Running head: TELEHEALTH 1

Telehealth

NUR410-2W1

Delaware Technical Community College

Jessica Elliott

July 27th, 2019

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Telehealth

As time goes on, technology becomes more and more relevant in the medical field.

Whether it’s workplaces on wheels, electronic medical records, health portals, or even just

automatic blood pressure cuffs, medical technology is rapidly evolving. Another important

advancement in medical field technology involves telehealth. Telehealth involves the use of

electronic devices and programs to remotely access and manage patients care. This includes, but

is not limited to, mobile devices and computers. (Telehealth, 2017) Telehealth allows the

patient’s physician to assess them within the comfort of their own home. This is especially

helpful for patients in rural areas. This can also be beneficial to special patient groups, such as,

young children, the elderly, and patients with compromised immune systems, such as oncology

or transplant patients.

In general, the use of telehealth can increase patient compliance with taking medications

and attending doctors’ appointments. When focusing on immunocompromised patient

populations, telehealth can help to decrease the risk of becoming ill by eliminating the doctor’s

office. In addition, it can help to monitor and manage different symptoms associated with

medications or disease progression. (Charalambous, 2018) When using the video chatting option

of telehealth, the need for patients to find a ride to appointments, for patients to find babysitters

for their children, and for patients to worry about what they could be exposed to in the doctors’

office, is now eliminated.

When thinking of telehealth, many people think of video chatting with their healthcare

team. While this feature is absolutely a part of telehealth, there are also many other aspects of

telehealth. Another example of telehealth is a patient portal. Depending on the doctors’ office,

patient portal can allow the patient to view lab results, review notes from the visit, view and
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schedule their next appointment, request medication refills, and even send messages to their

healthcare team. While this process is slightly different than videoing with the provider, the

ultimate goal is the same- to increase medical compliance among vulnerable populations. While

further education may need to be provided to patients, telehealth can be easily accessed from

nearly anywhere by nearly anybody. While certain considerations, such as visual ability, hearing

ability, and mental status, may need to be considered, telehealth promotes a healthier lifestyle.

Telehealth can also help caregivers care for their loved one and make it easier to learn

information about their medical condition. (Charalambous, 2019)

Legal Implications for Nurses

The ultimate goal of telehealth is to help patients have access to their healthcare team.

However, there are certain legal implications that need to be considered by the healthcare team

before introducing telehealth to patients. When using patient portal services, nurses typically

respond to medication requests and basic questions within their scope of practice. When using

video services, there are even “nurse visits” to keep the patient in contact.

However, it’s important to consider where both the patient and nurse are located. (Sewell,

2019) If a nurse is in Delaware but a patient is in New Jersey, then the nurse could potentially be

practicing in a state where her license is not valid. While New Jersey is awaiting to become a

compact licensure state, this has not yet occurred. Telehealth laws vary state to state. Because of

this, it is important to know the laws of both the state the nurse and the patient are in. Nurses

should be aware of these laws before participating in telehealth medicine. (Sewell, 2019)
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Implementation

In order for patients to be comfortable with using the different aspects of telehealth, the

processes should be explained when the patient is seen in the office. For example, at Peninsula

Regional Medical Center in Salisbury, MD, the patient portal is only offered to patients at

doctor’s appointments and at emergency room visits. This “offer” includes a piece of paper with

a username, temporary password, website, and minimal directions. In order for more patients to

be comfortable with this system, a new way to explain it to patients needs to be implemented.

Instead of handing patients a piece of paper and sending them on their way, nurses need

to help patients set up their account before the doctor comes in to see them. More times than not,

patients have to wait in between seeing the nurse and seeing the provider. This would be the

perfect opportunity to explain the process to patients. Instead of just handing over a piece of

paper, the nurse can help the patient set up their account and answer any questions that they may

have about the patient portal. By doing this, patients have a better understanding of the patient

portal and all of the resources that can be used through it.

When the time is taken to actually explain the process to patients, more patients are

willing to use the portal. In addition, using the portal can help to eliminate unnecessary office

visits. When these visits are eliminated, it opens up the providers schedule and saves the practice

money and resources.

Policy

In order for a healthcare policy to be considered safe and ethical, evidence-based research

must be conducted on the subject. Aspiration or marketing-based approaches are not considered

ethical when evidence-based practice is available. (Rigby et al, 2016) Since telehealth is still
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evolving into its own entity, there are not as many polices on the subject when compared to

others. Telehealth has the potential to save time, money, and lives. However, with its lacking

policies, telehealth is not where it could or should be. An example of a telehealth policy is: All

patients should be offered help enrolling in the patient portal service at first office visit. By

making this into a policy, there is a higher chance of nurses complying with the change. This

policy helps patients to have access to their healthcare information and healthcare team, without

coming to the office. While not all health systems have a patient portal, this policy would be

beneficial to health systems that do participate in patient portal systems.

After implementing this policy, a significant increase in patients would have access to

their information from any smartphone, laptop, computer, or tablet device. Patients across all age

ranges have now learned to use these devices. While some patients may decline the service, it

should still be offered. It may not always be appropriate for the patient to use; however, it may

be appropriate for the caregiver. This could potentially be the case for young children, the

elderly, and patients with certain disabilities.

This policy helps to advocate for all patients. By implementing this policy, more patients

have access to life saving healthcare opportunities. While not all patients may be comfortable

with telehealth, the benefits outweigh the risks to the patient. The patient portal can help to

manage known symptoms in the chronically ill. Rather than coming in for an appointment every

time something gets a little worse, this can be monitored through the patient portal.

(Charalambous, 2019)
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Conclusion

Overall, telehealth is a beneficial system to patients, caregivers, and providers. Not only

does the process advocate for the patient’s health, but it also helps to save money, time, and

doctors visits. When using the patient portal or other telehealth systems, it is important for both

nurses and patients to understand the system. Without the proper knowledge, nurses could

potentially be practicing against their license. Without the proper knowledge, patients would not

know the full potential of the patient portal. With the implementation of the new policy, more

patients would know how to access their health information in an easier, more accessible way.

Telehealth is more than just a way to save a dollar. Telehealth helps to ensure the highest

level of care is provided to the patient, no matter the situation at hand.

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References

Mayo Clinic. (2017, August). Telehealth: Technology meets healthcare. Retrieved from: https://

www.mayoclinic.org/healthy-lifestyle/consumer-health/in-depth/telehealth/art-20044878

Charalambous, A. (2018, November 11) Utilizing the advances in digital health solutions to

manage care in cancer patients. Asia-Pacific Journal of Oncology Nursing. 6(3) 234-237.

Sewell, J. (2019) Informatics and nursing: Opportunities and challenges. Philadelphia, PA:

Wolters Kluwer.

Rigby, M., Magrabi, F., Scott, P., Doupi, P., Hypponen, H., & Ammenwerth, E. (2016, October

31). Steps in moving evidence-based health informatics from theory to practice. The

Korean Society of Medical Informatics. 22(4) 255-260. doi: 10.4258/hir.2016.22.4.255