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.

Topic 6 DQ 2

May 19-23, 2022

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.

The Institute of Health Care improvement stated that telehealth could be very impactful with meeting the triple aim needs of the healthcare system by improving the health of the population and providing accessibility and reliability with practice care and decreasing the costs of healthcare to the population. Telehealth is defined as being able to use information electronically with telecommunications technologies to provide long-distance clinical care to a patient, provide, continue and maintain patient health-related education and manage health administrative services and public health (Alexander, Hoy, & Frith, 2019).

The Pros of Telehealth

The digital era has made it easy to integrate stored computerized information and transmit it through voice and video data at such a high speed to provide quick access care to local and remote areas lacking professional services. It has enabled the use of telehealth services such as remote access to patient information, videoconferencing, remote monitoring. It has also provided real-time applications with the care provided using live video synchronous conferencing. The information is recorded and documented immediately. It can also be stored and forwarded to the consulting physician later, such as with medical visits, or x-rays or photos of wounds. There is also the use of remote patient monitoring (RPM). This is the use of medical equipment’s at home and transmitted to the provider. And also, the mobile health (mHealth). This is using mobile technologies like smart phones, personal digital assistants, tablets (PDAs) to transmit information (Alexander, Hoy, & Frith, 2019). Successful implementation of digital health technology will be imperative for improving patient outcomes and ensuring financial stability for health care practices (American Medical Association. (2022). This electronic communication means the use of interactive telecommunications equipment that includes, at a minimum, audio and video equipment. Telemedicine is viewed as a cost-effective alternative to the more traditional face-to-face way of providing medical care (Center 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.

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. 

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

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.