Helping Drive Health Care's Fast-Moving Technology Train

UCSF School of Nursing Dean David Vlahov with the school's new director of information technology, Kylie Grenier.

A team of engineers and scientists from GE Global Research and GE Healthcare recently huddled with a team of nurse scientists from UCSF School of Nursing to explore a collaboration to create and refine technology-based clinical interventions that would be fully informed by the real-world needs of patients and providers.

Such collaborations are less common than one might think. Since the early 1990s, some researchers have observed the way health care institutions jump aboard the technology train and have voiced concerns. They worry that the seductive nature of technology and the speed of technological change sometimes outpace the ability and willingness of health care institutions and scientists to appropriately shape the tools or assess and mitigate the risks of adoption.

It’s not that those raising the questions fail to understand the miracles technology has promised and often delivered. New medical technologies like artificial organs and more precise diagnostic tools have saved countless lives and significantly improved the quality of countless others.

Advances in informatics, particularly electronic health records, connect provider to provider, patient to provider and both to essential health research and information. Mobile technology means providers can efficiently extend their ability to help patients far beyond traditional health care settings. A deepening understanding of online learning promises to expand and diversify the health care workforce at a time when both are desperately needed.

But, says David Vlahov, RN, PhD, dean of the UCSF School of Nursing, “Our role in technology adoption has to be that of supportive skeptics. We have to evaluate and mold technology-related tools and interventions so that we optimize the benefits and avoid unintended consequences.”

And unintended consequences do happen – from alarm fatigue due to overly sensitive patient monitors to confusing electronic health record implementations and a proliferation of mobile phone applications that have not undergone the rigors of clinical validation and, at best, go unused by patients.

Christina Baggott shares her mobile app with a pediatric oncology patient

“We have to process, interpret and respond so the right technology and interventions are getting to the right users,” says nurse scientist and pediatric nurse practitioner Christina Baggott, RN, PhD, PNP, who facilitates a group at the School of Nursing examining the changing roles that nurse scientists can play in the process.

“With technology becoming a part of everything we do in health care, my vision here is to create an expert consulting group of technology-savvy nurse scientists who research, evaluate and even develop health care technology and who use the online world to expand access to education,” says Vlahov.

Evaluating Future Technology Trends

Realizing that vision requires both patience and dedication. Though faculty at the School of Nursing have been involved with technology-related projects for some time, it wasn’t until a schoolwide rally in the fall of 2011 that a dedicated technology group became a reality. That group is striving to create synergies within and outside the school by marrying faculty skill sets and interests with relevant research and educational initiatives.

“Expanding on and amplifying our technology expertise seemed like a natural next step forward for a leading school of nursing, because there is a gap in nurse researchers and educators assuming the role they should in helping understand the nurse-technology interface,” says Vlahov. “At UCSF, we are so close to Silicon Valley that we have a unique opportunity to help technologists build tools that incorporate nursing’s perspective in ways that truly improve patient care and nursing education.”

That effort is being helped along by the hiring of Kylie Grenier to be the school’s first director of information technology. A Silicon Valley veteran, Grenier’s primary role is to serve as a consultant to help faculty evaluate future technology trends and work effectively with the IT community to create lasting solutions.

“I’m passionate about the effort here to acknowledge that technology underlies everything we do, and that we must find a way to use these new tools effectively to move us forward as educators and scientists,” says Grenier.

Tom Gentile, president and CEO of GE Healthcare Systems (a division of GE Healthcare) with UCSF School of Nursing’s Barbara Drew.

For example, she is playing an active role in facilitating the type of academic-industry partnerships that the GE Healthcare meeting represents. That meeting emerged from the work of faculty member and cardiac care expert Barbara Drew, RN, PhD, on a project in which she is studying alarm fatigue in ICUs. Research and anecdotal reports have shown that patient monitors are so sensitive and generate so many false alarms that some frustrated nurses are shutting the alarms off so they can better do their jobs.

“Barbara’s project is a great example,” says Vlahov. “GE can bring the perspective of how they addressed alarm fatigue in aviation, and together we can come up with a solution that tailors their aviation solution to clinical settings.”

He notes that Drew is not alone, that many faculty members have established research programs that can and do add value to such partnerships. Another example: For years, Glenna Dowling, chair of the Department of Physiological Nursing, has partnered with Red Hill Studios to create video games that help patients with Parkinson’s disease better manage some of the disease’s physical challenges. Vlahov’s plan is to expand work like this by easing the lines of communication among School of Nursing researchers, colleagues from other disciplines throughout UCSF, collaborators at other health sciences institutions and private industry.

Read the full story on the UCSF School of Nursing's Science of Caring website.

Photos by Elisabeth Fall/fallfoto.com