DNP 805 Topic 6 DQ 2 Evaluate current implementation strategies for telehealth systems and provide an assessment of the pros and cons.

DNP 805 Topic 6 DQ 2 Evaluate current implementation strategies for telehealth systems and provide an assessment of the pros and cons.

DNP 805 Topic 6 DQ 2 Evaluate current implementation strategies for telehealth systems and provide an assessment of the pros and cons.

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Topic 6 DQ 2

Consider current telehealth strategies and alternatives. Evaluate current implementation strategies for telehealth systems and provide an assessment of the pros and cons. Identify a particular practice area (e.g., clinic, hospital, primary care site) and discuss how you as a health care leader might you implement a similar strategy in that area?

REPLY TO DISCUSSION

Consider current telehealth strategies and alternatives. Evaluate current implementation strategies for telehealth systems and provide an assessment of the pros and cons.

According to the Institute of Health Care Improvement, telehealth might have a significant impact on satisfying the healthcare system’s triple purpose demands by enhancing population health, offering accessibility and dependability with practice care, and lowering population healthcare expenditures. Telehealth is defined as the ability to use electronic information and telecommunications technologies to provide long-distance clinical care to a patient, to provide, continue, and maintain patient health-related education, and to manage health administrative services and public health (Alexander, Hoy, & Frith, 2019).

Telehealth’s Advantages

Digital technology has simplified the integration of stored computerized information and its transmission at such high speeds via speech and video data to provide immediate access care to local and rural areas lacking expert services. It has enabled telehealth services such as remote patient information access, videoconferencing, and remote monitoring. It has also provided real-time applications by utilizing live video synchronous conferencing. The data is recorded and documented as soon as possible. It can also be saved and later sent to the consulting physician, as with medical visits, x-rays, or wound images. There is also remote patient monitoring (RPM). This is the use of medical equipment at home and the transmission of data to a doctor. In addition, the mobile health (mHealth). This is the use of mobile technology, such as smart phones, personal digital assistants, and tablets (PDAs), to transfer information (Alexander, Hoy, & Frith, 2019). The successful implementation of digital health technology will be critical for improving patient outcomes and ensuring the financial stability of health care practices (American Medical Association) (2022). This electronic communication necessitates the use of interactive telecommunications technology, which consists primarily of audio and video equipment. Telemedicine is regarded as a less expensive alternative to traditional face-to-face medical care (Centers for Medicare and Medicaid Services (CMS)) (2021)

The Cons of Telehealth.

Patient privacy and security is one of the biggest concerns in the healthcare system. The system faces a lot of issues with providing and protecting patient privacy and patients have a right to protect their privacy. All means of communication for the patient care using telehealth must be compliant with the policies and standards of care and with the regulations of the Health Insurance Portability and

Accountability Act (HIPAA). The use of technology for older adult patients may create stress because they do not know how to use it. So, providers expecting them to use it and create stress to them is unethical. With telecommunications, there are issues with network downtime, wrong documentations, issues of passwords failures or resets. Sometimes the video and audio may not be clear and cause delays and frustrations. The portability of licensure for providers across several states is still an issue with telehealth. There is movement towards providing licensure across the Unites States for providers using telehealth (Alexander, Hoy, & Frith, 2019).

Identify a particular practice area (e.g., clinic, hospital, primary care site) and discuss how you as a health care leader might you implement a similar strategy in that area?

The clinical practice area that I will discuss is the hospital center. Some patients come to the ED and go through and triage and some directly via an ambulance and bypass physical triage and others are transfers from other hospitals. Sometimes with these situations, there is no updated family contact, phone numbers are wrong. Either the patient was unable to answer these questions, or they were confused and there was no family with them or sometimes, it is sad to say the registrants do not verify this information correctly and ask the patient is the emergency contact is the same or they do not ask at all. Sometimes, and emergency contact still on the face sheet has been deceased for several years or the emergency contact is no longer in contact with the patient, they may have moved away and their phone numbers are wrong. Sometimes these are not taken care of until the Case manager is working on that patient. I would implement a telehealth system that flags that information until it is resolved by admitting, nursing or case management so that it is not forgotten. It is a job for everyone even the physicians can help provide any information that they know.

Click here to ORDER an A++ paper from our Verified MASTERS and DOCTORATE WRITERS: DNP 805 Topic 6 DQ 2 Evaluate current implementation strategies for telehealth systems and provide an assessment of the pros and cons.

References:

Alexander, S., Hoy, H., & Frith, K. (2019). Applied clinical informatics for nurses (2nd ed.). Jones & Bartlett Learning.

American Medical Association. (2022, February 16). Digital health implementation playbook series. https://www.ama-assn.org/practice-management/digital/digital-health-implementation-playbook-series

Center for Medicare and Medicaid Services (CMS). (2021, December 1). Telemedicine. Medicaid.gov: the official U.S. government site for Medicare | Medicaid.

https://www.medicaid.gov/medicaid/benefits/telemedicine/index.html

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REPLY

Your post has been interesting. I share your concerns about missing demographic data. Demographic data is an issue everywhere globally where there has been incomplete data inputted and sometimes in an emergency to gain access to family member about adverse or life changing events, there is no contact information. Usually, the clients who are brought in unresponsive or with altered mental status their admission details can be sketchy especially if a family member is not present. Another area that is the medication reconciliation. I do agree that the system should be able to alert clinician when the data is incomplete. I know that in some systems, it will reflect as an incomplete task and some systems won’t allow the task to be signed complete if it is not filled out.

REPLY

Thank you for the post. I agree with you when you indicated that “patient privacy and security is one of the biggest concerns in the healthcare system.” This is an ongoing issue whether electronically, via phone, paper-based, or in person (verbal). HIPAA is widely used in the healthcare system in order to ensure that patients’ privacy is respected. Actually, if we think about it, respecting and observing one’s privacy should be our mission, because this is a way to continue our care to our patients. Stay safe .

REPLY

Telehealth system usage increased during the pandemic. Telemedicine provides a cost-effective option for healthcare versus in-person office visits. Centers for Medicare and Medicaid Services (CMS) allows states to determine if telemedicine is included in services provided. (Medicaid, nd). Implementing a telemedicine program would start with an assessment of the needs for the organization. Knowledge of how state and federal guidelines for CMS. The four domains of applications for telehealth consist of remote monitoring, mobile health, store, and forward applications, and real-time applications. (Alexander, et al. 2019)

Use of telemedicine in a clinical setting for patients with congested heart failure (CHF). My experience is that those participating in telemedicine post-hospitalization have decreased readmissions. CHF patients post discharged would be followed by a CHF Case Manager (CM). Through telemedicine (real-time), the case manager and the patient would go over vital signs, and weight, it provides a nurse to have eyes on the patient. Of course, there would have to be established protocols, education for patients, etc. CHF CM would not replace a doctor’s visit but as a 3-5 day follow-up post-discharge. Centers for Medicare and Medicaid Services provides a toolkit to guide in implementing a telehealth program. Prior to implementing a program, healthcare professionals must review state and federal rules and regulations, insurance company reimbursement, the ability of the organization to provide technical assistance, and organizational policy regarding obtaining vendors. An important thing to remember is to have stakeholder support and appropriate training for those involved.

Patients living with chronic disease conditions, such as patients with diabetes and/or heart condition, may be vulnerable to the COVID-19 disease and are therefore regarded as a high-risk population. In response to the health threat of a global pandemic, social distancing is a one of the key factors to slow the spread of COVID-19, with the result that follow-up medical visits have been changed from in-person to remote medical appointments. The current health systems have therefore adopted telemedicine with remarkable speed not only for Covid-19–related care but also for chronic disease management. Thus, electronic health (eHealth), telehealth, and/or telemedicine technologies have become ideal ways for medical visits in this era of communicable disease (Bitar & Alismail, 2021). The advantages of using such technologies in times of public health disasters/crises and pandemic situations have been well documented and therefore cannot be underestimated.

In my practice area of Long-term care, video chat or zoom conferences are identified for monitoring patients with chronic conditions such as heart failure, cancer (except Chemo sessions), cardiovascular, GI issues, etc. Most of the patients are elderly or have dementia, so the conference with specialty providers is done with the patient’s assigned nurse present to answer the provider’s questions.  However, there are barriers to telehealth. Some of these challenges include limitations with performing comprehensive physical examinations, possibilities for technical difficulties, security breaches, and regulatory barriers (Bitar & Alismail, 2021). For example, the physician just seeing the patient on facetime or zoom call does not utilize all the assessment techniques of palpation, inspection, percussion, and auscultation.

Moreover, vulnerability to security risks cannot be ruled out. Most telehealth platforms are highly encrypted and in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards and regulations, but no platform is 100% safe from hackers or data breaches. These challenges notwithstanding, telehealth remains an efficient and effective tool for improving health care access and outcomes (Gajarawala & Pelkowski, 2020).

 

References

Bitar, H. & Alismail, S. (2021).The role of eHealth, telehealth, and telemedicine for chronic …

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8060773

 

Gajarawala, S. N. and Pelkowski, J. N. (2020). Telehealth Benefits and Barriers

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7577680