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“Tele means transmission over a distance” (Stephens, 2014, p. 30)

The utilization of technology to deliver health information and/or services   over a distance (Sewell, 2016)

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•NASA

•1950’s-1960’s Closed-Circuit Television

•1970’s Radiology and Pathology then Ophthalmology and dermatology

•1980’s Some Interest

•1990’s Rural Development Act, Health Insurance Portability and Accountability Act (HIPAA)

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Health IT (e.g., telehealth) = engage patients in health care. However, we are far from achieving this, several issues are addressed, including the role of the nurse informaticist (Gephart & Effken, 2013).

Voice and video over the Internet Protocol (VoIP), pilot study shows respondents expressed low confidence in the privacy and security of three VoIP software systems (Watzlaf et al., 2012).

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Review of Literature, Security/Privacy and Telehealth

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Review of Literature, Security/Privacy and Telehealth

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Gaps remain despite federal and state guidelines for telehealth privacy and security. In order for telehealth to succeed, security risks must be identified (Hall & McGraw, 2014).

Hale and Kvedar (2014) found patients are willing to accept greater privacy risk for telehealth. The benefits of telehealth outweigh the risk of sharing information.

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During trauma situations, telehealth brings a multidisciplinary approach for rural trauma patients. Telehealth allows expertise of trauma surgeons to facilitate necessary care with rural practitioners to prevent unnecessary or outdated procedures with poor outcomes (Bjorn, 2012).

Telehealth was studied to reduce wait times in an Emergency Department for patients of lower acuity. The average time for a lower acuity patient in the ED was at least a couple of hours, with telehealth 30 minutes (Guss & Sharma, 2016).

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Review of Literature, Chronic Diseases and Telehealth

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Review of Literature, Chronic Diseases and Telehealth

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Ho et al. (2016) found patients with the chronic obstructive pulmonary disease who participated in telehealth, saw a reduction in the rates of readmission and visits to the emergency room after six months from initial admission.
A meta-analysis of articles from 2000 to 2012 found telehealth in the chronic heart failure population saw a significant reduction in mortality by 34% and CHF related admission by 43% (Xiang, Li, & Liu, 2013)

Young et al. (2014) found patients with diabetes that participated with telehealth nurses were significantly effective in behavioral changes toward management than non-participants.

Use of telehealth within the Deaf community, that sign, was found to be an excellent fit to address mental health issues. This was due to Deaf and hearing impaired patients use other means of communication like TTY and video phones (Wilson and Schild, 2014).

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Telehealth will continue to expand as more technology becomes integrated into daily life. It will become the responsibility of Informatic Nurse to educate patients and organizations on the added value of technology integration into patient care. Telehealth will improve health outcomes for patients. At the same time, telehealth will increase productivty and reduce waste for health care organizations (McGonigle and Mastrian, 2015)

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As telehealth expands, the hope is to reduce the size and increase portability. This will allow underserved minority populations to gain access to care (Wilson et al., 2011). We are starting to see this in various forms in smartphones and smart watches (Chan, Esteve, Fourniols, Escriba, and Campo, 2012). At the same time, there must be a balance of security and privacy when transferring information.

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Bjorn, P. (2012). Rural teletrauma applications, opportunities, and challenges. Advanced Emergency Nursing Journal, 34(3), 232-237

Gephart, S., & Effken, J. (2013). Using health information technology to engage patients in their care. Online Journal of Nursing Informatics (OJNI), 17(3). Retrieved from http://ojni.org/issues/?p=2848

Guss, B., Mishkin, D., & Sharma, R. (2016). Using telemedicine to address crowding in the ED. ED Management, November 2016, 127-131.

Hale, T. M., & Kvedar, J. C. (2014, December). Privacy and security concerns in telehealth. Virtual Mentor, 16(12), 981-985. Retrieved from http://journalofethics.ama-assn.org/2014/12/jdsc1-1412.html

Hall, J. L., & McGraw, D. (2014, February). For telehealth to succeed, privacy and security risks must be identified and addressed. Health Affairs, 33(2), 216-221. https://doi.org/10.1377/hlthaff.2013.0997

Ho, T. W. Huang, C. T., Chiu, H., C., Ruan, S. Y., Yi-Ju Tsai, Y. J., Yu, C. J., Lai, F., & The HINT Study Group.  (2016, March).  Effectiveness of Telemonitoring in Patients with Chronic Obstructive Pulmonary Disease in Taiwan-A Randomized Controlled Trial.  Scientific Reports, 6(23797).    DOI: 10.1038/srep23797

McGonigle, D., & Mastrian, K. G. (2015). Nursing informatics and the foundation of knowledge (3rd ed.). Burlington, MA: Jones and Bartlett Learning.

Sewell, J. (2016). Informatics and nursing: Opportunities and challenges (5th ed.). Philadelphia, PA: Wolters Kluwer.

Stephens, S. (2014, May). Telehealth is calling. PT in Motion, 6(4), 30-39. Retrieved from https://web-b-ebscohost-com.ju.idm.oclc.org/ehost/pdfviewer/pdfviewer?vid=6&sid=35307a1f-ca56-4b40-87a1-851ad28d8d4e%40sessionmgr102

Watzlaf, V., Fahima, R., & Ondich, B. (2012). VoIP for telerehabilitation: A pilot usability study for HIPAA compliance. International Journal of Telerehabilitation, 4(1), 25-32. doi: 10.5195/IJT.2012.6096

Wilson, C., Alam, R., Latif, S., Knighting, K., Williamson, S., & Beaver, K. (2011, January). Patient access to healthcare e-services and optimization of self-management for ethnic minority populations living with diabetes:  a systematic review. Health and Social Care in the community, 20(1), 1-19. https://doi.org/10.1111/j.1365-2524.2011.01017.x

Wilson, J. A., & Schild, S. (2014). Provision of mental health care services for deaf individuals using telehealth. American Psychological Association, 45(5), 324-331. https://doi.org/10.1037/a0036811

Xiang, R., Li, L., & Liu, S. X. (2013, July 9). Meta-analysis and meta-regression of telehealth programmes for patients with chronic heart failure. Journal of Telemedicine and Telecare, 19(5), 249-259. https://doi.org/10.1177/1357633X13495490

Young, H., Miyamoto, S., Ward, D., Dharmr, M., Tang-Feldman, Y., & Berglund, L. (2014, September). Sustained effects of a nurse coaching intervention via telehealth to improve health behavior changes in diabetes. Telemedicine and e-Health, 20(9), 828-834. https://doi.org/10.1089/tmj.2013.0326