Telemedicine in Nursing Informatics
Introduction
The way telemedicine has revolutionized the healthcare industry is astonishing. Just few decades back, it was an impossible thing to imagine that a patient can be treated without actually visiting a doctor. Times have changed and so have healthcare industry and the treatment options. This paper talks about the numerous ways telemedicine has played a significant role in improving and transforming nursing informatics in particular and healthcare industry in general. It also discusses how the availability and convenient use of telemedicine services have benefitted people throughout the developed and developing world. In the last section, the reasons telemedicine has an illuminating future have been mentioned along with various criticisms of the technology.
Telemedicine
In the contemporary healthcare industry, cost-effectiveness, quality, accessibility, and equity are major issues faced by the clients/patients. In fact, these issues are experienced by people in both developing and developed countries. With the introduction and employment of the modern-day Information and Communication Technologies (ICTs) including smart phones, computers, and the Internet, the researchers and innovators have been successful in alleviating the health problems considering the convenience and inexpensiveness of such technologies. In this regard, the term telemedicine refers to “the use of modern information technology, especially two-way interactive audio/video communications, computers, and telemetry, to deliver health services to remote patients and to facilitate information exchange between primary care physicians and specialists at some distances from each other” (Darkins & Cary, 2000). When it comes to nursing informatics, the development and expansion of telemedicine has considerably changed the ways nurses serve consumers and patients.
Contribution of Telemedicine
Telemedicine has remarkably contributed to nurture a value-based and high-quality environment for the enhancement of patient engagement and satisfaction along with better accessibility and reduced costs. Distance is the basic determinant in the utilization of telemedicine as healthcare professionals use ICTs to remote areas considering the inaccessibility and inconvenience. Thus, ICTs makes it possible for the doctors and patients to share the pertinent details for apt and timely diagnosis, evaluation, research, treatment, and prevention of the disease/medical condition. Nursing informatics has segmented telemedicine into various applications such as cardiological, neurological, dermatological, and respiratory categories to be used in the management of various pathologies, conditions, and diseases.
Alternative of Traditional Method
Furthermore, people in their final stages of AIDS/HIV are benefiting from telemedicine as their human contact is decreased. Yet, the patients are accepted, respected, and treated through telemedicine (Breen & Matusitz, 2009). Similarly, telemedicine has guaranteed patient satisfaction due to a decrease in travelling time, waiting time, and minimization of other issues related to appointments and follow-ups. Telemedicine has turned out to be an incredibly life-saving alternative to traditional methods of healthcare counseling particularly for terminal and debilitated populations living in remote regions.
Telemedicine in Mercy Health System
Mercy Health System (a hospital without a bed) is a virtual care center wherein nurses and doctors keep working around the clock. This one-of-a-kind healthcare facility in the United States offers remote support to 38 smaller hospitals situated in states from Oklahoma to North Carolina (for emergency rooms, intensive-care units, and various other programs). A majority of these hospitals have no on-site physician 24/7. Mercy Virtual President reported a 30% decrease in the number of deaths than anticipated. Also, a 35% decrease in the average length stay of the patients was made possible due to the provision of telemedicine services at the facility. The observations indicate that the lives of 1000+ people were saved with the special assistance provided through telemedicine. According to a trade group, the American Telemedicine Association, remote medical care was provided to more than 15 million Americans in 2015 alone which ultimately grew by 30% the next year (Breen & Matusitz, 2009).
International Impact
On an international level, there has been a considerable interest to bring improvements in the healthcare industry’s safety, quality, cost-effectiveness, and cleanliness through telemedicine. McLean conducted a study to investigate and analyze the impact of telemedicine on the quality and safety of the healthcare. It was revealed that the improvement in the quality of life of patients was apparent. Also, improvements were observed in patients of asthma and chronic heart failure (McLean, Sheikh, Cresswell, Nurmatov, Mukherjee, Hemmi, & Pagliari, 2013).
Telenursing
Information technology usage has actually evolved the nursing roles specifically within home settings. Telehealth nursing or telenursing is focused on patients’ long-term physical wellness and self-management. It can be said that telemedicine has empowered the present-day nurses with a better ability to supervise, gather data, inform, follow-up, and offer multidisciplinary care comprising of pain management, distant involvements, and family support. According to a report, “agencies using telehealth have an average patient-to-nurse ratio of 15:1, as compared with non-telehealth agencies having a ratio of 11:1” (Bashir & Bastola, 2018). Consequently, a remarkable difference could be made if telemedicine is effectively used for the provision of patient care to underserved regions experiencing nursing shortage and inaccessible health care.
Nursing and Telemedicine
The lack of specialists in rural areas results in a majority of patients being devoid of well-timed health care interventions. This gap could be easily filled up if more and more home health agencies with telemedicine facilities train their nurses to care for chronic patients while utilizing ICTs. Such provision of care and sense of security allows the nurses to intervene and manage patient condition under expert physician care (Bashir & Bastola, 2018).
Nurse Informatics Uses
As indicated by the above discussion, there is a rare involvement of hands-on patient care in nursing informatics. As an alternative, nurses make use of technologies and tools to assess the patients’ progress via telemedicine. For instance, blood glucose, blood pressure, and heart rate and other vital signs are recorded and evaluated by using tools. Such equipment is usually set up in the domestic setting wherein the patient is placed. The nurse informaticists educate the patients and their family members about the usage of equipment and how to troubleshoot them if a technical issue arises. Similarly, professionals engaged in nurse informatics also facilitate other health care personnel to use telemedicine and other related equipment in a proper manner.
It needs to be noted here that not every nurse is aware of the recent methods and technologies used in telemedicine. A patient whose treatment involves telemedicine cannot be just evaluated by any nurse. Instead, a nursing trained in nursing informatics and knows how specific technologies are used can help in taking care of the populations treated under the umbrella of ICTs. However, telemedicine nurses are necessitated to possess the same nursing skills that are a prerequisite for all nurses whereby “excellent organization, critical thinking and communication skills are required also, but the most important skill is to understand the technology and its potential and limitations, and have the intuitiveness in how to utilize it to provide the care needed at the time” (Page, 2013). Therefore, nurses interested in using technology to provide high-quality health care must obtain a nursing informatics certification to start with.
Telemedicine Counseling
Telemedicine counseling also helped in reducing the maternal fatigue affecting mothers who had infants with difficult behaviors. Parents who had infants with extremely low birth weight rates were also provided with emotional support and education. Overall, telemedicine resulted in patient satisfaction whereby it reduced cost and travel time along with increased convenience. In a Canadian review of various telemedicine programs, the rural areas had higher patient satisfaction as compared to the urban areas. In comparison to waiting for longer personal counseling, 76% people preferred telemedicine counseling due to its ease and convenience (Breen & Matusitz, 2009).
Telemedicine Knowledge in US
In developed countries, such as the United States of America, the healthcare industry has incorporated telemedicine. Even though several issues have popped up with the implementation in different states including legality problems and reimbursement, it is extremely important for developing countries to learn with USA example and incorporate telemedicine by means of volunteer efforts in the regions where healthcare professionals are unable to reach. Both governments and stakeholders need to ensure that telemedicine must replace the obsolete alternatives to treat populations in far-away regions.
Criticism on Telemedicine
Even though telemedicine is gaining popularity on a large scale, criticism concerned with the quality of care received through telemedicine has also surfaced. According to the opponents of telemedicine, various barriers hinder the growth of telemedicine in some regions including developing countries considering the inadequacy of the infrastructure for proper utilization of the modern Internet technologies. Also, the instability of the electric power supplies, unreliable connectivity of the Internet, computer viruses, and limited availability of bandwidth hinder the adoption of telemedicine (Breen & Matusitz, 2009).
Financial Cost
In addition, the financial cost associated with telemedicine is also a major barrier to the adoption and application of telemedicine services. Training cost, equipment, maintenance, and transportation expenses can be difficult to be managed for developing and underdeveloped countries. The application of telemedicine is also restricted due to lack of knowledge, resources, and local skills. In many countries, the education required to be a competent nursing informatics professional is not available.
Conclusion
Today, the big promises have started to materialize while telemedicine is being implemented to its full potential. The swiftness of deliverance of health care services and increase in the number of nursing informatics professionals, it has become crystal clear that people could not be treated in hospitals alone; the Internet connections, modified insurance standards, availability and cheap usage of smart phones as well as technologically-aware nursing personnel are changing the conventional modes of delivering health care services.
It has been proved that information and communication technologies like cell phones, the Internet, and computers have the propensity to address the health problems on a global level. It can be done through the deliverance of nursing and health services via telemedicine. Telemedicine contributes in improving the as the health care situation and physical wellbeing of deprived populations in remote areas when health care professionals use ICTs for an exchange of the information for diagnosis, treatment, and provision of education to nursing staff and health care providers (though in limited numbers) in such areas. Similarly, the healthcare’s safety, quality, cost-effectiveness, and cleanliness have considerably enhanced worldwide through telemedicine. Though there are various hindrances to the application of telemedicine in developing countries, a focused approach towards its implementation may result in miraculous outcomes for poor nations as the health of the local people is improved.
With certain challenges such as limited coverage by insurers, diagnosing difficulties, and privacy issues, telemedicine is evolving with each passing day. The fact that remote areas have no access to healthcare facilities as well as the increasing aged population signifies that telemedicine will flourish in the future despite the mentioned challenges. One cannot simply ignore the advantages of telemedicine. In this regard, healthcare professionals can play a major role “through the development of strategic, industrywide best practices and regulations” along with the preservation of patient-nurse and patient-physician relationships (“How Will Telemedicine Impact the Future of Health Care”? 2016)
References
Bashir, A., & Bastola, D. R. (2018, May 25). Perspectives of Nurses Toward Telehealth Efficacy and Quality of Health Care: Pilot Study. Retrieved April 11, 2019, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5993972/
Breen, G., & Matusitz, J. (2009). An Evolutionary Examination of Telemedicine: A Health and Computer-Mediated Communication Perspective. Social Work in Public Health, 25(1), 59-71. doi:10.1080/19371910902911206
Darkins, A. W., & Cary, M. A. (2000). Telemedicine and Telehealth: Principles, Policies, Performances and Pitfalls. New York: Springer Publishing Company.
How Will Telemedicine Impact the Future of Health Care? (2016, November 03). Nursing@Georgetown. Retrieved April 11, 2019, from https://online.nursing.georgetown.edu/blog/future-of-telemedicine/
McLean, S., Sheikh, A., Cresswell, K., Nurmatov, U., Mukherjee, M., Hemmi, A., & Pagliari, C. (2013). The impact of telehealthcare on the quality and safety of care: a systematic overview. PloS one, 8(8), e71238. doi:10.1371/journal.pone.0071238