Signature Essay Peer Review WorksheetFor this assignment, your o.docx

Signature Essay Peer Review Worksheet
For this assignment, your objective is to provide high-level
feedback to one of your fellow classmates that will help to
improve her or his final essay. Please completely fill out each
question in this worksheet to help your fellow student.
Name of the student whose essay youreviewed:
Your Name:
First,in three to five sentences, summarize the overall argument
addressed in this essay as well as how well you think this draft
meets the assignment requirements listed in the Signature
Assignment Instructions.
Next, answer each of the following questions using complete
sentences, addressing each question in its entirety, and
providing specific examples when possible.
Remember that you can give both positive and negative answers
to help highlight the best aspects of the essay and those areas
that need revision.
Content-Specific QuestionsCan you identify the main argument
being discussed?Can you identify the thesis statement? Does it
address the main points that the writer will be making in the
essay?At any point in the essay, can you identify the author’s
opinion on the controversy? If so, can you address where the
bias is revealed?Are the arguments for both sides equally
addressed?
OrganizationHow effectively does the introduction engage the
reader while providing an overview of the main argument? Can
you identify the topic sentences for each body paragraph? Be
sure to list any body paragraphs that do not appear to have topic
sentences.Does the paper effectively use transitions? Be sure to
point out any areas where a topic shift occurs that seems to be
abrupt.Is the conclusion effective? Does it summarize the main
points and bring the discussion to a logical and satisfying

ending?
Format
Does the essay use appropriate APA formatting, including
double-spacing, Times New Roman, 12-point font, 1" margins,
and appropriate paragraph indentations? Can you identify any
areas where outside sources appear to be used without including
in-text citations? Provide specific examples here. When in-text
citations are used, do they follow APA formatting?Does the
essay include the required eight sources?Can you identify any
issues with the reference page? If so, please provide specific
examples,
Grammar and MechanicsDoes the writer use proper grammar,
punctuation, and spelling? If not, please provide examples of
errors in need of correction.Is the writing clear and
comprehensible throughout the draft? If not, please provide
examples in need of improvement.
Three strengths of this version of this essay are:
Three aspects of this essay to work on before final submission
are:
Running head: TELE HEALTHCARE
1
Tele Healthcare

5
Tele Healthcare
Enrique Cateriano
Written Communications II
Jennifer Haber
West Coast University
08/12/18
Tele Healthcare
Approximately over 50 years of telehealth development has seen
tackling of numerous medical conditions through the utilization
of different types of technologies. Tele healthcare has been
associated with a wide variety of outcomes in the healthcare.
Despite the fact that it as shown great promise in the modern
times, it has also triggered a number of challenges for
interpretation and technical issues that are linked to the lack of
technological expertise among the healthcare practitioners. For
instance, then challenges that exist in defining such terms as
telehealth is a reflection of the broader difficulties when it
comes to the interpretation of the complex interplay that exists
between clinical output, patient involvement, service designs
and technology. Despite these significant challenges whose
impacts in the healthcare delivery is great, the significance of
telehealth practices cannot be overlooked in terms of the patient
outcomes and efficiency of healthcare delivery. Tele healthcare
has enhanced information sharing between patients and doctors
even those who are located in the remote areas. It has made it
possible to monitor the progress of patients within and outside
the facilities devoid of the need to have physical meetings. The
benefits of tele healthcare outweigh its pitfalls hence it is
important that is integrated into medical practices to optimize
patient outcomes.

Tele healthcare is depicted as personalized healthcare that is
delivered over a long distance such that data is transferred from
the patients to the professionals and back. It has played a key
role in enhancing feedback from the patients to the
professionals for the interest of evidence-based decision making
and treatment. For instance, the significance of telehealth can
be evident among the inpatients with severe long-term
conditions such as diabetes and long-term asthma. It has played
a key role in reducing hospital admissions without increasing
mortality.
Advantages of Tele Healthcare
There are numerous advantages of tele healthcare. To start with
is that it is powered by technology. Technological advancement
in the modern times has made it easy for various organizational
operations. Technological advancement has been adopted across
all spheres of life and healthcare is not an exemption. Creating
a balance between healthcare practices and technology is a key
requirement when it comes to the medical operations and
practices (Dorsey & Topol, 2016). The case of the importance
of tele healthcare can be witnessed in electronic health records
whereby a medical professional admits the patient and their data
is keyed in the system. This data is required in the entire
decision making process that concern the various approaches to
treatment.
In the nursing practice, the concept of evidence-based practice
has gained course with the increasing need to implement and
adopt it in the healthcare. As such, telehealth has played a key
role in eradicating the physical barriers that used to undermine
the treatment process. Specifically, the patients who do not need
to be admitted or readmitted to the nursing homes have a chance
to receive medical services while still at their homes (Lee &
Billings, 2016). They are monitored through the tele healthcare

approaches that facilitate the transmission of data from the
patients to the professionals and back. Long-term conditions
such as diabetes and asthma are claiming many lives in the
United States today.
According to Gulla (2018), approximately more than 100
million people are living with diabetes in the United States. The
Centers of Disease Control and Prevention has reported that
around 9.4% are living with acute diabetes in the United States
(Gulla, 2018). The basic question that comes herein is how tele
healthcare has played a major role in the delivery of health
services from the medical professionals to the patients
especially those in remote areas who have remained
underserved. The Centers of Disease Control and Prevention
have cited cost as one of the biggest challenges that have
undermined the remediation of the long-term conditions in the
country. The cost of treatment has been reduced significantly
with reduced physical meetings between the nurses and patients.
The patient have a chance to acquire medical assessment and
advice while at their homes without necessarily having to hold
physical meetings with the practitioners.
It is important to underscore the fact that tele healthcare is a
win-win situation for both the patients and medical
practitioners. This is because the pressure that has been piling
in nursing homes has reduced. According to Kaambwa et.al.
(2017), the key cause of medical errors in the nursing facilities
is high doctor-patient ratio. The focus on one patient has been
overlooked due to the huge populations of patients who visit
healthcare facilities every day. Tele healthcare has helped by
and large to remedy this challenge that has remained to be a
thorn not only in the nursing practice and in the entire
healthcare fraternity.
Timely information access is another advantage associated with
tele healthcare. It has helped the healthcare professionals to
have access to information at any given time and place provided

there is network coverage and the access is authorized. One of
the ways in which telehealth has helped to achieve this is the
integration of patient data. Hospitals have come together and
integrated their data for the interest of enhancing patient
outcomes. Medical professionals have, for instance, joined
associations that have reiterated the significance of having an
integrated system to enhance information access between the
patients and medical professionals. The patient with long-term
conditions could have special gadgets that they can use to make
important communications with the medical professionals in
which they are able to receive medical advice. This is one of the
practices that have played a major role in reducing mortality
rates and deaths associated with time lapses especially as a
result of delays between the occurrence of an emergency and
response time (Polinski et.al., 2016).
In tele healthcare, by a click of a button, one can be able to
access the history of the patients from the time of admission to
the subsequent treatments that they have been subjected to for
the interest of understanding the best medical approaches to
subject them to. The history of the patient includes data of the
previous treatments in other facilities for the same or different
diseases. This has been key in the decision making process in
the healthcare arena.
According to Hellen (2017), the primary interest of the
healthcare practices is to enhance patient outcomes and help the
patient to regain their health both in the short-term and long-
term. Take for instance the case of the Affordable Care Act. It
was enacted with the interest to enhance patient outcomes
through the provision of universal healthcare insurance,
efficiency in the standard procedures and practices of treatment
and more importantly reduction of costs. Tele health is among
major approaches that have bene established to increase
efficiency of healthcare delivery. In other words, when it comes
to the debate on the best practices in healthcare, the aspect of

time cannot be overlooked. In other words, the patient outcomes
of the treatment process also depend on the response time.
Some conditions such as diabetes trigger other related
conditions such as high blood pressure and inconsistent glucose
levels in the body. These are issues that if not resolved within
the shortest time possible could see patients even lose their
lives.
As mentioned above, the use of radiofrequency transmissions
and other related technologies has enabled the medical
professionals to understand the condition of the patients at any
given time. With this understanding, the treatment process has
been simplified real time because of the close coordination
between the patients and nurses. It should be noted that
information forms the primary basis of the treatment process. A
lack of information is an indication that the decision making
process will definitely be delayed which means that the
condition of the patient could worsen off by the time they are
attended to. The ability to fast-track the progress of the patient
has become key in resolving some of the key issues that affect
the patients with long-term conditions that have been claiming
many lives in the United States today.
Telemedicine has relieved the nursing homes of the burden to
provide round-the-clock care for the patients suffering from
complex medical conditions. As mentioned earlier, tele
healthcare has made it possible to gather data from the patients
which is further used in the decision making process. The
pressure that used to be witnessed in then healthcare facilities
has been eased significantly with the increasing need to enhance
outcomes and make the treatment process as efficient as
possible (Wade et.al, 2016).
Controversies Surrounding Tele Healthcare
In as much as tele healthcare has eased the treatment process

significantly, the has come another burden to the patient and the
nursing homes to get the necessary equipment to facilitate the
treatment process. It follows that according to Collins et.al,
(2017), the healthcare industry whether private or state
healthcare organizations are grappling with the challenge of
underfunding and budget deficits. It is important to underscore
the fact that the treatment process by use of telemedicine is also
increasingly technical. This is because of the technology that
comes in between the coordination of technology and delivery
of healthcare. Acquisition of the necessary equipment has
become a key challenge in the nursing practice.
The issue of network is also a challenge. This is especially for
the patients who reside in remote areas which are network
deprived. Then coordination of the technological gadgets that
are used in tele healthcare cannot work properly without proper
technological connections. Whenever there are mishaps in
information flows, the consequences of such a situation could
be dire. It follows that medical practitioners may be unable to
fast-track the condition of the patients in the short-term,
something that could lead to delayed care.
The culture of technical meetings with the patients has made it
difficult to adopt tele health in the nursing practice. For
instance, there are patients who are used to face to face
meetings with the medical professionals. There are others who
are not educated hence efficiency of treatment cannot be
overlooked in this equation of healthcare practice. The use of
technology for these parties could sound challenging especially
when it comes to interpreting the various indications of the
gadgets. This is a key challenge that has significantly
undermined the treatment process.
Possible Challenges when Using Tele Healthcare
Network and level of education are key challenges when using

tele-healthcare. Network is required in the transmission of
information from the patients to the medical professionals and
back. The challenge of network is especially witnessed in the
remote areas. The level of education has impact on how
efficient the technology gadgets are in helping the patients to
transmit data and any inquiries to their respective facilities.
Other issues include the level of training, cultural
competencies, resource availability among others.
Technology Contributions to Healthcare
The contributions of technology to the healthcare are both
positive and negative. The positive significance of technology
include reduced costs, enhanced information sharing, efficiency,
accuracy, speedy treatments, emergency responses, reduction in
workloads among the medical professionals among others.
Misdiagnosis is a primary challenge undermining the healthcare
practices. Any case of misdiagnosis is inherited in the entire
treatment process. Other challenges include lack of standard
practices in then healthcare to facilitate tele health services.
In conclusion, tele healthcare has extended its beneficial aspects
to different sets of capacities including patients, providers,
communities and government. Patients are no longer required to
travel to distant specialists to acquire medical attention. This is
being done conveniently in their homes. Circuit riding
specialists using tele healthcare approaches are saving
substantial amounts of time. Some of the challenges associated
with it include technical problems, safety concerns such as
confidentiality and data losses and interface problems. The
benefits, however, outweigh the challenges by a large margin.
References
Collins, A., Burns, C. L., Ward, E. C., Comans, T., Blake, C.,
Kenny, L., ... & Best, D. (2017). Home-based telehealth service

for swallowing and nutrition management following head and
neck cancer treatment. Journal of telemedicine and
telecare, 23(10), 866-872.
Dorsey, E. R., & Topol, E. J. (2016). State of telehealth. New
England Journal of Medicine, 375(2), 154-161.
Gulla, V. (2018). Telehealth networks for hospital services:
New methodologies. Hershey, PA: Medical Information Science
Reference.
Helen, M. (2017). Fundamental aspects of long term
conditions: A handbook for students of nursing and health.
London: Quay Books, a division of MA Healthcare.
Kaambwa, B., Ratcliffe, J., Shulver, W., Killington, M., Taylor,
A., Crotty, M., ... & Kidd, M. R. (2017). Investigating the
preferences of older people for telehealth as a new model of
healthcare service delivery: A discrete choice
experiment. Journal of telemedicine and telecare, 23(2), 301-
313.
Lee, A. C. W., & Billings, M. (2016). Telehealth
implementation in a skilled nursing facility: case report for
physical therapist practice in Washington. Physical
therapy, 96(2), 252-259.
Polinski, J. M., Barker, T., Gagliano, N., Sussman, A., Brennan,
T. A., & Shrank, W. H. (2016). Patients’ satisfaction with and
preference for telehealth visits. Journal of general internal
medicine, 31(3), 269-275.
Wade, V. A., Taylor, A. D., Kidd, M. R., & Carati, C. (2016).
Transitioning a home telehealth project into a sustainable,
large-scale service: a qualitative study. BMC health services
research, 16(1), 183.
HIV ROUGH PAPER
Criminalizing HIV non-disclosure laws were first established in
the 1990s before a clear understanding of HIV and HIV

transmission. In the beginning of the HIV crisis, HIV was being
transmitted at high rates. Lawmakers believed that by making
criminalizing laws that it would increase HIV non-disclosure
rates. However, because the laws targeted people with HIV fear
was created by people with HIV of being prosecuted. Instead of
people disclosing their HIV status, they failed to get tested and
didn’t disclose their status to anyone. Over the past thirty years,
the criminalizing HIV has not shown to have no impact on HIV
transmission. Medication available today has been studied and
shown to decrease transmission rates and even stop new
transmission of HIV to people who are HIV negative.
In the past thirty years, the HIV epidemic has impacted
individuals on a global level. In the beginning of the HIV crisis,
many people were being infected with the deadly disease. In
1981 the first person was diagnosed with HIV (CDC, 2018).
Within two decades, the disease had spread to thousands of
people. Thousands of men, women and children were being
infected and diagnosed with HIV. Because the disease was
spreading at an alarming rate, the government decide to
implement a law regarding HIV transmission. In 1990, the first
criminalizing HIV non-disclosure law was established.
According the Center for Disease Control, “these laws impose
criminal penalties on people living with HIV who know their
HIV status and who potentially expose others to HIV” (CDC,
n.d.). The laws may have been intended to stop the transmission
of HIV, however that purpose was not achieved. The
criminalizing HIV law installed fear and contentment for people
with HIV. Instead of helping and educating people with HIV,
the law made people infected with HIV hide in fear of being
prosecuted for having the disease. In men clinic, a questionnaire
conducted by Kesler, Kaul, Loutfy, Myers, & Brunetta
involving HIV testing. Of those questioned, 73% of the
participants stated that they were scared of being put in jail for
not disclosing their HIV status (Kesler, 2018). In another
research involving women with HIV, the authors states “women
may delay disclosure to sexual partners due to fear of stigma”

(Patterson, Milloy, Ogilvie, Greene, Nicholson, Vonn, Hogg,
Kaida). The fear of repercussions of jail time must be removed
from the HIV communities to aide in disclose. Communities are
put at risk when people with HIV fail to disclose their HIV
status. The current HIV criminalizing laws are based on
outdated information. HIV non-disclosure laws doesn’t
incorporate prevention measures, new medication available or
the use of condoms (Lehman, Carr, Nichol, Ruisanchez, Knight,
Langford, Gray, & Mermin, 2014). To reduce fear in the HIV
community, to increase HIV testing and decrease HIV
transmission the criminalizing HIV law should be eliminated as
law prosecuting HIV individuals.
“For the past three decades, legislative approaches to
prevent HIV transmission have been used at the national, state,
and local levels” (Lehman, 2014). In the United States, 32 states
have criminalizing HIV non-disclosure laws. The current laws
are formatted from information and statists from the 1990.
According to Stackpool-Moore a person that knows their HIV
status and engages in irresponsible or careless behavior can be
subjected to criminal misconduct and placed in jail (Stackpool-
Moore, 2013). Under the criminalizing HIV laws, an individual
with HIV can be imprisoned for risky behavior such as spitting
on a person. Even though saliva has been ruled out as a risk for
transmitted HIV, HIV-positive people can face jail time for
spitting. A person with HIV can be prosecuted for a
misdemeanor or felony depending on the states the act occurred
in. For example, in North Carolina and Maryland a person that
fails to disclose their HIV status can be charged with
misdemeanor (Lehman, 2014). In other states the person can
face up to ten years in prison for not disclosing HIV status.
States are using outdated information related to HIV. In Canada,
if a positive HIV individual is convicted under their
criminalization law, they can face up to life in jail and listed on
the National Sex Offender Registry (Patterson, 2015).
Consequently, people with HIV are being targeted by these

outdated laws. “Arguing against the criminalizing HIV law,
some health commentators believe the laws undermine U.S.
public health efforts to prevent further infections” (Hanrsono,
Galletly, O’Keefe, & Lazzarini, 2017).
Fear of incarceration continues to deter individuals with HIV
from essential testing. In order for an individual to receive
medication for HIV, they must be tested first. Many individuals
know the law exist and fail to get tested because of it.
According to Kesler, because individuals are afraid of the
criminalizing HIV law they are refusing to get tested and
putting thousands of people at risk for HIV transmission. So, if
fear is what is stopping individuals from testing shouldn’t the
fear be removed. The criminalizing HIV laws has placed fear in
the communities instead of promoting health as once believed.
In an article written by Grace the author states, “ there is no
scientific evidence to suggest that a positive correlation exists
between the law prevalence of HIV in a country and the use of
the criminal law” (Grace, 2015). Eliminating the criminalizing
HIV non- disclosure law, could increase HIV testing. Testing is
an important aspect to decreasing HIV transmission. Knowing
their HIV status could decrease transmission rates.
Communities HIV transmission rate decline with each test
performed on at risk individuals. The criminalizing HIV laws
were established without considering medication that could
reduce transmission of HIV and even prevent the transmission
of HIV.
Currently there are several antiviral medications available to the
community to reduce HIV. Treatment of antiretroviral
medication has shown to slow down the probability of
contracting HIV. According to the CDC, antiretroviral HIV
regimen helps individual with HIV live longer and healthier
lives. In addition, individuals are now being offered medication
that can stop the transmission of HIV. Pre- exposure
prophylaxis (known as PreP) is a medication that is given to
people that do not have HIV but at risk for contacting the

disease. The CDC further states the medication PreP works by
keeping the virus from becoming a permanent infection. If
people are risk for HIV or that have HIV begin treatment
regimens to stop the disease, why does the law still criminalize
them? Criminalizing HIV does not promote intake of medication
or preventive medication. Promoting healthy habits by
individuals with is why the law was started however, that is not
the circumstances at the present.
In conclusion, laws that criminalize individuals because of their
HIV status is not supporting positive health in the society. As
stated by Lazzarini, Galletly, Mykhalovaskiy, Harsono,
O’Keefe, Singer, & Levine, “ concerns remains that these laws
are often used to punish behavior that poses little or no risk of
transmission and may have negative impacts on public health
practices and efforts to reduce HIV infections” (Lazzarini,
2013). Studies have shown over the past thirty years that
preventive measures and the right medication can prevent the
spread of HIV. If HIV transmission rates can be decreased with
medication and HIV transmission can even be stopped does
society really need laws criminalizing HIV individuals? With
new and current technology and medication being study, HIV
can be eradicated. The criminalizing HIV law may have worked
in the beginning however, now they are outdated and only
elicits fear in the HIV communities.
References
CDC. (n.d.). Retrieved August 12, 2018, from HIV- Specific
Criminal Laws:
https://www.cdc.gov/hiv/policies/states/exposure.html
Grace, D. (2015, July). Criminalizing HIV transmission suing
model law: troubling best practice standardizations in the global
HIV/AIDS response. Critical public health, 25(4), 441-454.
Retrieved July 9, 2018, from
http://dx.doi.org/10.1080/09581596.2015.1049121

Harsono, D. G. (2016). Criminalization of HIV Exposure: A
Review of Empiricals Studies in the United States. AIDS Behav,
21, 27-50. doi:10.1007/s10461-016-1540-5
Kesler, M. K. (2018, January). Posecution of non-disclosure of
HIV status: Potential impact on HIV testing and transmission
among HIV-negative men who have sex with men. PLOS ONE;
San Francisco, 13(2). doi:10.1371/journal.prone.0193269
Lazzarini, Z. J. (2013, August). Criminalization of HIV
Transmission and Exposure: Research and Policy Agenda.
American Journal of Public Health, 103(8). Retrieved August 7,
2018, from
web.ebscohost.com.westcoastuniversity.idm.oclc.org/ehost/pdfv
iewer/pdfviewer?vid=18sid=d6eob118
Lehman, S. C. (2014). Prevalance and public health implications
of state laws that criminalize potential HIV exposure in the
United States. AIDS AND, 18(6), 997-1006.
doi:10.1007/s10461-014-0724-0
Patterson, S. M.-J. (2015, December). The impact of
criminalization of HIV non-disclosure on the healthcare
engagement of women living with HIV in Canda: A
comphrensive review of the evidence. Journal Of The
International AIDS Society, 18(1). doi:10.7448/IAs.18.20572
Stackpool-Moore, L. (2013, June). The intention may not be
cruel...but the impact may be: understand legislators' motives
and wider public attitudes to a draft HIV Bill in Malawi. Sexual
Transmitted Infections; London, 89(4), 285.
doi:10.1136/sextrans-2012050976

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