Issues and Trends in HBI Ch25 pp

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Issues and Trends in HBI Ch25 pp

  1. 1. Handbook of Informatics for Nurses & Healthcare Professionals Fifth Edition CHAPTER 25 Telehealth Handbook of Informatics for Nurses & Healthcare Professionals, Fifth Edition Toni Hebda • Patricia Czar
  2. 2. Learning Outcomes1. Define the term telehealth.2. List the advantages of telehealth.3. Identify equipment and technology needed to sustain telehealth.4. Discuss present and proposed telehealth applications.5. Describe legal and practice issues that affect telehealth. Handbook of Informatics for Nurses & Healthcare Professionals, Fifth Edition Toni Hebda • Patricia Czar
  3. 3. Learning Outcomes6. Review the implications of telehealth for nursing and other health professions.7. Identify several telenursing applications.8. Discuss some issues pertaining to the practice of telenursing. Handbook of Informatics for Nurses & Healthcare Professionals, Fifth Edition Toni Hebda • Patricia Czar
  4. 4. Telehealth• The use of telecommunication technologies and computers to exchange healthcare information and to provide services to clients at another location, previously known as telemedicine. Handbook of Informatics for Nurses & Healthcare Professionals, Fifth Edition Toni Hebda • Patricia Czar
  5. 5. Telehealth Services• Health promotion• Disease prevention• Diagnosis• Consultation• Education• Therapy• Decision support Handbook of Informatics for Nurses & Healthcare Professionals, Fifth Edition Toni Hebda • Patricia Czar
  6. 6. Related Terms• Telenursing—use of computer technology and telecommunications for the delivery of nursing care• E-care—provision of health information, products, and services online as well as the automation of administrative and clinical aspects of care delivery• E-health—term used interchangeably with e-care Handbook of Informatics for Nurses & Healthcare Professionals, Fifth Edition Toni Hebda • Patricia Czar
  7. 7. Telehealth Services• The development of telehealth is creating new areas of specialization within the healthcare disciplines. Handbook of Informatics for Nurses & Healthcare Professionals, Fifth Edition Toni Hebda • Patricia Czar
  8. 8. Delivery Mechanisms• Teleconferences and videoconferences are the predominant methods to deliver telehealth services – Persons at different sites have video and/or video contact• May also rely upon remote monitoring Handbook of Informatics for Nurses & Healthcare Professionals, Fifth Edition Toni Hebda • Patricia Czar
  9. 9. Historical Background• Began with telephone consults• U.S. government−sponsored efforts – NASA – Military – Indian Health Services – Grant monies• State-sponsored efforts – Healthcare for inmates Handbook of Informatics for Nurses & Healthcare Professionals, Fifth Edition Toni Hebda • Patricia Czar
  10. 10. Historical Background• Interest declined with a decrease in funding during the 1980s• Technical developments in recent years makes telehealth feasible• The military developed applications that feed images from the battlefield for the treatment of casualties and robotics equipment for surgery Handbook of Informatics for Nurses & Healthcare Professionals, Fifth Edition Toni Hebda • Patricia Czar
  11. 11. FIGURE 25–1 Diagram of a teleconference involving client, nurse, and physician at separate sites Handbook of Informatics for Nurses & Healthcare Professionals, Fifth Edition Toni Hebda • Patricia Czar
  12. 12. Telehealth Funding Sources• U.S. Departments of Defense, Commerce, Agriculture, Education, Justice, Health and Human Services, Veterans Affairs, and the Department of Homeland Defense• Private, nonprofit groups – Center of Excellence for Remote and Medically-Underserved Areas (CERMUSA) – The Acumen Fund Handbook of Informatics for Nurses & Healthcare Professionals, Fifth Edition Toni Hebda • Patricia Czar
  13. 13. Key Legislation• 1991 Rural Development Act laid technical groundwork• Telecommunications Act of 1996— allowed vendors of cable and telephone services to compete in each others’ markets• Snowe–Rockefeller Amendment— limited telecommunication charges for rural providers to help make care affordable for rural residents Handbook of Informatics for Nurses & Healthcare Professionals, Fifth Edition Toni Hebda • Patricia Czar
  14. 14. The Scope of Telehealth• The United States led in the development of technologies that enable telehealth• Current world leaders in the use of telehealth: – Australia – Canada – Norway – Sweden Handbook of Informatics for Nurses & Healthcare Professionals, Fifth Edition Toni Hebda • Patricia Czar
  15. 15. The Scope of Telehealth• Telehealth services have proven particularly useful in sparsely populated areas or regions in which travel is difficult – Extreme weather conditions – During disasters – Great distances and time for travel Handbook of Informatics for Nurses & Healthcare Professionals, Fifth Edition Toni Hebda • Patricia Czar
  16. 16. Driving Forces• Patient safety • Means to improve• Cost containment access to care• Managed care • Means to improve• Disease the quality of care delivered management Handbook of Informatics for Nurses & Healthcare Professionals, Fifth Edition Toni Hebda • Patricia Czar
  17. 17. Driving Forces• Emphasis upon • Means to deal with keeping an aging shortages of population certain types of functional in their healthcare own homes as long providers as possible Handbook of Informatics for Nurses & Healthcare Professionals, Fifth Edition Toni Hebda • Patricia Czar
  18. 18. Realization of Cost Savings• Earlier care with fewer costly interventions• Decrease costs for care delivered in the community• Increase quality and continuity of care Handbook of Informatics for Nurses & Healthcare Professionals, Fifth Edition Toni Hebda • Patricia Czar
  19. 19. Realization of Cost Savings• Increase record quality• NP and PA use extends physician access• Providers spend less time in travel and more in delivery of care Handbook of Informatics for Nurses & Healthcare Professionals, Fifth Edition Toni Hebda • Patricia Czar
  20. 20. Additional Benefits• Centralized health records—clients remain in the same healthcare system• The consumer becomes an active member of the healthcare team• Collaboration among professionals• Improved decision making• Access to electronic resources• Education of consumers and professionals Handbook of Informatics for Nurses & Healthcare Professionals, Fifth Edition Toni Hebda • Patricia Czar
  21. 21. Marketing• The delivery of telehealth services serves as a marketing tool.• Large facilities providing telehealth services typically provide links with the understanding that they will render additional services at their institutions.• Telehealth services also attract new staff. Handbook of Informatics for Nurses & Healthcare Professionals, Fifth Edition Toni Hebda • Patricia Czar
  22. 22. Legal and Privacy Issues• Reimbursement and licensure issues – Medicaid reimbursement—discretion of states – Balanced Budget Act of 1997—payment for some services – SCHIP Benefits Improvement and Protection Act of 2000 – Need for professional licensure in both sites Handbook of Informatics for Nurses & Healthcare Professionals, Fifth Edition Toni Hebda • Patricia Czar
  23. 23. Legal and Privacy Issues• Concerns over privacy• Liability Handbook of Informatics for Nurses & Healthcare Professionals, Fifth Edition Toni Hebda • Patricia Czar
  24. 24. Nurse Licensure Compact (NLC)• Participating states “recognize” the licensure of the original state in which the nurse practices, eliminating the need to be licensed in the second state• Currently recognized in approximately half of the states• Supported by the National Council of State Boards of Nursing Handbook of Informatics for Nurses & Healthcare Professionals, Fifth Edition Toni Hebda • Patricia Czar
  25. 25. Other Telehealth Issues• Lack of standards• Need for technical support• Lack of available infrastructure• Accreditation and regulatory requirements• Homeland security• Limitations• Lack of funding Handbook of Informatics for Nurses & Healthcare Professionals, Fifth Edition Toni Hebda • Patricia Czar
  26. 26. Establishing Telehealth Services• Part of the organization’s strategic plan• Development of a telehealth plan• Building the infrastructure and purchasing equipment• Buy-in from healthcare professionals• Training for healthcare professionals• Technical support Handbook of Informatics for Nurses & Healthcare Professionals, Fifth Edition Toni Hebda • Patricia Czar
  27. 27. Telenursing• Uses: – Telephone triage – Follow-up calls – Checking biometric measurements – Education – Consultations – Patient assessment – Electronic house calls Handbook of Informatics for Nurses & Healthcare Professionals, Fifth Edition Toni Hebda • Patricia Czar
  28. 28. Major Growth Areas• Homecare: – Monitoring – Prompts to take medications – Prompts for appointments – Smart homes – Robots• Disease management: – Reduce frequency of admissions and number of hospital days Handbook of Informatics for Nurses & Healthcare Professionals, Fifth Edition Toni Hebda • Patricia Czar
  29. 29. Telenursing Resources• International TeleNurses Association (ITNA)• The American Nurses Association Core Principles on Telehealth• American Academy of Ambulatory Care Nursing, Telehealth Nursing Practice Standard, 4th ed. Handbook of Informatics for Nurses & Healthcare Professionals, Fifth Edition Toni Hebda • Patricia Czar
  30. 30. Future Directions• Telehealth is expected to change the way that healthcare is delivered and create new roles for providers.• The role of the healthcare consumer is also evolving with the development of telehealth applications.• Telehealth offers the means to help keep an elderly population independent in their own homes. Handbook of Informatics for Nurses & Healthcare Professionals, Fifth Edition Toni Hebda • Patricia Czar

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