DNP 805 Topic 6 DQ 2 Evaluate current implementation strategies for telehealth systems and provide an assessment of the pros and cons.
DNP 805 Topic 6 DQ 2 Evaluate current implementation strategies for telehealth systems and provide an assessment of the pros and cons.
DNP 805 Topic 6 DQ 2 Evaluate current implementation strategies for telehealth systems and provide an assessment of the pros and cons.
Topic 6 DQ 2
May 19-23, 2022
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?
REPLY TO DISCUSSION
Consider current telehealth strategies and alternatives. Evaluate current implementation strategies for telehealth systems and provide an assessment of the pros and cons.
According to the Institute of Health Care Improvement, telehealth might have a significant impact on satisfying the healthcare system’s triple purpose demands by enhancing population health, offering accessibility and dependability with practice care, and lowering population healthcare expenditures. Telehealth is defined as the ability to use electronic information and telecommunications technologies to provide long-distance clinical care to a patient, to provide, continue, and maintain patient health-related education, and to manage health administrative services and public health (Alexander, Hoy, & Frith, 2019).
Telehealth’s Advantages
Digital technology has simplified the integration of stored computerized information and its transmission at such high speeds via speech and video data to provide immediate access care to local and rural areas lacking expert services. It has enabled telehealth services such as remote patient information access, videoconferencing, and remote monitoring. It has also provided real-time applications by utilizing live video synchronous conferencing. The data is recorded and documented as soon as possible. It can also be saved and later sent to the consulting physician, as with medical visits, x-rays, or wound images. There is also remote patient monitoring (RPM). This is the use of medical equipment at home and the transmission of data to a doctor. In addition, the mobile health (mHealth). This is the use of mobile technology, such as smart phones, personal digital assistants, and tablets (PDAs), to transfer information (Alexander, Hoy, & Frith, 2019). The successful implementation of digital health technology will be critical for improving patient outcomes and ensuring the financial stability of health care practices (American Medical Association) (2022). This electronic communication necessitates the use of interactive telecommunications technology, which consists primarily of audio and video equipment. Telemedicine is regarded as a less expensive alternative to traditional face-to-face medical care (Centers for Medicare and Medicaid Services (CMS)) (2021)
Patient privacy and security is one of the biggest concerns in the healthcare system. The system faces a lot of issues with providing and protecting patient privacy and patients have a right to protect their privacy. All means of communication for the patient care using telehealth must be compliant with the policies and standards of care and with the regulations of the Health Insurance Portability and
Accountability Act (HIPAA). The use of technology for older adult patients may create stress because they do not know how to use it. So, providers expecting them to use it and create stress to them is unethical. With telecommunications, there are issues with network downtime, wrong documentations, issues of passwords failures or resets. Sometimes the video and audio may not be clear and cause delays and frustrations. The portability of licensure for providers across several states is still an issue with telehealth. There is movement towards providing licensure across the Unites States for providers using telehealth (Alexander, Hoy, & Frith, 2019).
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?
The clinical practice area that I will discuss is the hospital center. Some patients come to the ED and go through and triage and some directly via an ambulance and bypass physical triage and others are transfers from other hospitals. Sometimes with these situations, there is no updated family contact, phone numbers are wrong. Either the patient was unable to answer these questions, or they were confused and there was no family with them or sometimes, it is sad to say the registrants do not verify this information correctly and ask the patient is the emergency contact is the same or they do not ask at all. Sometimes, and emergency contact still on the face sheet has been deceased for several years or the emergency contact is no longer in contact with the patient, they may have moved away and their phone numbers are wrong. Sometimes these are not taken care of until the Case manager is working on that patient. I would implement a telehealth system that flags that information until it is resolved by admitting, nursing or case management so that it is not forgotten. It is a job for everyone even the physicians can help provide any information that they know.
References:
Alexander, S., Hoy, H., & Frith, K. (2019). Applied clinical informatics for nurses (2nd ed.). Jones & Bartlett Learning.
American Medical Association. (2022, February 16). Digital health implementation playbook series. https://www.ama-assn.org/practice-management/digital/digital-health-implementation-playbook-series
Center for Medicare and Medicaid Services (CMS). (2021, December 1). Telemedicine. Medicaid.gov: the official U.S. government site for Medicare | Medicaid.
https://www.medicaid.gov/medicaid/benefits/telemedicine/index.html
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REPLY
Your post has been interesting. I share your concerns about missing demographic data. Demographic data is an issue everywhere globally where there has been incomplete data inputted and sometimes in an emergency to gain access to family member about adverse or life changing events, there is no contact information. Usually, the clients who are brought in unresponsive or with altered mental status their admission details can be sketchy especially if a family member is not present. Another area that is the medication reconciliation. I do agree that the system should be able to alert clinician when the data is incomplete. I know that in some systems, it will reflect as an incomplete task and some systems won’t allow the task to be signed complete if it is not filled out.
REPLY
Thank you for the post. I agree with you when you indicated that “patient privacy and security is one of the biggest concerns in the healthcare system.” This is an ongoing issue whether electronically, via phone, paper-based, or in person (verbal). HIPAA is widely used in the healthcare system in order to ensure that patients’ privacy is respected. Actually, if we think about it, respecting and observing one’s privacy should be our mission, because this is a way to continue our care to our patients. Stay safe .
REPLY
Telehealth system usage increased during the pandemic. Telemedicine provides a cost-effective option for healthcare versus in-person office visits. Centers for Medicare and Medicaid Services (CMS) allows states to determine if telemedicine is included in services provided. (Medicaid, nd). Implementing a telemedicine program would start with an assessment of the needs for the organization. Knowledge of how state and federal guidelines for CMS. The four domains of applications for telehealth consist of remote monitoring, mobile health, store, and forward applications, and real-time applications. (Alexander, et al. 2019)
Use of telemedicine in a clinical setting for patients with congested heart failure (CHF). My experience is that those participating in telemedicine post-hospitalization have decreased readmissions. CHF patients post discharged would be followed by a CHF Case Manager (CM). Through telemedicine (real-time), the case manager and the patient would go over vital signs, and weight, it provides a nurse to have eyes on the patient. Of course, there would have to be established protocols, education for patients, etc. CHF CM would not replace a doctor’s visit but as a 3-5 day follow-up post-discharge. Centers for Medicare and Medicaid Services provides a toolkit to guide in implementing a telehealth program. Prior to implementing a program, healthcare professionals must review state and federal rules and regulations, insurance company reimbursement, the ability of the organization to provide technical assistance, and organizational policy regarding obtaining vendors. An important thing to remember is to have stakeholder support and appropriate training for those involved.
Rubric Criteria
Criterion | 1. Unsatisfactory | 2. Less Than Satisfactory | 3. Satisfactory | 4. Good | 5. Excellent |
|---|---|---|---|---|---|
Mind Map: Subtopics Related to the Main Topics and the Main Idea Mind Map: Subtopics Related to the Main Topics and the Main Idea | 0 points Mind map does not include subtopics related to the main topics and the main idea. | 8 points Mind map includes subtopics related to the main topics and the main idea, but they are incorrect or incomplete. | 8.8 points Mind map includes subtopics related to the main topics and the main idea, but they lack clarity. | 9.2 points Mind map includes subtopics related to the main topics and the main idea that are clear and logical. | 10 points Mind map includes subtopics related to the main topics and the main idea that are extremely thorough and logical. |
Conclusion: Provides a Summary of Ideas and Supports the Main Claim of the Paper Conclusion: Provides a Summary of Ideas and Supports the Main Claim of the Paper | 0 points Conclusion is not included. | 4 points Conclusion is incomplete or incorrect. | 4.4 points Conclusion is included but lacks sufficient amount of detail. | 4.6 points Conclusion is complete and includes a sufficient amount of detail. | 5 points Conclusion is extremely thorough and incorporates substantial supporting detail. |
Thesis Development and Purpose Thesis Development and Purpose | 0 points Paper lacks any discernible overall purpose or organizing claim. | 5.6 points Thesis is insufficiently developed or vague. Purpose is not clear. | 6.16 points Thesis is apparent and appropriate to purpose. | 6.44 points Thesis is clear and forecasts the development of the paper. Thesis is descriptive and reflective of the arguments and appropriate to the purpose. | 7 points Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear. |
Paper Format (Use of appropriate style for the major and assignment) Paper Format (Use of appropriate style for the major and assignment) | 0 points Template is not used appropriately or documentation format is rarely followed correctly. | 4 points Template is used, but some elements are missing or mistaken; lack of control with formatting is apparent. | 4.4 points Template is used, and formatting is correct, although some minor errors may be present. | 4.6 points Template is fully used; There are virtually no errors in formatting style. | 5 points All format elements are correct. |
Precis: Statement of Focus of the Scholarly Article (How It Was Organized and Completed) Precis: Statement of Focus of the Scholarly Article (How It Was Organized and Completed) | 0 points A statement of focus of the scholarly article (how it was organized and completed) is not included. | 4 points A statement of focus of the scholarly article (how it was organized and completed) is incomplete or incorrect. | 4.4 points A statement of focus of the scholarly article (how it was organized and completed) is included but lacks clarity and meaningful expression. | 4.6 points A statement of focus of the scholarly article (how it was organized and completed) is organized and contains clear meaningful expression. | 5 points A statement of focus of the scholarly article (how it was organized and completed) is extremely thorough, organized, and contains clear meaningful expression. |
Precis: Statement of Why the Information in the Article Is Important to the Field of Study of the DN Precis: Statement of Why the Information in the Article Is Important to the Field of Study of the DNP Learner | 0 points A statement of why the information in the article is important to the field of study of the DNP learner is not included. | 4 points A statement of why the information in the article is important to the field of study of the DNP learner is incomplete or incorrect. | 4.4 points A statement of why the information in the article is important to the field of study of the DNP learner is included but lacks clarity and meaningful expression. | 4.6 points A statement of why the information in the article is important to the field of study of the DNP learner is organized and contains clear meaningful expression. | 5 points A statement of why the information in the article is important to the field of study of the DNP learner is extremely thorough, organized, and contains clear meaningful expression. |
Mind Map Discussion: Connection to the Usefulness of the Information in Practice Mind Map Discussion: Connection to the Usefulness of the Information in Practice | 0 points Mind map discussion that explains a connection to the usefulness of the information in practice is not included. | 4 points Mind map discussion that explains a connection to the usefulness of the information in practice is incomplete or incorrect. | 4.4 points Mind map discussion explains a connection to the usefulness of the information in practice but lacks a sufficient amount of detail. | 4.6 points Mind map discussion includes a connection to the usefulness of the information in practice that is complete and includes a sufficient amount of detail. | 5 points Mind map discussion explains a connection to the usefulness of the information in practice that is extremely thorough and incorporates substantial supporting detail. |
Argument Logic and Construction Argument Logic and Construction | 0 points Statement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources. | 6.4 points Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility. | 7.04 points Argument is orderly, but may have a few inconsistencies. The argument presents minimal justification of claims. Argument logically, but not thoroughly, supports the purpose. Sources used are credible. Introduction and conclusion bracket the thesis. | 7.36 points Argument shows logical progressions. Techniques of argumentation are evident. There is a smooth progression of claims from introduction to conclusion. Most sources are authoritative. | 8 points Clear and convincing argument that presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative. |
Introduction Introduction | 0 points An introduction is not included. | 4 points An introduction is incomplete or incorrect. | 4.4 points An introduction is included but lacks supporting detail. | 4.6 points An introduction is complete and includes supporting detail. | 5 points An introduction is extremely thorough, with substantial supporting detail. |
Documentation of Sources Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style) | 0 points Sources are not documented. | 4 points Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors. | 4.4 points Sources are documented, as appropriate to assignment and style, although some formatting errors may be present. | 4.6 points Sources are documented, as appropriate to assignment and style, and format is mostly correct. | 5 points Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error. |
Mind Map: Identifiable Main Idea Mind Map: Identifiable Main Idea | 0 points Mind map does not include an identifiable main idea. | 8 points Mind map includes an identifiable main idea that is incorrect or incomplete. | 8.8 points Mind map includes an identifiable main idea but it lacks clarity. | 9.2 points Mind map includes an identifiable main idea that is complete, clear, and logical. | 10 points Mind map includes an identifiable main idea that is extremely thorough and logical. |
Precis: Statement of What Was Studied Precis: Statement of What Was Studied | 0 points A statement of what was studied (i.e., argued, discussed, or deliberated) is not included. | 4 points A statement of what was studied (i.e., argued, discussed, or deliberated) is incomplete or incorrect. | 4.4 points A statement of what was studied (i.e., argued, discussed, or deliberated) is included but lacks clarity and meaningful expression. | 4.6 points A statement of what was studied (i.e., argued, discussed, or deliberated) is complete. The statement is organized and contains clear meaningful expression. | 5 points A statement of what was studied (i.e., argued, discussed, or deliberated) is extremely thorough, organized, and contains clear meaningful expression. |
Mind Map: Main Topic Branch or Branches Related to the Main Idea Mind Map: Main Topic Branch or Branches Related to the Main Idea | 0 points Mind map does not include a main topic branch or branches related to the main idea. | 8 points Mind map includes a main topic branch or branches related to the main idea, but they are incorrect or incomplete. | 8.8 points Mind map includes a main topic branch or branches related to the main idea, but they lack clarity. | 9.2 points Mind map includes a main topic branch or branches related to the main idea, and they are clear and logical. | 10 points Mind map includes a main topic branch or branches related to the main topic, and they are extremely thorough and logical. |
Precis: Statement of Information Identified or Learned From the Scholarly Article Precis: Statement of Information Identified or Learned From the Scholarly Article | 0 points A statement of information identified or learned from the scholarly article is not included. | 4 points A statement of information identified or learned from the scholarly article is incomplete or incorrect. | 4.4 points A statement of information identified or learned from the scholarly article is included but lacks clarity and meaningful expression. | 4.6 points A statement of information identified or learned from the scholarly article is complete. The statement is organized and contains clear meaningful expression. | 5 points A statement of information identified or learned from the scholarly article is extremely thorough, organized, and contains clear meaningful expression. |
Mechanics of Writing (includes spelling, punctuation, grammar, language use) Mechanics of Writing (includes spelling, punctuation, grammar, language use) | 0 points Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is used. | 4 points Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register) or word choice are present. Sentence structure is correct but not varied. | 4.4 points Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct and varied sentence structure and audience-appropriate language are employed. | 4.6 points Prose is largely free of mechanical errors, although a few may be present. The writer uses a variety of effective sentence structures and figures of speech. | 5 points Writer is clearly in command of standard, written, academic English. |
Mind Map Discussion: Critical Evaluation of Ideas and Connections Related to the Topics and Subtopic Mind Map Discussion: Critical Evaluation of Ideas and Connections Related to the Topics and Subtopics | 0 points Mind map discussion providing a critical evaluation of ideas and connections is not included. | 4 points Mind map discussion provides a critical evaluation of ideas and connections that is incomplete or incorrect. | 4.4 points Mind map discussion provides a critical evaluation of ideas and connections but lacks a sufficient amount of detail. | 4.6 points Mind map discussion provides a critical evaluation of ideas and connections that is complete and includes a sufficient amount of detail. | 5 points Mind map discussion critical evaluation of ideas and connections is extremely thorough and incorporates substantial supporting detail. |