Telemedicine, Telehealth, and Telenursing

This week’s content discussed the use of innovative technology by means of mHealth, telehealth, telenursing, and telemedicine. The definitions of, examples of use, and the advantages and disadvantages of mHealth, telehealth, telenursing, and telemedicine were presented. Based on the information you reviewed and professional experience answer the following questions.Telemedicine, Telehealth, and Telenursing

1. Discuss the current state (e.g., acceptance / use of) of such services in the United States. Provide statistics to support your discussion.

2. Discuss the role of the DNP prepared nurse in advancing the use of such services to positively influence patient outcomes.

3. Describe the potential barriers the DNP prepared nurse may encounter when planning, implementing, and evaluating such services. Identify at least two strategies for overcoming the identified barriers.

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Following the implementation of the American Recovery and Reinvestment Act of 2009, many billions were released to fund facility updates, health IT systems, and research to improve access to care, quality and improve healthcare delivery. In the year 2010, the National Broadband Plan further highlighted and directed funds for further development and use of IT through the expansion of infrastructure to ensure high-speed internet access to assist in remote monitoring and establishing telemedicine (Balenton & Chiappelli, 2017).  Today, telehealth is a way to attain most aims of healthcare reform especially in improving the value, delivery, and access to affordable care. According to the American Telemedicine Association, four of every five states in the US have improved telehealth reimbursements and coverage. An estimated 76% of hospitals have telehealth payment services (American Hospital Association, 2019). While nearly every Medicaid program at the state level covers telehealth services, most private payers are also covering telehealth services.

DNP prepared nurses to use telemedicine and telenursing services to fill the roles of primary care providers in underserved areas by physician specialists and primary care physicians. Their education facilitates them to provide a wide range of services and ensure continuity of care for different patient populations. For instance, for chronically ill patients transitioning from the hospital to homes, DNP prepared nurses can organize synchronous visits to coach patients, monitor their self-care and supervision during an acute exacerbation of a chronic illness.

The lack of a standard and uniform telemedicine policy confuses the design and use of telemedicine programs and related services. Policy barriers instill fear of legal issues associated with malpractice among DNP prepared nurses and prevent them from actively participating and developing telemedicine programs (Scott et al., 2018). This reveals that malpractice liability is a significant barrier in practicing telemedicine due to the lack of specific public policies to guarantee the confidentiality, privacy, and security of telemedicine users during teleconsultations (Scott et al., 2018).  Besides, current regulatory frameworks linked to reimbursements of teleconsultations in the public and private sectors are weak which demotivates practitioners. To address policy barriers, it is essential that the state and federal levels of government frame policies, guidelines, and regulations of telemedicine practice (Scott et al., 2018). An additional measure is allocating adequate financial resources for the use and development of telemedicine.Telemedicine, Telehealth, and Telenursing

References

American Hospital Association (2019). Fact Sheet: Telehealth. Available at https://www.aha.org/system/files/2019-02/fact-sheet-telehealth-2-4-19.pdf

Balenton, N., & Chiappelli, F. (2017). Telenursing: Bio information Cornerstone in Healthcare for the 21st Century. Bioinformation, 13(12), 412–414. https://doi.org/10.6026/97320630013412

Scott Kruse, C., Karem, P., Shifflett, K., Vegi, L., Ravi, K., & Brooks, M. (2018). Evaluating barriers to adopting telemedicine worldwide: A systematic review. Journal of telemedicine and telecare, 24(1), 4–12. https://doi.org/10.1177/1357633X16674087 Telemedicine, Telehealth, and Telenursing