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Tele . . . What? The Evolution of Using Telehealth in Patient Care

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Brenda F. Johnson has 28 years experience as a BSN and specializes in Gastrointestinal Nursing.

5 Followers; 77 Articles; 107,766 Profile Views; 266 Posts

What are your thoughts on the future of healthcare using telehealth?

As a kid, every day after school, I would throw my books down and plant myself in front of the television to watch my favorite shows. Among those favorites were Lost in Space and Star Trek. The futuristic, even outlandish methods of medical care shown in those shows seemed far-fetched to this schoolgirl. But here we are in 2020, practicing medicine over the phone, by computer, with robotics, using video, audio, and biometrics. The list will continue to grow as technology improves.

Tele . . . What? The Evolution of Using Telehealth in Patient Care
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Medical Advances

Whether we like it or not, the future has caught up with us. Old school nurses like me who have been practicing for thirty years or more have witnessed many changes. Just a couple of examples are needleless methods of administering medications and the multitude of other safety measures initiated that decrease medical and medication errors.  Electronics have improved surgical, endoscopy, and X-Ray equipment by increasing accuracy. Oh, and let’s not forget electronic charting. When electronic charting first came, we nurses often complained. The common complaint was that we felt the computer took us away from the patient. Paper charting allowed us to chart at a later time and was much less complicated.  However, computer charting has decreased mistakes with hard stops and standardization of the nursing language. 

Each step of medical advancement has increased the quality of patient care and decreased complications. And here we are on the cusp of improving the world in medicine even more. Telehealth has been around for a bit actually, but it is getting ready to be a large part of the healthcare system. 

What is Telehealth?

What is Telehealth? It is the use of electronic information to transmit patient information and providing healthcare services.  As mentioned earlier, this method of care has been used in the United States since 1964 when they used closed-circuit television (Nelson & Staggers, 2017). It has been used in medical teaching for a long time as well, beginning with live video. 

Benefits

There are many benefits to using telehealth, such as decreasing or removing travel barriers for the poor, rural, and disabled. Telehealth will provide more immediate care which can lead to earlier detection of disease or health issues. By putting the power back into the patient’s hands, they become empowered, more independent, and therefore more compliant.

Telenursing allows nursing and technology to combine in order to give care to those who may have trouble accessing medical care for a myriad of reasons. As we know, rural patients have difficulty with transportation due to geographic conditions, and less access to practitioners. Medical compliance is lower in rural patients, making chronic conditions harder to manage. Veterans are another group of patients that need assistance to connect with providers. Veterans with disabilities may have trouble traveling to appointments for services that are not offered locally. 

There are several successful programs that use telehealth in order to better provide care. The one we will focus on is The Department of Defense. Real-time appointments are conducted via video between the patient and the provider. The patients may include active service members, retirees, or dependents. Some of the services that are provided include mental health, dermatology, pulmonary disease, and cardiology care through telehealth. For more information, here is their website.  

Technology allows doctors to monitor vital signs, blood sugar levels, temperature, bi-pap readings, and much more. This eliminates the need to go to the doctor's office so often in the case of chronic conditions, homebound patients, and handicapped patients. Biometric data can help to not only monitor conditions but also to diagnose issues. Loop recorders are a good example. When patients have short periods of heart arrhythmias, it is often hard to record, and therefore diagnose and treat. Loop recorders are small devices implanted in the upper chest that record heart activity. They activate and begin recording when the heart rhythm becomes abnormal. This information helps the cardiologist to diagnose the patient.

The question may arise asking if telehealth is equal to a face-to-face visit. Studies have shown that telehealth is just as effective (Nelson & Staggers, 2017). Another concern when using telehealth is privacy. The same rules and laws apply to these situations that apply to any other HIPAA related issue. Another consideration is the patient’s media/computer and health literacy. These factors must be considered as medicine moves forward using telehealth.

Telehealth is becoming more sophisticated and applicable with each passing year. There is much to contemplate as we move forward using telehealth in the United States.  

What are your thoughts on the future of healthcare using telehealth? Share your thoughts and experiences with the allnurses community.

https://youtu.be/cC88besDEDc

References

Nelson, R., & Staggers, N. (2017). Health Informatics: An Interprofessional Approach (2nd ed.). Maryland Heights, MO: Mosby. ISBN - 13: 978-0323402316

5 Followers; 77 Articles; 107,766 Profile Views; 266 Posts

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OUxPhys has 4 years experience as a BSN, RN and specializes in Cardiology.

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I think telehealth is a good thing to a degree. It won't ever (and should never) replace a hospital stay if warranted but it at least saves you a trip to a MD office or urgent care (and possibly some money) or it can be used to advise you to go to your nearest ER if warranted. 

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juniper222 has 2 years experience and specializes in Pre Nursing.

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At the state of the art we have the Da Vinci system.  Although it requires a surgeon to be nearby, In the future, with the improvement of our networks, something like this could be transported to remote locations for life saving procedures. 

In the field of radiology, the use of AI to diagnose the images is in development.  The development of color X-rays is also on the horizon.

The future of medicine looks like it will be an exciting time!

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CharleeFoxtrot has 7 years experience as a ADN, RN.

629 Posts; 8,268 Profile Views

A form of Telehealth has been used in home health care in my area for at least 7 years. The tech is vastly improved over the first units which were the size of a small suitcase and quirky to work with. Now it's a tablet with blue tooth connected BP cuff, pulse ox and scale. These units are great teaching tools for CHF patients, and they record and send vitals to the central location. Weight, BP, pulse ox etc all have programmed parameters and a deviation will trigger an RN phone call to the patient. A nurse button instantly connects these patients to a live RN who can answer questions.

Overall a great system, wish we could have units like this permanently in the homes all my chronic CHF patients.

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