NUR 514 Discuss some benefits and drawbacks of virtual care/telehealth
NUR 514 Discuss some benefits and drawbacks of virtual care/telehealth
Telehealth is a healthcare technology that implies that a patient access healthcare services away from where the hospital or the nurse is. Such can be done using remote patient monitoring and store and forward. There are advantages and disadvantages of telehealth in patient care. For instance, it enhances the convenience of health care for patients.
Patients can access healthcare services in their homes without having to travel to acquire them. Such are accessible through remote patient monitoring, live video conference, and medical education. Additionally, it is cost-efficient for patients and healthcare providers (Breton., et al., 2021). Because both parties incur costs during visits, telehealth accessing patients and accessing healthcare services does not need traveling costs; instead, getting such at home or the office.
Telemedicine is a convenient technology for accessing healthcare as it helps in engaging patients and provides better health results. The use of telehealth helps in checking the patient virtually. Thus healthcare providers may decide to strengthen treatment adherence. Such is applicable as it impedes unnecessary admissions at the hospitals (Breton., et al., 2021). Notably, when patients want to shift from a particular treatment procedure, with telehealth, the patient can make a quick inquiry on the same and get answers without traveling.
Disadvantages of telehealth
Telehealth requires expensive equipment and technology to provide health services to patients with serious health problems. For instance, people with chronic illness. Such is costly because all the details regarding the patient’s health information are channeled into software and hardware, which are expensive (Breton., et al., 2021). Additionally, there is a limitation to a physical examination; for instance, some diagnoses and treatments cannot be offered via video conferencing. Such makes it challenging to provide quality care that satisfies the patients.
The role of the advanced registered nurse
The advanced registered nurse plays a significant role in diagnosing and treating illnesses. Additionally, an ARN is trained to provide decisions to the public concerning health issues that may be encountered. In managing chronic diseases, ARN plays a significant role in ensuring that people with chronic conditions are well taken care of and get quality healthcare services (Sánchez-Gómez., et al., 2019). ARN can also educate patients regarding their needs and provide referrals to other specialists.
Breton, M., Deville-Stoetzel, N., Gaboury, I., Smithman, M., Kaczorowski, J., Lussier, M. T., Haggerty, J., Motulsky, A., Nugus, P., Layani, G., Paré, G., Evoy, G., Arsenault, M., Paquette, J. S., Quinty, J., Authier, M., Mokraoui, N., Luc, M., & Lavoie, M. E. (2021). A Portrait of its Rapid Implementation during the COVID-19 Pandemic: Telehealth in Primary Healthcare. Healthcare Policy | Politiques De Santé, 17(1), 73–90. https://doi.org/10.12927/hcpol.2021.26576
Sánchez-Gómez, M., Ramos-Santana, S., Gómez-Salgado, J., Sánchez-Nicolás, F., Moreno-Garriga, C., & Duarte-Clíments, G. (2019). Benefits of Advanced Practice Nursing for Its Expansion in the Spanish Context. International Journal of Environmental Research and Public Health, 16(5), 680. https://doi.org/10.3390/ijerph16050680
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Virtual and telehealth technologies in healthcare have truly come a long way over the last decade, however I believe that it has rapidly evolved over the last couple years due to the covid pandemic. “The evolving roles of the Internet, electronic and personal health records, mobile health, health information exchanges, and telehealth all will support a more integrated healthcare model (McGonigle & Mastrian, 2022).” I have witnessed pros and cons with the technologies. For example, during the pandemic our ED deployed the use of telemedicine for some specialty consults and for some hospitalists. This allowed the provider to not have to come to the ED and potentially be exposed and to prevent spread to other patients. Another pro I have experienced was when my grandmother had a stroke and there was not a comprehensive stroke center nearby to get her to in time to start a thrombolytic if needed, but they had a neurologist on virtual/telehealth call 24/7 for stroke consults. After this telehealth bedside consult, the decision was made by the neurologist to administer thrombolytics. This decision saved her life, she made a full recovery after having a severe CVA. One con with telehealth is the fact that you cannot have a hands-on experience. Sometimes this is necessary to get a full picture as to what is going on with the patient, such as skins, etc. One negative experience I have seen with telehealth was a patient with complaints of chest pain, who was scared to come into the ED due to the covid pandemic. The patient instead had a telehealth visit with their primary physician where the patient’s wife had shared with us that the physician felt the patient did not need to come to the ED. The patient coded at home shortly thereafter and was brought in via EMS in full arrest. Unfortunately, the patient was unable to be revived. This was a point early in the covid pandemic that really broke me down as a nurse, as this patient might have been someone who if had come to the ED, we might have been able to quickly identify a STEMI, medicate and go to cath lab and save him. The point is, if the patient had been in person, you would’ve likely performed an EKG, rapid troponin or chem 8, checked skins, peripheral pulses and other vitals and this would have led you down a different diagnosis path.
McGonigle, D., & Mastrian, K. G. (2022). Nursing Informatics and the foundation of knowledge. Jones & Bartlett Learning.
Telehealth has expanded tremendously in healthcare within the last couple years. This can be extremely beneficial when it comes to rural communities, to provide easier access to healthcare for individuals. However, some of the drawbacks to this at the same time, can be unreliable technology (Butzner, 2021). As a person who almost moved to a rural community, the access to internet and phone service was very minimal.
When it comes to a more urban location, internet can lag, due to the numerous amount of people utilizing it. from a staffing standpoint, Telehealth requires more advanced practice registered nurses, which is inclusive of those that work in acute care facilities. As we are aware, healthcare is largely understaffed. Creating new ways for patients to receive healthcare, requires more staff, which in the end leads to an even larger shortage. This shortage places a heavier load on APRN, physicians, and bedside nurses, which in return causes burnout at an exponential rate.
Butzner, M., & Cuffee, Y. (2021). Telehealth Interventions and Outcomes Across Rural Communities in the United States: Narrative Review. Journal of medical Internet research, 23(8), e29575. https://doi.org/10.2196/29575
The use of virtual health care and telehealth technologies has the ability to reach many people that do not have health care readily available. The use of telehealth nursing can make a tremendous difference in providing patient care, particularly in rural or underserved areas telehealth nursing can make a difference in providing patient care, mainly where primary care and specialist are not easy to access (Bishar, 2018). Telehealth nurses can reach patients and provide clinical information to the providers, allowing patients to receive immediate intervention for chronic and acute patient needs (Bishar, 2018). Some patients include elderly home-bound clients due to respiratory illnesses, mobility issues, and other chronic diseases (DeNisco, 2021). Devices for telehealth patients are scales to monitor weight changes, cardiac monitors to assess heart rates, and devices that monitor patients’ activity, including falls. Many of these practices during the Covid pandemic were elevated to commonplace to care for patients. This benefit allowed patients to be seen for regular checkups, receive treatment for acute problems and monitor chronic issues. Nurse practitioners were able to act as the provider’s eyes during this time, providing direct care, prescribing medications, and dictating plans of care that the providers would review. Advanced practice nurses in the home care field are active case managers collaborating with physical, occupational, and speech therapists. One of the downfalls of telehealth visits is the hands-on treatment and conversation needed by patients. Many patients may not provide all the information to the providers on their current state of health. The symptoms of deterioration could be easily seen during a one-on-one visit. The use of telehealth also depends upon the participant using any of the monitoring devices. An elderly patient without technology experience often becomes confused with equipment use inhibiting the treatment. Patient privacy is another concern because all the information is transferred through the internet and must be encrypted.
Bishar, A. (2018). Perspectives of Nurses Toward Telehealth Efficacy and Quality of Health Care: Pilot Study. JMIR. doi: 10.2196/medinform.9080
DeNisco, S. (2021). Advanced Practice Nursing.
Virtual care/telehealth does offer benefits one of the major benefits is reaching to people who have social determinants to health such as living in a rural community. Telehealth allows for specialty care and follow up care to occur without the patient or the practitioner having to travel long distances. Technology is providing tools to help bridge the gap of those who are geographically isolated. One of the major deficits to virtual care/telehealth is not being able to see, touch, smell, listen, and assess the patient in person. This can lead to errors in diagnosing patients because nuances may not be conveyed through the technology as well when doing the assessment. This is a challenge that all practitioners have. This can be mitigated by using the technology to enhance communication between the health care providers. For example, by having the practitioner with the patient participate in the assessment. Another area of concern is maintaining patient privacy. Patients need to consent to have a telehealth visit and the advanced practice nurse needs to ensure all efforts are made to maintain patient privacy. Laws have been passed and they protect the privacy and security of health information collected by covered entities (Gajarawala, S.N., Pelkowski, J. N., 2020). As technology continues to evolve in healthcare telehealth will continue to have inherent risk however the benefit to the patient population is greater.
Gajarawala, S.N., Pelkowski, J. N., (2020). Telehealth Benefits and Barriers. The Journal for Nurse Practioner. 17(2). pp 218-221. Retrieved from: https://doi.org/10.1016/j.nurpra.2020.09.013