NURS FPX 4900 Assessment 3 Assessing the Problem Technology Care Coordination and Community Resources Considerations
Student Name
Capella University
NURS-FPX 4900 Capstone project for Nursing
Prof. Name
Date
Assessing the Problem: Technology, Care Coordination, and Community Resources Considerations
Obesity in the United States has been continuously prevailing in society. Currently, 41.9% of adults (age group 20-39), and complexity increases with other health conditions like heart diseases, diabetes, or cancers. The medical cost associated with obesity in the US is approximately $173 billion every year (CDC, 2022). Sarah, a 38-year-old woman, is one of the patients among many suffering from obesity and its related diseases, namely hypertension, immobility, and diabetes. This paper assesses obesity and its related issues from a technological perspective, meaning that Sarah’s health condition can be improved through technology in healthcare. Moreover, the care coordination approach will be assessed for improving her quality of life and leveraging available community resources. The role of standard practices and policies will be entailed for obesity management via technology and an integrated care approach.
Impact of Healthcare Technology
Healthcare technology plays a pivotal role in addressing a patient’s (Sarah) health problem, especially concerning issues associated with obesity, such as diabetes and hypertension. Recently, with obesity prevalence, it has been stated that obesity is a preventable health condition, and technological and digital solutions are becoming popular. The solution is becoming popular for stages of obesity management, from assessment, treatment, and prevention purposes to enhancing well-being (Kim et al., 2022). Following is the explanation of the pros and cons of technological solutions in healthcare, their current use, and barriers to their vast implementation.
Advantages and Disadvantages of Specific Technology
Healthcare technology includes information and communication to improve healthcare issues. It includes hardware and software applications to gather and share information among stakeholders such as patients, their families, and healthcare professionals (Jen & Korvek, 2023). Technology like telehealth allows healthcare teams to remotely monitor patients’ vital signs, adherence to treatment plans, and progress in obesity management. Telehealth services facilitate virtual consultations, educational sessions, and support groups, enhancing access to care for patients like Sarah, who can face barriers to regular hospital visits due to immobility concerns (López et al., 2022). The disadvantages associated with telehealth extend towards disparity concerns due to the digital divide or technical concerns like internet connectivity, which creates accessibility issues for obese patients.
It can also limit physical examination, which is essential for treating obesity-associated issues like joint pain and immobility (Haimi, 2023). Advanced analytics tools can process vast healthcare data to identify trends, predict disease progression, and personalize treatment plans. For obese patients, Electronic Health Records (EHRs) can help record patient history and medication information, facilitating streamlined documentation and real-time information sharing among healthcare professionals (Ratwani, 2020). However, EHRs have the possibility of information breach, hacking, and unauthorized access that can be disadvantageous, causing legal and ethical implications.
For smooth interoperability and avoiding errors, complex EHR interfaces or incompatible systems can compromise Sarah’s health outcomes (Ratwani, 2020). Apps (such as fitness and nutritional apps) and wearable (such as smart watches) can track physical activity, monitor calorie intake, provide nutritional guidance, and offer support. These tools empower them to take control of their health, make informed lifestyle choices, and stay engaged in their treatment journey. Data accuracy and reliability can vary, leading to inaccurate interpretation and decision-making in obesity management (Holzmann & Holzapfel, 2019).
Current Technology Use in Professional Practice
At my workplace, Northwestern Memorial Hospital, we have been using technology to improve health outcomes, utilizing health information technology like EHRs and telehealth services. We used telehealth to provide counseling and follow-up care purposes to enhance access to healthcare services. EHRs have also been implemented for a while, and they are being used to document patient information, take notes, and help in care continuity for many patients, including those who are obese. Wearable devices have also been recommended and utilized to monitor patients’ signs and physical activity levels, providing them with real-time feedback (Holzmann & Holzapfel, 2019).
It enhanced adherence to lifestyle modifications and treatment plans significantly. I have also recommended mobile apps for personalized plans to encourage sustained behavior change and self-management for obese patients. However, some patients need more infrastructure and adequate internet connectivity, posing barriers to the broad adoption of healthcare technology. There is also resistance or hesitation among a few patient population and staff members for its effectiveness in managing obesity or other health conditions (Bertolazzi et al., 2024). There is also a need for training and workforce development for staff to become skillful in healthcare technology, or it will yield limited results. It demands investing in training and development while adhering to regulatory compliance regarding cybersecurity issues (Iyamu et al., 2022).
Utilization of Care Coordination and Community Resources
Care coordination is essential for obesity management, especially with obesity-related health conditions. A study by Ells et al. (2022), comprehensively describes the role of coordination in obesity management. For instance, it is a source of personalized care plans based on Sarah’s emotional, physical, and social needs while acknowledging the need for modification at any stage of the course plan. This study also mentions the integration of respect and compassion while communicating, considering the language, and seeking permission. Care coordination allows accessible and understandable information about obesity management and the utilization of 5A’s approach in care coordination (Ells et al., 2022).
For Sarah, care coordination benefits from managing obesity and related health issues (hypertension, immobility, and diabetes) with primary care physicians, nutritionists, endocrinologists, physiologists, nurses, and mental health professionals. Through a coordinated approach to care, these experts will use personalized meal plans, exercise routines for immobility, medication adjustment, education, and emotional support for managing obesity effectively. Nurses and other healthcare providers can use resources effectively and improve Sarah’s health outcomes (Dietz et al., 2021).
NURS FPX 4900 Assessment 3 Assessing the Problem Technology Care Coordination and Community Resources Considerations
Community resources also play a role in managing diseases outside clinics and hospitals. Partnering with community organizations benefits in addressing those factors that pose long-term sustainability of clinical intervention, meaning social determinants (like housing, education, or accessibility concerns) (Skelton et al., 2019). A study by Jacobs et al. (2021), highlights the World Health Organization (WHO) recommendation for community-based interventions in obesity and related health issues alongside established policies of healthy eating and physical activity.
The study also highlights the benefit of CBI on weight management due to addressing transportation concerns, mental health factors, and other social factors (Jacobs et al., 2021). Some popular community resources that can help Sarah include the Community Preventive Services Task Force (CPSTF), which provides healthcare providers and government agencies with knowledge about preventive measures after rigorous research and educating care providers (Neilson et al., 2020). There is also another evidence-based eight-week manual-based program named Shape-Up, which helps obese people with self-augment and self-regulatory strategic plans and prevent relapse through dietary and physical plans (Soni et al., 2021).
Current Use in Professional Practice Along With Barriers
I have used care coordination for patients like Sarah for regular communication and collaboration among care providers through EHRs for shared information, meetings, and individualized planning. It helps seclude appointments, follow up with patients, and ensure continuity of care. For community resources, we take support and provide referrals to patients (like Sarah) based on social and environmental factors. However, there are concerns regarding the accessibility of these resources due to limited awareness among staff members and the population or financial constraints because some interventions require insurance coverage. These factors are essential for successfully implementing care coordination and community-based interventions for efficient obesity management (Skelton et al., 2019).
State Board Nursing Practice Standards
Standard practices have guided nurses in healthcare, facilitating an informed decision-making process. For instance, the American Nurse Association (ANA) establishes standards and instructions for nurse faculty. ANA’s code of ethics emphasizes provisions surrounding Sarah for improving her quality of life through ethical and moral standards. These standards enable nurses to commit to duties and responsibilities to manage diseases like obesity and its related health concerns (Ernstmeyer & Christman, 2022).
ANA ensures high-quality care through guidelines and encourages personalized care through care coordination. Nurses who do not abide by the ethical principles (Beneficence, non-maleficence, autonomy, and justice) have consequences. In that case, they are liable to severe implications as it is their prime duty to ensure the patient (like Sarah) gets equitable and high-quality care). The nurses are also liable to legal implications if they do not abide by the standards and policies stated below through monetary fines and cancellation of their license.
CDC and WHO are two organizations that guide healthcare professionals and the public with evidence-based information about health issues, including obesity, diabetes, hypertension, and mental health concerns. These organizations provide guidelines for best practices, which can be utilized through a care-coordinated approach within healthcare. For instance, preventive measures, promoting healthy eating and physical activity habits, and educational intervention for obesity management. The Academy of Nutrition and Dietetics (AND) is an organization with nutrition professionals that can help healthcare professionals design personalized plans for obese patients (like Sarah) to manage weight based on nutritional evidence (Colomer et al., 2022)
NURS FPX 4900 Assessment 3 Assessing the Problem Technology Care Coordination and Community Resources Considerations
To make healthcare outcomes effective in obese management, the Affordable Care Act (ACA) plays a significant role in patient insurance coverage. It allows accessibility to healthcare services and medication in an affordable manner. Healthcare professionals must ensure the financial concerns for managing health conditions existing together, like obesity along with hypertension and diabetes (Rdesinski et al., 2023). ACA will help Sarah by expanding insurance coverage for preventive services, nutritional counseling, and weight-loss programs, thus improving her access to comprehensive care.
Similarly, the Health Insurance Portability and Accountability Act (HIPAA is another policy that targets patient technological security. It allows healthcare professionals to ensure the infrastructure (hardware and software) utilized for patient information has a friendly user interface and strict security policies to avoid unauthorized access. These policies allow healthcare providers, including nurses, to comply with regulatory standards, respecting patient privacy and autonomy while using technology and a coordinated approach (Rozenblum et al., 2019). It will help safeguard Sarah’s health information and sensitive data from unauthorized access, ensuring confidentiality in the healthcare system.
Part Two
Documentation of Two Practicum Hours
I met Sarah, 38, an individual struggling with obesity-related health issues. Her case is particularly complicated due to hypertension, diabetes, and mobility issues. She had been admitted to the hospital, highlighting the severity of her condition and the need for obesity management through comprehensive interventions. As part of my engagement with Sarah, I focused on evidence-based practices for obesity management, including dietary modifications, activity recommendations, and behavioral strategies. I utilized reputable websites such as CDC and WHO and professional organizations like AND, which enhanced my knowledge about healthy diets, recommendations to quit sugar and fats in diets, and alternative dietary options for supporting Sarah’s care plan.
My experience highlighted significant challenges in delivering high-quality care while managing escalating healthcare costs. Obesity-related complications often led to frequent hospitalizations, increased use of healthcare resources, and prolonged recovery periods for patients like Sarah. This affected the quality of care by not utilizing healthcare resources optimally, posing a financial burden on individuals and the healthcare system. Despite efforts to implement EBP and optimize care coordination, barriers such as limited access to specialized services and gaps in patient education persisted, impacting quality and cost-effectiveness for obesity management.
Conclusion
In conclusion, tackling obesity and related health issues demands a comprehensive strategy integrating technology, care coordination, and community resources. While healthcare technology like telehealth and EHRs improves access and monitoring, challenges like digital disparities and data security need addressing. Care coordination is crucial for personalized care, guided by standards like those from ANA and policies such as ACA and HIPAA. Leveraging community resources complements clinical efforts, addressing social determinants for sustainable outcomes. Integrating these approaches effectively can significantly improve outcomes for patients like Sarah and combat the obesity epidemic.
References
Bertolazzi, A., Quaglia, V., & Bongelli, R. (2024). Barriers and facilitators to health technology adoption by older adults with chronic diseases: An integrative systematic review. BMC Public Health, 24(1), 506. https://doi.org/10.1186/s12889-024-18036-5
CDC. (2022, May 17). Adult obesity facts. www.cdc.gov. https://www.cdc.gov/obesity/data/adult.html
Colomer, F. L., Llorente, M. T. M., García, M. E. L., Ferré, A. P., & Bermejo, M. P. (2022). Differences in classification standards for the prevalence of overweight and obesity in children. A systematic review and meta-analysis. Clinical Epidemiology, 14, 1031–1052. https://doi.org/10.2147/CLEP.S375981
Dietz, W. H., Fassbender, J. E., Levi, J., Pronk, N. P., Yanovski, S. Z., & Fukuzawa, D. D. (2021). Lessons learned for obesity prevention and care from five integrated programs. NAM Perspectives, 11. https://doi.org/10.31478/202111a
Ells, L. J., Ashton, M., Li, R., Logue, J., Griffiths, C., Torbahn, G., Marwood, J., Stubbs, J., Clare, K., Gately, P. J., & Campbell-Scherer, D. (2022). Can we deliver person-centred obesity care across the globe? Current Obesity Reports, 11. https://doi.org/10.1007/s13679-022-00489-7
Ernstmeyer, K., & Christman, E. (2022). Chapter 6 – Ethical practice. Www.ncbi.nlm.nih.gov; https://www.ncbi.nlm.nih.gov/books/NBK598377/#:~:text=The%20American%20Nurses%20Association%20(ANA)%20provides%20a%20framework%20for%20ethical
NURS FPX 4900 Assessment 3 Assessing the Problem Technology Care Coordination and Community Resources Considerations
Haimi, M. (2023). The tragic paradoxical effect of telemedicine on healthcare disparities- a time for redemption: A narrative review. BMC Medical Informatics and Decision Making, 23(1), 95. https://doi.org/10.1186/s12911-023-02194-4
Holzmann, S. L., & Holzapfel, C. (2019). A scientific overview of smartphone applications and electronic devices for weight management in adults. Journal of Personalized Medicine, 9(2), 31. https://doi.org/10.3390/jpm9020031
Iyamu, I., Ramírez, O. G., Xu, A. X., Chang, H.-J., Watt, S., Mckee, G., & Gilbert, M. (2022). Challenges in the development of digital public health interventions and mapped solutions: Findings from a scoping review. Digital Health, 8. https://doi.org/10.1177/20552076221102255
Jacobs, J., Strugnell, C., Allender, S., Orellana, L., Backholer, K., Bolton, K. A., Fraser, P., Le, H., Brown, A. D., & Nichols, M. (2021). The impact of a community-based intervention on weight, weight-related behaviors and health-related quality of life in primary school children in Victoria, Australia, according to socio-economic position. BMC Public Health, 21(1). https://doi.org/10.1186/s12889-021-12150-4
Jen, M. Y., & Korvek, S. J. (2023, June 20). Health information technology. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK470186/
Kim, S., Rhee, S. Y., & Lee, S. (2022). Effectiveness of information and communications technology-based interventions for obesity and metabolic syndrome. Journal of Obesity & Metabolic Syndrome. https://doi.org/10.7570/jomes22027
NURS FPX 4900 Assessment 3 Assessing the Problem Technology Care Coordination and Community Resources Considerations
López, A., Escobar, M. F., Urbano, A., Alarcón, J., Peña, L. L., Martinez-Ruiz, D. M., & Casas, L. Á. (2022). Experience with obese patients followed via telemedicine in a Latin American tertiary care medical center. International Journal of Environmental Research and Public Health, 19(19), 12406. https://doi.org/10.3390/ijerph191912406
Neilson, E., Villani, J., Mercer, S. L., Tilley, D. L., Vincent, I., Alston, A., & Klabunde, C. N. (2020). Sources of support for studies that inform recommendations of the community preventive services task force. Public Health Reports, 135(6), 813–822. https://doi.org/10.1177/0033354920954557
Ratwani, R. M. (2020). Electronic health records and improved patient care: Opportunities for applied psychology. Current Directions in Psychological Science, 26(4), 359–365. https://doi.org/10.1177/0963721417700691
Rdesinski, R., Chamine, I., Valenzuela, S., Marino, M., Schmidt, T., Larson, A., Huguet, N., & Angier, H. (2023). Impact of the affordable care act medicaid expansion on weight loss among community health center patients with obesity. The Annals of Family Medicine, 21(Supplement 1). https://doi.org/10.1370/afm.21.s1.3731
Rozenblum, R., De La Cruz, B. A., Nolido, N. V., Adighibe, I., Secinaro, K., McManus, K. D., Halperin, F., Block, J. P., Bates, D. W., & Baer, H. J. (2019). Primary care patients’ and providers’ perspectives about an online weight management program: A qualitative study. Journal of General Internal Medicine, 34(8), 1503–1521. https://doi.org/10.1007/s11606-019-05022-6
Skelton, J. A., Palakshappa, D., Moore, J. B., Irby, M. B., Montez, K., & Rhodes, S. D. (2019). Community engagement and pediatric obesity: Incorporating social determinants of health into treatment. Journal of Clinical and Translational Science, 4(4), 279–285. https://doi.org/10.1017/cts.2019.447
NURS FPX 4900 Assessment 3 Assessing the Problem Technology Care Coordination and Community Resources Considerations
Soni, A., Beeken, R. J., McGowan, L., Lawson, V., Chadwick, P., & Croker, H. (2021). “Shape-up”, a modified cognitive-behavioural community programme for weight management: Real-world evaluation as an approach for delivering public health Goals. Nutrients, 13(8), 2807. https://doi.org/10.3390/nu13082807