Telehealth By: David Guthrie
Objectives • Describe telehealth as an informatics trend • Evaluate the hardware and software used in telehealth • Summarize an information system used in telehealth • List the advantages and disadvantages of telenursing • Explain the ethical and legal issues in telenursing • Review the competencies and role of informatics in telehealth
What Is Telehealth? • Videoconferencing • The internet • Store-and-forward imaging • Streaming media • Terrestrial and wireless communications (HRSA, 2008)
Benefits of Telehealth • Long distance care • Remote monitoring • Advice regarding disease without travel • Treatment follow-ups via telecommunications • Tele-triage
Hardware • Telephone • Computer • Fax machine • Monitoring equipment • Diabetes monitors • Cardiovascular monitors
Hardware Cont. Cardiovascular Monitoring Equipment • Has been proven to reduce cardiovascular risk • Available in remote areas • Proven favorable to traditional patient check ups (Cardiol, 2008)
Telehealth Software • Microsoft Windows/Operating Systems • Databases • Internet browsers • Email clients • Conferencing software • UpToDate
Software Cont.UpToDate • Database accessed via the world wide web • Helps patients better understand treatments • Helps patients better understand medical conditions • Provides access to most recent studies and health information (UpToDate, 2009)
Software ContUpToDate: Usability • Ease of use - excellent • Ease of learning-fair • Satisfaction with using –excellent • Efficiency of use-very efficient • Error tolerance- excellent • Fit of system to the task-excellent
Information Systems • Elemental Clinic • Mental health information software • Electronic medical record • Can be hosted locally or from a distance • Web based software (open sourcery, 2002)
Review of Elemental Clinic • Clinical information system • Available for use with all healthcare professionals • Performs variety of tasks and functions • Web based accessibility (open sourcery, 2002)
Telenursing Advantages • Nursing can be provided to remote locations • Cost efficient • Time saving • Increases patient involvement in self care (Hoglund and Holmstrom, 2008)
Telenursing Disadvantages • Nurses unable to visualize the patient • Faceless encounter for patient • Ethical dilemmas for nurses • Technological difficulties (Hoglund and Holmstrom, 2008)
Ethical/Legal Issues in Telenursing • Privacy • Security • Confidentiality • Autonomy (Hoglund and Holmstrom, 2008)
Telenursing Competencies • Use of email • Use of database software • Use of videoconferencing software when applicable • Use of web browser (McGonigle and Mastrian, 2009)
Functions of the Informatics Nurse in Telehealth • Installation of hardware • Patient education • Monitoring devices • Troubleshooting equipment (Starren et al., 2005)
Summary of Telehealth • Growing trend utilizing various forms of communication • Encompasses telemedicine, and telenursing • Hardware and software are key operational components • Allows healthcare professionals to practice at a distance
References • HRSA, HRSA Telehealth. Retrieved June 4, 2009, from http://www.hrsa.gov/telehealth/ • Cardiol, Can, J. (2008, January). Cardiovascular risk reduction via telehealth: a feasibility study.PubMed, 24, Retrieved June 23,2009, from http://www.ncbi.nlm.nih.gov.ezaccess.libraries.psu.edu/pubmed/18209771?ordinalpos=14&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum • UpToDate, (2009). About the Company. Retrieved June 24, 2009, from UpToDate Web site: http://www.uptodate.com/home/about/about.html • Open sourcery, (2002). A different kind of EMR. Retrieved July 11, 2009, from elemental Clinic Web site: http://www.elementalclinic.com/home • Hoglund, A, & Holmstrom, I (2008). Ethical issues in telenursing. InternationalHospital Equipment & Solutions, 34, Retrieved July 31, 2009, from http://www.ihe-online.com/index.php?id=2695. • McGonigle, D, & Mastrian, K (2009). Nursing informatics and the foundation of knowledge.Sudbury, Massachusetts: Jones and Bartlett Publishers. • Starren, J, Tsai, C, Bakken, S, Aidala, A, Morin, P.C., Hilliman, C, Weinstock, R.S., Goland, R, Teresi, J, & Shea, S (2005, July). The role of nurses in installing telehealth technology in the home.. Computers, informatics, nursing:CIN., 23, Retrieved Jul 30, 2009, from http://www.ncbi.nlm.nih.gov/pubmed/16027532