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Communication: Direct To Digital

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­ Personal Communication
Over the last 25 years, there is no question that technology has significantly impacted the way that people communicate with each. The reliance on face-to-face interaction, telephone conversation or mail delivery to keep in contact with family at a distance has been augmented or replaced by an ever-increasing number of platform options designed to bring people together through digital access. Today, eight in 10 Canadians are on the Internet (cira.ca, 2015) and three- quarters of parents use social media sites, such as Facebook and Twitter (London, 2013). Platforms that prioritize imagery are also increasingly popular, as two-thirds of parents have adopted Pinterest and Instagram as a way to keep in contact with friends and family (Sanghani, 2013).

“It seems pretty obvious to most observers that our social networks have changed in the past few decades thanks to technology. The widespread use of cell phones…the rise of the internet, and the advent of social media have changed the way we work, the way we live, and the way we make and maintain friendships” (Masket, 2014).

Where geographic distance used to be a barrier to staying in touch, technology has significantly closed that gap. Given that the widespread availability of mobile devices, such as smart phones, we have instant access to any information we need and any method for contact. And we don’t put them down. We have integrated mobile devices into every part of our lives. “With 91% of people sleeping within arms reach of their mobile device, it is safe to say that we are both addicted to our mobile device and dependent on it” (Newman, 2014).

As individuals change their communication patterns, so do families. Siblings text each other during the day, grandparents use Skype to virtually visit their grandkids in another city, and parents “use WhatsApp to say dinner is ready” (Sanghani, 2013). The impact of technology on families is not just how they communicate when they don’t live together, but also how they communicate when they do live together.

Research conducted by sociologist Barry Wellman suggests that “decades ago, our social networks were decidedly local; we primarily spoke with our neighbors and nearby friends and family members” (Masket, 2014). However, “more recently, we have become, in Wellman’s words, “glocalized,” simultaneously involved in both local and long-distance relationships” (Masket, 2014). For families that rely on communication over distance to maintain connections, the shift to a wider network of relationships can be highly beneficial.

As the technology behind mobile devices and tablets has advanced at a rapid pace, high-quality cameras, including video, are now standard offerings and have supported online video-conferencing applications, such as Skype and FaceTime. Adoption rates for Skype have been dramatic, with worldwide users reaching 300 million in 10 years (Steele, 2013), compared to over 100 years for telephone and 25 years for cell-phone users. The attraction of online video conferencing is hard to resist, as users share stories of Skype allowing a soldier serving overseas to witness the birth of a child or a classroom of primary school children experiencing a “virtual field trip” to the bottom of the ocean (Steele, 2013).

Networking People Together
Along with a shift in person-to-person communication is the emergence of online platforms that strengthen the connection of people in an existing social circle, and around a person and/or caregiver in need of support. Although Facebook is commonly used to keep in touch with family (Jones, 2014), when there is a health crisis, the issue of privacy may drive families to seek out alternate platforms. Tyze Network and CaringBridge are two examples of specialty-technology networks designed to support caregiving.

Tyze is an online-care collaboration tool that organizes people around one person—a social network for the purpose of creating a caring network for people with an illness or disability. Private, secure, mobile and without advertising, the tool facilitates sending updates, managing appointments, organizing friends and family who can help and creating a “private care space” to share news, stories and photos (tyze.com, 2014). CaringBridge is a similar platform that supports the sharing of updates and coordinating help, while ensuring online privacy and security (CaringBridge, 2015).

Although the healthcare environment might be considered lagging behind in a more liberal adoption of technology for the purposes of communication, Ontario is able to draw on The Ontario Telemedicine Network (OTN) as a secure network. Considered a “world leader in telemedicine, OTN helps Ontarians get more out of the health care system by bridging the distance of time and geography to bring more patients the care they need, where and when they need it” (OTNhub, 2015). Although the primary purpose of the OTN is to support care delivery within Ontario, there are examples of the service supporting communication between distance family members.

At the Thunder Bay Regional Health Sciences Centre, the OTN has been used to create a Tele-Visitation program. Providing health services for Northwestern Ontario, the population in the region has only approximately 122,000 people. However, the geographic area served is large and spread out, and within the catchment area are 70 First Nations communities, including 24 that are only accessible by air or icy winter roads (Nicholas, 2013).

Initially developed to address the needs of First Nations patients that had family in remote communities, the Tele-Visitation program “is the virtual transportation of a patient’s family to the bedside, regardless of the patient’s location within an acute care setting” (Nicholas, 2013). Even though the program was initiated to support more positive outcomes for patients in acute care, a new opportunity for expansion may include end-of-life visitation as a tool for the Palliative Care Team within the hospital (Nicholas, 2013).

DESIGN IMPLICATIONS
Mobile devices and inter-connectivity is on the rise. Younger generations will expect to have access to information and will not have the same expectations of privacy and confidentiality. Healthcare providers will need to respond.

Mobile devices and emerging online platforms are intrinsically changing how people communicate with each other. Younger generations, such as Millennials and Generation Y, have been born into a time where mobile connectivity and access to information is ubiquitous. In a February 2015 Report on the Networked Society, Ericsson predicts that, by 2016, smart-phone subscriptions will surpass that of basic telephones (Ericsson, 2015) and that “90% of individuals over 6 years old will have a mobile phone” (Ericsson, 2015). With the ability to connect whenever we want, with whomever we want, at our finger tips, expectations for access to information will be high. This expectation of immediately available information will impact the healthcare system and healthcare providers, as “digital natives”—those born into technology (Prensky, 2001)—demand access and test the boundaries of privacy and confidentiality.

 



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