Digital technology continues to evolve rapidly and change many aspects of our daily lives. It is revolutionising health care and will fundamentally change many aspects of nursing care. Nurses need the skills to function within this new world and the vision to use opportunities to improve the quality of care and the working environment.
Advances in digital technology have already led to improved outcomes and greater patient empowerment. Service users are able to become expert managers of their own disease through online access to a huge range of information and apps that allow virtual consultations with healthcare staff. Huge leaps in computing power have accelerated our understanding of the human genome and made the use of genomics a reality. Artificial intelligence (AI) algorithms aid analysis of large datasets and informatics is enabling healthcare providers to manage resources effectively. As connectivity improves, remote monitoring, biosensors and AI-supported diagnostics will shift health care more closely to patients' homes. The goal is to tailor provision to meet every individual's specific needs.
Many of these developments and their potential impact are discussed in a recently published report (Health Education England (HEE), 2019). The Topol review is well worth reading; it examines, in detail, how digital technology will influence health care in the next 20 years. It explores how we might prepare the future workforce to function effectively when 90% of all healthcare interactions will be influenced by technology. For this vision to be realised there needs to be a major shift in culture, strong leadership and further financial investment in staff development. Given the challenges that the NHS currently faces much of this may be difficult to achieve.
Even before the Topol review was commissioned it was suggested that a digitally literate workforce would lead to faster adoption and uptake of new technology and improved outcomes (Department of Health, 2016). A subsequent paper from Health Education England and the RCN (2017) outlined six digital literacy domains, one of which is technical proficiency, the area most people worry about. The others are communication, teaching, scholarship, managing data and online safety. The paper takes a broad view of digital literacy and acknowledges that many of our daily interactions with technology are improving our professional skills in this area.
The Topol review hints that digital proficiency should be considered part of any recruitment strategy, but it is not clear how this would be implemented. Pre-registration standards for nursing recognise the importance of these skills, although, given the title ‘future nurse’ the emphasis is slight (Nursing and Midwifery Council, 2018). Proficiency 1.15 places digital and technology skills alongside literacy and numeracy. However, elsewhere in the standards, references to these skills are limited. There seems to be little indication that they need to be tested as a part of any entry or interview process in the same way that numeracy and literacy skills are evaluated.
New generations of healthcare students have been exposed to technology from an early age, they demonstrate different learning styles and behaviours, and have different skills and expectations. Despite this, not all will have advanced digital literacy skills, especially if we think about managing data, scholarship and online safety. Being digitally literate does not mean having to champion or engage with every innovation. Some nurses may not wish to become technically focused, and will have reservations about how this will affect their role and patient care. In 2020, the Year of the Nurse, it is hard to argue that digital literacy is not essential for all registered nurses. Continued development of these skills will enable the profession to inform change and ensure ‘good’ technology allows staff to spend more time, rather than less, with patients.