Chapter 19 by Audrey Kinsella and Kathleen Albright

1. Chapter 19by Audrey Kinsella and Kathleen Albright Telenursing and Remote Access Telehealth

2. Objectives • Explore the use of telehealth technology in nursing practice. • Identify socioeconomic factors likely to increase the use of telehealth interventions. • Describe clinical and nonclinical uses of telehealth.

3. Objectives • Specify and describe the most common telehealth tools used in nursing practice. • Explore telehealth pathways and protocols. • Identify legal, ethical and regulatory issues of home telehealth practice.

4. Objectives • Describe the role of the telenurse. • Apply the Foundation of Knowledge model to home telehealth.

5. Key Terms Defined • Call Centers • Chronic Disease • Centers for Medicare and Medicare Services • Central Stations/Web Servers/Portals

6. Key Terms Defined • Home Healthcare • Home Telehealthcare • Medication Management Devices • Outcomes and Assessment Information Set

7. Key Terms Defined • Medication Management Devices • Outcomes and Assessment Information Set • Patient Health Outcomes • Patient Informed Consent

8. Key Terms Defined • Patient Health Outcomes • Patient Informed Consent • Personal Emergency Response Systems • Peripheral Biometric (Medical) Devices

9. Key Terms Defined • Real-Time Telehealth • Sensor and Activity Monitoring System • Store-and-Forward Telehealth • Telehealthcare

10. Key Terms Defined • Telehealth • Telemedicine • Telemonitoring • Telenursing

11. Key Terms Defined • Telephony • Teleradiology • Telepathology

12. Nursing Aspects of Telehealth • Understanding Telehealth • Telehealth Interventions

13. Driving Forces For Telehealth • What will affect nursing in the next decades to come? • Estimations by the year 2040 • The Nursing Shortage Crisis is Two-Fold

14. Driving Forces For Telehealth • Health Resources and Services Administration 2002 Report • Pennsylvania Homecare Association and Penn State University 2004 Study • How many Americans are living with one or more chronic conditions?

15. Driving Forces For Telehealth Centers for Disease Control and Prevention 2005 Report Securing Necessary Resources

16. Driving Forces For Telehealth • Baby Boomers are Shifting Health Care Needs • Many Baby Boomers are More Comfortable With Technology • How much does the American health care system spend on conventional medical care? • Is this figure expected to grow? • What is the solution for this growing need? • The Use of Telehealth Technology

17. Telehealthcare • “Telehealth” and it’s Broad Meaning • Store-and-Forward Telehealth • Real-Time Telehealth • The Use of Computers in Telehealthcare

18. Telehealthcare Examples telehealth applications: • Telemental Health • Telerehabilitation • Telehomecare • Teleconsultations • Telehospice/ Telepalliative care • Remote Monitoring Devices • Telephone Monitoring and Telehealth

19. Telenursing • Telenursing • The most developing area of telenursing • Association for Retired Persons 1996 Study • Care at Home

20. Telenursing • The Home Care Industry’s Newest Challenge • Home Care Telenursing Involvement • Home Care Telenurses Expectations

21. Terms of Home Telehealth • Telecommunications-Ready Tools • Multifunctional Telehealthcare Platforms and Application Servers. • Key Components to Telehealth

22. Terms of Home Telehealth • Peripheral Biometric Devices • What is the most popular household communication tool for telehealthcare? • A Telephone Device Can be Augmented

23. Terms of Home Telehealth • Video Cameras and Videophones are Useful Tools • Personal Emergency Response Systems

24. Terms of Home Telehealth • Sensor and Activity Monitoring Systems • Medication Management Devices • There are 32 million people that take 3 or more medications daily

25. Home Telehealth Practice and Protocols • Different Home Telehealth Programs • Informed Written Consent and Telehealth • Telehealth and Patients

26. Home Telehealth Practice and Protocols • The Use of Telehealth Tools • Home Telehealth Protocols • Telehealth, Law and Ethics • A High Level of Security Must Be Achieved

27. The Patient’s Role in Telehealth • What was a “mega trend” of Telehealth in 2007? • Telehealth and Home Goals for the Patients

28. The Foundation of Knowledge Model and Home Telehealth • There is Much to Learn about “usual” Home Telehealthcare • Knowledge Acquisition and Telehealth • Knowledge Processingand Telehealth

29. The Foundation of Knowledge Model and Home Telehealth • The Next Step After Processing Information • Nurses Apply Data as it Pertains to the Patient • The Nurse Determines How the Knowledge Will be Used • Telehealth is Rapidly Developing • Telehealth Will Provide New Advances for the Medical Community

30. Thought Provoking Questions 1. Telehealth technology has extended the arms of traditional health care delivery into homes, clinics, and other environments outside the bricks and mortar of hospitals.Will the increased use of these telehealth technology tools be viewed as “de-humanizing” patient care or will they be viewed as a means to promote more contact with healthcare providers and new ways for people to “stay connected” as in on-line disease support groups), thereby creating better long term disease management and patient satisfaction?

31. Thought Provoking Questions 2. As telehealth technology advances towards seamless data access regardless of distance or health system, how can we protect patient privacy rights and the confidentiality of personal medical data?