Telehealth: An Example Of The Transitional Care Model

Telehealth Introduction Telehealth is the use of technology for the exchange of health information in a two way communication from one location to another using a variety of tools or applications. Tools and applications such as smart phone devices, video conferencing, emails, and other wireless applications are used for the convenience and improvement of delivery of healthcare. It has the advantage of connecting healthcare personnel and primary care provider with patients and provides knowledge through the network system regarding patient care and monitoring (Katzman, 2013). Telehealth is a cost effective way for the Advanced Nurse Practitioners (ANP) to have the ability to reach a wider geographical area and broader populations.

As discussed earlier, Roja et al. (2014) found that there is minimal effort in developing programs for the Aboriginal community that are deemed culturally safe and appropriate care provided by health care professionals. With current advancements in technology, remote Aboriginal communities can now utilize a videoconferencing service where a physician can attend to them via Telehealth. According to Kowpak & Gillis (2015), this method uses a robot that has ‘peripheral examination tools such as a stethoscope, ENT camera, and a general exam camera’. Although this method paves way to a much acceptable timeframe to consult with a physician, Telehealth also has its fair share of criticisms (Health Canada, 2014). Telehealth is another form of service

I also was quite startled by the health disparities rural populations face in regard to access to care issues and recruiting health care providers. I am originally from the state of Iowa -- I saw many parallels between rural health care in West Virginia and Iowa. In college I did my nursing clinical rotation in a rural area in Iowa and I remember how hard it was for patients to find transportation to a health care facility. It was especially difficult for patients who needed specialty health care services like oncology. This is where I really think innovative information technologies like Telehealth can make a difference in rural populations’ health outcomes. Hopefully, more rural health care centers will make the commitment to adopting

Regarding the move towards a more technological way of documenting information about patients, home care companies have even tried to go electronic. One home care company in Colorado uses a system called Teletrack. This information system is used to document patient information using a telephone. Employers and family members are then able to access the patient information through an online database. When a caregiver comes in contact with a client/patient, the caregiver must clock in using a telephone. This allows the company to see the exact time the caregiver was with the client/patient. While the caregiver is with the client/patient, there are a variety of tasks the caregiver can perform depending on the care plan set in place by the family.

Fortunately, we do utilize computerized charting as well as the physician order entry system, but there is room for improvement in our home health organization. Epic home health is the system that we utilize, unfortunately, internet service is required to sync/update patient information. In order to review previous nurse, physician notes, and lab/test results internet service is needed. Many of our patients live in rural areas where cell phone service and internet service is not available. Therefore, we must often wait until we return to the home health office to find the patient information we need and to submit our charting. I am grateful our organization utilizes computerized charting, but often it is difficult to communicate with other healthcare providers or pull up pertinent patient information while in the field. Certified nursing assistants, nurses, physical therapists, social workers, and case managers are all required to use the same charting system, using the same system does improve communication within the organization. Nurse Managers review our charting on a regular basis and provide staff members with feedback and updates if changes are made in the computerized system. Also, technical service representatives are available 24-7 for employees to assist with questions and to address technical issues regarding

Favoring the use of telemedicine can save underserved patients time and money. An article by Russo, McCool, and Davies, analyzed the time and money spent by 5,695 veterans, who visited Veteran Affairs healthcare systems, to identify how much time and money could be saved per year by utilizing telemedicine techniques (209). From 2005 to 2013, it was discovered that in White River Junction, Vermont, the average patient saved 145 miles of travel time and 142 minutes of visit time by means of telemedicine (Russo, McCool, & Davies 209). As a result, the government saved $18,555 expenses in travel per year (Russo, McCool, & Davies 209). This study reflects the high expenses and valuable time related to medical care that typical veteran members will experience, which is a fraction of the nation’s population. If taken into consideration the number of underserved individuals in the nation, it can be seen that these expenses cannot be afforded. Now, consider using a telemedicine system on a national scale, which could be a great benefit to many underserved Americans and lower their expenses to be more manageable. By utilizing telemedicine strategies, the United States government can help underserved individuals save thousands, if not millions, of dollars.

Telehealth refers to healthcare that does not necessarily involve any form of in person clinical services. Telemedicine is the use of medical information substituted from one place to another through several electronic communications to improve the health status of patients. Telehealth and telemedicine include several services that include primary care, specialist consultations, imaging services, distance patient monitoring, and medical education. In New York, there has been an increase in the use of telehealth especially after the implementation of the telehealth parity law. The main benefits of telehealth on the patient include improvement of convenience through countering geographical barriers, enhanced access especially to people in the rural areas and reduction in time wasted traveling particularly when queuing in

Telehealth technology also plays a significant role in time and cost saving (Mofat& Ely 2010). Through the technological applications, nurses are in a position to communicate and monitor their outpatients without the need to travel (Nagel et al., 2015). Also, through applications such as teleconferencing, health specialists such as cardiologists are now in a position to train the interns in the field without the need to travel to his/her theater (Tuerk & Shore, 2014).

One way to achieve continuity of care with standardized nursing language and communication is the implementation of electronic medical records for home health care. The utilization of SNL will create relevant evidence of services and also improve decision making and nursing documentation quality. In implementing these changes nursing data will improve the ability to measure and compare the effects of home care nursing (Lee, Lee, & Moorhead, 2009).

They provide high quality evidence based care across the lifespan to enhance patient safety, reduce adverse events, impact and improve patient’s satisfaction, support and promote optimal health status, track admissions and readmissions, and manage costs within and among continually expanding, diverse, and complex populations. This means that registered nurses are essential to the delivery of safe, high quality care and should not be replaced by less skilled licensed or unlicensed members of the healthcare team. Registered nurses are the people that are best prepared to facilitate the functioning of interprofessional teams across the care continuum. They also coordinate care with patients and their caregivers, and also mitigate the growing complexity or transitions in care. Registered nurses play a critical role in the delivery of telehealth services and virtual care. The development of the art of science of telehealth nursing practice has improved and expanded coordination of healthcare services, reduced patient risk, and contributed significally to care management models. Registered nurses must practice at the top of their license, education, and expertise to affect quality and cost through patient engagement, care coordination, enhanced teamwork, resource reduction, improved access, and quality and outcome improvement. Registered nurses must lead, participate, and support performance improvement activities designed to promote and enhance quality and safety, improve efficiency in care delivery, and evaluate impact on patient outcomes. Registered nurses also have the expertise in the development, implementation, and sustainability of quality measures and clinical practice

In the modern world technology is everywhere and it affects everyone’s daily life. People are constantly attached to cell phones, laptops, and other electronics, which all have affected how people live their lives. Technology is also a large part of the healthcare system today. There are many electronics and technologies that are used in health care, such as electronic health record, medication bar code scanning, electronic documentation, telenursing, and there are many more forms of technology that impact nursing. One technology that stands out is the electronic health record. The electronic health record, also referred to as EHR, is an electronic version of a patient’s chart, and it contains is a list of the patient’s current medications, allergies, laboratory results, diagnoses, immunization dates, images, treatments, and medical history (“Learn EHR Basics,” 2014). The purpose of the electronic health record is to have a patient’s health care record available to health care providers nationwide, but the patient can decide who has access to their record (Edwards, Chiweda, Oyinka, McKay, & Wiles, 2011). The electronic health record is a very important technology in health care and it impacts nurses, nursing care, and has a significant impact on patient outcomes.

Telehealth is becoming a widely-used tool for seeking medical care, or consultation. The world of technology we live in is ever growing, making healthcare easily accessible through telehealth. While many different organizations define telehealth using different words, they all have the same idea. I found in my research that telehealth and telemedicine are defined differently.

Telehealth, which is defined by the Department of Health and Human Services (HHS) as “The use of electronic information and telecommunications technologies to support remote clinical health care, patient and professional health-related education, public health and health administration” (Stowe & Harding 2010). Telehealth has the capability of collaborating those healthcare professionals to take advantage of healthcare services among several of settings as well as distances (Stowe & Harding 2010). This report would start from the effectiveness of telehealth and possible disadvantages. Some evaluation for integrating personal experience and discussion about whether telehealth is a viable alternative to face-to-face practice would also be

Experience plays an important role in assessment because experienced listeners have a higher inter-rater reliability than inexperienced listeners (Munson, Johnson and Edwards, 2012). This means that experienced listeners have a better judgment when determining speech sounds in error. Experience is crucial in all aspects of assessment. For instance, when a client has difficulty with the /s/ sound by saying the /t/ sound, it could be difficult to realize what the client is saying unless the clinician knows that the sound that the client is trying to exhibit is the /s/ sound. This skill comes with experience and practice of understanding speech sounds that could be in error.

The purpose of this paper is to identify and describe two health information and communication technologies (HICTs) and how they aid nurses in supporting safe, quality care, facilitating continuity of care and care coordination, and partnering with patients and families to increase participation in health care. HICT involves electronic creation, storage, exchange, and analysis of health information to advance delivery of health care. Widespread use of HICT within the healthcare industry can achieve the following goals: improve healthcare quality and safety, reduce costs and health disparities, enhance clinical research, and ensure security of patient health information (McGonigle & Mastrian, 2015). Several examples of HICTs include: electronic medical record systems, electronic prescribing, consumer health applications, and telehealth (Agency for Healthcare Research and Quality [AHRQ], 2015). Integration of HICTs in healthcare settings is valuable for all clinicians, but most importantly nurses as they are primary caregivers.