the relationship between technology and changing professional.pptVIP

The relationship between technology and changing professional roles in health care : a case-study in teledermatology Dr. Stephen Timmons, School of Nursing, University of Nottingham Mrs. Sandra Lawton, Consultant Nurse, Dermatology, Queens Medical Centre, Nottingham Background Huge unmet need for dermatological care Increasing referrals and waiting lists/times Too few dermatologists Difficult physical access to hospital Patients seen by the most appropriate member of the dermatology team An equitable service across the district Results/Discussion The unimportance of technology Shifting boundaries : how ? By using teledermatology, individual and organisational practices have been adjusted Nurses collect information But, crucially, decide when how to refer The nurses’ role now, effectively, includes diagnosis Patients Like the service, and are unconcerned about the profession of the person seeing them GPs value the expertise of the nurses The GPs An ‘advance’ in nursing practice A contentious point (in nursing) Not just working to protocols (as often happens in ‘nurse-led’ services) Used existing skills and knowledge, and developed new ones. How was it possible ? Policy push Skills of the nurses Agreement support from the consultant the GPs The technology A bit of theory ANT ? Social construction of technology * Geography Nurse led community clinics in primary care supported by teledermatology. Store and Forward Telemedicine Mail Server Telemarque Server Unit Training Data Base NHS Net Remote GPwSI QMC Dermatology Unit Unit Live Remote PCT Clinics Teledermatology Store Forward Digital Camera Lap Top Email Methods Case Study Design Embedded single case design Single case – community clinics Subunits- all those involved in patient journey (GP, Patient,Nurse, Dermatologist and others) Patient Journey Sample Purposively selected 2 patient journeys: GP, Patient, Nurse, Dermatologist and others Data Collection Semi-structured intervi