As a trained nurse and nursing administrator, Donna Byrne focuses on homecare from the perspective of Health Promotion and Prevention. Her private homecare company, Health Access Sante and Telehealth Access, combines traditional healthcare with education for the patient. She’s very active in innovative approaches, helping individuals learn to manage and take charge of their health using technology. From 2006 through 2010, Donna developed a TeleSanté video conferencing homecare program through a number of studies done in collaboration with Dr. Antonia Arnaert of McGill University.
“It’s really by seeing that the study is going somewhere, but not knowing where, that we’ll learn. We needed to see how it worked – does a telehealth nurse visit work, does the client feel they’ve been seen effectively?
“With the people who were on these studies, we could track how many times they were in hospital before and afterwards. We had a patient in our study who had a chronic lung disease. She was at home with oxygen and we began following her remotely. With our help she began learning to calm herself down to look after her breathing, so she would not have to go back into hospital. This resulted in much fewer hospitalizations after, than before, the study.
“We were looking at colon cancer – how scary is that, to go home without access to anyone?! Here, we had video conferencing, where we could take more the supportive role. We could say things like ‘This is a crummy deal. Yah, it’s hard to manage even dealing with the idea of a colostomy.’ And at the end, the anecdotal stuff told us everything. It was the nurse who looked after most of those patients, who said they told her: ‘I don’t know how I could’ve gotten through it without you.’
“The approach was so much more respectful: the person turns on the computer and video monitor, ‘Accepts’ the visit; the nurse ‘Accepts’ the visit, and they visit. They’re not waiting in line; they’re not waiting in wheelchairs in waiting rooms; and they know they have support for getting through the initial days of something they just have to get through.
“How do you get people on board with telehealth video conferencing to think they really have seen a nurse? The idea that older persons resist technology, for instance – it’s a bit of a myth that all are afraid of it. One result we had was with a study in which we were setting up video conferencing in a seniors’ residence that was an Autonomous Living environment. One guy had a friend, so when she saw what was being done for him, she brought our nurse into her computer room to set it up for her, too!
“We set it up, hooked it up to her printer. Took her blood pressure regularly so the nurse could see it here in our office. And she could print it off and bring it to her doctor - all her results taken over a couple weeks.
“The nurses were afraid in the beginning. So I told them: ‘We’re going to play with this, so we know it better. If it sometimes breaks down, just try.’ We said to the client: ‘If it doesn’t work don’t worry. You can just pick up the phone. But we’re going to just play with it’ – selling it as access to the nurse, a tool. We made it as light as possible, and we would always tell them ‘The minute it’s a hassle, it’s OFF. Technology’s just a thing’.
“And they got it! At the beginning, some of them were more frustrated. So I was pushing this to my staff: that you can’t let them get frustrated, you can’t let them get to that point. And the comments after, were: ‘In the beginning it was frustrating, but now I like it a lot.’ The woman with chronic lung disease, who was not eligible for lung transplants, she got so much better following the instruction and the help she got from video conferencing with a nurse, that they put her on the list for a transplant!
“So the patients started to like it, to see it more as their nurse, not as ‘technology’. And some were even using Blackberries!
“Where this technology is going to make a difference is in giving people learning access, to teach them about their own care… and to keep people out of hospital.”