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DQ: Discuss some benefits and drawbacks of virtual care/telehealth particularly related to the collaboration and coordination of care and the role of the advanced registered nurse

DQ: Discuss some benefits and drawbacks of virtual care/telehealth particularly related to the collaboration and coordination of care and the role of the advanced registered nurse

DQ: Discuss some benefits and drawbacks of virtual care/telehealth particularly related to the collaboration and coordination of care and the role of the advanced registered nurse

NUR 514 Topic 8 DQ 2

DQ Discuss some benefits and drawbacks of virtual care telehealth particularly related to the collaboration and coordination of care and the role of the advanced registered nurse

Telehealth is the use of telecommunications technology that allows for health data collection and transfer, communication between providers and patients, allowing care to be provided to patient’s remotely despite of their location. Frey & Chiu (2021) mentions there are four methods of telehealth which include: synchronous or live video, store-and-forward, remote patient monitoring, and mHealth (mobile health). Synchronous or live video involves a two-way communication between a provide and a patient in real time. Store-and–forward is data and patient history collected by a provider which is stored and can later be obtained by another provider through a secure platform. Remote patient monitoring consists of using digital or electronic tools, that records patient’s health information, such as blood sugar and blood pressures, which can be transmitted automatically to a provider for review. Mobile health refers to the practice of medicine and public health aided by mobile devices such as mobile phones, tablets, personal digital assistants, and the wireless infrastructure (Innovatemedtec, 2021).

Virtual care is the channel by which healthcare providers communicate with their patients; it is the actual virtual visit that takes place between the healthcare team (MD, nurse, PT, etc.) and the patient. For virtual care to happen communication technologies, such as video, chat or phone are required. This allows patients to be connected to the quality care they need, when they need it most (Synzi, 2018).

Telehealth can be beneficial when coordinating care for patients. For example, surgical patients needing pre-surgical care and post-surgical care. Nurses can contact patients via e-mail, video conferencing, or the phone, to setup appointments, do post-op teaching, and check on how patients are doing once discharged home after surgery. An example mentioned by McGonigle & Mastrian (2017) is that virtual care allows a nurse to coordinate and complete 12-16 telehealth visits vs 7 visits by a conventional home health care nurse.

A drawback a nurse can encounter with telehealth, is not being able to do an actual physical examination. There may be instances

DQ Discuss some benefits and drawbacks of virtual care telehealth particularly related to the collaboration and coordination of care and the role of the advanced registered nurse
DQ Discuss some benefits and drawbacks of virtual care telehealth particularly related to the collaboration and coordination of care and the role of the advanced registered nurse

where a hands-on comprehensive physical assessment is important, which would require the patient to either go to the office or where a nurse would need to go to the patient’s home. Having to draw blood or the patient requiring radiology tests, and technical difficulties with technological devices, could also affect telehealth encounters.

Nurses need to be mindful of HIPPA regulations and remember they can only treat patients within the state they are licensed in when participating in telehealth (Frey & Chiu, 2021).

References

Frey, M.B. & Chiu, S.H. (2021). Considerations when using telemedicine as the advance practice registered nurse. The Journal for Nurse Practitioners, 17 (2021), 289-292). https://doi.org/10.1016/j.nurpra.2020.11.011

Innovatemedtec. (2012). What is mHealth? https://innovatemedtec.com/digital-health/mhealth

McGonigle, D., Mastrian, K. (2017). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning. ISBN-13:9781284121247

Synzi, L. H. (2018, June 8). Why virtual care is the “new” telehealth. https://www.healthitoutcomes.com/doc/why-virutal-care-is-the-new-telehealth-0001

 

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RESPOND HERE (150 WORDS, 2 REFERENCES)

I agree with you that the use of telehealth and virtual health platforms have resulted to increased access to healthcare. This came in as a very crucial alternative in the wake of the covid-19 pandemic where movement was restricted and patient had to continue with their medication and clinical procedures online (Monaghesh & Hajizadeh, 2020). The use of these technologies is advantageous in the sense that it saves time since the patient does not need to travel to the healthcare facility but can still access the required expert information and medical assistance from the comfort of the home. There major disadvantage of telehealth is lack of continuity of care especially where the client is using on-demand telehealth services, he or she maybe linked up at random to a healthcare provider who does not have history of the previous medical conditions or medication of the patient. This lack of coordinated care may prove to be dangerous to the patient as it can result to either omission or duplication of medical procedures (Kho et al., 2020). I do agree with you that the advanced practice nurses have a responsibility to ensure that they practice according to their areas of specialization and licensure. Additionally, the state mandated regulations should also be adhered to.

References

Monaghesh, E., & Hajizadeh, A. (2020). The role of telehealth during COVID-19 outbreak: a systematic review based on current evidence. BMC Public Health, 20(1). https://doi.org/10.1186/s12889-020-09301-4

Kho, J., Gillespie, N., & Martin-Khan, M. (2020). A systematic scoping review of change management practices used for telemedicine service implementations. BMC Health Services Research, 20(1). https://doi.org/10.1186/s12913-020-05657-w

Re: Topic 8 DQ 2

The terms telehealth or telemedicine, encompass real-time, audio-video communication tools that connect providers and patients in different locations; store-and-forward technologies that collect images and data that can be transmitted and interpreted later, and remote patient monitoring tools such as home blood pressure monitors (Balestra, 2018). Rules that define and regulate telehealth are evolving and vary greatly across states, so much that health care groups are issuing different guidelines about the standard of care that applies in telehealth encounters.

Distance and travel time between patients and care providers can limit access to care. Telemedicine can overcome geographic barriers to healthcare, especially for specialized providers. Telemedicine can be particularly beneficial for patients in medically underserved communities and those in rural geographical locations where clinician shortages exist. Telemedicine can improve the quality of care for patients with both medical and mental health conditions. With telemedicine, patients had fewer hospital admissions and readmissions, spent fewer days in the hospital, and were more engaged in their healthcare (Care Innovations, n.d.). For nurse practitioners (NP) who deal with patients in a variety of settings, telehealth can help improve healthcare delivery to underserved communities.

Telemedicine can increase efficiency of care delivery, reduce expenses of caring for patients or transporting to another location, and can even keep patients out of the hospital. A strong doctor-patient relationship is the foundation for high-quality patient care and reducing health care costs. Telemedicine should support, not replace, traditional care delivery. With telemedicine care providers can continue to care for patients in-person while still providing the flexibility and convenience of seeing patients remotely for follow up visits, check-ups, and education when appropriate or necessary. Telemedicine makes it easier and more convenient for patient to stay healthy and engaged in their health care (Care Innovations, n.d.). Patients love the convenience, flexibility and real-time care with their providers. For providers, telemedicine can improve job satisfaction by making it easier to meet the patients. Providers can use telemedicine to make it easier to balance their work and family life.

While telemedicine promises to grow rapidly, there are still some technical and practical problems for healthcare providers. Restructuring IT staff responsibilities and purchasing equipment takes time and costs money. Training is crucial to build the effective telemedicine program. All-staff and physicians need to be trained on the new systems. In cases where patients are using an on-demand telemedicine service, they are connected with a random healthcare provider, care continuity suffers. A patient’s primary care provider may not have access to records from those other visits and end up with an incomplete history for the patient. This increases the risk that a doctor won’t know a patient’s history or have notes about care routines (Bull, Dewar, Malvey, & Szalma, 2016). Because reduced care continuity can decrease care quality, telemedicine providers must apply sound data solutions to maintain adequate and accessible patient records. As more healthcare providers adopt telehealth to use with their own patients, especially during the current pandemic, care continuity will increase. Many providers worry about technical problems associated with telemedicine. Poor broadband connections could lead to possible patient mismanagement. Healthcare laws, reimbursement policies, and privacy protection rules struggle to keep up with this fast-growing industry. As a healthcare provider, best practices should still be followed when approaching telemedicine.

The rules and regulations addressing NP requirements differ from state to state, and this variability creates confusion for NPs involved in the practice of telehealth. Some of the most critical issues include; Licenses and credentialing. Typically, a nurse practitioner is licenses only in the state in which he or she practices medicine (Balestra, 2018). Telemedicine technology allows NPs to assess patients remotely and in a variety of settings, and could include patients located across state borders. The NP providing collaborative care must be licensed in the state the patient is located and be in collaborative practice with a provider in that state.

Major developments have been made to telehealth reimbursement over the past couple years, and even more since the start of the pandemic it still remains a common stumbling block for providers interested in telemedicine. While telemedicine still has some limitations, many healthcare providers are innovating to solve these issues and improve their patients’ access to quality care.

Telehealth can be an added benefit to healthcare when the planets are aligned, and things work together for good. With that being said, what happens when the opposite of great takes place? Technology glitches! Technology medicine has a far reach because physicians can be accessed remotely when patients need care that isn’t emergent, which saves patients time and money. Patients can communicate directly with physicians if questions regarding medication use arise. However, when using technology, there is always the possibility of losing connection in the middle of the conversation, not to mention the possibility of internet outages. The “old school” population may also struggle with navigating the software. Physicians that aren’t computer savvy tend to shy away from telemedicine. Another drawback would be the absence of physical assessments. Some physicians may prefer diagnosing in person over a computer (Mayo Clinic, 2020).

On the other hand, telehealth benefits include better outcomes for patients. Physicians can reinforce treatment plans remotely by checking in on patients more efficiently and quicker than with prolonged office visits. Physicians can also cut down on those showing up late to appointments and still demanding to be seen, which sets all the other patients with appointments back. Telehealth can also be beneficial for preventing no calls no shows because non-compliant patients can suffer grave consequences. Typically, the nurse’s role would be to ensure the telehealth cart is charged and ready for use. Also, the nurse must know when the calls are coming in to eliminate missed calls. Technology is constantly evolving, and if the changes are intended to improve patient care, then I support it.

Mayo Clinic. (2020, May 15). Telehealth: Technology meets health care. Mayo Clinic. https://www.mayoclinic.org/healthy-lifestyle/consumer-health/in-depth/telehealth/art-20044878