In today’s technological savvy society, people have become increasingly dependent on computers. They use computers to gain and manage a plethora of information. In recent years, healthcare websites have been utilized abundantly. With rising healthcare costs, many prefer to self-treat. They may refer to one of the healthcare websites and then make a visit to their local pharmacy. This makes receiving the care needed quick and easy-which is one of the objectives of telenursing. Traditionally, when a person said he/she was going to see a nurse it meant that one had to go to a local healthcare facility. In the technologically advanced times of today, seeing a nurse can mean something totally different. Nurses can now administer care from the comfort of their own home to a patient that is in the comfort of their own home. Telenursing is a subsidiary of telehealth that focuses on delivering, managing, and coordinating the healthcare services by means of telecommunications technology. Telehealth uses a variety of telecommunications technology via computers and telephones to provide healthcare services and information to patients who are located at a different site. Telenursing has existed to a certain extinct for about 35 years. The first recorded use of telenursing was done by Mary Quinn in 1974. She reportedly documented her care of patients at Logan Airport via telemedicine while working for a hospital in Massachusetts. Much has changed in the world of technology since 1974. Today, telenurses are monitoring patients with chronic diseases, helping patients manage their symptoms, and coordinating care for patients. Any nurse or healthcare provider who has provided guidance, educational information, or lab results over the phone or via internet has provided telenursing services. Nonetheless, telenursing can be more complicated than talking over the phone or sending a patient an email. Telenurses may use two-way audio or video systems, satellites, or any other means of communicating with a patient. Telehealth is an optimal way to provide healthcare services to patients who otherwise would be unable to receive adequate services.
What is Telenursing/Telehealth?
According to the Health Resources and Services Administration, “Telehealth is the use of information and communication technology (ICT) to deliver health services, expertise and information over distance. It includes Internet or web-based e-health and video-based applications, and can be delivered real-time (live) or through store-and-forward (record now, view later) mode”. Wheeler says that telehealth is changing the way people think about and provide healthcare services around the world. Telehealth is making innovations in health possible by delivery of healthcare educational information, such as access to medical records by patients. He finally says, “It is a unique global tool which has the capability to cross all existing geographical, temporal, political, social and cultural barriers within the health sector. Telehealth will impact us all” (2002, p. 39). Telehealth may use any of the following technologies: videoconferencing, the internet, store-and-forward imaging, streaming media, and terrestrial and wireless communications.
E-health and informatics deals with the collection, management, and use of health related data. This data is used to improve patients’ orientation on healthcare issues. The use of electronic health data provides patients with an opportunity to “own” their ailment. They can use this data to research information about their disease, effective treatments, medication safety, and the causes of the disease. These tools empower the patients by showing them a realistic view of their situation.
Who Benefits from Telenursing/Telehealth?
Telehealth provides beneficial outcomes to the patient and his/her family, healthcare providers, community organizations, healthcare facility, and the government. First, telehealth improves the way patients and their families gain access to healthcare services. This is especially important to families who do not have adequate transportation or live in rural areas that are long distances from healthcare facilities. Having access to remote services will decrease hospitalizations and re-admissions to hospital. Many patients in these circumstances wait until they can no longer tolerate the symptoms before traveling to the hospital. With access to remote services, they can address issues before they require hospitalization. Often community organizations will assist patients by providing transportation to and from healthcare appointments. If patients are being served remotely, organizations will be able to use funding set aside for transportation for something else. For instance, “teleconference can be used to attend administrative meetings, leading to substantial savings on travel costs; however, the redistribution of savings between organizations and levels of care is an important and complex issue” (Hu P.J., Chau P.Y., & Sheng O.L. 2000 ). Also, one of the major complaints of in-site nurses is being over-worked. Many healthcare facilities are over-crowded. Consequently, nurses feel they are unable to provide adequate services to all of their patients. The lack of these crucial services can lead to UTI’s, bed sores, extended stays, and possibly death of a patient. Finally, there are great economic benefits. Most importantly, the patient is not placed in such a financial strain because they are not worried about transportation costs, extended stay costs, and large co-pay premiums.
Implementation of Telenursing/Telehealth
Implementing telenursing can prove difficult because it is an entirely new way of managing healthcare and will not fit into most existing healthcare frameworks. To be done correctly, the processed needs to be thoroughly planned, piloted, governed, and evaluated. Telenursing is often implemented in rural, remote areas where access to healthcare and specialist is limited. According to Jennett P, Jackson A, Healy T, Ho K, Kazanjian A, Woollard R, Haydt & S, Bates,
Telehealth can support the delivery of specialized services in a timely fashion for remote populations, facilitate access to education for clinicians, and save travel costs for patients and professionals. Moreover, as telehealth technologies become more integrated into the health care system, they could increasingly contribute to the reorganization of medical workforce supply and exert a profound influence on physician practice, especially in remote areas (p. 260).
So, location is one of the key factors in the successful implementation of telehealth. Once the proper location has been established, potential patients in that area need to be briefed on the services available through telehealth. Next, there needs to be a trial run over a set period of time. During this time all information must be document for later use. The number of patients that used the services, they type of services the patients needed, complaints from patients and clinicians, etc. is all important data to be gathered during the pilot period. Also, there must be certain governing rules in place for the remote services. For example what type of credentials is required of the nurses is a very important issue. Many patients would be reluctant to use the services if they felt the nurses weren’t properly educated. Once the set amount of time is completed, the program needs to be evaluated by all stakeholders to determine if full implementation is feasible.
The proper implementation of telehealth services will enhance patients’ quality of care. Studies have shown that rural areas have a shortage of doctors. While hiring more doctors seems like the logical solution, it isn’t always the most feasible solution because doctors in lager cities prefer to stay in larger areas (Arnaert & Delesie, p. 313). Telehealth also makes it easier for healthcare providers to manage ongoing care for patients with chronic illnesses, such as diabetes, high blood pressure, asthma, etc. Although these are serious illnesses, they are well controlled when patients follow strict guidelines. Through telehealth, patients are required to integrate healthcare into their daily lives, not just the limited contact they make with healthcare providers on office visits. For these patients the overall goal is self-management.
The use of telehealth has the potential of reducing healthcare costs. First, patients have the opportunity to be matched with the right doctor for their ailment. This saves them from being transferred from one facility to the next in efforts to diagnose a condition. Also, some patients may be more reluctant to go to the doctor’s office; with telehealth they can get the much needed assistance before the problem escalates into a much worse condition. In 2010, a study was completed on the one year pilot study completed by the Eddy Visiting Nursing Association in New York. They reported that the benefits of telehealth services included: a drop in the rate of hospitalization, ER visits, and total medical costs. This equated to a 55 percent drop in hospitalization, 29 percent reduction in ER visits, and 42 percent drop in medical costs-from 3 million to 1.7 million dollars (Mazzacco, 2010). This data suggests that using telehealth services will significantly reduce healthcare costs.
Telehealth is an innovative technology that can increase access to health services, the quality of those services, and lower the financial burden healthcare imposes. Consequently, the implementation of telehealth/telenursing provides great benefits to all stakeholders. Chronic health issues are rapidly growing around the world. Telehealth will enhance healthcare facilities ability to provide quality healthcare services to these patients within their homes. These services will alleviate costs of traditional healthcare services and extended nursing home stays. Telehealth will not only save money, but it will make much needed services available to patients in remote, rural areas. The implementation of telehealth services will not be an easy process, but with the corporation of all stake holders the transition can be done smoothly.
Arnaert, A. &Delesie, L. Telenursing for the elderly. (2001). The case for care via video-telephony. J Telemed Telecare 7, 311-316.
Hu P.J, Chau, P.Y., & Sheng, O.L. (200). Investigation of factors affecting healthcare organization’s adoption of telemedicine technology. Computer Society 3, 23-30.
Jennett, P., Jackson, A., Healy, T., Ho, K., Kazanjian, A., Woollard, R., Haydt, S., & Bates, J. (2003). A study of a rural community’s readiness for telehealth. J Telemed Telecare 9(5), 259-263.
Mazzacco, Michelle. Study confirms benefits of home telehealth (2010). The Educator http://www.hcanys.org/documents/TheEducatorVolume1Edition1.pdf.
Wheeler, T. (2002). Strategies for delivering tele-home care .Telemed Today 6, 37-40.