NUR 514 Topic 8 DQ 2 Virtual care and telehealth technologies have the capability to greatly expand access to quality health care
Sample Answer for NUR 514 Topic 8 DQ 2 Virtual care and telehealth technologies have the capability to greatly expand access to quality health care Included After Question
NUR 514 Topic 8 DQ 2 Virtual care and telehealth technologies have the capability to greatly expand access to quality health care
Topic 8 DQ 2
Virtual care and telehealth technologies have the capability to greatly expand access to quality health care. Discuss some benefits and drawbacks of virtual care/telehealth, particularly related to the collaboration and coordination of care and the role of the advanced registered nurse.
REPLY TO DISCUSSION
A Sample Answer For the Assignment: NUR 514 Topic 8 DQ 2 Virtual care and telehealth technologies have the capability to greatly expand access to quality health care
Title: NUR 514 Topic 8 DQ 2 Virtual care and telehealth technologies have the capability to greatly expand access to quality health care
JB
Nov 19, 2022, 12:48 PM
Read
Hello class!
“High utilizers” or what we call “frequent fliers” are a small population, 5% of the population at that, but in healthcare account for 49% of total healthcare expenses! Let us think about this for a moment! Staggering!
The use of telehealth in managed care, could provide real-time care coordination for these high utilizers decrease health care costs through utilization of telehealth?
Thank you for sharing your thoughts!
Take care,
Dr. B
References: Virtual care and telehealth technologies have the capability to greatly expand access to quality health care.
Stanton, M. W. (2017). The high concentration of U.S. health care expenditures. Research in Action, 19.
REPLY
-
IA
Nov 19, 2022, 5:02 PM
Read
Dr B,
According to Ng and colleagues, high healthcare utilizers are a small class of patients who inflict an unduly high burden on the healthcare system because of their high resource utilization yet have unmet care needs or receive superfluous care. Cost is a useful measure of utilization and can be used as a proxy for utilization across different resource types. However, cost is highly impacted by the number of inpatient bed days accrued by a patient, so considering cost only may not portray a full picture of utilization volume. Therefore, other measures such as outpatient visits to clinics, emergency attendances, and inpatient readmissions rates in a specified period or length of stay (LOS) are also used. These together help policymakers and clinicians to consider multiple facets of resource use and appreciate the various causal factors to understand fully the causes of healthcare utilization (Ng, et al., 2019).
Ng and colleagues averred that expansion in adoption of electronic medical record (EMR) systems in hospitals is helping to make available far-reaching administrative cost and utilization data over several years. This information can be used to group the general patient population, identify, and address the different needs of each patient population. Grouping them will help distinguish homogenous patient subgroups and offer understanding on their characteristics, needs and courses over time. This knowledge then can assist development and implementation of mediations directed at each subgroup, and eventually assist program evaluation and tracking outcomes for each group (Ng, et al., 2019).
Reference NUR 514 Topic 8 DQ 2 Virtual care and telehealth technologies have the capability to greatly expand access to quality health care
Ng, S. H.-X., Rahman, N., Ang, I. Y., Sridharan, S., Ramachandran, S., Wang, D. D., . . . Tan, X. Q. (2019, July 5). Characterization of high healthcare utilizer groups using administrative data from an electronic medical record database. BioMed Central Health Services Research, 19(1), 1-14. doi:https://doi.org/10.1186/s12913-019-4239-2
REPLY
-
CH
Nov 21, 2022, 9:29 AM
Read
Frequent flyers and ED bouncebacks are frustrating, both due to the unnecessary use of limited resources and because the ED is often not capable of providing best care for the real problem. Montoy, et al. (2019) studied ED visits to try and find a predictor to frequent flyer visits. Interestingly, they did not find that certain illnesses or lack of follow up to be a cause for frequent visits (although they do mention the need for further studies). The one consistent predictor for another ED visit within days was to have frequent visits within the last 6 months (no matter how low “frequent” is defined) (Montoy, et al., 2019). This is interesting and useful information, as I think most people assume that there would be some chronic disease or other cause. Although more research is needed on this topic, recognizing that past behavior is a high risk for frequent ED visits will help us intervene appropriately. Technology gives us great opportunities for improvement. Telehealth provides connection to patients that could easily be without needed medical monitoring (McGonigle & Mastrian, 2018). Despite this, we need to understand why “frequent flyers” exist or we risk wasting more medical resources in ineffective care.
McGonigle, D., Mastrian, K. (2018). Nursing informatics and the foundation of knowledge (4th ed.). Jones & Bartlett Learning.
Montoy, J. C. C., Tamayo-Sarver, J., Miller, G. A., Baer, A. E., & Peabody, C. R. (2019). Predicting emergency department “bouncebacks”: A retrospective cohort analysis. Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health, 20(6), 865–874. https://doi-org.lopes.idm.oclc.org/10.5811/westjem.2019.8.43221
REPLY
JB
Nov 18, 2022, 8:57 AM
Read
Hello class!
Telehealth can only advance as fast as the technology that supports it! Here is a good read regarding some of those technologies that will help to advance telehealth:
http://cliniciantoday.com/4-technologies-that-will-take-telehealth-further-than-ever-before/
What are your thoughts?
Thank you for sharing!
Take care,
Dr. B
REPLY
-
CH
Nov 18, 2022, 1:32 PM
Read
I never would have put solar energy with telehealth! It makes perfect sense, though. When natural disasters take out the electrical grid, solar energy is there to provide the needed electricity. Much in the same way, telehealth services can provide invaluable medical contact when buildings and providers are unavailable (Wade, 2018). In case of disasters, local healthcare professionals are busy tending to a potentially large number of critically ill patients. For those that need to see a healthcare provider, telehealth can be the answer to ensure contact is made before problems occur in an already overwhelmed area. When you put solar energy with telehealth, you have a connection to healthcare providers at a time when help will be scarce.
Wade, E. (2018, March21). 4 technologies that will take telehealth further than ever before. Clinician Today. http://cliniciantoday.com/4-technologies-that-will-take-telehealth-further-than-ever-before/
REPLY
- TW
Nov 20, 2022, 7:11 PM
Read
Hi Dr. B.,
The article on the advancement of telehealth was an informative read, thank you so much for sharing. The first thought that came to my mind was that this article was written prior to the COVID-19 pandemic. The author made predictions on how telehealth would have made progress by 2020, but he had no way of knowing just how much telehealth would advance between the end of 2019 and the end of 2020 (Wade, 2018). The pandemic forced parts of the healthcare industry to adopt telehealth to provide care to patients at a faster rate than previously thought possible. Overnight, the country and the world went on lockdown and physicians had to figure out ways to provide, at the very least, continuation of care and follow-up care to their patients. Telehealth provided this
opportunity. Thankfully the foundations of the system were already in place and despite the steep learning curve for physicians, patients and staff, the transition went smoothly.
Reference: NUR 514 Topic 8 DQ 2 Virtual care and telehealth technologies have the capability to greatly expand access to quality health care
Wade, E. (2018). Four Technologies That Will Take Telehealth Further Than Ever Before. Healthcare Tech. https://cliniciantoday.com/4-technologies-that-will-take-telehealth-further-than-ever-before
NUR 514 Topic 8 DQ 2 Virtual care and telehealth technologies have the capability to greatly expand access to quality health care Grading Rubric Guidelines
| Performance Category | 10 | 9 | 8 | 4 | 0 |
| Scholarliness
Demonstrates achievement of scholarly inquiry for professional and academic decisions. |
|
|
|
|
|
| Performance Category | 10 | 9 | 8 | 4 | 0 |
| Application of Course Knowledge –
Demonstrate the ability to analyze, synthesize, and/or apply principles and concepts learned in the course lesson and outside readings and relate them to real-life professional situations |
|
|
|
|
|
| Performance Category | 5 | 4 | 3 | 2 | 0 |
| Interactive Dialogue
Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts a minimum of two times in each graded thread, on separate days. (5 points possible per graded thread) |
|
Summarizes what was learned from the lesson, readings, and other student posts for the week. |
|
|
|
| Minus 1 Point | Minus 2 Point | Minus 3 Point | Minus 4 Point | Minus 5 Point | |
| Grammar, Syntax, APA
Note: if there are only a few errors in these criteria, please note this for the student in as an area for improvement. If the student does not make the needed corrections in upcoming weeks, then points should be deducted. Points deducted for improper grammar, syntax and APA style of writing. The source of information is the APA Manual 6th Edition |
|
|
|
|
|
| 0 points lost | -5 points lost | ||||
| Total Participation Requirements
per discussion thread |
The student answers the threaded discussion question or topic on one day and posts a second response on another day. | The student does not meet the minimum requirement of two postings on two different days | |||
| Early Participation Requirement
per discussion thread |
The student must provide a substantive answer to the graded discussion question(s) or topic(s), posted by the course instructor (not a response to a peer), by Wednesday, 11:59 p.m. MT of each week. | The student does not meet the requirement of a substantive response to the stated question or topic by Wednesday at 11:59 pm MT. |
Check Out Also: NUR 514 Topic 8 DQ 1 discuss a specific communication technology
Virtual care and telehealth technologies have the capability to greatly expand access to quality health care. Discuss some benefits and drawbacks of virtual care/telehealth particularly related to the collaboration and coordination of care and the role of the advanced registered nurse.
ELIZABETH
Re: Topic 8 DQ 2
Telehealth is the use of telecommunications technology that allows for health data collection and transfer, communication between providers and patients, allowing care to be provided to patient’s remotely despite of their location. Frey & Chiu (2021) mentions there are four methods of telehealth which include: synchronous or live video, store-and-forward, remote patient monitoring, and mHealth (mobile health). Synchronous or live video involves a two-way communication between a provide and a patient in real time. Store-and–forward is data and patient history collected by a provider which is stored and can later be obtained by another provider through a secure platform. Remote patient monitoring consists of using digital or electronic tools, that records patient’s health information, such as blood sugar and blood pressures, which can be transmitted automatically to a provider for review. Mobile health refers to the practice of medicine and public health aided by mobile devices such as mobile phones, tablets, personal digital assistants, and the wireless infrastructure (Innovatemedtec, 2021).
Virtual care is the channel by which healthcare providers communicate with their patients; it is the actual virtual visit that takes place between the healthcare team (MD, nurse, PT, etc.) and the patient. For virtual care to happen communication technologies, such as video, chat or phone are required. This allows patients to be connected to the quality care they need, when they need it most (Synzi, 2018).
Telehealth can be beneficial when coordinating care for patients. For example, surgical patients needing pre-surgical care and post-surgical care. Nurses can contact patients via e-mail, video conferencing, or the phone, to setup appointments, do post-op teaching, and check on how patients are doing once discharged home after surgery. An example mentioned by McGonigle & Mastrian (2017) is that virtual care allows a nurse to coordinate and complete 12-16 telehealth visits vs 7 visits by a conventional home health care nurse.
A drawback a nurse can encounter with telehealth, is not being able to do an actual physical examination. There may be instances where a hands-on comprehensive physical assessment is important, which would require the patient to either go to the office or where a nurse would need to go to the patient’s home. Having to draw blood or the patient requiring radiology tests, and technical difficulties with technological devices, could also affect telehealth encounters.
Nurses need to be mindful of HIPPA regulations and remember they can only treat patients within the state they are licensed in when participating in telehealth (Frey & Chiu, 2021).
References
Frey, M.B. & Chiu, S.H. (2021). Considerations when using telemedicine as the advance practice registered nurse. The Journal for Nurse Practitioners, 17 (2021), 289-292). https://doi.org/10.1016/j.nurpra.2020.11.011
Innovatemedtec. (2012). What is mHealth? https://innovatemedtec.com/digital-health/mhealth
McGonigle, D., Mastrian, K. (2017). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning. ISBN-13:9781284121247
Synzi, L. H. (2018, June 8). Why virtual care is the “new” telehealth. https://www.healthitoutcomes.com/doc/why-virutal-care-is-the-new-telehealth-0001
RESPOND HERE (150 WORDS, 2 REFERENCES)
Hello Elizabeth,
I agree with you that the use of telehealth and virtual health platforms have resulted to increased access to healthcare. This came in as a very crucial alternative in the wake of the covid-19 pandemic where movement was restricted and patient had to continue with their medication and clinical procedures online (Monaghesh & Hajizadeh, 2020). The use of these technologies is advantageous in the sense that it saves time since the patient does not need to travel to the healthcare facility but can still access the required expert information and medical assistance from the comfort of the home. There major disadvantage of telehealth is lack of continuity of care especially where the client is using on-demand telehealth services, he or she maybe linked up at random to a healthcare provider who does not have history of the previous medical conditions or medication of the patient. This lack of coordinated care may prove to be dangerous to the patient as it can result to either omission or duplication of medical procedures (Kho et al., 2020). I do agree with you that the advanced practice nurses have a responsibility to ensure that they practice according to their areas of specialization and licensure. Additionally, the state mandated regulations should also be adhered to.
References
Monaghesh, E., & Hajizadeh, A. (2020). The role of telehealth during COVID-19 outbreak: a systematic review based on current evidence. BMC Public Health, 20(1). https://doi.org/10.1186/s12889-020-09301-4
Kho, J., Gillespie, N., & Martin-Khan, M. (2020). A systematic scoping review of change management practices used for telemedicine service implementations. BMC Health Services Research, 20(1). https://doi.org/10.1186/s12913-020-05657-w
LA SHIONNA
Re: Topic 8 DQ 2
The terms telehealth or telemedicine, encompass real-time, audio-video communication tools that connect providers and patients in different locations; store-and-forward technologies that collect images and data that can be transmitted and interpreted later, and remote patient monitoring tools such as home blood pressure monitors (Balestra, 2018). Rules that define and regulate telehealth are evolving and vary greatly across states, so much that health care groups are issuing different guidelines about the standard of care that applies in telehealth encounters.
Distance and travel time between patients and care providers can limit access to care. Telemedicine can overcome geographic barriers to healthcare, especially for specialized providers. Telemedicine can be particularly beneficial for patients in medically underserved communities and those in rural geographical locations where clinician shortages exist. Telemedicine can improve the quality of care for patients with both medical and mental health conditions. With telemedicine, patients had fewer hospital admissions and readmissions, spent fewer days in the hospital, and were more engaged in their healthcare (Care Innovations, n.d.). For nurse practitioners (NP) who deal with patients in a variety of settings, telehealth can help improve healthcare delivery to underserved communities.
Telemedicine can increase efficiency of care delivery, reduce expenses of caring for patients or transporting to another location, and can even keep patients out of the hospital. A strong doctor-patient relationship is the foundation for high-quality patient care and reducing health care costs. Telemedicine should support, not replace, traditional care delivery. With telemedicine care providers can continue to care for patients in-person while still providing the flexibility and convenience of seeing patients remotely for follow up visits, check-ups, and education when appropriate or necessary. Telemedicine makes it easier and more convenient for patient to stay healthy and engaged in their health care (Care Innovations, n.d.). Patients love the convenience, flexibility and real-time care with their providers. For providers, telemedicine can improve job satisfaction by making it easier to meet the patients. Providers can use telemedicine to make it easier to balance their work and family life.
While telemedicine promises to grow rapidly, there are still some technical and practical problems for healthcare providers. Restructuring IT staff responsibilities and purchasing equipment takes time and costs money. Training is crucial to build the effective telemedicine program. All-staff and physicians need to be trained on the new systems. In cases where patients are using an on-demand telemedicine service, they are connected with a random healthcare provider, care continuity suffers. A patient’s primary care provider may not have access to records from those other visits and end up with an incomplete history for the patient. This increases the risk that a doctor won’t know a patient’s history or have notes about care routines (Bull, Dewar, Malvey, & Szalma, 2016). Because reduced care continuity can decrease care quality, telemedicine providers must apply sound data solutions to maintain adequate and accessible patient records. As more healthcare providers adopt telehealth to use with their own patients, especially during the current pandemic, care continuity will increase. Many providers worry about technical problems associated with telemedicine. Poor broadband connections could lead to possible patient mismanagement. Healthcare laws, reimbursement policies, and privacy protection rules struggle to keep up with this fast-growing industry. As a healthcare provider, best practices should still be followed when approaching telemedicine.
The rules and regulations addressing NP requirements differ from state to state, and this variability creates confusion for NPs involved in the practice of telehealth. Some of the most critical issues include; Licenses and credentialing. Typically, a nurse practitioner is licenses only in the state in which he or she practices medicine (Balestra, 2018). Telemedicine technology allows NPs to assess patients remotely and in a variety of settings, and could include patients located across state borders. The NP providing collaborative care must be licensed in the state the patient is located and be in collaborative practice with a provider in that state.
Major developments have been made to telehealth reimbursement over the past couple years, and even more since the start of the pandemic it still remains a common stumbling block for providers interested in telemedicine. While telemedicine still has some limitations, many healthcare providers are innovating to solve these issues and improve their patients’ access to quality care.
References
Balestra, M. (2018). Telehealth and Legal Implications for Nurse Practitioners. Journal for Nurse Practitioners, 14 (1), 33-39. https://doi-org.lopes.idm.oclc.org/10.1016/j.nurpra.2017.10.003
Bull, T.P., Dewar, A.R., Malvey, D.M., & Szalm, J.L. (2016). Considerations for the Telehealth Systems of Tomorrow: An Analysis of Student Perceptions of Telehealth Technologies. JMIR medical education, 2(2), e11. https://doi.org/10.2196/mededu.5392
Care Innovations. (n.d.) How Virtual Care Benefits Patients, Clinicians & Healthcare Organizations. [Blog]. Retrieved from : https://news.careinnovations.com/blog/how-virtual-care-benefits-patients-clinicians-healthcare-organizations
RESPOND HERE (150 WORDS, 2 REFERENCES)
Hello La Shionna,
I agree with you that telehealth and telemedicine have overcome the geographic barriers that exist in traditional care. However, telehealth cannot replace traditional care but both of them have to be used in tandem so that they support each other. The utilization of modern technologies in healthcare have been the drivers in successful implementation of telehealth (Chen et al., 2019). It has offered several advantages among them reduces cost of medical care. The patients can access the care from the comfort of their homes remotely without incurring extra cost of having to travel to the facility. Moreover, they need not to pay for the hospital beds as care can be coordinated by the care-givers or close relatives who are in constant communication with the medical teams. However, there are challenges that arise from the use of telehealth, for example, most of the diagnosis like tests on blood, stool, samples, body parts imaging and scans require patients to present themselves in person at the healthcare facility. In some situations, samples such as blood, stool, urine and other body fluids can be taken and transported to healthcare facility but it might take loner than when the patients present themselves at the facility. It is the responsibility of APRNs to ensure that as they deliver the telehealth services they adhere to the ethical and legal considerations of care at all times (Nittari et al., 2020).
References
Nittari, G., Khuman, R., Baldoni, S., Pallotta, G., Battineni, G., Sirignano, A., Amenta, F., & Ricci, G. (2020). Telemedicine Practice: Review of the Current Ethical and Legal Challenges. Telemedicine and E-Health, 26(12). https://doi.org/10.1089/tmj.2019.0158
Chen, C.-H., Lan, Y.-L., Yang, W.-P., Hsu, F.-M., Lin, C.-L., & Chen, H.-C. (2019). Exploring the Impact of a Telehealth Care System on Organizational Capabilities and Organizational Performance from a Resource-Based Perspective. International Journal of Environmental Research and Public Health, 16(20). https://doi.org/10.3390/ijerph16203988
LA SHIONA
Re: Topic 8 DQ 2
The healthcare industry is always evolving and with that comes the expansion of virtual care and telehealth technologies. Digital technology is making it easier for healthcare professionals to communicate with their patients, breaking down the barriers that can impede a patient’s access to medical care (InTouch Health, 2018). Between rural areas or just avoiding a provider’s office/hospital due to a pandemic has patients neglecting their own health needs. Although there can be disadvantages to these practices, providing patients more opportunities and access to medical treatment can improve quality of health, especially in vulnerable populations.
There are many benefits that come with utilizing technology when it comes to patient care. Using technology to deliver health care has several advantages, including cost savings, convenience, and the ability to provide care to people with mobility limitations, or those in rural areas who don’t have access to a local doctor or clinic (Harvard Medical School, 2021). Allowing providers to expand their office hours with telehealth visits can fit more patient visits into one day and prevent the build up of patients in an actual waiting room. Having the convenience of telehealth during a pandemic has also helped prevent the spread or catching of a virus. People seem to really enjoy a virtual waiting room in their living room vs driving and sitting in a doctor’s office.
With benefits also comes some disadvantages to having virtual care and telehealth medicine. A downside is that it isn’t possible to do every type of visit remotely; you still have to go into the office for things like imaging tests and blood work, as well as for diagnoses that require a more hands-on approach (Harvard Medical School, 2021). Sometimes there could be a delay in treatment because the patient cannot go get tests done the same day they had their visit. Things can be missed in a virtual visit because the provider cannot physically exam the patient head to toe or see things like edematous legs when the patient is complaining about a congested nose in the telehealth visit.
References
Harvard Medical School. (2021). Telehealth: The advantages and disadvantages. Retrieved June 11, 2021, from https://www.health.harvard.edu/staying-healthy/telehealth-the-advantages-and-disadvantages
InTouch Health. (2018, October 17). Telemedicine vs. virtual care: Defining the difference. Retrieved June 9, 2021, from https://intouchhealth.com/finding-the-right-term-for-modern-digital-healthcare/
RESPOND HERE (150 WORDS, 2 REFERENCES)
Hello LaShionna,
I do agree with you that the advancement of information and technology in healthcare has made it easier for patients to access specialized care and access to expert advice which was not readily available in the past. The implementation of systems to support virtual care has been a major boost in the fight against the spread of covid-19 pandemic. It has promoted continued care despite the strict regulations imposed by WHO and world governments to curb the spread of the virus (Kichloo et al., 2020). This made medical care accessible and reduce the strain on healthcare systems. The emergence of the pandemic caused most healthcare systems to be overwhelmed by increased number of patients who required specialized care. Therefore, other patients who did not require highly specialized care were discharged and monitored from home to full recovery. One of the major disadvantages associated with incorporation of telemedicine and telehealth is breach of confidentiality on patients’ health records. This has witnessed increased risk in cybersecurity and cyber crimes that results to hacking of the systems and even manipulating the billing records (“Telehealth poses big cybersecurity dangers, Harvard researchers warn”, 2020). Therefore, the APRNs and the nurse leaders and managers have a responsibility to ensure that all the stakeholders are well trained on proper handling of confidential medical information to safeguard it against the online criminals.
References
Telehealth poses big cybersecurity dangers, Harvard researchers warn. (2020, December 16). Healthcare IT News. https://www.healthcareitnews.com/news/telehealth-poses-big-cybersecurity-dangers-harvard-researchers-warn
Kichloo, A., Albosta, M., Dettloff, K., Wani, F., El-Amir, Z., Singh, J., Aljadah, M., Chakinala, R. C., Kanugula, A. K., Solanki, S., & Chugh, S. (2020). Telemedicine, the current COVID-19 pandemic and the future: a narrative review and perspectives moving forward in the USA. Family Medicine and Community Health, 8(3), e000530. https://doi.org/10.1136/fmch-2020-000530