Digital Health Talks - Changemakers Focused on Fixing Healthcare

Virtual Nursing and AI: Transforming the Future of Patient Care

Episode Notes

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Join us as we discuss virtual nursing and the integration of artificial intelligence (AI) in healthcare. We’ll discuss how AI-powered tools and virtual nursing are revolutionizing patient care, remote monitoring, and support. We discuss the benefits of virtual nursing, including alleviating workload, improving patient satisfaction, and providing opportunities for experienced nurses to continue their careers in less physically demanding roles. We will also address the challenges and concerns surrounding the implementation of AI in nursing, such as the importance of maintaining the human touch and empathy in patient care, the need for AI to adapt to individual patient needs and preferences, and the potential biases and limitations of AI-generated recommendations. 

 

Linda Macomber, Associate Professor, National University 

Megan Antonelli, Chief Executive Officer, HealthIMPACT 

 

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Episode Transcription

{00:00:30] Megan Antonelli: Welcome to Health Impact Live Digital Health Talks. In today's episode, we'll dive into the future of nursing, virtual nursing, and artificial intelligence in healthcare with our special guest, Professor Linda Travis McComber. Linda is a renowned health tech professional and faculty member at National University in San Diego, California.

As the founding program director, she launched the MS health informatics program in 2010 and continues to teach and advise students in emerging digital health practices and careers. Linda is also a creator and editor of healthtechdiscovery. com resource. With a career spanning several decades, Linda has been at the forefront of pioneering and comprehensive health information initiatives.

She has collaborated with hospitals, clinics, consulting firms, and technology developers to drive innovation in the field. Starting her journey as a pediatric RN and ICU nurse at Boston Children's Hospital, Linda has since become a prolific writer and presenter on digital health, health informatics, and EHRs.

Our discussion will explore the emerging trend of virtual nursing and how AI powered tools are enabling nurses and all caregivers to provide remote patient care, monitoring and support. We'll delve into the benefits and challenges of this new career path and how it could help address growing staffing shortages in the healthcare industry.

So get ready to discover the exciting possibilities and challenges that lie ahead as we explore the intersection of virtual nursing, AI, and patient care. Let's dive in. Hi, Linda. Thank you so much for being here today.

[00:02:04] Linda Macomber: Hi, Megan. Thank you so much for the invitation. Looking forward to the conversation.

[00:02:09] Megan Antonelli: Oh, well, it's such an honor to have you here I'd love to hear, as a tech pioneer, with experience, obviously in practice and nursing and educating around informatics, How do you envision the role of nursing, changing and addressing the current and future staffing challenges in health care?

[00:02:28] Linda Macomber: Well, I often think that a lot of my career has focused on being really in the human potential business. And so I look at how can we pass on a lot of the rich collective wisdom Of kind of baby boomer generation, both through technology, as well as using technology to connect people.

So I look at the potential and challenges of a lot of our young, nurses and health care professionals. And how can we better support them? I mean, certainly one way is through AI systems that really provide the needed alerts so that we're much more proactive or catching things earlier.

Instead of, reacting and looking at the, heavy costs, both in terms of financial costs when things aren't caught until it's much later in the process, but also, to support our nurses and healthcare professionals. So they can identify challenges earlier or potentially have those virtual support networks that can also contribute.

So it's not just about monitoring, but it's about smart alerts that go to the right person that can have the actionable, impact on making a difference. And so, I think that ultimately we've got, not just artificial intelligence, but better intelligence that we use as human beings and that we make better decisions.

[00:04:00] Megan Antonelli: Yeah. It's amazing to think, I mean, as, for you, you know, as a young nurse coming into the field when, EHRs and technology were just beginning and the discipline of healthcare informatics. And now I think we're at this crossroads where we have AI as, an additional tool.

And of course we've seen, fast periods of adoption. Obviously the pandemic was a huge, leap in virtual care. So tell us a little bit about, your experience. I mean, you have worked on, billion dollar global DOD initiative with the CHCS system, around adoption, implementation, development. Tell us a little bit about, the context of that to now and, maybe draw some parallels there.

[00:04:45] Linda Macomber: Sure. I guess I do like to think about the technology and healthcare as as more of an evolution versus a revolution. I mean, it's kind of this incredible. You know, moment of of of a I and kind of a revolution.

But actually, for those who study history, those who don't study history everything is unprecedented particularly chat GBT, but we look at it, I started my career with University of Michigan, and, the University of Michigan Medical Center. Back in the days, I guess, B. c., before chat GPT, but also, you know, before COVID, before computers, even, quite frankly. And so, looking at it, where we've come is absolutely amazing and incredible. We do live in historic times, no doubt. But there's so many challenges in healthcare I mean, over 40 years, there's never been a time when there hasn't been a nursing shortage.

And so we look at how, can we help those frontline, caregivers to have what they need. And so oftentimes people say, Oh, we need to spend less time with computers. And I'm like, well, wait a minute. Let's just focus on what we're doing with those systems. If those systems are providing life saving alerts, for goodness sakes, use them.

Don't cut the time that we're, we need maybe more time. But maybe we need to reinvent the way care delivery is done. It's an opportunity. Because of these technology systems to do so for example, just taking care of my dad because sort of at the end of life, I even from a distance, I could look up his.

actual notes, and be able to have much more engaging conversations with his care team and with my family. So how can we leverage the rich collective wisdom of the baby boomer generation, for example, that still have a lot to give, but may not necessarily, want to work on the front lines of care any longer?

But that doesn't mean that they can't work in, virtual support teams to use AI systems. There's too much data out there and that's very overwhelming, but the AI systems can help us to find the signal to the noise. But sometimes I think we need a team approach to do that. So some virtual care support team perspectives that can be, across time zones that can make a huge impact.

[00:07:15] Megan Antonelli: Yeah, I think that's really interesting. And I mean, I love the point that you make around baby boomer generation and just, you know, both at the beginning and the end of a nurse's career or any healthcare professional the value that they can give. You know, it is increased by these tools. Of course, that doesn't mean, I mean, just like with electronic health records, and there's always that, that push and pull and a somewhat resistance to change.

I think just recently we saw the California Nurses Association protesting outside Kaiser San Francisco about, you know, Sort of that fear and discussion around AI's inability to replace human touch and that, you know, Kaiser, as always, has been an early adopter when when we talk about the promise and the potential, it's great.

What are some of the, concerns or how do you recommend we safeguard those essential, human elements of nursing and what can we do to ensure that those human elements, stay a part of this and, ensure the patient experience is still optimal and also that the nurse's career is still what she wants, when she or he went into it for.

[00:08:30] Linda Macomber: I think that we can look at risk, and how do we manage that risk and how do we best make decisions. And so should we use the technology, whether that be, any digital system, or the more current AI enabled systems. I mean, there's certainly the risks and looking at where the, you know, whether you call it human in the loop, or I always think that, back from my days as a pediatric, I see there's a double dose of humanity for every dose of technology is usually about the right balance.

And so I think that, we need to apply that to AI today. And so looking at a lot of different uses and use cases, certainly some of them are summarizations. Some of it's finding the signal through the noise of all of the data, what is significant.

The AI systems can offer suggestions. They can certainly help us to summarize, but they might miss things in the summarization. And so I think that we need, as with all the challenges in health care, we truly need all of the hands on deck to address them. So, if we have some. People in their 60s that want to help contribute let's make sure that everyone who wants to be working is and and figure out ways that we can use these systems to help the human in the loop be somebody who can truly do that validation.

It may be that someone who's fresh out of school is not necessarily. Able to do that human validation as easily as someone who is more experienced. So, to tap the more experienced people and health professionals, to tap all of the capabilities of these new systems, we need a lot of work to test them.

Similarly to testing clinical trials for new medications, we need a lot of testing of and a lot of different applications. Whether it be at the individual level at the health professional level at the organizational level and at the public health levels. The opportunities across the board.

[00:10:47] Megan Antonelli: For sure, I mean, what are some of the big kind of lessons learned that you, experienced yourself, both as a clinician and now, working in it and consulting to industries around, how to overcome the resistance to change.

Right? I mean, how do we, educate around that, or, assist people with that transition.

[00:11:09] Linda Macomber: That's a great question. I think that there are many different people that come into this process. And what I found, one of the most gratifying perspectives of being a professor at National University over the past 15 years, is getting the LinkedIn message from, those people that have advanced in their career and really at that intersection of health and technology, innovation, leadership.

As people progress in their careers, oftentimes they do grow into leadership roles. And sometimes, people want to be managers or administrators, but I think the thought leadership innovation. Is a wonderful opportunity for career growth for many people.

And as more people do grow into those roles, I think that it's easier for us to kind of. Connect the change, whatever it is. To something that we have done in the past. And so it's like, wait a minute, you know, I've been down a similar road before. And to help people, oftentimes it's people instead of a super user of a technology, you're really an ambassador connecting the dots, becoming, bilingual in the language of technology as well as the language of health care.

And you need a lot more cross functionally skilled people that are comfortable. In these different worlds. And so there's a whole new opportunity with AI, certainly.

[00:12:40] Megan Antonelli: Yeah, well, I think that's really interesting. I think also important. I love the idea of an ambassador and, you know, an ambassador in the evolution.

You know, I will, I'm reading Susanna Fox's book, Rebel Health. So then I think of the Star Wars analogy is to, to how we, how we do work the revolution. But, there are a lot of important changes that we want to see happen faster. But as we look at the context of this, you're right.

Healthcare has changed so much, the practice of it, the discipline of it. And of course, you know, the world has changed, right? I mean, it's changing with the world, maybe not as fast as we want it to, but, certainly the generation of nurses and physicians coming in are more tech savvy and always connected.

So, you know, less resistance, to this change, however, you know, when some of, I think the Nvidia Hippocratic AI story around the AI healthcare agents and talking about how the tools outperform human nurses in certain tasks. And, you know, that sounds a little scary to some, who care that, you know, that's their profession.

They've invested in it and they want to work in it. What do you say to them? What would your advice be to a nurse who is, perhaps standing outside of Kaiser right now saying, I don't want to be replaced by AI. It seems like a valid concern. How would you, sort of comfort them and bring them to the other side of this evolution?

[00:14:03] Linda Macomber: Well, I would share that technology over time is something that has helped us to really be better nurses. And I think that ultimately, we have to look at, are we adding more years to To our lives and more life to our years and nurses at the front lines are the best people to Decide whether or not this technology should be used in each of these different areas You know if it helps us to Have better handoffs at shift change time If it helps us to provide that quality Wow, I'm so glad that the system was there and alerted me.

And I think that if it helps us to connect generations of wisdom through different virtual care support. I think, ultimately, You know, yes, there's the copilot analogy. I think it's going to take some time to figure out where it's best to use the technology and AI and we need nurses to be the ones who make those decisions doctors and healthcare professionals.

that are closest to what's going on. I think there's incredible opportunity for ambient systems to capture a lot of the information behind the scenes. Tremendous opportunity for systems to help us to prioritize. I like to think of it as, you know, going beyond a patient problem list to a health priority list.

And I think we can use these systems in so many ways to help certainly keyboard liberation being 1 of them. For nurses and healthcare professionals, I think that we should. Embrace from wherever we can get it.

[00:15:53] Megan Antonelli: Well, and that's a really great point that we've been hearing a lot lately is, you know, focus less on the technology less on the tool and more on the problems that it's going to solve for the nurses and for the patients and for the physicians.

Right? So a little bit of, whether it's, around the access or the career, the length of the career and the access. But, that's so important. And so I want to talk a little bit more about virtual nursing, because I think that that is, an area where not only it solves so many problems for, patients being able to get care at home, or, that access to care That isn't available to them if they're in certain areas or certain time zones.

So tell me a little bit about that because I think while AI is can be scary, virtual nursing, like no doubt, creates more jobs. It creates more access. It creates more touch points with the patient. So tell me a little bit about where you think that virtual care, you know, the opportunities are particularly for the nursing career, but also all clinicians.

[00:16:53] Linda Macomber: Well, I guess I think about, AI not as artificial intelligence, but and not even augmenting intelligence, but really hopefully advancing intelligence so that we can redesign health care. There's just incredible opportunities to say, hey, wait a minute. Maybe we don't need to go to health care. Health care can come to us and wouldn't we prefer that?

So how can we be most proactive? And so if the best way to to do that oftentimes is to using virtual tools and not just monitoring but alerting. And so finding all of the incredible number of systems that we can use at home But oftentimes, again, it goes back to that double dose of humanity. So there's, there's so many people that, that, you know, have the potential financially to purchase some of these devices, but there's often a gap.

You know, here's the look at the function of the technology and the AI. And here's how I use it in day to day life, whether as you know, a new mom as someone taking care of a parent. We need to connect the dots between. That human connection of saying, hey, wow, let's use a continuous glucose monitor instead of, doing, actual, blood testing.

And let's figure out how we can best use all of these monitoring equipment, opportunities. So looking at. Not just virtual care, but it's just smarter care. And who wouldn't want to have care at home instead of, waiting and emergency care or, ending up in an ambulance or in hospitals that wasn't necessary.

[00:18:46] Megan Antonelli: Right. Yeah. No, it's interesting on that whole continuum, whether it's you're caring for your children or the pediatric ICU and, that transition out of it, that need to have, a clinician's perspective, and having that, available, it could be something that we grow accustomed to.

We never, thought we would have all of the tools that we have of our watch, with us 24 seven. But to have that, particularly for both, I think, new moms and people caring for their parents where you become a caregiver ultimately, and it's sort of maybe perhaps out of your league when you're not a physician, right?

And so having that access is incredibly valuable. And of course, to the patient as well. So tell us a little bit about, over the years, the program that you started at National University and, how that's evolved and changed and, how you're, sort of working with folks as they continue their education.

[00:19:39] Linda Macomber: Yeah, I mean, certainly the first. 30 years of my career was working in, hospitals and clinics and, you know, as a consultant, as a developer of software, certainly with the CHCS system, with Kaiser Permanente and others. But, you know, really, I wanted to, pass that rich collective wisdom of our generation on.

To the next, and I felt the best way to do that was through graduate programs, national university. I think sometimes some of the hidden secret we've got over 40, 000 students or nonprofit. University really serving for the most part working adults and so giving people opportunities to grow in their careers.

So if you have, worked as a nurse, worked as a healthcare professional, worked as a technology professional, or even had different liberal arts backgrounds, but wanted to move into health IT. You need to learn the language of healthcare, you need to learn the language of technology, and how they intersect and help to lead innovation.

Any of the favorite things is when they get those messages from, linkedin from graduates from years ago, where they progressed in their careers. So really looking at it from a human potential business of how can we continue to kind of add the next chapter of our careers. Some want to work more in health informatics.

Others may focus more on the public health side or the health care administration side. I teach across the graduate programs to help, advance the technology and AI in all of these areas.

[00:21:25] Megan Antonelli: Yeah, it's so important. I think it's particularly important with women who, in some cases, perhaps they have left the, career for a bit to raise kids or, just had a different path where they've had to take it a little bit, more slowly.

But when you have something like this, I mean, we've talked about the revolution versus the evolution, but This is a fast sprint in innovation that is happening. And it's not just happening in healthcare. It's happening in media and advertising and publishing and, all facets of the world in terms of, the workplace has changed.

And certainly this technology is going to revolutionize, what those jobs all look like. And so keeping. Up to date on it, you know, and not being resistance to change, you know, and, and I guess it's relevant whether you're in the job at the moment coming into the job new or, in mid career as the case may be, it's important to stay educated and stay, current and all of that.

So in that, tell us a little bit about, where you think, healthcare workers should really stay focused to, continue their, education and evolution as this innovation sprint occurs.

[00:22:37] Linda Macomber: Yeah, and it's certainly my work with graduate students as well as my work over decades and consulting.

It's really getting hands on practice can make a huge difference. So, you know, you can read about it, but, nothing like experiencing it so I think, and you can study that in, in different ways. So fortunately, that today there's so many, wonderful videos, just like, your recordings and others.

So, what I encourage is for students and for others really is, To watch many of the videos and to then also, augment your skill sets, with graduate degrees and others where you can meet with other people that have similar interests and in a really advancing healthcare. And healing health care.

[00:23:27] Megan Antonelli: I can see from your path and your career that you know that curiosity and that sort of desire to continue to learn has always been there. And I think, yeah, that's what's so important to keep people. In it and, stay relevant and keeping that, valuable, contribution to healthcare and whatever career you're in.

Well, thank you, Linda, so much for being here today and for all the work that you do to educate healthcare leaders in this space. Share with us, any closing words and tell us, tell the audience, how to find you. Sure.

[00:23:58] Linda Macomber: Well, I started the website renaissance dot health. It can also be found on linkedin.

What you'll find on my website renaissance dot health is a focus on really collecting great stories and and I you know health IT and digital health. So there's several hundred videos there that I've curated. For students and then, sorted them to look at how we can advance health care for individuals, as well as for health professionals, organizations, public health, cybersecurity, it's my book that's online.

So there's a lot of resources there, as a hub to learn more. And so we use that in our graduate programs. At National University as well, so that we're connecting, the great stories, where we can go next, and I think just artificial intelligence to really advancing our human intelligence using all of these incredible tools.

[00:25:00] Megan Antonelli: Amazing. Yes. Well, I look forward to checking it out myself. Thank you again, Linda, for sharing your insights and thank you to our listeners for tuning in until next time. Remember innovation is a journey, not a destination. Keep pushing boundaries, challenging the status quo and always keep the patient at the heart of everything you do.

This is Megan Antonelli and you're listening to Digital Health Talks Podcast Health Impact Live, where we make an impact one episode at a time.