342 ■ III: ROLE FUNCTIONS OF DOCTORAL ADVANCED NURSING PRACTICE
“Cloud computing” will further increase the portability of personalized web content.
As more and more applications, content, and communities become web- based, we will
demand access to the web anytime and everywhere. It is expected that expanded band-
widths and the capabilities of smartphones and other wireless devices globally will con-
tinue to evolve and further expand opportunities to access and use data (Newton, 2009).
Another transformative change that is anticipated with the expanded functionality
of the Internet (smarter web and ubiquitous wireless network access) is the ability to use
widely dispersed sensors to collect all types of data. The data collection possibilities will
thus be limitless. For example, sensors can collect “... vital signs, energy usage, soil mois-
ture, traffic patterns, manufacturing efficiency... it will all be tracked remotely and ana-
lyzed in real time and fed into the Smart Web” (Newton, 2009, p. 1). This opens the door for
extraordinary research opportunities; however, consideration must be given to the privacy
concerns that are bound to arise. The doctoral APN must be prepared to take a leadership
role in supporting new research while championing the privacy rights of the individual.
It is reasonable to expect that all advances in technology described thus far will
impact the health care system. One major impact will be on system interoperability.
Currently, many hospital systems are not integrated and, consequently, system wide
communication is impaired, making it difficult to provide seamless care. Improved data
tracking and tightly integrated systems will transform health care by improving dis-
ease management and patient outcomes. Health care delivery will likely become more
decentralized due to an extensive network- based system, high- tech equipment, and
software permitting more sophisticated telehealth encounters in one’s home via clini-
cal video teleconferencing. The area of telehealth offers many opportunities (e.g., tele-
intensive care unit [ICU], teledermatology, telemental health, etc.) for the doctoral APN.
This innovative care delivery model coupled with interoperability will spill over to
other areas of the health care system and even our personal lives, bringing new levels of
“life- wide” connectivity across the life span.
One concern and limitation regarding the application and use of technology in
the clinical setting are policies that prohibit the use of mobile devices. This is a very
nuanced issue. There are many benefits that such devices provide in such a setting, but
they can be distracting or lead to breaches in confidentiality. Policies that note specific
uses versus outright bans may be an option to consider. Given the potential benefits of
mobile data collection, analysis, and decision support at the point of care, it will be very
short- sighted to ban the use of mobile devices.
Cybersecurity considerations will be in the forefront. The recent highly publicized
security breaches at Community Health Systems and Anthem as well as reported inci-
dents of wireless biomedical infusion pumps being “hacked” clearly convey the serious
risks that currently exist and that are likely to increase in the future. These incidences
substantiate the need for health professionals in leadership positions to work closely
with interdisciplinary team to ensure proactive security measure are in place. In 2014,
the Ponemon Institute reported that cyber attacks on health care organizations have
doubled since 2010 and that patient medical records are the targets of these attacks, so
the APN must be cognizant of risks, both actual and potential.
High Fidelity, Second Life, Active Worlds, Wonderland, and other virtual worlds
will become more sophisticated, and we will likely see overlap between virtual worlds
and the real world via technologies that enable “augmented reality” interfaces. This
blend will enhance our opportunities to provide rich simulated learning experiences for
students, support continuing education among our practicing professionals, and con-
duct research. In addition, augmented reality technology will also provide the capabil-
ity to provide enhanced clinical decision support in real time at the bedside where it is
needed most and will have the greatest impact upon patient outcomes.