Telehealth is lowering the quality of healthcare according to the authors. While telehealth uses technology to expand access to care, it can replace traditional in-person treatment. This raises ethical concerns about patient privacy and integrity when records are electronic. It also questions physicians' ability to properly diagnose and treat patients remotely without physical exams or high-quality images. Overall, the increased use of technology in place of actual medical treatment may be causing lower standards of care in the US.

1. 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

2. 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.

3. 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.

4. 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.

5. 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)

6. 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.

7. 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

8. 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

9. 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.

10. 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.

11. 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

12. 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.

13. 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=c
onsumer&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
_Telehealth_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

14. 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

15. 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.

16. 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.

17. 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

18. 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

19. 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

20. 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.

21. 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.

22. 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.

23. 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.

24. 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/

25. 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.

26. 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.

27. 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.

28. 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.

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

30. 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.

31. 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.

32. 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.

33. 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

34. 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.

35. A Physician’s Responsibility
Juan Gonzalez Pineda
 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.

36. What is a Physician Responsible for?
Juan Gonzalez Pineda
 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.

37. Research Strategy
Juan Gonzalez Pineda
 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

38. What is an Acceptable Source?
Juan Gonzalez Pineda
 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

39. Reasons to Reject a Source
Juan Gonzalez Pineda
 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

40. Research Methodology
Juan Gonzalez Pineda
 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.

41. Statistical Data
Juan Gonzalez Pineda
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.

42. Conclusions
Juan Gonzalez Pineda
 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.

43. Bibliography
Juan Gonzalez Pineda
 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/

44. 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.

45. 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

46. 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

47. 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.

48. 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.

49. Research Methodology
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.

50. 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

51. 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/

52. 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.

53. Rebuttal
Tori Vanderheyden
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).

54. Research Strategy
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.

55. 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

56. Rejected articles
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/9780199917907.0
03.0001
• 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.

57. Research Methodology
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

58. 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

59. 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

60. 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

61. 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.

62. 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”.

63. Bibliography
Group #1
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Societal Drivers in the Applications of Telehealth. Telemedicine & e-Health, 14(9),
998-1002.
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issues. Prometheus, 25(4), 373-393. doi: 10.1080/08109020701689227
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disciplinaryactions-argue-national-telehealth-license/
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Respiratory Failure: A Randomized Control Trial. The Gerontologist, 52(4), 541-
522. doi: 10.1093/geront/gnr134

64. 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
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Manitoba. Telemedicine & e-Health, 20(5), 478-484. doi: 10.1089/tmj.2013.0161
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