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DNP 805 Topic 6 Discussion Question Two
DNP 805 Topic 6 Discussion Question Two
Consider current telehealth strategies and alternatives. Evaluate current implementation strategies for telehealth systems and provide an assessment of the pros and cons. Identify a particular practice area (e.g., clinic, hospital, primary care site) and discuss how you as a health care leader might you implement a similar strategy in that area?
Telehealth is the use of digital information and communication technologies, such as computers and mobile devices, to access health care services remotely and manage your health care. These may be technologies you use from home or that your doctor uses to improve or support health care services.
Consider, for example, the ways telehealth could help you if you have diabetes. You could do some or all of the following:
- Use a mobile phone or other device to upload food logs, medications, dosing and blood sugar levels for review by a nurse who responds electronically.
- Watch a video on carbohydrate counting and download an app for it to your phone.
- Use an app to estimate, based on your diet and exercise level, how much insulin you need.
- Use an online patient portal to see your test results, schedule appointments, request prescription refills or email your doctor.
- Order testing supplies and medications online.
- Get a mobile retinal photo screening at your doctor’s office rather than scheduling an appointment with a specialist.
- Get email, text or phone reminders when you need a flu shot, foot exam or other preventive care.
The goals of telehealth, also called e-health or m-health (mobile health), include the following:
- Make health care accessible to people who live in rural or isolated communities.
- Make services more readily available or convenient for people with limited mobility, time or transportation options.
- Provide access to medical specialists.
- Improve communication and coordination of care among members of a health care team and a patient.
- Provide support for self-management of health care.
The following examples of telehealth services may be beneficial for your health care.
Your primary care clinic may have an online patient portal. These portals offer an alternative to email, which is a generally insecure means to communicate about private medical information. A portal provides a more secure online tool to do the following:
- Communicate with your doctor or a nurse.
- Request prescription refills.
- Review test results and summaries of previous visits.
- Schedule appointments or request appointment reminders.
If your doctor is in a large health care system, the portal also may provide a single point of communication for any specialists you may see.
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Some clinics may provide virtual appointments that enable you to see your doctor or a nurse via online videoconferencing. These appointments enable you to receive ongoing care from your regular doctor when an in-person visit isn’t required or possible.
Other virtual appointments include web-based “visits” with a doctor or nurse practitioner. These services are generally for minor illnesses, similar to the services available at a drop-in clinic. Some large companies provide access to virtual doctors’ offices as a part of their health care offerings.
When you log into a web-based service, you are guided through a series of questions. The doctor or nurse practitioner can prescribe medications, suggest home care strategies or recommend additional medical care.
Similarly, a nursing call center is staffed with nurses who use a question-and-answer format to provide advice for care at home. A nursing call center doesn’t diagnose an illness or prescribe medications.
While these services are convenient, they have drawbacks:
- Treatment may not be coordinated with your regular doctor.
- Essential information from your medical history may not be considered.
- The computer-driven decision-making model may not be optimal if you have a complex medical history.
- The virtual visit lacks an in-person evaluation, which may hamper accurate diagnosis.
- The service doesn’t easily allow for shared doctor-patient decision-making about treatments or making a plan B if an initial treatment doesn’t work.
A variety of technologies enable your doctor or health care team to monitor your health remotely. These technologies include:
- Web-based or mobile apps for uploading information, such as blood glucose readings, to your doctor or health care team
- Devices that measure and wirelessly transmit information, such as blood pressure, blood glucose or lung function
- Wearable devices that automatically record and transmit information, such as heart rate, blood glucose, gait, posture control, tremors, physical activity or sleep patterns
- Home monitoring devices for older people or people with dementia that detect changes in normal activities such as falls
Doctors talking to doctors
Doctors can also take advantage of technology to provide better care for their patients. One example is a virtual consultation that allows primary care doctors to get input from specialists when they have questions about your diagnosis or treatment.
The primary care doctor sends exam notes, history, test results, X-rays or other images to the specialist to review. The specialist may respond electronically, conduct a virtual appointment with you at your doctor’s office, or request a face-to-face meeting.
These virtual consultations may prevent unnecessary in-person referrals to a specialist, reduce wait times for specialist input and eliminate unnecessary travel.
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