INTRODUCTION:

Digital transformation in healthcare refers to the integration of digital technologies to improve service delivery, patient outcomes, and system efficiency. Rapid technological advancement, changing patient expectations, and global health challenges have accelerated the adoption of digital tools across healthcare settings.

Organizations such as the World Health Organization emphasize digital health as a critical strategy for achieving universal health coverage and strengthening health systems.

Nurses are central to healthcare delivery and are uniquely positioned to influence digital adoption due to their continuous patient interaction, coordination responsibilities, and clinical expertise. As healthcare systems increasingly depend on electronic health records, telemedicine, artificial intelligence, robotics, and wearable monitoring systems, the nursing profession must adapt to evolving digital environments.

AIM OF THE REVIEW:

This narrative review aims to examine the role of nurses in digital health transformation, focusing on key technologies, associated benefits and challenges, and implications for nursing education, leadership, and practice.

METHODOLOGY:

This study was conducted as a narrative review. Literature was searched using databases including PubMed, Scopus, Google Scholar, and CINAHL. Articles published between 2015 and 2024 were considered.

Keywords used included:

“Digital health and nursing”, “Electronic health records”, “Telehealth in nursing”, “Artificial intelligence in healthcare”, “Robotics in nursing”, “Wearable technology in healthcare”

Peer-reviewed articles in English focusing on nursing roles in digital transformation were included. Editorials without empirical or conceptual relevance and non-English publications were excluded.

Electronic Health Records (EHRs):

Electronic Health Records (EHRs) are fundamental to digital healthcare systems. They improve documentation quality, enhance communication among healthcare teams, reduce medication errors, and facilitate clinical decision-making.

However, usability concerns have been linked to increased workload, documentation burden, burnout, and reduced patient interaction. Nurses often spend significant portions of their shift on EHR documentation. Poorly designed interfaces may compromise patient safety and workflow efficiency.

Nursing leadership plays a crucial role in:

· Advocating for user-friendly systems

· Participating in system redesign

· Integrating AI-driven decision support

· Promoting workflow optimization

· Improved usability and targeted training can significantly reduce digital fatigue and improve patient outcomes.

Mobile Health (mHealth):

Mobile health technologies enable remote monitoring and self-management of chronic diseases such as diabetes, hypertension, and cardiovascular disorders. These tools support behavior modification, medication adherence, and early detection of complications.

However, the digital divide remains a challenge. Limited digital literacy, poor internet connectivity in rural areas, and lack of awareness may restrict access. Nurses play a critical role in educating patients, recommending reliable applications, and assessing digital readiness.

Integration of mHealth platforms with EHR systems and institutional policies is necessary for sustainable implementation.

Telehealth and Telerehabilitation:

Telehealth gained prominence during the COVID-19 pandemic and remains an essential model of care delivery. It improves access to healthcare, especially for rural populations and during infectious disease outbreaks.

Nurses coordinate virtual assessments, patient education, chronic disease monitoring, and interdisciplinary communication. Advanced practice nurses have demonstrated leadership in telehealth adoption and regulatory navigation.

Telerehabilitation programs have shown benefits in improving psychological outcomes and self-management in chronic illness. However, limitations include technological challenges, reduced physical examination capability, and potential trust barriers.

Hybrid models combining telehealth with periodic face-to-face consultations may provide optimal patient outcomes.

Artificial Intelligence (AI):

Artificial intelligence enhances predictive analytics, clinical decision support, workflow automation, and risk stratification. AI-driven systems can assist nurses in early identification of patient deterioration.

Despite its benefits, AI presents concerns related to:

· Algorithmic bias

· Data privacy

· Ethical accountability

· Resistance to technological change

AI cannot replace human empathy, ethical reasoning, or holistic assessment. Instead, it should complement nursing expertise. Nurses must be included in AI policy development, implementation strategies, and ethical oversight frameworks.

Automation Technologies: Robotics and Drones:

Robotics and drones represent emerging innovations in healthcare logistics and patient support. Drones improve supply chain efficiency, particularly in remote areas, while robotics assist with mobility support, infection control, and repetitive tasks.

Robots can:

· Support rehabilitation exercises

· Facilitate patient engagement

· Reduce infection transmission

However, adoption depends on nurses’ attitudes, digital competence, and institutional support. Training and exposure to technological benefits improve nurse–robot engagement.

Wearable Devices and Continuous Monitoring:

Wearable technologies enable real-time monitoring of vital signs, mobility, and physiological parameters. Continuous monitoring can enhance early warning systems and reduce adverse events.

Nevertheless, challenges include alarm fatigue, data overload, and integration issues. Big data analytics and structured clinical protocols are necessary to maximize utility.

Nurses must balance technological monitoring with maintaining therapeutic patient relationships.

Summary of Digital Technologies and Nursing Implications

Technology	Benefits	Challenges	Nursing Role
EHR	Improved documentation, safety	Documentation burden	Workflow optimization, system redesign
mHealth	Chronic disease management	Digital divide	Patient education
Telehealth	Increased access	Reduced physical interaction	Virtual assessment and coordination
AI	Decision support	Ethical concerns	Oversight and policy involvement
Robotics/ Drones	Efficiency	Resistance to adoption	Training and engagement
Wearables	Real-time monitoring	Alarm fatigue	Clinical interpretation

DISCUSSION:

Digital transformation presents opportunities to enhance patient-centered care, operational efficiency, and clinical safety. Nurses are key facilitators of digital adoption due to their direct patient interaction and system navigation roles.

However, successful implementation requires:

· Digital literacy development

· Curriculum integration in nursing education

· Leadership participation

· Organizational culture that supports innovation

· Policy-level nurse involvement

· Balancing technology with compassionate care remains essential to preserving the core values of nursing.

CONCLUSION:

Digital transformation is redefining modern healthcare systems. Nurses are indispensable drivers of this transformation, contributing clinical expertise, ethical oversight, and patient advocacy.

While technologies such as EHRs, telehealth, AI, robotics, and wearable devices enhance care delivery, challenges related to usability, digital literacy, equity, and workforce readiness must be addressed.

Strengthening education, leadership engagement, and supportive policies will ensure that nurses remain at the forefront of digital innovation. By actively participating in decision-making and technological development, nurses can shape a safe, equitable, and patient-centered digital future.

REFERENCES:

1. Abraham, J., et al. Electronic health record use and advanced practice nursing workflow. Journal of the American Association of Nurse Practitioners. 2022

2. Akhu-Zaheya, L., Al-Maaitah, R., and Bany Hani, S. Quality of nursing documentation: Paper-based health records versus electronic-based health records. Journal of Clinical Nursing. 2018; 27: e578–e589. https://doi.org/10.1111/jocn.14097

3. Alexander, G. L., Powell, K. R., and Deroche, C. B. An evaluation of telehealth expansion in U.S. nursing homes. Journal of the American Medical Informatics Association. 2021; 28(2): 342–348. https://doi.org/10.1093/jamia/ocaa253

4. Bahrainwala, L., Knoblauch, A. M., Andriamiadanarivo, A., Diab, M. M., McKinney, J., Small, P. M., et al. (). Drones and digital adherence monitoring for community-based tuberculosis control in remote Madagascar: A cost-effectiveness analysis. PLOS One. 2020; 15(7): e0235572. https://doi.org/10.1371/journal.pone.0235572

5. Booth, R. G., and Strudwick, G. How the nursing profession should adapt for a digital future. BMJ. 2021; 373: n1190. https://doi.org/10.1136/bmj.n1190

6. Iyawa, G. E., Herselman, M., and Botha, A. Digital health innovation ecosystems: From systematic literature review to conceptual framework. Procedia Computer Science. 2016; 100: 244–252.

7. Kutney-Lee, A., et al. Electronic health record usability and nurse outcomes. Medical Care. 2021; 59(7): 625–631. https://doi.org/10.1097/MLR.0000000000001536

8. Lee, A. Y. L., Wong, A. K. C., Hung, T. T. M., Yan, J., and Yang, S. Nurse-led telehealth intervention for rehabilitation (telerehabilitation) among community-dwelling patients with chronic diseases: Systematic review and meta-analysis. Journal of Medical Internet Research. 2022; 24(11): e40364. https://doi.org/10.2196/40364

9. Lu, L., Zhang, J., Xie, Y., Gao, F., Xu, S., Wu, X., and Ye, Z. Wearable health devices in healthcare: Narrative systematic review. JMIR mHealth and uHealth. 2020; 8(11): e18907. https://doi.org/10.2196/18907

10. Moy, A. J., et al. Measurement of clinical documentation burden among physicians and nurses using electronic health records: A scoping review. Journal of the American Medical Informatics Association. 2021; 28(5): 998–1008. https://doi.org/10.1093/jamia/ocaa325

11. Okem, Z. G. Innovation in health in Turkey's EU membership process: Innovation, sustainable growth and health sector. Sis Printing. 2011

12. Riek, L. D. Healthcare robotics. Communications of the ACM. 2017; 60(11): 68–78. https://doi.org/10.1145/3127874

13. Rutledge, C. M., O’Rourke, J., Mason, A. M., et al. Telehealth competencies for nursing education and practice: The four P’s of telehealth. Nurse Educator. 2021; 46(5): 300–305. https://doi.org/10.1097/NNE.0000000000000988

14. Sabaakbar, M., et al. Automation in nursing decision support systems: A systematic review of effects on decision making, care delivery, and patient outcomes. Journal of the American Medical Informatics Association. 2021; 28(11).

15. Stoumpos, A. I., Kitsios, F., and Talias, M. A. Digital transformation in healthcare: Technology acceptance and its applications. International Journal of Environmental Research and Public Health. 2023; 20: 3407. https://doi.org/10.3390/ijerph20043407

16. Tsai, Y. C., Hsiao, P. N., Kuo, M. C., et al. Mobile health, disease knowledge, and self-care behavior in chronic kidney disease: A prospective cohort study. Journal of Personalized Medicine. 2021; 11: 845. https://doi.org/10.3390/jpm11090845

17. Weenk, M., et al. Continuous monitoring of vital signs in the general ward using wearable devices: Randomized controlled trial. Journal of Medical Internet Research. 2020; 22(6): e15471. https://doi.org/10.2196/15471

18. Varzaru, A. A. Assessing digital transformation of cost accounting tools in healthcare. International Journal of Environmental Research and Public Health. 2022; 19: 15572. https://doi.org/10.3390/ijerph192315572

Received on 26.03.2026 Revised on 16.05.2026

Accepted on 20.06.2026 Published on 27.07.2026

Available online from August 01, 2026

Asian J. Nursing Education and Research. 2026;16(3):203-206.

DOI: 10.52711/2349-2996.2026.00041

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