How could things in 2000 be all that different for home healthcare?
Until all diseases and injuries are cured or prevented and all of us are out of jobs and donating our time to our favorite humanitarian causes, we will need all the help we can get. To help all of us working in the field, here is my version of every home healthcare nurse's wish list for the new millennium.
Hang on, we are about to make a short jump to light speed and arrive at a new era that really may not be so very far, far away. Make sure your seat belt is securely fastened...here we go!
Portable lap-top computers capable of printing patient educational materials on-site
These teaching guides would be available in several languages (including Braille), on several grade levels (1st grade through college), and would take into consideration such things as culture and food preferences. For example: 2 Gm Sodium, 1800 calorie Hispanic diet, in Spanish, 8th-grade level, patient is allergic to milk products.
Access to a comprehensive medical records system through an on-line file
Every person in the country would have their own computer chip with information imprinted that authorized persons could access to update home healthcare outcomes. The chip would contain data listing all current physicians and be indexed to easily access information regarding the patient's last hospitalization, drug allergies, vaccinations, laboratory results, etc.
On-line access to everything necessary to care for a patient
This would include insurance verification, patient and field staff supply inventory and ordering, information, and educational/training resources for nurses. Imagine the potential to standardize care and better communicate treatments among colleagues through exchange of ideas and information across the country while promoting innovative ideas.
Distance learning for home healthcare nursing
Employees living in remote areas could obtain patient information, orders, and necessary forms over a secure Intranet resource. Notes would be transmitted to the office using the same medium in real-time. The time and gasoline saved could be better spent elsewhere or, even better, saved.
Home care nurses involved in nontrauma 9-1-1 emergency medical response teams
Nurses on these teams could refer patients to appropriate community resources that reduce or prevent hospitalizations and inappropriate use of emergency services. The resources and suffering saved could be tremendous by proactively applying early solutions to potentially expensive problems.
A nursing uniform complete with the ability to leap tall buildings
This special garb would would give the wearer x-ray vision, potent infection-fighting prowess, and telepathic powers to contact physicians directly. Optional two-way wrist-radio also available.
Lightweight portable clipboards that "morph" into a fax machine and/or computer
These marvels of science would come complete with e-mail capability for instantaneous communication from the office. Clipboards could also morph into compact cell phones, beepers, and pizza warming plates.
A drive-thru window in the office for field staff
Staff could drop off what little paperwork they have. The special drive-thru comes complete with Pit Crew to clean windshields and restock vehicles with supplies (energy bars, atomic fuel, etc.). Laboratories and medical equipment supply companies with similar drive-thru windows would be handy as well for nurses to drop off specimens or collect items for patients. Hey-ya want fries with that?
Computer kiosks at several secure, but convenient locations
Employees without a personal computer at home and with proper authorization could submit, print, or view up-to-date patient information, plans of care, medication sheets, latest laboratory results, assignment sheets, and schedules. Directions to the location and in-home supply inventory are some of the things that could also be easily accessed.
An onboard navigational voice computer or homing beacon
This would guide the employee to patient locations at impossible to find addresses.
Sensible Medicare coverage criteria
It is imperative that Medicare coverage allow patients with spinal injuries to work and still meet homebound requirements after they've been helped out of bed and have had their bowel and bladder needs met. It is a waste of talent in a business world needing workers not to use these gifted people who are very capable of contributing to society and paying taxes!
Funding for a nationwide home care university program
This could be a "virtual" classroom where field staff attend class through the Web and have identified mentors. More consistency in content and up-to-date knowledge could be given to everyone at their own pace and in the time most convenient to each individual.
Agreements with local child-and adult-care centers for exchange programs
This would allow home care employees to use these facilities for their children and loved ones as needed in exchange for services provided by home care employees such as PRN nursing assessments, Flu clinics, and medication administration.
Realistic funding
Some type of funding for the unfortunate 79-year-old woman trying to care for her chronically ill 80-year-old husband with Alzheimer's Disease. Are nursing homes cheaper?
A special nurse-mobile
Perhaps Detroit could develop a car (or better yet, Stuttgart and Porsche) that meets the total needs of home care nurses. When parked, the front seat would turn around to face an area to be used as a desk complete with fax, computer, and home healthcare paperwork files. Other options would include a small refrigerator, running water, and a bio-medical waste storage area. The "Nurse's Best Friend" feature would allow the vehicle to come to your rescue when called-from dark alleys, pouring rain, and any other hazardous situations. It would also be equipped with a bathroom and a microwave oven.
The impossible dream
Absolutely, fully-integrated yet nonduplicative paperwork and computer software. Where information is written once.
A new holiday
A national holiday (perhaps on Florence Nightingale's birthday), that would honor all caregivers to celebrate and recognize the diversity and contribution they make in helping others and humanity. Can you imagine a world without caregivers?
Home care graduates.
A certificate for patients graduating from home healthcare complete with the congratulatory signatures of the caregivers involved in that care.
A return to our basic reason for being nurses
The wisdom to use all of the above and more to enhance the quality and quantity of our human connection to help others and not to merely make things easier on ourselves. Despite rampant automation of nearly everything, direct human contact is our business. Better access to information will likely not make our jobs any easier, but will allow us to do more for our patients. However, being exhausted at the end of the day is acceptable to most of us if we know we are truly making a difference in the lives of our patients.
Now return your seat backs to their original upright positions.
We are about to land in a new world where keystrokes are mightier than armies. Join me in preserving and nurturing human compassion in this age of automation. May this new millennium become the best of times for home healthcare...and may the Force be with us.