NUR 514 Topic 8 DQ 2 Virtual care and telehealth technologies have the capability to greatly expand access to quality health care

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Topic 8 DQ 2

Nov 17-21, 2022

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

Jamie Buchanan

Nov 19, 2022, 12:48 PM

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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:

Stanton, M. W. (2017). The high concentration of U.S. health care expenditures. Research in Action, 19.

Isaac Adu

replied toJamie Buchanan

Nov 19, 2022, 5:02 PM

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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

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

Corina Heimke

replied toJamie Buchanan

Nov 21, 2022, 9:29 AM

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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

Jamie Buchanan

Nov 18, 2022, 8:57 AM

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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

Corina Heimke

replied toJamie Buchanan

Nov 18, 2022, 1:32 PM

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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/

Tuova Williams

replied toJamie Buchanan

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

NUR 514 Topic 8 DQ 2 Virtual care and telehealth technologies have the capability to greatly expand access to quality health care

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:

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

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