In this posting, we take a closer look at how nursing is set to change because of this crisis, and how those currently in the profession and those planning to join it can prepare for the future.
The World Health Organization reports a global shortfall of around six million nurses worldwide. This is expected to grow over for the next few years. The factors contributing to the shortfall include:
Studies suggest that nurses were overstretched before COVID-19. In one survey it showed more than one in three considered leaving the profession. That is on top of the one million RNs who were expected to retire by 2030. Many administrators, however, acknowledge the problem and are seeking solutions. One of these would be to use technology and outside resources to reduce current nursing demand.
Excessive regulation in many countries is another issue. This hurts medical services delivery in a variety of ways. To eliminate some of these impediments, for example, the U.S. federal government has loosened regulations to reduce administrative bloat. The type of regulatory change includes issues like having to have a pathologist on-site to read biopsy slides. Now pathologists can use the power of the Internet and digital technology to work from home. And in addition regulations around Medicare and Medicaid coverage have been altered to include telemedicine consultations. This is allowing nurses to stay at home because of health concerns or to remain in quarantine while continuing to assist patients.
Adding new medical technology can improve patient outcomes, but it is prompting nurses to learn how to use it. This has led to nursing assistants with associate’s degrees or vocational diplomas to be increasingly seen as unqualified to work in their field even in the face of an industry shortage. It is increasing demand, furthermore, for nurses with advanced degrees, whether working in the ICU or in electronic medical records management.
This is where online learning can make a difference. The advent of Internet-based education is set to make a big impact on staffing. Nurses will now be able to get a baccalaureate in nursing science, a BSN, online from some of the most well-respected nursing schools in the United States without even having to leave their home state. Programs like Baylor University’s online accelerated BSN is allowing nurses to earn a degree relatively quickly through a full-time program that combines online courses, interactive courses, and clinical experience.
The benefits of an accelerated BSN program include:
While technology is set to improve education and reduce nursing workloads, it is not making up for the 12% increase in demand expected for RNs by 2030 while supply is in decline. Online classes, however, can play a role in reducing the impact of these shortages.
It is also possible that the COVID-19 crisis will result in higher pay for ICU and emergency nurses for a variety of reasons. The public now realizes that nurses are putting their lives on the line every day during a pandemic. The result is a general increase in pay for hazardous duty, and that has created improving retention rates and new recruits into a number of higher-risk nursing specialties. All of this, however, isn’t making for the lack of training or an inadequate supply of personal protective equipment (PPE). It should be a priority that nurses and other health personnel be be trained on how to use every kind of PPE needed, or face the consequences of losing them to illness or weeks in quarantine.
Hospitals and clinics alike tend to have dedicated, specialized areas. But these have been proven to be insufficient in the face of pandemic when there has been a need for an increase of 30% or more in hospital beds or dozens of more ICU units to accommodate patients. Nor has it been fair to patients to stick them in vacated offices or hallways. We can expect, therefore, hospitals to begin building flexibility into the design of their existing space with some areas switched from triage to ICU, or to storage, as needed.
Healthcare infrastructure will also have to evolve. We can expect future hospitals to have separate air handling units to isolate areas within the hospital, minimizing the spread of airborne pathogens. Advanced air filtration systems will be a certainty and could become the norm in entire facilities, not just in dedicated areas.
We may also see the creation of modular hospitals that can be built faster and more cheaply than existing designs. Modular hospitals have the added benefit of being mobile. For example, a number of field hospitals have been built during the present pandemic that are as good as the brick-and-mortar hospitals allowing for the isolation of COVID-19 patients from facilities that need to treat cancer patients, women in labor, and people having elective surgery.
COVID-19 has shown the profession that healthcare needs to change radically. Some of those solutions we have outlined here and we should see them being moved to the forefront because of the current crisis. Don’t be surprised if most, if not all we have described become mainstream.
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This is not yet a general consumer device even though it works with iPhones from the models SE, 6S and up to the new iPhone X. It’s the real deal communicating with PACS and DICOM worklist servers, the picture archiving and communication systems used by diagnostic imaging departments in hospitals today. The images Butterfly iQ creates are stored in the cloud securely and are totally HIPAA compliant.
What’s revolutionary about the Butterfly iQ isn’t just the fact that it works with iPhones.
The wand that creates the pictures and is connected to an iPhone by USB cable uses 9,000 capacitive micro-machined ultrasound transducers (CMUTs) integrated into a semiconductor chip the size of postage stamp. The CMUT is a tiny ultrasonic emitter and each is capable of creating detailed images, but together, they produce ultrasounds that are pretty close in terms of detail to those produced by much more expensive machines found in hospitals and testing labs. And unlike those far more expensive machines which require multiple wands to produce a range of images for different applications, the Butterfly iQ is a single device capable of creating images that meet FDA standards across a range of clinical applications including ultrasound for:
Think of what a difference maker this device can be for an emergency room physician who can pull it out of his or her pocket, plug it into an iPhone and immediately see an image that can lead to a faster diagnosis and intervention. And at the price, every paramedic could have one on board an ambulance to instantly understand the extent of the injury or condition of a patient in their care.
The Butterfly Network will start shipping the Butterfly iQ to what is a growing backlog of orders by early in 2018. Meanwhile, the company continues to work on adding artificial intelligence software to the product so that it can be used by people with no previous experience with ultrasound. The app would then help with positioning the device, collecting the images, and interpreting them. Will all of us soon be able to do our own diagnostic imaging and see the results on a smartphone? Perhaps very soon.
We are in the midst of a (medical) revolution driven by exponential technology: artificial intelligence, sensors, robotics, 3D printing, big data, genomics and stem cells.
Today’s $3.8 trillion dollar healthcare industry is in the deceptive phase of its march towards dematerialization, demonetization and democratization
What does that mean? Imagine a time within the next 10 years when:
These breakthroughs are materializing because of the convergence of the following key accelerating technologies.
Artificial Intelligence (AI):
AI will enable better diagnoses and personalized medical recommendations.
Sensors:
Wearables, connected devices, and quantified-self apps will allow us to collect enormous amounts of useful health information.
Robotics:
The precision, accuracy, and mobility of medical robotics will allow us to serve more humans around the world, faster and cheaper.
3D Printing:
On-demand manufacturing will make medical devices cheaper and more readily accessible to millions, and it will make scarce resources like organs-for-transplant abundantly available.
Genomics & Big Data:
The cost of genome sequencing has plummeted 100,000-fold, from $100M per genome in 2001 to $1,000 per genome today… outpacing Moore’s Law by 5x.
Stem Cells:
We are now in the earliest stages of stem cell therapy development. Future therapies will be transformative and, frankly, mind-boggling.
Diamandis, seen in the picture below from Xconomy San Diego, is Chairman and CEO of the X-Prize Foundation, and a co-founder of the Singularity University, an institution focused on science and technology and role they play in solving the challenges of the 21st century. I have written about the X-Prize on numerous occasions and recently was asked to join the X-Prize Vanguards in the launch of the newest $15 million prize quest, to develop software for teaching children literacy and numeracy without the need for bricks and mortar schools. And if you haven’t read Abundance – The Future is Better Than You Think, I highly recommend it.
Toyota’s new robot is called the Human Support Robot or HSR, and is geared specifically for the disabled people living alone. It seems appropriate that a Japanese manufacturer would be looking to serve this growing market since Japan has the highest percentage of senior citizens of any country in the world.
This isn’t Toyota’s first effort building robots. They have been doing it for a number of years. For example in 2007 they unveiled two robots, one that had the dexterity to play the violin, and the other a personal transporter. But neither were meant to be much more than concepts. The HSR, on the other hand is a serious attempt to address older and disabled individuals living on their own with limited human assistance.
The HSR is controlled through a graphical display or by voice commands. It also can wear a tablet computer on its head that allows remote family members to visually communicate over Skype or other video conferencing tools. Each HSR comes with a robotic arm equipped with a two-fingered gripper. Weighing about 32 kilograms (70 pounds), HSR can pick up and hold objects weighing a little more than a kilogram (2.6 pounds).
HSR is strictly a homebody. Fastest speed is 3 kilometers (1.8 miles) per hour. Like the Roomba robotic vacuum from iRobot, HSR can traverse floors whether carpeted or hardwood. It can climb a 5 degree slope. It is also equipped with stereo cameras and motion and depth sensors.
Since 2011 HSR has been undergoing testing at a rehabilitation centre in the city of Yokohama. Toyota intends to unveil HSR publicly between September 26 and the 28 at a health care conference in Tokyo. Interestingly, the Japanese public health insurance will cover 90% of the cost of a robot helper like HSR anticipating that such devices are very much needed for an aging population.
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