Essay On Telemedicine Improving Quality Of Care In Obstetrics

Telemedicine services often result in the creation of health information in formats that historically have not been part of the patient’s medical record such as audio recordings, videos and other forms of remote monitoring data (Erbetta, 1999).  While hospitals and other providers have some flexibility in determining the information that comprises the medical record, there are circumstances where an organization may want or the law may require that such information to be included in the record.  For example, it may be necessary to include such information in the medical record in order to comply with state medical record laws or for risk-management purposes (McCrossin, 2003).

In 2014, diabetes was responsible for 4.9 million deaths, approximately one death every seven seconds (Bone, 2015). For some women, pregnancy can precipitate diabetes causing numerous subsequent lifelong complications for both the mother and her fetus/newborn. The previous shocking statistic is just one of the many reasons why implementing evidence-based practice (EBP) protocols is an essential aspect in providing great patient care. In addition, EBP is crucial in improving patient outcomes while decreasing negative outcomes that can result in lifelong complications due to gestational diabetes. The process of establishing an EBP requires research to be critically appraised before it could be used

Telehealth is a newer form of healthcare that is presenting a positive impact on patients’ health and on healthcare costs. Telehealth covers a range of technology from mobile device use to physician to physician or physician to patient consults through video to assessing a patient physically who is in a different state or country. This type of technology is becoming an acceptable form of healthcare for patients, providers and insurers. Telehealth is improving the outcomes for patients while decreasing the costs of healthcare. Physician offices as well as hospitals are diving deeper into this type of care. The ability to monitor patients remotely saves time and money for the patient but also decreases visits to the hospital. In 2012 it was reported that 308,000 patients around the world utilized remote monitoring for: hypertension, diabetes, congestive heart failure (CHF), chronic obstructive pulmonary disease and mental health conditions. PriceWaterhouseCoopers (PWC) estimated in 2009 that utilization of remote monitoring could reduce healthcare costs by $197 billion dollars by 2025. PWC also found that one out of two respondents surveyed were open to utilizing technology for healthcare. The Veteran’s Administrator’s telehealth program showed that utilization of health systems was reduced by 30% for those enrolled in the telehealth program. (Thomas-Hertz, 2013)

In the state of Texas, a physician-patient relationship must be established in all cases to provide telemedicine care. The reason for this is to ensure the patient is who they say they are, to discuss diagnosis/evidence/risks/benefits, ensure a follow up, and more importantly to diagnose the patient with a full medical history. Texas provides two options to establish a physician-patient relationship. The first option is an in-person evaluation where the patient and provider are in the same physical location. The second option is a face to face evaluation that is performed by a distant site provider at distant location in an established medical site. An established medical site is a with qualified patient presenter staff, quality technology

Jardine-Brown et al, 1996, highlight many areas of substandard care and indicate the lack of specialist maternity services for the diabetic woman with resultant increases in poor pregnancy outcome. Even though improvements in care for the pregnant diabetic woman have been made over the last decade, the statistics provided by the NSF (2001) and CEMACH (2002-03) suggest insufficiency. In the search for safety and a reduction in mortality/morbidity rates, the professional must use the best available evidence for care decisions (Page, 2000).

First, there is inconsistent obstetric practice. Hospitals across the USA lack a standard approach to managing obstetric emergencies and the complications of pregnancy and childbirth are often identified too late. A second factor is the increasing number of women who present at antenatal clinics with chronic conditions, such as hypertension, diabetes and obesity, which contribute to pregnancy-related complications. Many of these women could benefit from the closer coordination of antenatal and primary care – including case management and other community-based services that help them access care and overcome cost and other obstacles. Another factor is the general lack of good data – and related analysis – on maternal health outcomes. Only half

Teleradiology services are now embedded into the workflow of many radiology practices in the United States, driven largely by an expanding corporate model of services (Silva E., 2013). Although telemedicine is a tool that enables providers to deliver health care services to patients at distant locations, in radiology, it has existed long time ago. Due to the rapid evolution of technology, images can be transmitted virtually to any part of the world to be interpreted. Although some studies and procedures requires the presence of a radiologist, Grand Hospital can perfectly provide a combination of on-site services and teleradiology to simplify geographic and overnight coverage challenges. In view of the rural location

The article titled “Follow-Up of Gestational Diabetes Mellitus in an Urban Safety Net Hospital: Missed Opportunities to Launch Preventive Care for Women” is a qualitative study from the Journal of Women’s Health. This study aimed at assessing follow-up care of patients with GDM in the postpartum period amongst a group of women with racial and ethnic

Tradition: Practicing medicine is finding a course to diagnose a disease from an illness (discomfort) with invasive procedure (testing or experimenting) to use drug for a treatment that will cause a sickness for (reduce health). Practicing medicine for primary care is the use of drug for pharmaceutical development. Therefore, there is potential for harm in practicing medicine by exposure to toxins and drugs

According to O'Higgins, McGuire, Mustafa and Dunn (2014) pregnant women with diabetes need support and reassurance regarding their ability to control BGL; while coping with the many challenges associated with the management of diabetes in pregnancy. In addition clinic provides the support and reassurance needed by the client as well as regular assessment also having access to expert guidance by health care professionals, interacting with women who have similar concerns as well as feeling cared for and not being alone in this situation. Levitt (2008) explains that frequent clinic visit by the client provides them with support through counselling on nutrition and physical activity as well as improve the client basic knowledge of diabetes management

During her pregnancy, a woman should see her doctor about once each month for the first six months of pregnancy, then every two weeks for the seventh and eighth month of pregnancy, and then every week until her baby is born. However, if a woman is over 35 or has a pregnancy with high risks due to health problems, she would probably have to see her doctor more often.

The relationship between telemedicine and practicing medicine is the benefit of Healthcare Information Technology (HIT). Although the test such as, EKG, EEG, ECT are often used with informed consent for going to doctor office. Health information technology are used in many private practices such as, a family practice for adopting computerized electronic medical record (EMR) or electronic health record (EHR) with manual operation of test such as, an EKG or an ECG for documentation. The problem to error is human is if a procedure is not documented is assume not perform or the error of mismatch of a record and inappropriate operation of medical devices are too common in practicing medicines for primary care.

In recent years, midwifery and obstetrics have become two of the most prominent and primary ways of care for women of childbearing age in comparison to unassisted births and other documented methods. Although midwifery is not as prevalent as obstetrics, there is a rise in midwifery today. In the United States women and their partners are faced with the choice of who should provide care before, during and after pregnancy. As of today there has been a rise in how many births are attended by nurse midwives than it was a quarter of a century ago but the number of births attended by an obstetrician gynecologist (OBGYN) is still significantly higher. Faced with either option, OBGYN or nurse midwife, women of childbearing age are not adequately informed or are misinformed on their choices when it comes to each specialty. This paper explores the issue of women being thoroughly informed on their birth options and on which provider is necessary. This paper also compares the two professions, midwifery and obstetrics in the realm of pregnancy, pregnancy care and childbirth. This examination of professional practices for pregnant women points out the limitations of each obstetrician gynecologists and their attendance in low risk pregnancies and deliveries and suggests the need for midwives more than ever.

The pattern of antenatal care can vary greatly between trusts and although the World Health Organisation (WHO) have taken an extremely proactive approach with regards to the schedule of care that should be given, several trials have been carried out and according to Villar et al (2008), maternal satisfaction is greatly diminished when there contact with health professionals, especially there midwives is broken or changed. It is currently recommended that primiparous low-risk women like Rebecca, should receive 10 antenatal appointments and multiparous should receive seven. NICE (2008). A Cochrane review of studies conducted throughout the world suggests that 4 prenatal visits is the minimum for low-risk women Villar et al (2008).

Prenatal care is widely accepted as an important element in improving pregnancy outcome. (Gorrie, McKinney, Murray, 1998). Prenatal care is defined as care of a pregnant woman during the time in the maternity cycle that begins with conception and ends with the onset of labor. A medical, surgical, gynecologic, obstretic, social and family history is taken (Mosby's Medical, Nursing, and Allied Health Dictionary, 1998). It is important for a pregnant woman as well as our society to know that everything that you do has an effect on your baby. Because so many women opt not to receive the benefits of prenatal care, our society sees the ramification, which include a variety of complications primarily