Nursing Trends in Nursing Trends in TelehealthTelehealthHomecareHomecare

Presented by:

Norma I. Rojas

ObjectivesObjectivesduring this presentation we will…during this presentation we will…

Describe the trend in telehealth homecare Describe and evaluate the hardware and software

utilized with this trend Describe and evaluate the information system used

with this trend Assess the role and functions of the nurse

informaticist when working with this trend. Examine related legal issues

Objectives Objectives (cont.)(cont.)

during this presentation we will…during this presentation we will…

Discuss the advantages/disadvantages from a nursing perspective

What is telehealth What is telehealth homecare?homecare?

Telehealth homecare provides patients with healthcare, health information, and health education across a distance with the use of

telecommunications technology, and specialty adapted equipment.

(Telehealth leadership initiative, 2008)

What is telehealth What is telehealth homecare?homecare?

This service allows doctors, nurses, and other healthcare providers to assess, diagnose and

treat patients without having to be in the same physical location.

(Telehealth leadership initiative, 2008)

The evolution of The evolution of healthcarehealthcare

In order to provide more services to our growing population, healthcare

will evolve into a highly community-based industry.

(Auerbach et al, 2009)

Hardware used in telehealth Hardware used in telehealth homecarehomecare

Blood Glucose MetersCardiac monitorsElectronic stethoscopesBlood pressure monitorsPulse oximetry devicesElectronic thermometers

(Liddy et al, 2008)

Hardware used in telehealth Hardware used in telehealth homecarehomecare

Home PCVideo conferencing devicesTelephone, fax, EmailsSpecialized telephone adapters

(Liddy et al, 2008)

How to use telehealth hardwareHow to use telehealth hardwareusing telephone adaptersusing telephone adapters

Adapter is connected to a simple telephone line Patient logs into a system and follows a series of

directions Voice prompts patient to adhere to medication regimens

and treatments Patients vital signs, weight, electrocardiogram, etc. are

transmitted to the healthcare provider This information is used to treat patients at home

(Center for Aging Technologies, 2008)

Types of software used in telehealth Types of software used in telehealth homecarehomecare

AFHCAN Software CapSure Software GIGISim Philips Web-based Clinical Software Omnivisor WebVMC and more…

Use of Philips Web-based softwareUse of Philips Web-based software

Software flags patients vital signs if they are out of range Library of surveys available for patients with various

diseases Care plans and protocols available Tracks trends and generates reports Patient contact information available to facilitate a rapid

response

(Phillips, Inc., 2008)

Philips Web-based software usabilityPhilips Web-based software usability

Easy to use Easy to learn Patients reported satisfaction with its use Efficient Error tolerance- minimal workarounds The system fit with the task at hand

(Staggers, 2003)(Phillips, Inc., 2008)

Cardiocom’s Telehealth Computer-Cardiocom’s Telehealth Computer-based Clinical Information Systembased Clinical Information System

Collects, stores and manipulates healthcare data in real-time

Provides secure access by multidisciplinary healthcare team

User-friendly system Used for observation, interventions and

documentation

(Mastrain, K. & McGonigle, D., 2009)(Cardiocom, 2008)

Review of the Cardiocom Review of the Cardiocom Information System Information System

Clinical computer-based information system Used primarily by doctors, nurses, pharmacists,

etc. Used to diagnose and treat Configuration: LAN, microcomputers, etc. Data standards set by Health Level 7, DICOM and

PACS

(Cardiocom, 2008) (Tan , J., Cheng, W., & Rogers, W., 2008)

Review of the Cardiocom Review of the Cardiocom information system information system

The disease and procedure classification used in telehealth are SNOMED and ICD10

Recommended by healthcare providers

(Wikipedia, 2008)

Advantages of telehealth services for Advantages of telehealth services for nurses and other healthcare nurses and other healthcare

professionalsprofessionals

Recommended for the treatment of chronic and low acuity diseases

More cost-effective Reduce hospital ER wait times Provide patients with more autonomy Increase accessibility (esp. rural areas) Promote health through comprehensive follow-ups

(Center for Aging Technologies, 2008)(Cardiocom, 2008)

Disadvantages of telehealth services for Disadvantages of telehealth services for nurses and other healthcare professionalsnurses and other healthcare professionals

Possible lack of compliance from patients Some patients may seem overwhelmed with the

equipment use (esp. the elderly) Lack of human contact Nurses fear of being replaced with automation

(Cassin, 2008)

Telehealth legal issuesTelehealth legal issues Privacy issues Reimbursement Malpractice Licensing issues Accreditation and regulations Fraud and abuse

(Center for Telehealth and E-Health Law, 2006)

Informatics competencies for Informatics competencies for telehealth nursestelehealth nurses

Proficient with computers and telehealth software

Proficient with the use of specialized equipment

Obtain excellent clinical and critical thinking skills

Ambulatory care and/or informatics nurse certification

(American Nurses Credentialing Center, 2008)

Functions and responsibilities of an Functions and responsibilities of an informatics nurse in telehealthinformatics nurse in telehealth

Telehealth home care nurses:

Setting up telehealth software and hardware in patients homes

Assessing and monitoring patients from a distance

Providing patients with health education and education regarding equipment

Functions and responsibilities of an Functions and responsibilities of an informatics nurse in telehealthinformatics nurse in telehealth

Telehealth home care nurses: Act as a patient advocate and promotes

client health and safety Performs accurate documentations of

assessments and care plans Provides ethical care and is accountable

for own actions Provides evidence-based care

Functions and responsibilities of an Functions and responsibilities of an informatics nurse specialist in informatics nurse specialist in

telehealthtelehealth

Telehealth clinical manager/coordinator: Administration/management of facility and

staff Theory formulation, design and development Testing and selection of telehealth technology Oversees training and education Research and evaluation of services

(American Nurses Credentialing Center, 2008)

Telehealth Nursing SummaryTelehealth Nursing Summary

Telehealth home care provides patients with healthcare, health information and health education across a distance with

the use of specialized telecommunications technology.

Telehealth Nursing SummaryTelehealth Nursing Summary

Specialized hardware devices used in telehealth: cardiac monitors, electronic stethoscopes, etc

How to use a hardware device (with a telephone adapter)

Specialized software used in telehealth: Omnivisor, Philips Web-based software, etc.

Review of Philips Web-based software including evaluating its level of usability

Telehealth Nursing SummaryTelehealth Nursing Summary

Review of Cardiocom’s clinical information system in telehealth

Advantages of telehealth include: increasing accessibility, reduce healthcare costs, etc.

Disadvantages of telehealth include: lack of human contact, possible lack of compliance, etc.

Legal issues in telehealth include: licensing, malpractice, reimbursement, etc.

Telehealth Nursing SummaryTelehealth Nursing Summary

Informatics competencies in telehealth nursing include: knowledge of computers and use of specialized equipment

Functions and responsibilities of an informatics nurse in telehealth include: health education, equipment management, research, etc.

In conclusionIn conclusion

The remarkable advances in technology continues to change the way that we conduct

healthcare. Telehealth homecare provides patients with healthcare services in a new and

innovative way. Healthcare professionals should embrace technology as we continue to improve

our healthcare delivery methods to provide high-quality care.

 

ReferencesReferencesAuerbach, D.I., Buerhaus, P., Staiger, D.O. (2009). The

future of the nursing workforce in the united states:

Data , trends and implications. Sudbury,MA: Jones

and Bartlett Publishers.

Cardiocom Multi-disease Management. (2005). Health

plans. Retrieved December 5, 2008, from

http://www.cardiocom.com/health_plans.html

Liddy, C., Dusseault, J. J., Dahrouge, S., Hogg, W.,

Lemelin, J., & Humber, J. (2008). Telehomecare for

patients with multiple chronic illnesses. Canadian

Family Physician, 54(1), 58-65.

ReferencesReferencesCenter for aging services technology. (2006). Economic benefits of

e-technology in managing congestive heart failure.

Retrived October 11, 2008, from http://www.aging

tech.org/documents/EconomicBenefits_of_eTech.pdf

Philips, Inc. (2008). Web-Based clinical software. Retrieved

October 11, 2008, from http://www.medical.philips.com/

main/products/telehealth/products/software.wpd

Telehealth leadership initiative. (2008). What is telehealth. Retrieved

October 11, 2008, from http://www.telehealthleadership.

org/telehealth101.html.

ReferencesReferences Cassin, K (2008). Implementation of home telemonitoring for chronic

disease: A case study of resurrection home health services.

Telemedicine Information Exchange, Retrieved December

1, 2008, from

http://tie.telemed.org/articles/article.asp?path=articles&arti

cle=resurrectionHomeServices_kcassin_tie08.xml

Mastrain, K. & Mcgonigle, D. (2009). Nursing informatics and the

foundation of knowledge. Sudbury, MA: Jones and Barlett

Publishers.

Center for Telehealth and E-Health Law (2006). Nurse licensure.

Retrieved December 05, 2008, from

http://www.telehealthlawcenter.org/?c=143

ReferencesReferencesTan, J., Cheng, W., Rogers, W. (2002). From telemedicine to e-health:

Uncovering new frontiers of biomedical research, clinical

applications & public health services delivery. The Journal of

Computer Information Systems: Special Issue, 42(5), 7-18. 

Retrieved November 1, 2008, from ABI/INFORM Global 

database.

ICD. (n.d.) Retrieved November 1, 2008, from Wikipedia Web site:

http://en.wikipedia.org/wiki/ICD

Staggers, N. (2003). Human factors: Imperative concepts for

information systems in critical care. AACN Clinical Issues,

14(3), 310-319.

ReferencesReferences

American Nurses Credentialing Center. (2008). Informatics nurse

certification eligibility criteria. Retrieved December, 5,

2008, from http://www.nursecredentialing.org/Eligibility/

InformaticsNurseEligibility.aspx