Telehealth Case Study

At the San Diego VAMC, we proudly offer two Store and Forward Telehealth (SFT) programs. The first SFT program offers an eye screening exam (Tele-retinal) to a diabetic Veteran at a local VA clinic. These images are then reviewed by an Eye Specialist, who determines if the Veteran needs a face to face eye clinic appointment. The second SFT program takes pictures of the Veteran's skin lesions, which are then uploaded to the electronic medical record so that a Dermatologist can best determine how to treat the lesion. Telehealth appointments save Veterans an extra office visit and create a 'one-stop shop health care'.

Florida VA hospitals are among the busiest in the nation. Access can be an issue for non-emergency care, and in some cases, these delays have reportedly resulted in harm to patients. In 2012, West Palm Beach VA Medical Center served 64,358 veterans since they have opened the medical center in 1995 in which it was projected to serve 30,000. Outpatient visits totaled a record of 689,662 and 7,417 inpatient discharges. Since WPB VAMC opening, it has had a 66 percent increase in staffing to help meet the needs of Veterans. During my time at the West Palm Beach VA Medical Center, I have spent seven months assisting in the director’s office as a program support. I helped with patient advocacy issues on as a needed basis and also helped with pulling data collection, tracking, analysis and reporting. In fiscal year 2013, there was an 11% increase in the number of Veterans served by Telehealth. VA Telehealth services use health informatics, disease management and telehealth technologies to target care and case management to improve access to care with the intent to providing the right care in the right place at the right time. Further, as the numbers of veterans served by Telehealth grown so did the amount of complaints to access or timeliness in which there was a 12% increase. For example, in medical administrative services, phone calls were not returned or letters were not

Telehealth services refers to the exchange of health information and services through telecommunication services in order to support anyone, at any time, in any location. Telehealth systems allows doctors to be in one place and treat patients in rural or urban areas – such as their homes or any another providers premises. The technology behind such concept is particularly helpful for patients with trouble leaving the house, or that live in remote areas from specialists (Narisi, 2013)

The nurse can utilize home telehealth monitoring to enhance the patient experience by providing medical care, treatments, education and support in the convenience of the family home. McGonigle & Mastrian found, “According to regular surveys conducted by the AARP (1996), more than

That is amazing! Patients can ask questions while in their own comfort zone and be reassured of any concerns. The Center for Connected Health Policy (CCHP) states that “Telehealth is a collection of means or methods for enhancing health care, public health, and health education delivery and support using telecommunications technologies.” Equipment and supplies which aid Telehealth digital technology to provide health services remotely are computers, internet service, telephones, smart phones, mobile devices, software and hardware.

The delivery of health care has always been influenced by technological developments and innovations. This is particularly true in modern health care professionals where they are obsessed with technology and rush to apply them. One of the most recent applications of ICT – Information and computer technology- is telehealth. Telehealth is the use of communication, diagnostic and information technology to provide health care when patients and providers are geographically separated [2], Technologies include videoconferencing, the internet, store -and-forward imaging, streaming media, terrestrial and wireless communications. Telehealth could be as simple as two health professionals discussing a case over the telephone or as

Under the ACA, telehealth is a new electronic service used to communicate and provide clinical services as well as other types of health information.2 In rehabilitation, the goal of telehealth is to deliver physical therapy services, over large and small distances. It may be used to provide health education and advice, communicate patient reminders, monitor clinical status, or deliver interventions.2 Overall, the goal of telehealth is to deliver effective health care information within the United States.

Telehealth has been a large topic of debate in recent years because of the economic, political, and regulatory points of view. In deciding outcomes in these areas, it is the responsibility of all healthcare professions to identify information gaps in order to come to the more rational and beneficial conclusion about telehealth (Grace, 2014). Economically, there are concerns regarding the access and affordability of telehealth equipment. At the same time, telehealth is being adapted in ways to be utilized with technological devices that many individuals already have access to like telephones, cellular phones, and personal computers/laptops. Telehealth can positively impact both clients and providers by increasing access to care and reducing the time and costs associated with traveling for health care (Allen, Aylott, Loyola, Moric, & Saffarek, 2015). As telehealth develops technological devices can be made more affordable and can be covered by insurance policies (Thomas et al., 2014). Many nurses functioning as case managers can help provide the tools and resources individuals require to manage their health.

Telehealth is the monitoring via remote exchange of physiological data between a patient at home and health care professionals at hospitals or clinics to assist with diagnosis and treatment. As our society ages and health care costs increase, government and private insurance payers are seeking technological interventions. Technological solutions may provide high quality healthcare services at a distance, utilize professional resources more effectively, and enable elderly and ill patients to remain in their own homes. Patients may experience decreased hospitalization and urgent care settings, and out of home care may not be required as the patient is monitored at home. However, no study has been able to prove telehealth

Home telehealth option 2 is designed to leverage the SCI Center expertise through the hub and spoke model of care. The patient is sent home with the same videoconferencing unit as per telehealth scenario 1 and follows the same schedule. In this scenario, the patient connects with the SCI center; this provides oversight by the SCI Center with appropriate clinical attention

In the United States, a renewed interest occurred in telehealth in the 1990s according to McGonigle and Mastrian because of escalating costs, the need for greater access for all

Overall patient’s perceptions of tele-home care are resoundingly position. Tele-homecare information can also empower homebound patients with chronic diseases to make informed decisions about their disease as well as reduce the burden currently experienced by their formal and informal caregivers. Patients felt that tele-homecare promoted daily self-monitoring activities, and they were satisfied that the clinicians were monitoring their tele-homecare readings daily. Patients report an increase sense of security by having tele-access to their clinicians and from knowing the clinician able to facilitate daily remote monitoring, surveillance, and support, which otherwise would not have been possible without tele-homecare technology. Continuity of

Telemedicine is similar to Telehealth. Telehealth refers to a broader scope of remote healthcare service but Telemedicine refers specifically to remote clinical services. Telehealth can also refer to remote non-clinical services. For example provider training and meetings (link 3). In the past the network is not as fast as now, thus telemedicine is only use in clinical services. Now, due to the development of network, more information can be transferred in a shorter period, thus Telemedicine can be to provide other non-clinical services. The word “Telehealth” refers to both clinical and non-clinical services.

There are several forms of technology that is used to monitor, assist patients with self-care management, assist physicians with delivering care to their patients, including consultation with specialist, and overcoming barriers with transportation. “60% of the healthcare executives, physicians, and nurses in this inaugural survey said that telemedicine was a high priority for 2015“ (Vockley, 2015, para. 7) Telemedicine

Telemedicine is the use telecommunications and information technology to provide healthcare to patients located in the remote or distant locations. For example: people staying in the mountainous areas or islands can get medical services right at their home with the help of smart devices or patients who cannot go to the hospital for some reason.