Chapter 29 Emerging Technologies and the Generation of Knowledge

Objectives Outline the history of technology development and informatics applications. Describe some of the state of the art technologies of today. Predict the evolution of technology and its impact on knowledge generation in nursing.

Introduction We envisage a future with a high degree of continuing technological development and general worldwide economic growth, and an absence of some of the possibilities that might bring much of our global infrastructure crashing down around our ears. We assume there will not be widespread global social breakdown, the predicted possible pandemics of avian and swine influenza, and other problems, will not happen, or catastrophic climate change will not produce as rapid effects as the worst prognostications suggest. However, we are aware many of these things could happen, to some degree or other. We do know that change is coming, and much of it is far enough advanced as to be virtually unavoidable.

Looking Back From the Future Visions of societies of the future, both utopias and dystopias, have been produced by many people. The future will be on us more rapidly than many expect, and, as nurse informaticians, we need to be at least aware of, if not directly involved in determining, the many new emerging technologies and their possibilities for use within our domains of interest and practice.

Historical Overview From the early 1900s through the 1950s, a number of hardware developments emerged with respect to computing Colossus Mark I Electronic Numerical Integrator and Computer (ENIAC) Universal Automatic Computer (UNIVAC). Technology applications “exploded” in the 1990s with the advent of increasingly sophisticated hardware, software, cheaper memory and speed, and the decreased cost of digital computer technology.

Historical Overview This shift of information access, acquisition, and interpretation, for both provider and patient, may result in overload in terms of content and comprehension. Managing this overload will increasingly consume both providers and patients. How this issue will be managed is of great concern whether by an increased use of technology or a regression away from technology.

Some technologies we have today Computerized decision support systems Wireless speech recognition and touch screen triage support systems in emergency departments in Taiwan Nurse-managed telehealth services in United Kingdom dermatology clinics Use of open-source software for development of Web-based nursing informatics education in Germany Nurse-led development of a personal health record system in the United States Demonstrated uses of wireless biomedical sensors for invasive monitoring in Norway

What Will Affect the Future Among the key issues that emerged from the discussions that are important for the international nursing informatics community to explore in coming years were: The development of the concept, and a possible model, of u-nursing (ubiquitous nursing), which, as well as having implications for the practice of nursing, also has profound implications for all aspects of the education and continuing professional development of nurses The role of the nurse changing to become more of a knowledge professional, working in partnership with the patients and their other caregivers The continuing growth of patient informatics, perhaps as a growth and evolution of the current concept of consumer health informatics, and with the increasing centrality of the patient as the controlling force in the whole enterprise The vast impact that genomics will have on all aspects of life, and in particular health care

Some Emerging Technologies and other Issues that will Impact Nursing and Health Care Information and communications technologies Nanotechnology Beyond Web 2.0

A Technology Wish List The kind of computer interface used in the film Minority Report: no mouse, no keyboard, just gesture-based interactions with virtual images projected into a vertical space at head height. Ubiquity of computational devices to the extent that conversation and discussion of these devices will disappear from everyday social interactions – the technology will be transparent or invisible. The ability to access information when and where we want it, irrespective of modality thereby maximizing mobility and other personal resources. This may lead to cell phones becoming the main avenue of access for more than text messages, speech, and video clips. Knowledge acquisition and utilization will then become ubiquitous and pervasive; new work roles will emerge to cope with this new and different technology.

Summary We know that the future will be different; however, it is likely that, in the foreseeable future, let us say the next 10–15 years, many of the changes that are likely to occur are already in development or will be extrapolations of current developments and trends. There is always, however, the possibility of new developments, or unexpected consequences, of the development of emerging technologies. In an ideal world, we would like to see solutions to see the development of easy to use tools for nurses to manage the coming knowledge “explosion” as more information becomes available to support diagnosis, treatment, and care.