TH Intervention Summary

E-health combines technology with health care. The use of this new and emerging technology allows the delivery of health care to take the form of e-visits, online patient charting, patient access to personal medical records and remote monitoring of vital health monitoring. The use of e-health in health care system with the support of federal guidelines and regulations will help improve the quality, efficiency, and access to

While sometimes used interchangeably in literature, telemedicine is the remote delivery of clinical data using the internet, telephone, wireless, and satellite media (“The Rise of Telehealth,” 2015). Telehealth services are provided through various devices such as cell phones, the internet, video, and computer software. The goal of telehealth is to “provide the right care at the right place at the right time” (“Home Telehealth: A Tool for Diabetic Self-Management,” 2016). Telehealth applications perform a wide array of functions. For instance, certain programs collect objective and subjective findings which help the healthcare team identify a diagnosis. Some telehealth technologies have been designed to allow images to be uploaded and assessed by healthcare professionals. Certain applications provide the patient with remote monitoring. Other services are designed to educate and prevent certain disease processes among its users (“The Rise of Telehealth,” 2015). All of the services which telehealth offer are designed to track various trends in patient data and the goal is that they be as user friendly as

Curtis et al., in the article, “The importance of daily weight measurements in heart failure patients: a performance improvement project”, addressed the problem of lack of accurate daily weights by 0500 daily. Despite the policy and importance of daily patient weights, it was shown that accurate daily weights were still lacking. They discovered that the problem was the lack of availability of standing scales and lack of nursing staff support (NSS) understanding of the importance of daily patient weights. They supplied the floor with an additional standing scale and educated the nursing staff and support on the importance of daily weights. With these implementations, accurate patient daily weights increased by 90% (Curtis et al., 2012).

The benefits of telehealth consultations are immeasurable; clients are able to access a knowledgeable health care professional and receive a telephone triage/assessment and recommendations. This allows the patient to have immediate access to good health advice and quicker solutions. Telemedicine is one of the many vehicles of telehealth; for example, the cardiologist orders an outpatient Holter Monitor trial to evaluate arrhythmias. The technician calls the patient at the sign of any abnormal rhythm and investigate the activity performed when the reading fluctuation then the reported is communicated to the cardiologist. If warranted, the cardiology staff will contact the patient with instructions schedule an immediate appointment. Telehealth services resources would benefit the client in this next example, an individual’s come in for a sick visit expecting a prescription to be written for their illness; they receive informative instructions because of the nature of the

Telehealth has been a large topic of debate in recent years because of the economic, political, and regulatory points of view. In deciding outcomes in these areas, it is the responsibility of all healthcare professions to identify information gaps in order to come to the more rational and beneficial conclusion about telehealth (Grace, 2014). Economically, there are concerns regarding the access and affordability of telehealth equipment. At the same time, telehealth is being adapted in ways to be utilized with technological devices that many individuals already have access to like telephones, cellular phones, and personal computers/laptops. Telehealth can positively impact both clients and providers by increasing access to care and reducing the time and costs associated with traveling for health care (Allen, Aylott, Loyola, Moric, & Saffarek, 2015). As telehealth develops technological devices can be made more affordable and can be covered by insurance policies (Thomas et al., 2014). Many nurses functioning as case managers can help provide the tools and resources individuals require to manage their health.

I have use evidence base practice often in homecare. I had a homecare patient who has hypertension and don’t check his blood pressure regular. I explained to him the important of checking blood pressure daily. Evidence based practice shows self-management of blood pressure is a useful tool in monitor hypertension and preventing stroke (McNamar, Versace, Marriott & Dunbar, 2014). I requested the family to buy an electronic blood pressure cuff. I encouraged patient to record blood pressure daily and record. I also instructed patient to take results to next doctor appointment.

Telemedicine is a vast subject, but as yet there are limited data on the clinical effectiveness and cost-effectiveness of most telemedicine applications. As a result, objective information about the benefits and drawbacks of telemedicine is limited. This write up is therefore based mainly on my review opinion referencing the case: “a Telemedicine opportunity of distraction? “of Harvard business. Many potential opportunities of telemedicine including, but not limited to: improved access to information; provision of care not previously deliverable; improved access to services and increasing care delivery; improved professional education; quality control of screening programs; and reduced health-care costs. Although telemedicine clearly has a wide range of potential benefits, it also has some disadvantages. The main ones that can be envisaged are: a breakdown in the relationship between health professional and patient; a breakdown in the relationship between health professionals; issues concerning the quality of health information; and organizational and bureaucratic difficulties. On balance, the benefits of telemedicine are substantial, assuming that more research will reduce or

Bosworth, Olsen, Grubber, Powers, and Oddone (2012) conducted a three-arm randomized controlled trial to determine the differences in AAs and Caucasians in two self-management hypertension interventions (N=636; non-whites n=328, and whites n=308). The subjects were randomly placed in the usual care (UC), home BP monitoring (HBPM), a tailored behavioral self-management intervention (TBSMI), and the two groups combined (TBSMI + HBPM). Data collection was done at the initiation of the research, 12 months, and 24 months from the control and intervention groups. BP results on whites at the baseline and intervention groups did not differ, but there was significantly reduction in the systolic BP of 7.5 mm Hg in AAs. This study denotes that a home BP monitoring in combination of nurse-administered telephone behavioral intervention was most effective in BP control in AAs.

Nursing interventions are focused on nursing behaviors to guide the patient in the direction of the most preferred outcome (Johnson et al., 2012). Fluid management, fluid/electrolyte management, and hypervolemia management are the major interventions in effective management of CHF. Fluid management is the most difficult intervention for all patients suffering from CHF. Evaluation of the patient’s ability to make the appropriate lifestyle changes required to

Telehealth is the monitoring via remote exchange of physiological data between a patient at home and health care professionals at hospitals or clinics to assist with diagnosis and treatment. As our society ages and health care costs increase, government and private insurance payers are seeking technological interventions. Technological solutions may provide high quality healthcare services at a distance, utilize professional resources more effectively, and enable elderly and ill patients to remain in their own homes. Patients may experience decreased hospitalization and urgent care settings, and out of home care may not be required as the patient is monitored at home. However, no study has been able to prove telehealth

The delivery of health care has always been influenced by technological developments and innovations. This is particularly true in modern health care professionals where they are obsessed with technology and rush to apply them. One of the most recent applications of ICT – Information and computer technology- is telehealth. Telehealth is the use of communication, diagnostic and information technology to provide health care when patients and providers are geographically separated [2], Technologies include videoconferencing, the internet, store -and-forward imaging, streaming media, terrestrial and wireless communications. Telehealth could be as simple as two health professionals discussing a case over the telephone or as

Caffery, Smith and Scuffham (2008) commented that email based telemedicine methodology is often considered a low-cost form of telemedicine. In their study, they took into account staff costs (including counselors and administrative staff) and fixed costs (development and implementation of the email service). Fixted costs totaled approximately $11,995 per year for the development and implementation of a purpose-written email-based telemedicine system. Furthermore, supervisory costs totaled $61,454 per year. In another study, Palmas and colleagues (2010) accounted for the estimated cost of delivering case management services to underserved populations. The authors found that the cost of the telemedicine equipment and supplies for the clinical team, for the first four years of the study totaled over $100,000 (Palmas, et al., 2010). This does not take into account salaries, the costs of the bioinformatics team, and vendor costs associated with the project, which total into the millions. The higher costs are associated with the level of technology required. Palmas, et al., utilized a telemedicine system (IDEATel) that, according to Shea (2007), combines video conferencing, access to the American Diabetes Association portal, remote glucose and blood pressure monitoring, and patient access to their own clinical data and a secure messaging service.

LifeStat, developed by SaskTel, is a device that serves the purpose of fulfilling the communication gap between patients and their caregivers. It allows SaskTel’s clients to examine their own blood pressure, glucose levels, and heart rate levels without having to physically go to the hospital. The information gathered by the client is then transmitted to SaskTel’s data center where a professional caregiver or physician is able to monitor the client’s personal health at anytime of the day. SaskTel’s executive committee recently approved a proposal to launch LifeStat into the Canadian healthcare market place. Pat Tulloch, senior director of marketing for SaskTel, was given the task

There is an increasing need within the U.S. for quality health care to be provided to individuals who have limited access whether it is due to a rural environment, disabilities, or in the field of battle. Telemedicine is literally medicine provided at a distance. Telehealth is able to alleviate some of the effects of a growing shortage of professionals such as primary care physicians. In this type of health care delivery, the dynamics between the patient and the entire health care system changes. Telemedicine meets the increasing demands of patients to have greater access, or responsiveness, from a health care provider. It also meets the needs of the provider who is very interested in time-saving, safety-enhancing assistance in their daily practice. Employers and health plans are also very interested in telemedicine as a means of improving compliance with treatment plans and care management initiatives (Hodgkins, 2008). The use of email also allows the patient to have increased access to their health care providers. Instead of calling their health care provider’s office, patients are now able to email their non-emergent health care questions to their provider. Conversely, health care providers are able to email patients reminders for appointments or wellness tips.

ef{fig:chapter2:overview}. Section 2.2 presents an overview of telehealth and its architecture with a detailed investigation of physiological sensing, data processing, data management, communication technique, and security. This is comparative studies of the existing technologies, techniques, and tools used in such system using qualitative comparison and use case analysis to give insight on the potential use of different techniques. Section 2.3 classifies the existing use of telehealth