levels. The time interventions will also lead to reduced spending because of the elimination of the institutional admission of the elderly.
Foreseeable Challenges
The acceptance of technology among the elderly population is relatively low (Bujnowska-Fedak, 2014). Following the findings of the study by Bujnowska-Fedak, at the initial stages of the project, it might be challenging as some of the older adults may forget to wear the device with the sensor or switch on and carry the smartphones everywhere they go. Further, there is a challenge of the smartphones running out of power while the users are away from home. To avert such anomalies, the elderly will be sensitized so that they have a picture of the positive impacts the technology is likely to confer to their health.
Vision for Change in Health Care
According to West (2012), up to 50% of the elderly tend to forget to take their prescriptions. They miss to either take the medications at the right time or miss totally. The proposed technology will eliminate the problems through the alert system with which it comes. The inconsistencies in taking medication lead to adverse health outcomes that increase the expenditure on health care, especially in managing chronic conditions such as diabetes. In the common setting of health care, patients have to visit the offices to undergo a medical checkup and report any anomaly in their conditions. Office visits are sometimes challenging and costly for the elderly. The technology will ensure round the clock monitoring of the conditions of the patients. Any fluctuation is noted and the corrective measure taken by the FNP. The real-time monitoring of the patients will revolutionize health care and reduce mortalities associated with diabetes among the elderly.
Next Steps
The next step will entail the evaluation of the impacts of the proposed mHealth technology after one year of operation. During year one, the focus will be on the sensitization of the elderly patients affected by diabetes enlightening them on how to use the technology. They will be taught on what they need to do to ensure their benefit maximally from the technology. Likewise, the FNPs and the RNs will receive training to prepare them for the expansion of the project to other parts of the country. After 12 months, a study will be conducted to determine the impact of the technology on the health of the diabetic patients. Further, another study will focus on determining the usability of the technology.
Proposed Budget
According to Kirkman, quarters of adults aged 65 and above are affected by diabetes. For the start of the project, the first year will target a population of 900 patients in the rural areas. Part of the budget will be directed towards the purchase of the smartphones for the pioneer patients. Training and employment of the FNPs and the RNs will take a portion of the budget. At the secretariat, there will be staff and equipment in aid of the program. A comprehensive budget for the program is available in Table 1 in the appendix.
Appendix: Table 1
| Item | Cost | Quantity | Total | |
| Technology | Smartphones plus wearable device | $300 | 1000 | $300,000 |
| Computers (For FNPs and Staff) | $450 | 50 | $22,500 | |
| Software for the mHealth on the computers | $200 | 50 | $10,000 | |
| Application for FNPs and patients | $250000 | 1 | $250,000 | |
| Staff | FNP | $75000/yr | 5 | $375,000 |
| RN | $60000/year | 2 | $120,000 | |
| Accountant | $50000/year | 1 | $50,000 | |
| IT consultant | $40000 | 1 | $40,000 | |
| Malpractice Insurance | $2000/year | 6 | $12,000 | |
| Training | Staff | $12000/month | 4 months | $4,8000 |
| Patients | $10000/month | 3 months | $30,000 | |
| Facility | Building | $400000 | 1 | $400,000 |
| Furniture | $200000 | 1 | $200,000 | |
| Transportation | $150/week | 2 RNs | $7,800 | |
| Total | 1, 865, 300 |
- Bujnowska-Fedak, M. M., & Pirogowicz, I. (2014). Support for e-health services among elderly primary care patients. Telemedicine and E-health, 20(8), 696-704.
- Caspersen, C. J., Thomas, G. D., Boseman, L. A., Beckles, G. L. A., & Albright, A. L. (2012). Aging, Diabetes, and the Public Health System in the United States. American Journal of Public Health, 102(8), 1482–1497. http://doi.org/10.2105/AJPH.2011.300616
- Caspersen, C. J., Thomas, G. D., Boseman, L. A., Beckles, G. L. A., & Albright, A. L. (2012). Aging, Diabetes, and the Public Health System in the United States. American Journal of Public Health, 102(8), 1482–1497. http://doi.org/10.2105/AJPH.2011.300616
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- O’Connor, A., & Wellenius, G. (2012). Rural–urban disparities in the prevalence of diabetes and coronary heart disease. Public health, 126(10), 813-820.
- Sakeah, E., McCloskey, L., Bernstein, J., Yeboah-Antwi, K., Mills, S., & Doctor, H. V. (2014). Is there any role for community involvement in the community-based health planning and services skilled delivery program in rural Ghana? BMC Health Services Research, 14, 340. http://doi.org/10.1186/1472-6963-14-340
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