Esto se acaba de publicar en el boletín de la OMS. Es justamente nuestro caballo de batalla para que se implemente telemedicina con calidad asistencial, solo que ahora está publicado por la OMS a lo mejor se dan cuenta ya de lo que es esencial. Para ello se necesita personal dedicado y experto; y la enfermería tiene un papel esencial.
http://www.who.int/bulletin/volumes/90/5/11-099424/en/index.html
Our review has revealed a growing emphasis on problems related to e-health systems’ workability but relatively little attention to: (1) e-health’s effects on roles and responsibilities; (2) risk management; (3) ways to engage with professionals; and (4) ensuring that the potential benefits of new technologies are made transparent through ongoing evaluation and feedback. These areas deserve more empirical investigation, as do ways to identify and anticipate how e-health services will impact everyday clinical practice. This involves examining how new e-health services will affect clinical interactions and activities and the allocation and performance of clinical work. Also in need of investigation are the effects of different methods of engaging with professionals before and during the implementation of e-health services.
Para ello emplean la denominada NPT (Normalization Process Theory) con sus 4 aspectos identificables:
- coherence– coherencia
- cognitive participation– participacion con conocimiento de causa.
- collective action– accion colectiva
- reflexive monitoring– monitorizacion reflexiva.
para conocer si el proceso esta integrado en la practica asistencia y asumido en la rutina diaria.
Table 1. NPT coding framework
| Coherence (Sense-making work) |
Cognitive participation (Relationship work) |
Collective action (Enacting work) |
Reflexive monitoring (Appraisal work) |
|---|---|---|---|
| Differentiation Is there a clear understanding of how a new e-health service differs from existing practice? |
Enrolment Do individuals “buy into” the idea of the e-health service? |
Skill set workability How does the innovation affect roles and responsibilities or training needs? |
Reconfiguration Do individuals try to alter the new service? |
| Communal specification Do individuals have a shared understanding of the aims, objectives and expected benefits of the e-health service? |
Activation Can individuals sustain involvement? |
Contextual Integration Is there organizational support? |
Communal appraisal How do groups judge the value of the e-health service? |
| Individual specification Do individuals have a clear understanding of their specific tasks and responsibilities in the implementation of an e-health service? |
Initiation Are key individuals willing to drive the implementation? |
Interactional workability Does the e-health service make people’s work easier? |
Individual appraisal How do individuals appraise the effects on them and their work environment? |
| Internalization Do individuals understand the value, benefits and importance of the e-health service? |
Legitimation Do individuals believe it is right for them to be involved? |
Relational integration Do individuals have confidence in the new system? |
Systematization How are benefits or problems identified or measured? |
