Initial Post

I am currently a home telehealth nurse for a  large VA hospital. I worked bedside for 17 years prior my current  position. Unlike the inpatient setting, the technology and advancement  made for the telehealth programs within the VA are impressive and  evolving rapidly.

Technology Trends and Risk

An obvious trend within the VA system is the  expansion of technology within the telehealth program. A large  percentage of the veterans live in rural areas.  At the time, home  telehealth technology is limited to monitoring patients with chronic  diseases through platforms via PC, a device to manually enter readings  daily, mobile apps, and manually entering readings through a phone  number.  The VA is now trending toward video assisted monitoring with  home telehealth.   There are physician’s offices and community-based  clinics are already using this technology. The primary challenge with  this technology is the accessibility of reliable signal strength to  patients in rural areas.  An additional struggle is difficulty with  these veterans working with this technology.

Data Safety

The VA medical system has an adequate privacy and  security protection as it relates to data safety and information sent  through telemedicine modalities.   The VA has a dedicated department  that strictly monitors all data activity. Despite the security in place  there are risk, specifically with telehealth transmission of personal  health information. These risks include accidental transmission of  household information and activities including personal interactions  with family members or indicators when the patient may not be home (Hall  & McGraw, 2014).

Patient Care

Patient care benefits of telemedicine are  endless. These benefits include less travel time, real time monitoring  of medication changes, monitors patients with chronic condition like  COPD and CHF closely to prevent or address acute episode (McGonigle  & Mastrian, 2018).  This cuts down on office visits and travel time.  More importantly, healthcare management is achieved sooner improving  overall patient outcomes.  Patient’s rely heavily on monitoring from  home creating a potential risk.  Often these patients with chronic care  management are not compliant with transmitting information or  information is sent inconsistently making it difficult to assist with  achieving overall goals.

Legislation

Telehealth  technology allows providers to treat remotely defined by state-by-state  licensure (Milstead & Short, 2019).  The benefit of state  regulation is the ability to closely monitor practice and outcomes on a  state level. The federal government is considering nationalizing the  regulations for telehealth. This presents a dilemma as physicians  practicing telehealth will require multi state licenses.

I believe the most promising healthcare trends  impacting healthcare technology and nursing practice is the advancement  of telemedicine.  The ability to remotely monitor patients and maintain a  consistent record provide information for time sensitive diagnosis and  treatment.  The impact this has on nursing is profound. Nurses will be  responsible not only for monitoring but for teaching these patients how  to manage these problems themselves. The nurse’s consistent  communication allows for education not only with medication but with  diet, exercise, weight loss and overall prevention.  Telehealth is a  promising tool to the new culture of preventative healthcare. While  patients are in the program, they can interact and learn about their  disease process and exacerbation prevention. Telehealth is a win win.

References

Hall, J. L., & McGraw, D. (2014). For  Telehealth to Succeed, Privacy and Security risks must be Identified and  Addressed []. Health Affairs33(2).                        https://doi.org/https://doi.org/10.1377/hlthaff.2013.0997

McGonigle, D., & Mastrian, K. G. (2018). Nursing Informatics and the Foundation of Knowledge (4 ed.). Burlington, MA: Jones & Bartlett Learning.

Milstead, J. A., & Short, N. M. (2019). Health Policy & Politics A Nurse’s Guide. Burlington, MA: Jones & Bartlett Learning Books.

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