telehealth1x - Personal.Psu.Edu

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14 Νοε 2013 (πριν από 3 χρόνια και 7 μήνες)

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Telehealth




By: Loretta Suarez



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Objectives




Define
telehealth


Explore how
telehealth

is made possible


Describe hardware and software used in
telehealth


Evaluate the usability of software in
telehealth


Describe system used in
telehealth


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Objectives



Identify advantages & disadvantages of
telehealth


Observe advantages & disadvantages of
telehealth


Identify ethical and/or legal issues


Explore competencies for nursing informatics


Describe functions of the informatics nurse


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What is
Telehealth
?


Telehealth

provides health care, health information, and health
education across a distance by using telecommunications
technology and specially adapted equipment.


Regardless of distance, it enables physicians, nurses, and
healthcare specialists to:





(
Telehealth

Leadership Initiative, 2008)



T











assess

diagnose

treat

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Telehealth

is made possible by
utilizing:


Computers


Interactive video


Virtual reality


Tele
-
robotics


Telephones


Picture phones


Fax


Emails


(
Telehealth

Leadership Initiative, 2008)

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What types of hardware are used in
Telehealth
?

Teleconferencing


-
telephones


-
picture phone

Computers


-
email

-
faxes

Biomedical peripherals

Interactive video
transmission


(ANA, 1997)

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Hardware:

Biomedical Peripherals




Micro
Audiometrics


ECG (12 lead)


Spirometer


Video
otoscope


Vital signs monitor


Digital camera


(AFHCAN,
2009)

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Software used in
Telehealth
?


AFHCAN
tConsult



Global Media
CapSure



HCC RX
-
1


CSX
Telemed


American
Telecare

NX Server


Second Opinion

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AFHCAN
tConsult
™ software


Designed by health care
professionals


Touchscreen

compatible


Color coded for easy
navigation


Meets HIPPA privacy
requirements


Minimal user training


Video conference and
computer based training


Easy access to peripherals


Options for clinicians to use
menus or free text


Design

Usability


(AFHCAN, 2009)

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tConsult
™ Evaluation of Usability


Based on the Three Axioms of Usability


(Staggers, 2003)

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Clinical Information Systems




Electronic Medical Records (EMR)


Clinical Data Repositories (CDR)


Decision Support Systems (DSS)


Handheld devices


Apply technology at the point of clinical care

A CIS include:


(
McGonigle

&
Mastrian
, 2009)

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Who utilizes Clinical
Information Systems in
Telehealth
?


Physicians & Physician Assistants


Nurse Practitioners & Nurses


Administrative assistants


Billing Department



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are most
Telehealth

CIS
based on?


Wide Area Network (WAN) & Wireless Local Area Network
configuration


Healthlevel

7 (HL7) standards


ICD
-
9 or ICD
-
10 & SNOMED Disease and Procedure Classification
System


NANDA taxonomy & SNOMED RT nursing practice standards
classification scheme


(
NorthropGrumman
, 2009)

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Advantages of
Telehealth


improved access to medical
specialists


quicker, more accurate
diagnosis and treatment


improved patient outcomes


reduced travel and cost


fewer hospital admissions



increased confidence in health
management


increased opportunities for
education


improved patient follow
-
up


collaborative research


decreased overall costs

Patient Advantages

Provider Advantages


(Digital
Telehealth

Inc., 2007)

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Disadvantages of
Telehealth


B
reakdown in the patient/healthcare professional
relationship


Poor infrastructure and inadequate regulation of
telecommunications


Maintaining quality of care


Policies/protocols regulating the use of tele
health


Potential medical malpractice liability due to uncertainties
concerning the legal status of telemedicine within and
between states


Confidentiality due to increased access to patient records



(
Sarhan
, 2009)

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Ethical Issues Related to
Telehealth


Depersonalization


Emotional impact on the healing relationship


Risk for exploitation


Access discrimination


Potential burden of technology for some patients, especially
the sick & dying


(Fleming, 2007)

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Legal Issues Related to
Telehealth


No licensure requirements


Lack of accreditation


Malpractice liability


Confidentiality & Privacy


Fraud & Abuse


Antitrust



(Klein & Manning, 1997)

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Informatics competencies required by
any RN working in
Telehealth
:


Technical
Competencies


Competent in the
use of information
& communication
technology

Utility
Competencies


Competent in the
use of automated
information in a
professional
context

Leadership
Competencies


Competent in
decision making
with respect to
planning for and
using both the
technology &
information


(Kaminski, 2008)

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(HIMSS,
2007)

Roles of

the

Informatic


Nurse in

Telehealth



Management

Training

Development
of
Educational
Programs

Ensures that
any system
meets the
needs of
nurses

Writing
Policies

Aid in design
of
Organizations
Intranet

Advises on
needs for
Clinical
System
Changes

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Telehealth

is:


Improving the health care delivery system


Connecting providers with difficult to reach patients


Informing patients and providers


Preventing illness


Educating patients and providers


Enhancing the way we practice health care

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References:


Alaska Federal Health Care Access Network (2009). AFHCAN
Telehealth

Solutions. Retrieved February 2, 2010 from

http://www.afhcan.org/


Elford
, R. (2004). Digital Health, Inc.: An Introduction to
Telehealth
.
Retrieved April 11, 2010 from

http://www.telehealth.ca/intrototelehealth.html


Fleming, D. (2007). Center for Health Ethics, University of Missouri.
Telehealth
: The Ethical Challenges of a New Technology. Retrieved
on April 11, 2010 from

http://ethics.missouri.edu/Tele
-
Ethics.aspx


HIMSS Nursing Awareness Task Force (2007). Informatics
. Nursing
Management,
March
p
. 39
-
42.


Kaminski, J (2008). Nursing Informatics 101. Retrieved on April 10,
2010 from

http://www.slideshare.net/junek/nursing
-
informatics
-
101
-
workshophttp://www.slideshare.net/junek/nursing
-
informatics
-
101
-
workshop








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References:


Klein, S. & Manning, W. (1997). The Health Law Resource.
Telemedicine and the Law. Retrieved April 11, 2010 from

http://www.netreach.net/~wmanning/telmedar.htm 1997


McGonigle
, D. &
Mastrian
, K. (2009). Nursing Informatics and the
Foundation of Knowledge. Sudbury, MA: Jones and Bartlett.


Milholland
, DK.

(1997)
.

Telehealth: A Tool for Nursing Practice.
Nursing Trends & Issues
, 2(4).


Northrop Grumman (2009). Clinical Information Systems.
Retrieved March 15, 2010 from

http://www.is.northropgrumman.com/by_solution/health_it/market
s/health_cis/index.html


+

References:


Sarhan
, F. (2009). Telemedicine in Healthcare 1: Exploring its uses,
benefits, and disadvantages. Retrieved on April 13, 2010 from

http://www.nursingtimes.net/nursing
-
practice
-
clinical
-
research/telemedicine
-
in
-
healthcare
-
1
-
exploring
-
its
-
uses
-
benefits
-
and
-
disadvantages/5007796.article


Staggers, N. (2003). Human Factors: Imperative Concepts for
Information Systems in Critical Care.
AACN Clinical Issue
. 14(3) pp.
310
-
319.


Telehealth

Leadership Initiative (2008). What is
Telehealth
?
Retrieved February 1, 2010 from

http://www.telehealthleadership.org/telehealth101.html