Transformative power of technology.

Technology is rapidly changing how we live each day and how healthcare is being delivered, recorded, and evaluated. A recent Gallop poll (Witters & Agrawal, 2014) indicates that approximately 65% of American adults have a smart phone. Of those surveyed, 20% stated they used apps such as calorie counting/tracking, healthy recipes, healthy restaurant menu options, alerts of times to take medications, reminders of appointment times, and daily exercise activity tracking to promote their health and well-being. Moreover, apps exist to help recognize signs and symptoms signaling the presence of a life threatening condition as a stroke or enabling individuals to selfmanage chronic conditions including diabetes, hypertension, and heart disease. In addition, over half of all healthcare professionals reported using tablets as part of their practice to document patient information as well as access journal articles, diagnostic tools, and clinical references to improve decision-making and quality of care (Brewster, 2013). Communication between healthcare providers and patients is being further enhanced through a secure means (e.g., username and password protected) to share electronic health records (e.g., test results, alerts for future appointments) and e-mail exchanges to address individual patient needs and concerns. Technology is dramatically affecting the teaching and learning process of professionals, students, patients, and their families as they access resources and communicate with one another. While you read the articles in this issue, consider how technology, in particular smart phones and tablets, may enable healthcare professionals, patients, and families to obtain resources to manage the care of patients with dysphasia and medication administration (Torres et al., 2015). Moreover, after reading the Jaimes, Thompson, Landis, and Warms (2015) and PowellCope, Moore, Weaver, and Thomason (2015) articles, contemplate how tablets, smart phones, or other forms of technology can be used to facilitate staff obtaining continuing education with a special emphasis on traumatic brain injury and spinal cord injuries. Although technology significantly influences our practice, we must be cognizant of some concerns needing to be considered. For instance, how do we keep tablet information secure and adhere to HIPPA privacy and security concerns? What about the cost constraints associated with purchasing and maintaining the necessary software and apps to make them work effectively? Are the respective apps appropriate for different reading abilities, ages, race/ethnicities, genders, geographic areas, etc.? How do we evaluate the quality, applicability, ease of use, and security of apps designed for monitoring and documenting patient outcomes? What are the inherent benefits of technology compared to the risks or barriers when framed within the context of healthcare? My intent is not to provide all of the answers, but to stimulate the discussion of how technology, and in particular, smart phones and tablets, affect our work as rehabilitation nurses. Despite their advantages, smart phones and tablets have some negative aspects. Chang, Aeschbach, Duffy, and Czeisler (2015) discovered that on the nights participants read electronic books on a light emitting device (LE-eBook), it took them longer to fall asleep, affected their circadian rhythm, and reduced next morning alertness. As a result, the researchers recommended when reading before bedtime, a printed paper book is preferred to a tablet or smart phone. Other health effects associated with tablets and computers are neck and back pain that occurs with extended use. With regard to use of tablets by children, the evidence is still forming. Initial research suggests tablets improve hand-eye coordination, facilitate the development of cause and effect reasoning, and help increase communication with children who have autism (Kasari et al., 2014). However, excessive use of tablets has also been identified as promoting more sedentary activities and thereby potentially contributing to the development of obesity, diabetes, and cardiovascular disease. In conclusion, smart phones and tablets are here to stay. Therefore, we must routinely consider how they can complement our practice along with the potential challenges they pose. If you are using them in your practice, we want to hear from you.