CS120G Group 1 ODU

Telehealth:
Lowering the quality of care
Arisha Assaf, Kerry de Mello, Juan Gonzalez Pineda, Olivia Rominiyi, Tori Vanderheyden, and Samantha Weygandt
Group #1
Professor Rekha Gupta

What is Telehealth Care?
 Telehealth is the delivery of health-related services and information via telecommunications
technologies.
 This technology encompasses telephone calls, fax machines, electronic health records, mobile applications,
websites, robotic surgical machines, and online pharmacy systems.

Reasons for Research
 America is considered to be a leader in health care technology, but on average American’s spend
8% more on health care than other devolved nations.
 Despite the presence of technology and money spent annually American’s still have some of the
highest rates for heart disease, obesity, diabetes, cancer, and pregnancy complications.

Identifying the Problem
 When examining the reasons for poor health in American there seems to be a common
denominator- the presence of technology in place of actual medical treatment.
 This lead our research group to form the following thesis:
 Telehealth care is an emerging practice that is using technology in place of “traditional medicine”, the
presence of telehealth is causing a standard of lower quality health care.

Tackling the Topic
 Our research group examined each of these fundamental health areas to show how telehealth is
lowering the quality of health care:
I. History of Healthcare (Olivia Rominiyi)
II. Ethical Concerns (Samantha Weygandt)
III. Technology Concerns for Patients (Kerry de Mello)
IV. Physician Responsibility (Juan Gonzalez Pineda)
V. Government Interventions (Arisha Assaf)
VI. Rebuttal (Tori Vanderheyden)

Olivia Rominiyi
Olivia Rominiyi is a senior at Old Dominion University majoring in biological
sciences and music performance. She hopes to pursue careers in obstetrics
and music therapy. She currently volunteers at Sentara Leigh Hospital in their
Healing Notes program as one of their volunteer performers, performing
various arias and art songs for the benefit and enjoyment of patients. In
addition to her studies and volunteer work, Olivia is also professional
musician. She often works with the ODU concert Choir, Virginia Opera,
Tidewater Opera Initiative, the I. Sherman Greene Chorale, and the Cantabile
Project of Hampton Roads. In her spare time, Olivia enjoys reading, shopping,
travelling, performing, and stimulating conversations. Her portion of this
paper covers the background and history of telehealth. This topic interests her
because she plans to work in healthcare and telehealth is rapidly becoming a
standard way of administering healthcare.

Background on Telehealth
Olivia Rominiyi
 Telehealth is the delivery of health related services and information via telecommunication
technologies.
 Telehealth is an expansion of telemedicine which encompasses preventative, promotive, and
curative aspects
 Telehealth has direct and indirect effects all over the globe

History of Healthcare
Olivia Rominiyi
I. The background and history of Telehealthcare
A. Healthcare is the diagnosis, treatment, and prevention of disease, illness, injury, and other
physical and mental impairments in human beings.
1. Healthcare is delivered by practitioners in allied health, dentistry, midwifery-obstetrics, medicine,
nursing, optometry, pharmacy, psychology, and other car providers.
2. It refers to the work done in providing primary care, secondary care, and tertiary care, as well as
public health

History of Healthcare
Olivia Rominiyi
II. Telehealth is the delivery of health related services and information via telecommunication technologies.
A. The term telemedicine was coined in the 1970s by the American Thomas Bird and, literally translated, means “healing at a distance” (from Latin
“medicus” and Greek “tele”).
1. The actual origins of telehealth date back to the 20th century.
2. Willem Einthoven, a Dutch physiologist, developed the first electrocardiograph in his laboratory in Leiden. This is considered the first use of
health at a distance.
B.. Telehealth is an expansion of telemedicine which encompasses preventative, promotive, and curative aspects
C. This type of health administration can be done using several different commonly used technological devices.
1. Computers, laptops, webcams are some of the most commonly used devices.
a. Two complementary methods of transmitting data, images and sound can be differentiated
1. The live technique, where the health professional has direct video contact with the patient.
2. The store and forward technique, where information is acquired in one location and reviewed in another at a later stage.
D. Telehealth has direct and indirect effects all over the globe.
A. It affects the world medically.
B. It affects different areas of the globe financially.

Research Strategy
Olivia Rominiyi
 My research started with a simple Google search of our topic.
 I also had to research the technologies that help to improve telehealth and make it possible.
 I search various combinations of terms and phrases such as “telehealth,” “telehealthcare
technologies,” “telemedicine,” “telehealth in the 20th/21st century,” and “telehealth in recent years.”
 I also utilized the ODU library database which gave me several of the same results.

Methodology
Olivia Rominiyi
With an increase in telehealth use to expand healthcare access and curb costs, there is an interest in
knowing the return on investment percentages generated by healthcare organizations' application
of telehealth and telemedicine. The Healthcare Intelligence Network's second annual Telehealth and
Telemedicine e-survey conducted in September 2010 captured the nuts and bolts of telehealth
services offered by 111 healthcare organizations, including the ROI reported by organizations with
telehealth services

Statistical Chart
Olivia Rominiyi
As seen in the chart (which has been remade in
exact likeness due to being unable to copy and
paste it), the majority of healthcare organizations
find it to be too soon to calculate or give a rough
estimate of their ROI, mainly because it is still a
relatively new course of action in the medical
field.

Bibliography
Olivia Rominiyi
 Boulanger, B., Kearney, P., Ochoa, J., Tsuei, B. & Sands,
F. . (2001). Telemedicine: a solution to the followup of
rural trauma patients. Journal of the American College
of Surgeons, 192(4), 447-452. doi:
http://dx.doi.org/10.1016/S1072-7515(01)00796-7
 Brown, N. (2005). Telemedicne Coming of Age. from
http://tie.telemed.org/articles/article.asp?path=consum
er&article=tmcoming_nb_tie96.xml
 Darkins, A. C., M. . (2000). Telemedicine and Telehealth:
Principles, Policies, Performance, and Pitfalls. New York,
NY: Springer.
 Higgs, R. (2009). What is Telemedicine? , from
http://www.icucare.com/PageFiles/Tele-medicine
 Puskin, D., Johnston, B. & Speedie, S. . (2006).
Telemedicine, Telehealth, and Health Information
Technology. from
http://www.americantelemed.org/docs/default-
source/policy/telemedicine-telehealth-and-health-
information-technology.pdf?sfvrsn=8
 Reeves, R. K., M. (2014). Telehealth: Driving Adoption of
Virtual Visits. from
https://www.mevisit.com/mevisit/resources/MPLC_Tele
health_FINAL.pdf
 Strehle, E. S., N. . (2006). One hundred years of
telemedicine: does this new technology have a place in
paediatrics? Archives of Disease in Childhood, 91(12),
956-959. doi: 10.1136/adc.2006.099622

Samantha Weygandt
Samantha is a junior, biochemistry major with a minor in environmental health at Old
Dominion University. She is hoping to peruse a career as a doctor or as an
environmental health officer. Samantha is an undergraduate research assistant in the
pathology department at Eastern Virginia Medical School. She also volunteered as a
Child Life Assistant at The Children’s Hospital of the King’s Daughters. Samantha has
been a nationally certified and Virginia State Licensed Pharmacy Technician for four
years. She is recently married and in her spare time she likes to play with her two
dogs, do yoga, go to the beach, and cook. Her section of this paper covers the ethical
concerns of telehealth care and how it impacts patients’ quality of care. She is
interested in this topic because it relates to the medical field and the concern of
quality treatment control and both of these topics relate to her future career choices

Ethical Concerns of Telehealth
Samantha Weygandt
 The telehealth care field is an emerging practice of the medical field that is not pardoned from
ethical concerns.
 Ethical issues in this case are defined by if the physician does what is right (ethical) or what is wrong
(unethical).
 This section will examine the key ethical concerns with telehealth that prevent patients from
receiving the highest quality health care possible.

Areas of Concern
Samantha Weygandt
The highest areas of ethical concern are:
 Patient privacy involving electronic health records (EHRs)
 This includes breach in records that make patients vulnerable to identity theft and insurance fraud
 Physicians’ ability to adapt to new technology
 This includes image quality control that effects time needed and quality of health care administered
 Physicians’ access to approved, current treatment protocols
 This includes unreliable sources of treatment protocols available to physicians via the internet
 Patient integrity involving telepharmacy
 This includes patients lying through telehealth applications that allow access to dangerous prescription medications.

Research Strategy
Samantha Weygandt
 The first research strategy I used was to use search engines such as google and key terms to find
sources.
 This strategy returned many unreliable sources that I could not use for my research.
 The second research strategy I used was the one I used to tackle my topic.
 This strategy involved using search engines, google scholar, and data bases to return reliable sources.
 Key terms, subject headings, and advanced search options were used.
 Examples of key terms used:
 Telehealth technology negative impact
 Telehealth lower quality health care
 Telehealth ethical concerns

What is an Acceptable Source?
Samantha Weygandt
 An acceptable source is a source that is written by an author that is considered to be an expert or a
qualified individual within the scope of the work.
 An acceptable source will also contain:
 Non-biased stances
 Current information on the topic
 References that are clearly indicated and can be found for cross referencing
 Quantitative and qualitative data relevant to the topic

Reasons to Reject a Source
Samantha Weygandt
 When implementing a proper research strategy,
one will encounter many results that are not
acceptable sources for information.
 Sources that are rejected normally have these
qualities:
 Lack of information relative to the topic
 Out of date material
 Authors that are biased and write based on
personal opinion
 Lack of references or references with proper
credentials
Sources that were rejected:
 Fasano, P. (2013). Transforming Health Care: The
Financial Impact of Technology, Electronic Tools
and Data Mining. New York, NY: Wiley.
 Wang, J. (2013). Body Area Communications:
Channel Modeling, Communication Systems,
and EMC. Singapore: J. Wiley & Sons
 Wootton, R., Tait, A., & Croft, A. (2010).
Environmental aspects of health care in the
Grampian NHS regions and the place of
telehealth. J Telemed Telecare 16(4), 215-
220. doi: 10.1258/jtt.2010.00415

Research Methodology
Samantha Weygandt
 The sources that were used for this topic contained statistical data, literature review, and personal
interviews as methodology for their work.
 Statistical data: This included data containing patients’ concern for privacy, identity and insurance fraud
rates in America, image quality of medical testing, and prescription abuse in the telepharmacy field.
 Literature review: The authors of the sources that were used reviewed literature published on the ethical
concerns of telehealth. The literature that was reviewed were scholarly, peer-reviewed articles published in
renowned medical journals that contained protocols, statistical data, and personal interviews.
 Personal interviews: The interviews conducted by the authors were done to show how telehealth effects all
aspects of the medical field. Manuscript from physicians, patients, nurses, and other health care
professionals related to telehealth were used.

Analyzing Statistical Figures
Samantha Weygandt
 The following chart shows the statistical make up of the top
drugs that are prescribed unnecessarily and sold illegally using
telehealth care applications in Tennessee.
 The majority of the drugs, 85%, are CIII & CIV classed which have
high and moderate risk for dependency and abuse
o The majority is made up of Analgesics: Hydrocodone, Tramadol,
Buprenorphine; Benzodiazepines: Alprazolam, Diazepam, Lorazepam,
and Clonazepam; and gamma-Aminobutyric Acid-ergic Agonists:
Zolpidem.
o The other 15% are schedule CII drugs which have the highest risk
among legal drugs for abuse and dependency.
o These include morphine products and oxycodone products.
o These prescriptions are manipulated from physicians by patients
using telehealth technologies to avoid detection of drug seeking
behavior, to be able to pick up a valid prescription from a local office.

Conclusions
Samantha Weygandt
 Patient privacy:
 Patients are not comfortable with their physician’s
ability to keep their personal information safe. The
possible breach of security can cause patients to
discontinue treatment or to be dishonest; which
will lower their quality of health.
 Adapting to Technology:
 Physician’s that use low quality equipment and the
variance of technology between offices cause
inaccurate images and cause patients to
unnecessarily repeat procedures.
 Access to Information:
 Physicians that do not have access to reliable
information through telehealth risk the chances of
misdiagnosing or providing inappropriate
treatment. These issues risk for serious issues in
the patient’s health and malpractice risks for the
provider.
 Patient Integrity:
 The dishonesty of patients to obtain prescription
medications raises extreme concern for the
physician and the public. If patients obtain
prescriptions for criminal purposes it puts the
public at risk a higher amount of drug dependent
citizens and for higher death rates from overdose.

Overall Conclusions
Samantha Weygandt
 Based on the qualitative and quantitative data recovered, one can determine that ethical issues
present in telehealth care cause the quality of health care administered to patients to be low.
 If patients are receiving lower quality health care then America is at risk for more chronic health
problems, earlier mortality age, prescription drug abuse, and other concerning matters.
 Providers should examine if telehealth technology is really a useful tool in providing quality
treatment, or if it is done out of convenience.

Bibliography
Samantha Weygandt
 All of these sources are acceptable sources that fit into the criteria
stated earlier in the presentation
 Ethical Issue. (2014). Web Finance, Inc. .
 Darkins, A. C., M. . (2000). Telemedicine and Telehealth: Principles,
Policies, Performance, and Pitfalls (Vol. New York, NY):
Springer.
 Fleming, D., Edison, K., &Pak, H. (2009). Telehealth Ethics.
Telemedicine Journal and e-Health, 15(8), 797-803. doi:
10.1089/tmj.2009.0035
 Khoja, S., Durrani, H., Nayani, P., & Fahim, A. (2012). Scope of Policy
Issues in eHealth: Results From a Structured Literature Review.
Journal of Medical Internet Research, 14(1), e34. doi:
10.2196/jmir.1633
 Lawrence, O., Gostin, J., Turek-Brezina, J., Powers, M., Kozloff, R.,
Faden, R. & Steinauer, D. . (1993). Privacy and Security of
Personal Information in a New Health Care System. The
Journal of the American Medical Association, 270(20), 2487- 2493.
doi: 10.1001/jama.1993.03510200093038
 McCann, E. (2014). Four-year EHR breach raises eybrows.
Healthcare IT News. Retrieved from
http://www.healthcareitnews.com/news/four-year-ehr-
breach-raises-eyebrows
 Murphy, K. (2013). What's preventing telehealth use by mental
health providers? EHRintellegence.com. from
http://ehrintelligence.com/2013/06/06/what%E2%80%99s
-preventing-telehealth-use-by-mental-health-providers/
 Sarhan, F. (2009). Telemedicine in healthcare2: the legal and
ethical aspects of using new technology. NursingTimes.net.
from
http://www.nursingtimes.net/nursingpractice/specialisms
/management/telemedicine-in-healthcare-2-the-legal- and-
ethical-aspects-of-using-new- technology/5008068.article
 Varney, D. (2014). PRESCRIPTION FOR SUCCESS: Statewide
Strategies to Prevent and Treat the Prescription Drug
Abuse Epidemic in Tennessee. Retrieved from
http://tn.gov/mental/prescriptionforsuccess/

Kerry de Mello
Kerry de Mello is a senior English Education major at Old
Dominion University. This is her last class before she finishes her
undergraduate degree! She is an alumna of Delta Zeta Sorority,
where she held the positions of Secretary and President. She also
received New Member of the Year and Sister of the Year. She is
currently interning in Human Resources at XO Communications
and is loving it. In her free time, she loves to travel and spend
time with her family and 4 dogs. Kerry is responsible for the
patient accountability aspect because she is interested in that
side of medicine and how it effects the recipients of it.

Patient Accountability
Kerry de Mello
 Telehealth is a field that can lead to patient misuse, in more ways than one.
 Groups of today’s population are unable to use technology in the way that it is supposed to be
used.
 This section will examine how patients should or should not have the ability to cut out face to face
time with their doctors.

Research Strategy
Kerry de Mello
 When I started my research, I began with regular Google – this is normally what I use and has
always given me a good starting point.
 As I went further, I found that going through the library databases provided more quality
information.
 Google Scholar was able to give me full articles that provided a lot of information on various
aspects of the subject.

Acceptable Sources
Kerry de Mello
 I chose sources that were notable, like Mayo Clinic, which is a large national institution.
 I also chose sources that gave full conclusions and showed a variety in patients studied.

Kerry de Mello
 The sources that I used contained the following methodology:
 Literature Reviews
 Statistical Data
 Patient Satisfaction Polls
 Government Documents

Rejected Sources
Kerry de Mello
 I chose to reject sources that were not current because the field of technology has changed so
much and is changing still today.
 I also rejected sources that did not have credible looking websites or have other educational articles
listed as sources.

Technology Takeover
Kerry de Mello
 This graph shows that technology is making
its way into the medical field. Now doctors
and patients need to decide whether it should
be or not.

My Side
Kerry de Mello
 I believe that telehealth is something that is really important to people all over the country, of
varying ages and mindsets—after doing research, I understand why my group is against telehealth,
since there are so many drawbacks. From my standpoint, I think that there are a lot of benefits that
can help doctor’s offices keep up with larger hospital systems, go green without the waste of
paperwork (online systems), and maintain a better database of information since it would all be
online.

Bibliography
Kerry de Mello
Currel, R. U., C., Wanwright, P. & Lewis, R. . (2000). Telemedicine versus face to face patient care: effects on
practice and health care outcomes. from
http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD002098/abstract
HIN. (2010). Top Coordinators of Care Transitions. from
http://hin.com/healthcareperformancebenchmarks/category/healthcare-trends/
Koch, S. (2005). Home telehealth—Current state and future trends. from
http://www.ijmijournal.com/article/S1386-5056(05)00188-7/abstract
Staff, M. C. (2014). Telehealth: When technology meets healthcare. from
http://www.mayoclinic.org/healthy-living/consumer-health/in-depth/telehealth/art-20044878

Juan Gonzalez Pineda
Juan Alberto Gonzalez Pineda is a student at ODU who is majoring
in Biology. He is currently taking summer courses and plans to
eventually go to medical to become a physician. He is belongs to
the greatest branch of the military in the world, the United States
Navy. He serves as hospital corpsman, third class at Naval Medical
Center Portsmouth. His goal is to attend the military’s medical
school in Maryland. He is drawn to this project because it is in the
vein of his future and is a very interesting topic. He is responsible
for the topic concerning a physician’s responsibility when using
telehealth technology.

A Physician’s Responsibility
 Physicians are not easily convinced to embrace new technologies.
 The physician is not a one man show, they have a support system which is vital to their success and
sanity.
 The key to success is found by acquiring the correct type of technology for the best interests of the
patient and provider, as well as understanding the reality of what a physician was meant to do.

What is a Physician Responsible for?
 Implementing technology for quality, not to be for compensated!
Too many times a physician is accepting a program for money or incentives.
 Staying in their scope of practice
• Doctors should not be burdened by technology, it should assist them and allow them to stay in their scope of
practice- diagnosing and treating patients.
 Choosing technology based on reliable information, not information from people receiving commission.
• There are many great technological advances to medical professionals, but the correct ones must be chosen to be
beneficial to the physician and patient.

Research Strategy
 For my first search I used google and it provided some decent article, but nothing substantial.
 Too many unreliable sources.
 The second research strategy was using ODU library system which provided some good journals for my
second assignment.
 I also used Scholar, Google, and Ebscohost
 Keywords:
 physician responsibility
 eHealth responsibility
 physician telehealth

What is an Acceptable Source?
 An acceptable source is authored by someone who is considered a subject matter expert.
 An acceptable source will also contain:
 Non-biased stances
 Current information on the topic
 References that are clearly indicated and can be found for cross referencing
 Quantitative and qualitative data relevant to the topic

Reasons to Reject a Source
 I rejected many sources because of these
qualities:
Biased toward one point, negative or positive.
Out of date material
Scope is too broad or too narrow.
Too much personal information and not
enough data.
One sided
 Rejected:
 Klaz I., Wohl Y., Nathansohn N., Yerushalmi N.,
Sharvit S., Kochba I. & Brenner S. (2005).
Teledermatology: quality assessment by user
satisfaction and clinical efficiency. Israel Medical
Association 7(8), 487-490. Retrieved from:
http://www.ncbi.nlm.nih.gov/pubmed/1616 771
 Bravo, S., Valero, M., Pau, I., Duarte, J., Carrillo, M.
& Blandino, J. (2012). A Tele-Health
Communication System Underserved Children in
Rural Areas of Nicaragua. Special Bilingual Issue:
Research on ICT4D from Latin America 8(4).
Retrieved from:
http://itidjournal.org/itid/article/view/965

 The sources that were used for this topic contained statistical data, literature review, and personal
knowledge as methodology for the work.
 The statistics covered physicians who were polled for the figure used in the document.
 The authors of the articles covered were by subject matter experts and were representing very high profile
organizations.

Statistical Data
The chart to the left shows how many physicians had
purchased Electronic Health Record Systems in 2012. 32 %
don’t plan to in the next year. This source also demonstrates
on how some physicians and groups can get incentives for
participating in programs such as this. The majority of the
participants were under 50 and were part of a large group.

Conclusions
 Compensation: Physicians should be looking for technology that will help the patient the most, not
looking for compensation to use an inferior technological solution.
 A doctor should be a doctor, not a secretary, a technician, or anything in between. They went to
school to be a physician and they should allow their support system to assist them with any
technology burdens.
 The right technology is out there. Physicians need to make sure they are informed from reliable
sources before purchasing expensive equipment.

Bibliography
 Aetna. (2014). Health care professionals: RelayHealth FAQs. Retreived from
http://www.aetna.com/faqs-health-insurance/health-care-professionals-relayhealth- faqs.html
 Jamoom, E., Beatty, P., Bercovitz, A., Woodwell, D., Palso, K. & Rechsteiner, E. . (2012). Physician
Adoption of Electronic Health Record Systems: United States, 2011. Hyattsville, MD: Centers for
Disease Control and Prevention Retrieved from
http://www.cdc.gov/nchs/data/databriefs/db98.htm.
 Sein-Echaluce, M. (2014). How 3D Systems’ Medical Modeling Is Changing the Operating Room
for the Better. Retrieved from http://3dprint.com/10195/3d-printing-operating- room/

Arisha Assaf
Arisha Assaf is a senior at Old Dominion University majoring in Human Service.
She has a passion in caring for others, especially children. Arisha is a member of
the Sigma Alpha Lambda Honor Society. She also enjoys spending time with her
family and cleaning. Her passion and dream is to finish nursing school and
become a Pediatric Nurse, while traveling around the word caring for those in
need. Her interest in this group comes from her passion and love for others, as
well as her interest in continuing her education within the nursing field. Arisha’s
section of this paper covers the governmental interventions of telehealth and its
effects towards patient care.

Government Intervention
Arisha Assaf
 The advance of technology within the medical field has changed the spectrum of the delivery and
services.
 The reticence demonstrated by these organizations has created a proliferation of legal issues to
arise. As a result, the quality of care among the telehealth industry has decreased.
 This section will examine the effects of the governments’ interventions within telehealth and how it
effects its patients

Key Issues
Arisha Assaf
o The issues concerning privacy and confidentially related to HIPAA
• Prohibitions of neglecting to comply with HIPAA laws
• Limitations of HIPAA coverage
o The hindrance of the reimbursement laws within telehealth
• Laws presiding, thus hindering users and physicians from obtains excellent service
o The licensure prohibitions of clinicians
• Jurisdiction of states
• Licensure requirements
o The limitation of software usage
• Cost and setup of software
• Connectivity issues

Research Strategy
Arisha Assaf
 I began my research by gathering information from google by using keywords and phrases. As a
result, I obtained a variety of sources and website to read from. Due to the high range of websites,
I then decided to use the advance search method, which limited down the number of website to
chose from. Later, I used journal article relative to my topic and search through reference page for
other journals relative to the article.
 After obtaining my selected sources by using relative terms and keywords, I then constructed a
tentative outline which displayed questions or each subhead to remind me what to research. My
overall research strategy incorporated journal articles, books, and websites.

Rejected Sources
Arisha Assaf
Reasons for Rejection:
• Out of date
• unreliable references,
• not relevant to topic
McNeese-Smith, D. K. (1997). The influence of
manager behavior on nurses' job satisfaction,
productivity, and commitment. Journal of
Nursing Administration,27(9), 47-55.
Wootton, R. (2012). Twenty years of telemedicine
in chronic disease management an evidence
synthesis. Journalof Telemedicine
andTelecare,18(4), 211-220.

Arisha Assaf
• The sources used were derived from scholarly, peer reviewed articles, and website that contain
studies conducted by doctors and research analyst.
• These sources also contains data from presiding institutions dedicated in detecting the effects of
telehealth.

Statistical Data
Arisha Assaf
• The chart to the left shows the correlation of
cost among the set up on the software kiosks.
• This software can cost up to 300,000 without
insurance, however, the cost of rental,
telephone lines, and technical support is not
included.
• A telephone line can cost between $30 per
month to $360 per year

Bibliography
Arisha Assaf
Dreyzehner, J. (2014). What is HIPPA. from
http://health.state.tn.us/hipaa/
Fong, B. (2010). Telemedicine technologies electronic resourse:
Information technologies in medicine and telehealth. Chickster,
West Sussex, U.K.: John Wiley & Sons.
Gellis, Z. K., B., McGinty, J., Bardellie, E., Davitt, J. & Have, T. .
(2011). Outcomes of Telehealth Invervention for
Homebound Older Adults With Heart or Chronic
Respiratory Failure: A Randomized Controal Trial. The
Gerontologist, 52(4), 541-522. doi: 10.1093/geront/gnr134
Hughes, M. B., M., Larson, D. & Weems, J. . (2010). Telehealth
Reimbursment. from www.ruralhealthweb.org
Central, P. (2014). from
http://www.apapracticecentral.org/update/
2014/0424/skype-hipaa.aspx.
Dossel, D., Travers, H. & Hunter E. . (2007). The use of
touch-screen technology for health-related
information in indigenous communities: Some
economic issues. Prometheus, 25(4), 373-393.
doi: 10.1080/08109020701689227
Downey, R. (2014). Medical Board Disciplinary Actions
May Argue Against National Telehealth License. from
http://www.globalmed.com/telehealthansw
ers/medical-board-disciplinaryactions-argue-
national-telehealth-license/

Tori Vanderheyden
Tori is a full time student at ODU, majoring in Biology and will
graduate in the Fall of 2014. She is an alum of Zeta Tau Alpha on
campus and has held three executive position including First Vice
President. In the spring she will complete her certificate program
where she will earn her certification in molecular pathology/biology
and work in the field of Pathology. In her free time she likes to do
yoga and play with her new puppy! Her interest in this group topic
follows with her interest in the healthcare field specifically her use of
technology in pathology.

o The rising cost of health care has been a positive
influence in the development of Telehealth
Technologies.
o Telehealth Technologies would significantly decrease the
cost of care by decreasing the amount of time spent with
a doctor (Noel, 2004).
o Convenience of Telehealth on the consumer
o Disabled individuals find it very hard to commute to an
appointment and find the technology very effective in
maintaining their health from home (Turner, 2014).
o Working individuals have little time to spare and want to
spend that time with their families instead making them a
huge factor in the push for the new technologies (Charles,
2008).
o Government Involvement in the advancement of
Telehealth and Telemedicine Technologies
o Government agencies have created federal mandates
requiring healthcare facilities participate in electronic
health records (Brusco, 2012).
o Policy makers are in the process of creating federal law
and policies in support of telehealth technologies with
the aid of Government agencies such as the FDA
(Brusco, 2012).
Rebuttal
Tori Vanderheyden

• I began the search using Google to get a general idea of the subject and
find a more narrow target to research
• As I used the databases powered by ODU, I was able to find many peer-
reviewed articles that gave many different view of why Telehealth is
beneficial to the consumer.
• Google scholar also aided me in my search however the articles I found were
not as credible as the database search article.
Research Strategy
Tori Vanderheyden

• I will continue to use the ODU databases to find pertinent articles related to the overall effectiveness and
acceptance of Telehealth
• I plan to prove these statements by the following points
• Government Involvement in the advancement of Telehealth and Telemedicine Technologies
• The rising cost of health care has been a positive influence in the development of Telehealth Technologies
• Convenience of Telehealth on the consumer
Research strategy
Tori Vanderheyden

• Turner, L. (2013). Patient Mortality in
Medical Tourism: Examining News Media
Reports of Deaths Following Travel for
Cosmetic Surgery or for Bariatric Surgery.
Oxford University Press.
doi:10.1093/acprof:oso/9780199917907.003.
0001
• I rejected this book because it did not
support the view that telehealth is beneficial
to the consumer.
• PAGE, D. (2014). Telemed system speeds stroke care.
H&HN: Hospitals & Health Networks, 88(4), 16.
• This article was very interesting however it was not
written by an expert in the field and was featured in
a periodical. It was more of an opinion piece rather
than factual evidence.
• Peck, A. D. (2013). 5 tech trends that will affect the way you
practice medicine in 2013. Medical Economics, 90(5), 48-42.
• Although this article had interesting information about new
technologies in the telehealth world, it did not expand on the
impact it would have on consumers or policy adaptations.
• Sood, S., Mbarika, Victor., Jugoo, Shakina., Dookhy, Reena., Doarn,
Charles R., Prakash, Nupur., Merrell, Ronald C. (Novemeber 2007).
What is telemedicine? A collection of 104 peer-reviewed
perspectives and theoretical underpinnings. . Telemedicine & e-
Health, 13(5), 573-590. doi: 10.1089/tmj.2006.0073
• I rejected this article because it was simply an explanation of
telehealth with no new information.
Rejected articles
Tori Vanderheyden

Tori Vanderheyden
 The resources I used for my topic included sources that used quantitative and qualitative data such as:
 Literature Reviews
 Government Documents
 Research Articles
 Including data
 Populations
 Controlled Variables
 Satisfaction Polls
 Healthcare Protocols

Statistical Data
Tori Vanderheyden
*[This table is from the article “Home Tele-health Reduces
Healthcare Costs. It exemplifies the total cost of care for an
individual with Congestive Heart Failure. The 1st row of total
cost is the cost before health insurance is applied. The 2nd row
of total cost is the cost after insurance is applied which the
patient is required to pay out of pocket. The first and third
columns are number configured by patients who are using
tele-health technologies. The second and fourth columns are
those patients who are not using the technology. The study
showed a significant decrease in the total amount of care cost
between the pre-study groups which in turn exemplified the
cost to patient was a significantly less amount of money spent
on care when using tele-health applications. The post study
costs are much closer in price than the pre-study.]
Cost of health care for Congestive heart failure patients

Bibliography
Tori Vanderheyden
Brusco, J. (2012). Mobile health application regulations
and compliance review. AORN Journal, 95(3), 391-
394. doi: 10.1016/j.aorn.2011.12.010
Charles, R., Peter, Y., Deborah, A., Denny, L., Sally D., Glenn,
H. & Joseph, K. (2008). Societal Drivers in the Applications
of Telehealth. Telemedicine & e- Health, 14(9), 998-1002.
Control, C. f. D. (2013). Rising health care costs are
unsustainable. from
http://www.cdc.gov/workplacehealthpro
motion/businesscase/reasons/rising.html
Hanalon-Dearman, A., Edwards, C., Schwab, D., Millar, M.
& Longstaffe, S. . (2014). 'Giving Voice': Evaluation of an
Integrated Telehealth Community Care Model by
Parents/Guardians of Children Diagnosed with Fetal
Alcohol Spectrum Disorder in Manitoba. Telemedicne &
e-Health, 20(5), 478-484. doi: 10.1089/tmj.2013.0161
Noel, H., Vogel, D., Erdos, J., Cornwall, D. & Levin, F. (2004).
Home telehealth reduces health care costs. Telemedicne
Journal and E-health, 10(2), 170-183. doi:
10.1089/tmj.2004.10.170
Turner, A., Sloan, A., Kivlahan, D. & Haselkom, J. . (2014).
Telephone Counseling and Home Telehealth
Monitoring to Improve Medication Adherence: Results
of a Pilot Trial Among Individuals With Multiple Sclerosis.
Rehabilitation Psychology, 59(2), 136-146. doi:
10.1037/a0036322

Conclusion
Group #1
While it may seem that telehealth has benefits such as cost effective spending for patients,
convenience, and government assistance it still has many discrepancies that do not qualify it as a
comparable application in the medical field. The complications with telehealth support the argument
that technology in health care not only effects patients and physicians, but all of America. Many issues
have been presented in this paper that support the statement that the emerging practice of telehealth
is using technology in place of “traditional medicine”, which is causing a standard of lower quality
health care

Conclusion
Group #1
o Ethical concerns highlight negligent systems causing concern for identiy theft and insurance fraud,
patients using technology for ulterior motives, and physicians using technology without researching
its capability.
o Patient concerns highlight how certain groups such as the elderly and disabled are unable to
conform to technology and how dishonesty of patients through lower their quality of health.
o Physician responsibility concerns show that doctors are using telehealth to line their pockets, all
while burdening themselves with extra work. This extra work takes away time from in office visits
which effects patient health.
o Government intervention limits rural and disabled patients from receiving care and also limits
doctors reimbursement rates, causing many Americans to go without.

Conclusion
Group 1
Americans spend more on health care than any other developed country and many relate this to the
“technology used”. This technology has given America the highest rate of heart disease, diabetes, and
obesity. It seems that the technology in place has given many patients and physicians a “placebo
effect”, meaning they think they are doing something about their health by using technology, but
really they are receiving nothing. Telehealth technology is damaging America’s health care system,
physicians, and patients; which leads one to assume that “if it’s not broken don’t fix it”.

Bibliography
Group #1
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Drivers in the Applications of Telehealth. Telemedicine & e-Health, 14(9), 998-1002.
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Bibliography
Group #1
 Hanalon-Dearman, A., Edwards, C., Schwab, D., Millar, M. & Longstaffe, S. . (2014). 'Giving Voice':
Evaluation of an Integrated Telehealth Community Care Model by Parents/Guardians of Children
Diagnosed with Fetal Alcohol Spectrum Disorder in Manitoba. Telemedicine & e-Health,
20(5), 478-484. doi: 10.1089/tmj.2013.0161
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Bibliography
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Improve Medication Adherence: Results of a Pilot Trial Among Individuals With Multiple Sclerosis. Rehabilitation
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 Varney, D. (2014). PRESCRIPTION FOR SUCCESS: Statewide Strategies to Prevent and Treat the Prescription Drug
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