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Digital roles

Digital innovations

Introduction

These case studies showcase the contributions that nurses and midwives are making to technology enabled care services (TECS) in health and social care settings.

We interview nurses and midwives who are digital innovators or who have been involved in projects that are introducing digital working practices.

Together these interviews:

  • demonstrate the scope of nursing contributions to digital innovation
  • explain the function of each digital innovation and the process of development/and or implementation
  • describe the benefits of digital ways of working

Our interviewees are change agents. We hope by sharing these experiences we may motivate other nurses and midwives to take part and shape the direction of health and social care.

We hope to add to the case studies here. We want to paint a rich picture of the many applications of digital innovation across health and social care.

🎬 - Indicates the innovation contains a video case study

🎧 - Indicates the innovation contains a podcast case study

Please watch the video below for more information on the resource:

Acute

Implementing large-scale digital change can be a once-in-a-generation effort for aÃÛÌÒÖ±²¥¯care organisation, making a huge difference to the way clinicians and managers use information. With the divide between care providers weakening and the health and social care system coming together to form an integrated one, implementing this sort of change has perhaps never had more potential to underpin new systems of population-based care.

Kings Fund (2018). Digital change in health and social care.

Tim has been a paediatric nurse for 17 years and still practices in the NHS. He has worked in the Paediatric Emergency Department, PICU, Surgical Pre-assessment, Bed Management and as a Clinical Informatics lead for an NHS Trust in the UK. He joined Cerner in 2015 as a Clinical Consultant in the transformation team.

Care home

“The social care sector has been slower to embrace the benefits of technology and evidence demonstrates that this is partly to do with culture and attitude, and partly to do with capability and capacity.

Yet, the Government is committed to ‘all patient and care records (being) digital, interoperable and real-time by 2020/1 and new care delivery models that are outcome based are also driving the need for change.

Integrated care means we need information to flow more effectively across health and care to support the delivery of better care, and this can be made much easier via the use of technology”.

Skills for Care (2018). Becoming a ‘digital’ social care organisation.  A guide for managers and leaders.

"EHR is a comprehensive medical and cross-institutional record or similar documentation of the past and present physical and mental state of health of an individual in electronic form. EHRs also provide for ready availability of these data for medical treatment and other closely related purposes. EHRs are real-time, patient-centred records that provide immediate and secure information to authorized users.

EHRs typically contain a patient’s medical history, diagnoses and treatment, medications, allergies, immunizations, as well as radiology images and laboratory results." - Digital Health Europe Glossary

Community

“For various and complex reasons, health services in the UK have found it challenging to keep up with the pace of change. Information technology is transforming care, as new treatments and diagnostic tools become available, procedures are undertaken in a less traumatic way, communication between professionals is easier than ever before and geography is less of a barrier, patients both own health equipment and are increasingly accessing their own records…

Information technology presents one of the greatest opportunities to make services more efficient and help manage patient need in a sustainable and equitable way”.

The Queen’s Nursing Institute (2018) Nursing in the Digital Age. Using technology to support patient in the home.

"Telehealth is a combination of equipment, monitoring and response that can help individuals to remain independent at home. So telehealth is a means of relaying specific physiological data from patients in their homes to clinicians in hospital, general practice or community / mental health settings, to support objective decisions about their clinical management. 

It can enable a clinical team to establish a ‘virtual ward’ of specific patients with remote monitoring of their vital signs. When telehealth is in place a patient’s vital signs and/or test results are available to clinicians caring for them from afar - in real time or close to real time; and patients are much more aware of how their body is functioning." - Dr Ruth Chambers. .

Morag is the Programme Manager for Lanarkshire’s Telehealth Programme which included United4Health as well as the European falls prevention study – SmartCare. Her involvement in these programmes has led to a subsequent expansion of Home & Mobile Health Monitoring across the Lanarkshire partnership area as part of the Scottish Government’s Technology Enabled Care Programme.

Since qualifying in 1974 as a nurse at Glasgow Royal Infirmary,  Morag has worked in various hospital and community settings and was instrumental in the establishment of the first early supported discharge team at Hairmyres Hospital, East Kilbride, Lanarkshire. Moving to NHSGG&C in 2003,  she used this experience in the roll out the Community Older People’s Team in Rutherglen/Cambuslang: a Joint Futures initiative with South Lanarkshire Social Work department.  Transferred back to Lanarkshire in 2009, Morag continued to play a lead role in setting up the innovative Integrated Community Support Team, before moving on to champion telehealth developments.

Healthcare app development is the process by which an app is built for mobile devices (smartphone, tablet, wearable) with the intent of informing citizens and healthcare professionals about preventive healthcare measures, treatment support and tracking the progress being made.

Emma Selby - Virtual reality podcast

· Emma Selby - Digital Innovations (Virtual Reality)                                                                                                                                      

Emma Selby is a multi-award winning Clinical Nurse Consultant in Mental Health and specialises in young people and parental mental health support. Emma began working with young people and tech developers to explore the role technology could play in preventative mental health back in 2015 and since then has set up her own company Digital Mentality which links clinical specialities to creative experts in order to develop a number of award winning national and international digital programs that support early intervention and prevention in mental health.

You can read more about Emma's work at , as well as , a new mental health and emotional wellbeing animation for children and young people.

Claire Russell - Digitising District Nursing service

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Cathy Woods - Caseload Allocation Tool (CAT)

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Ian is the senior clinical director at EMIS Health, a district nurse and Queen’s Nurse. Having worked in a number of clinical and managerial roles within the NHS, including chief clinical informatics officer (CCIO) at a Community NHS Trust, his personal interest in healthcare technology led him to join EMIS Health in 2015. With a focus on clinical leadership and cultural change, Ian and his teams ensure that everything at EMIS Health is clinically driven – improving experiences for both patients and clinicians.

Although his work sees him supporting all healthcare disciplines, Ian’s passion for district nursing remains strong and he continues to work closely with many national bodies to champion the care provided in community settings.

Education

“We can predict certain areas where the future nurse will need increased and different knowledge and skills. IT, telehealth and telecare are likely to be increasingly important as organisations accelerate the adoption of health IT, informatics and social networking sites to support the demands of an evolving healthcare system. The skills to use and develop these new ways of working should be part of the expectation for registered nurses.

There are, however, many unknowns about the knowledge and skills that future registered nurses will need, particularly taking into account possible future changes to technology and care delivery. This means that the emphasis in education must be as much on equipping newly qualified practitioners to be ready for lifelong learning as on specific technical skills…

HEIs are continually looking to develop new and innovative ideas to create effective supportive learning environment for students”.

Council of Deans of Health (2016). Educating the Future Nurse – a paper for discussion.

Sarah Chitongo is a midwifery educator at Middlesex University. She helped introduce the use of Augmented Reality (AR) into simulation based education.

Trainee midwives at the university can experience simulations of obstetric emergencies using AR headsets and lifelike models of mothers in labour. The goal of the technology is to help midwives be better prepared for situations where there is an increased risk of mortality, especially among ethnic minority pregnancies.

To see a short clip of Sarah's work in Augmented Reality in practice, please click .

Sarah Chitongo trained as a nurse and midwife. She has been awarded the QueenÃÛÌÒÖ±²¥™s Nurse (QN) title in recognition for her services in midwifery. She is the only midwife to have received the title. She has also won the Mary Seacole Award for her project investigating the experiences of midwives in caring for women from Black Asian Minority Ethnic (BAME) groups on delivery suite high dependency units within London hospitals.

Learning disability

“People with intellectual disability encounter several barriers to fully embracing digital technology, which may be overcome with appropriate support and adaptations. A small, but growing, literature attests to the value of incorporating digital technologies into the lives of people with intellectual disability, not only for promoting health but also for enhancing educational, vocational and leisure opportunities.

Clearly further evidence is needed to establish the safety and clinical efficacy of digital mental health interventions for people with and without intellectual disability. A digital inclusion strategy that explicitly addresses the needs of people with intellectual disability would ensure that all can share the benefits of the digital world”.

Sheehan R, Hassiotis A (2017) Digital mental health and intellectual disabilities: state of the evidence and future directions.

"PAMIS is a Scottish charity based in Dundee supporting people with profound and multiple learning disabilities (PMLD). People living with PMLD are some of the most excluded people in our communities as they have very little cognitive and communication skills and are often unable to communicate their thoughts and feelings. The digital passport is helping to change this, empowering those living with PMLD and their families.

The digital passport is an e-book containing relevant information specific to individuals including their likes and dislikes, specific care needs, medical procedures and effective ways of communication. Made up of photos, videos and sounds, the passport can be used to educate health care professionals on how to meet specific needs that aren’t necessarily standard care methods or procedures, but support individuals and their families."

FutureScot. Feb 2018.

Further information can be found .

Catriona Jamieson is a Community Learning Disabilities nurse working for PAMIS (Promoting A More Inclusive Society), the only organisation that works exclusively with people who have profound and multiple learning disabilities and complex health needs. She has lead and develop various aspects of PAMIS' work including PAMIS Digital Passports, our specialist PMLD First Aid course, the specialist epilepsy service, health related services for people with PMLD, and digital services for people with PMLD. She is passionate about using a digital and multimedia approach to assist in developing a broad range of supportive and inclusive services and tools from oral and living history projects to communicating practical health and care information.

If you wish to get in contact with her, you can do so at c.z.jamieson@dundee.ac.uk.

Mental health

“Good information technology is already critical to good clinical care. Effective, reliable and sustainable ways to record and communicate information between patients, professionals and organisations will be a foundation for further innovation.

While spending time with patients, empathising, discussing choices and coproducing personalised care plans will continue to be central to the role of a mental health clinician, new knowledge and skills will also be required. Technology will change expectations of the mental health workforce and the way that it is trained, managed and led, for the benefit of patients. Focus will be required to ensure that the same technology is usable and has a positive impact on the wellbeing of the workforce as well as patients”.

Foley T, Woollard J (2019) The digital future of mental healthcare and its workforce: a report on a mental health stakeholder engagement to inform the Topol Review.

"Simply put, artificial intelligence is about machines which act intelligently – typically making predictions or decisions about multiple aspects of the world in which we live." - The Turing Institute (2018). What does AI mean for the Turing?

Emma Selby - Artificial Intelligence

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Emma Selby is a multi-award winning Clinical Nurse Consultant in Mental Health and specialises in young people and parental mental health support. Emma began working with young people and tech developers to explore the role technology could play in preventative mental health back in 2015 and since then has set up her own company Digital Mentality which links clinical specialities to creative experts in order to develop a number of award winning national and international digital programs that support early intervention and prevention in mental health.

You can read more about Emma's work at , as well as , a new mental health and emotional wellbeing animation for children and young people.

Douglas has successfully delivered large scale IT Transformation projects within the healthcare sector and the private sector. Douglas is a practicing Mental Health Nurse with more than a decade of experience working across inpatient and community settings, he has successfully combined this with his strong background in engineering and technology, this allows him to add that extra validity and clinical expertise to consultancy and engagement with clinicians and technical staff. This is underpinned by strong effective leadership and coaching approach to successfully drive through change.

Douglas is passionately driven to introduce technology to improve the working lives for Health care professionals by enabling them to deliver a better care for citizens. His passion for patient empowerment has resulted in a chapter on Collaboration between patients and carers being published in Mental Health & Psychiatry 3rd Edition which is used to train nurses on care planning. He also is an honorary lecturer at Kingston University delivery the Recovery focused Care planning module to pre-registration nurses.

Primary care

"New models of general practice may be the key to unlocking the potential of new system-wide models of care; grounding them in local communities and providing holistic, continuing and co-ordinated care for patients, that is based on strong, Innovative models of general practice trusting relationships with professionals who know them and their communities.

There is clear evidence that this approach delivers benefits to the whole system, reducing pressure on specialist services, delivering better health outcomes for patients and improving the working lives of professionals in general practice."

The King’s Fund (2018). Innovative models of general practice.

Ann Gregory - Using technology during COVID-19                   

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Ann's podcast was originally recorded for the General Practice Nursing Forum.                                  

Public health

A fully digital public health system could better anticipate the public’s needs, and provide personalised tools to help  people live  healthier for longer.

Whilst digital interventions will not be a panacea, by building on the existing expertise in the UK and the evidence we’ve seen from other countries, we see digital playing a crucial role in bringing revolutionary changes to how people are supported to live healthier lives.

Predictive prevention will play a major part in building this, using our existing ways of promoting better choices and better health – but also driving further innovation as technology develops."

Public Health England (2018) Predictive prevention and the drive for precision public health. Public Health Matters.

Health Navigator’s ‘Proactive health coaching’ is a software and telephone-based nurse healthcare programme, founded in Sweden in 2010. It uses coaching to communicate with patients who are high-consumers of healthcare. Typically 1-2% of the total population in a healthcare system can account for 35-50% of the total healthcare spend per year.

The software used by Health Navigator is a predictive tool designed to identify patients who may become high consumers. These patients are invited to the programme, and either give consent to receive no coaching but be followed to see how they use healthcare; or consent to receive telephone-based, non-medical coaching from qualified nurse. The coaching helps ensure they understand their own health and use services appropriately. The programme is already established in Sweden, and is being used by Clinical Commissioning Groups in England. The service is being evaluated by the Nuffield Trust.

Further information can be found .

Creenagh started her career in project management in the construction and mining industries, and although very removed from nursing, learned many skills that she found to be highly transferable specifically around management and leadership.

She worked for two years in South Africa for an international organisation, and the experience of understanding the challenges and benefits of working with a diversity of nationalities and cultures has served her well in her nursing career, which started in Colo-rectal surgery. Here, she developed a greater understanding of effective communication and the positive effects this can have on both patients and staff in supporting positive outcomes.

From there, she moved to A&E, always a challenging environment, but by applying good team building skills, empowering nurses, and offering professional development opportunities, developed a highly effective nursing team that delivered outstanding levels of effective and compassionate care to patients.

As her areas of responsibility increased across the trust, she applied this same approach to leadership,  and whilst this was often not without its challenges, the satisfaction of seeing the nursing workforce empowered and grow in confidence and ability was very rewarding.  From the acute trust, she moved into social care for a number of years, and as Operations Director focused on both the clinical and business side of the organisation, again bringing previous experience to the role, but also learning about the essential need for a collaborative interface between healthcare and social care to deliver positive patient outcomes.

Now, back working within healthcare for a private organisation working within the NHS, she is able to utilize the many skills that she has gained along her career pathway, to empower and develop nurses, create safe and effective care pathways for patients and everyday love the challenges and opportunities that she is privileged to face.

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Page last updated - 19/02/2023

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