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Review one scholarly, peer-reviewed journal article about the efficacy of telehealth. Summarize the article and write your thoughts regarding how this might impact health care delivery in the future. Post at least three full paragraphs by Sunday at 11:59 p.m. (A paragraph must be at least five sentences). Be sure to include your reference in APA style at the bottom of your initial post. We will discuss these posts in class. This assignment is worth 10 points. See the grading rubric for more specific instructions.  Avoid choosing the same article as another student! 

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Review one scholarly, peer-reviewed journal article about the efficacy of telehealth. Summarize the article and write your thoughts regarding how this might impact health care delivery in the future. Post at least three full paragraphs by Sunday at 11:59 p.m. (A paragraph must be at least five sentences). Be sure to include your reference in APA style at the bottom of your initial post. We will discuss these posts in class. This assignment is worth 10 points. See the grading rubric for more specific instructions.  Avoid choosing the same article as another student! 

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I look forward to reading your summaries!
Dr. Nelson

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Telehealth Implementation in a Skilled Nursing Facility : Case Report for Physical Therapist Practice in Washington 

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Telehealth Implementation in a Skilled Nursing Facility : Case Report for Physical Therapist Practice in Washington 

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Mikaela Moore - HSC 360 - University of South Dakota

Telehealth Implementation in a Skilled Nursing Facility:

Due to shortages of physical therapists in skilled nursing facilities, compliance with regulations can become challenging, and the aging population results in an even higher increase in demands for rehabilitation in these facilities (Lee & Billings, 2016, p. 253). The purpose of this study I reviewed is to “(1) describe the development, implementation, and evaluation of a telehealth approach for meeting physical therapist supervision requirements in a skilled nursing facility (SNF) in Washington and (2) to explore clinical and human factors of physical therapist practice in a SNF delivered via telehealth.” (Lee & Billings, 2016, p. 252). In the area of Washington that this study occurred, they were experiencing a shortage in physical therapists, which led to the disruptions in the continuity of services to the residents. This study was first proposed at Infinity Rehab in Washington in November 2008, and in March 2009 the Board approved a pilot study. This study continued from March 2009 to June 2009, and in June they presented to the Board a telehealth session. “At this meeting, key issues such as public safety, literature support, and proper therapy via telehealth were discussed.” (Lee & Billings, 2016, p. 254). The telehealth physical therapy was approved in February 2011. (Lee & Billings, 2016, p. 255).

Patients in this study were alternately assigned to either a telehealth group or an in-person group. As this system progressed they came out with other ways to utilize telehealth such as tablets or laptops so that it was more portable and easier to interact accordingly (Lee & Billings, 2016, p. 255). It was also critical to residents and practitioners using telehealth for physical therapy to be mindful when considering eye contact. It was also important for the residents to be informed of the chance that the telehealth service could be deemed inappropriate, if their condition was instead calling for an in-person visit. Many of the residents that were supervised via telehealth scored “at least as well as residents seen in person” and “positive feedback with telehealth implementation was reported” (Lee & Billings, 2016, p. 256). This method also seemed to be effective and beneficial because of the cost savings to the skilled nursing facilities.

When I first found this article, I thought that I would read more about how telehealth was not compatible within the physical therapy field, and was surprised to read about the positive effects and outcomes it did have on patients and practitioners. I think throughout the future as we see an increase in need of practitioners in skilled nursing facilities, with our aging population, telehealth will be very useful. I also think that as we continue using this technology we will be able to find even more efficient and beneficial ways to use and improve this technology.

References

Lee, A. W., & Billings, M. (2016). Telehealth Implementation in a Skilled Nursing Facility: Case Report for Physical Therapist Practice in Washington. Physical Therapy, 96(2), 252-259. doi:10.2522/ptj.20150079

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To maintain good quality and costs in healthcare, telehealth is a good choice. Implementing this across the United States/ world will make for easy access to medication and treatment. Traveling can often be difficult for elders and people who live in rural areas. Telehealth can eliminate the travel time and wait time at clinics. This also gives the option of reaching healthcare to less populated areas. The focus of this article is the veteran’s affairs and veteran facilities are not always located at the easiest convenience for patients.

They are furthering telehealth, to talking over the phone or even face-to-face conversations with providers. Because veterans are more likely to live in rural areas, it is important that they are educated on telehealth. They would benefit the most from this technological advancement. Not only do the patients need to be educated on this technology but so the providers. The better the providers know how to operate the telehealth system, the more the patients will benefit from this technology.

After learning about telehealth, I believe this will have a large increase over the next decade. This should be encouraged to people when they are visiting clinics now, so people are aware of it. This could be a huge advantage when waiting rooms are packed and can require long wait time. In addition, weather can sometimes leave if difficult and unsafe when traveling to the medical facility. To make this be the most effective, telehealth needs to be expanded to all states.

Citation:

Perdew, C., Erickson, K., & Litke, J. (2017). Innovative models for providing clinical pharmacy services to remote locations using clinical video telehealth. American Journal of Health-System Pharmacy, 74(14), 1093-1098. doi:10.2146/ajhp160625

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Article: Investigating the Accuracy of a Novel Telehealth Diagnostic Approach for Autism Spectrum Disorder                                          Hannah Jorgensen- HSC 360 

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Article: Investigating the Accuracy of a Novel Telehealth Diagnostic Approach for Autism Spectrum Disorder                                          Hannah Jorgensen- HSC 360 

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When it comes to adolescent Autism Spectrum Disorder, there is often an extensive amount of time in-between the first initial concern/symptoms and the formal diagnosis of Autism Spectrum Disorder. With lengthy wait list for visits to see a doctor, initial diagnosis is being delayed and put off, which are often beneficial for optimal and better outcomes for the adolescent in and throughout their life. With that being said, it’s beginning to get too dangerous for the adolescent and scary for the parents (Smith et al., 2017). Telehealth approaches for ASD are now being examined to see if this will help improve this issue of long wait times and prolonged diagnosis. This article investigates the opportunity and importance of Telehealth and the expedited diagnosis of Autism Spectrum Disorder.

The study included 51 adolescents, between the ages of 18 months and 7 years, and at-least one of their parents. All children had parents whom wished to seek their child evaluation for ASD (Smith et al., 2017). “Families completed the Naturalistic Observation Diagnostic Assessment (NODA) for ASD, which was compared to an in-person assessment (IPA)” (Smith et al., 2017). NODA is a form of Telehealth technology in which families can share information with different healthcare professionals and receive an evaluation and diagnosis back. The results of the study showed that “NODA has potential to improve the efficiency of the diagnostic process of ASD” (Smith, et al., 2017).

I’ve always had my doubts about telehealth within healthcare. I constantly think how can a healthcare professional tell you what’s wrong over a computer/TV screen without ever even touching you.  After looking into different articles, and settling with this one, I have a more open mind about telehealth. If different studies are all showing positive results in relation to telehealth then obviously there are parts to this that can work! The world keeps changing, technology keeps growing. In the future, I see telehealth being huge in the world.

Smith, C., Rozga, A., Matthews, N., Oberleitner, R., Nazneen, N., & Abowd, G. (2017). Investigating the Accuracy of a Novel Telehealth Diagnostic Approach for Autism Spectrum Disorder. Psychological Assessment ,29(3), 245-252. doi:10.1037/pas0000317

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Real Time Video Communication- Rachel Dieger

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Real Time Video Communication- Rachel Dieger

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Telehealth in the health care system is an important aspect in expanding the way we use communication in treating and seeing patients. It is the delivery of services at a distance, using technology for information and communication. In this article, they use real time video communication to access on-call hospital specialists for home care and primary care. It helps eliminate waiting time for patients and can be a less expensive alternative. Although, it can be beneficial to the hospital setting, there are obvious down sides to this type of new communication.

As it has a cost-effective stand point for home care, regional, and rural health care, there are times where it is not always as cost effective as planned. For local delivery of services between the hospitals primary care and their specialists, this is not cost effective due to additional health care staffing. While it may not be cost effective because of staffing, their work space has a different outcome. For facility space, thinking about the location of each the patient and health care specialist reduces the need for office space. In this study, the cost for the hospitals were substantially high for the costs of medical staff time and additional costs for the connectivity and equipment used. The patients however, did not need to take time off work for the appointment and saved a decent amount of money on the visit.

I see the video communication being a helpful addition to health care systems worldwide, but as for the face-to-face communication, I do not see losing the personal experience with a health care provider being worth it. I agree with many of the proposals for the cost effectiveness of this system, but I see that it will help eliminate more illnesses being able to address the problem correctly and with out error. I think that we should stick to the in hospital visits and at home visits and leave the video communication for less invasive problems such as a sore throat, or bad cough. It will eliminate the chance for medical error and help diagnose people correctly and effectively.

Source:
Wade, V. A., Karnon, J., Elshaug, A. G., & Hiller, J. E. (2010). A systematic review of economic analyses of telehealth services using real time video communication. BMC Health Services Research, 10233-245. doi:10.1186/1472-6963-10-233

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Using Technology in the Delivery of Mental Health and Substance Abuse Treatment in Rural Communities

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Using Technology in the Delivery of Mental Health and Substance Abuse Treatment in Rural Communities

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Amy Davis

While telecommunication technology has become popular in urban geographic locations, this is not necessarily the case in rural areas.  This is especially true with the telehealth delivery of mental health and substance abuse services.  However, there are various advantages to implementing telehealth in rural communities.  These advantages include benefits for both the patient and the residing physician.  “The benefits of telehealth to the client include reduced travel time and cost, reduced separation of families, and a reduced number of missed appointments” (Benavides-Vaello, Strode, & Sheeran, 2013, p. 113).  Furthermore, benefits for the rural physician or provider include opportunities to network and collaboratively work with several healthcare providers and the ability to receive an enriched education (Benavides-Vaello, Strode, & Sheeran, 2013).  Implementing telehealth technology will positively enhance the mental health and substance abuse services that individuals residing in rural locations are able to receive.

On the contrary, there are various barriers to implementing telehealth technology in rural areas and communities who offer or want to offer mental health and substance abuse services.  “Financial instability has been one of the primary barriers to expansion of telehealth services in rural areas” (Benavides-Vaello, Strode, & Sheeran, 2013, p. 113).  This challenge has arisen in rural communities due to initial startup expenses of the service, such as the cost of telecommunication devices/equipment, and the continued costs that result from properly maintaining the new equipment (Benavides-Vaello, Strode, & Sheeran, 2013).  Additionally, availability of space in a healthcare center to store the equipment and insufficient training on how to correctly use the telecommunication modalities are also barriers to implementing telemedicine in rural areas (Benavides-Vaello, Strode, & Sheeran, 2013).  While these are known barriers, active leadership and advocation for telehealth in rural areas are needed to improve mental health and substance abuse services in rural areas.

In conclusion, further research and evidence-based literature is needed for practitioners and consumers to acknowledge the benefits surrounding telehealth services in the expansion of mental health and substance abuse treatments in rural communities.  I believe telecommunication technology will positively benefit the delivery of mental health and substance abuse services in the future.  For instance, I have confidence that telehealth medicine will allow vast populations, ranging from pediatric to geriatric populations, to receive these two increasingly needed services.  Furthermore, I believe that telehealth technology can decrease mental health or substance abuse disparities that specific populations are susceptible to.  Use of telehealth technology will continue to grow in mental health and substance abuse treatment services.

Reference:
Benavides-Vaello, S., Strode, A., & Sheeran, B. (2013). Using technology in the delivery of mental health and substance abuse treatment in rural communities: A review. Journal of Behavioral Health Services & Research, 40(1), 111-120. doi: 10.1007/s11414-012- 9299-6

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Telehealth for Survivors of Domestic Abuse and Sexual Violence in Rural Populations - Katie Rodig

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Telehealth for Survivors of Domestic Abuse and Sexual Violence in Rural Populations - Katie Rodig

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Many Americans are aware of the shortage of health care professionals in rural populations. In many rural populations, especially South Dakota, many individuals experience some sort of domestic violence or sexual assault. Many people believe that rural populations do not experience these issues as often as more highly populated areas, but that is certainly not the case. Studies by Gray et al. (2015) reveal that “assaults by unknown assailants – are statistically more common in urban contexts, prominent forms of interpersonal violence such as sexual assault and domestic violence are equally prevalent in rural contexts.” The shortage of health care professionals in rural populations makes it challenging for survivors of violence or sexual trauma to find clinical help, such as therapy. This article discusses the effectiveness in providing therapy for domestic violence and sexual assault survivors though telehealth communication.
This article found many benefits of using telehealth for therapy among domestic abuse and sexual violence victims. The article discusses how the victims of domestic abuse and sexual violence often experience emotional and psychological trauma which can often times lead to serious mental illness disorders. Individuals developing these mental disorders are in need of mental health providers, but the rural areas are seeing a shortage of providers. Telehealth may be key in improving these issues. The participants in the study by Gray et al. (2015) received psychological services through the use of telehealth. This article discusses that the studies conclude the effectiveness of telehealth for psychological treatment among this population. Gray et al. (2015) examines telehealth for the use of psychological treatment among this population, and it shows “very encouraging, preliminary support for the utility of videoconferencing-based therapy to effectively meet the needs of rural survivors of sexual assault and domestic violence.” The article also includes information stating both patients and health care workers found treatment to be very successful.

In conclusion, telehealth will be very important for the future health of rural populations. The use of telehealth for psychological treatment has proven to be effective for this specific population; therefore, many other populations are likely to benefit from telehealth. The use of telehealth among sexually and domestically abused individuals could help them have better mental health outcomes and improve the mental health of the overall population. This article supports the use of telehealth and provides strong evidence showing its benefits for the mental health of rural populations. Telehealth may become the future for improved mental health and psychological services among rural communities.

References:
Gray, M. J., Hassija, C. M., Jaconis, M., Barrett, C., Zheng, P., Steinmetz, S., & James, T. (2015). Provision of Evidence-Based Therapies to Rural Survivors of Domestic Violence and Sexual Assault via Telehealth: Treatment Outcomes and Clinical Training Benefits. Training & Education in Professional Psychology, 9(3), 235-241. doi:10.1037/tep0000083

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Telehealth programs in the past decade have brought enormous opportunities for psychologist to meet behavioral health needs of the population, particularly in high-need rural areas. One important unexamined area of Telehealth was using video teleconferencing to provide specialized behavioral health care for people with a disability. To meet these needs they have used Telehealth to extend specialty care to groups like children with a cognitive dysfunction. The cost depends on how far the person is at home to the Telehealth link site. The cost is normally around $40 and can be more expensive depending on how long they are talking to each other and your insurance.

One promising application of Telehealth is in neuropsychological assessment. Although test administration must still be done in person, the neuropsychologist can conduct the clinical interview with a client at a remote site using video teleconferencing. It is necessary to examine client and psychologist reactions to Telehealth in neuropsychological assessment, as well as client and provider-borne costs of Telehealth versus in-person services. Psychologists, however, expressed less satisfaction with Telehealth than with the conventional care setting. Costs for Telehealth care were much lower than for other methods of care involving travel to the medical center or to rural outreach sites. A number of factors may have produced.

After reading and learning about Telehealth, I believe it is going to keep growing over the next few years. This can help families who don’t have money to go to doctors or when you are busy. I didn’t even know this was a thing until I came to this class, so maybe people need to talk more about it so people know it is something you can do instead of going to the hospital. I don’t think using Telehealth for everything is a good idea, but if you have a small cold it is something I would use. If I had a more serious problem I would rather see the doctor in person then on a computer.

Reference

Schopp, L., Johnstone, B., & Merrell, D. (2000). Telehealth and neuropsychological assessment: New opportunities for psychologists. Professional Psychology: Research and Practice, 31(2), 179-183. doi:10.1037/0735-7028.31.2.179

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A Pilot study of Telehealth intervention for persons with Spinal Cord Dysfunction- Miranda Stabe

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A Pilot study of Telehealth intervention for persons with Spinal Cord Dysfunction- Miranda Stabe

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Adults who are living with spinal cord dysfunction are prone to secondary conditions that can have severe consequences. The prevalence of pressure ulcers in adults who have spinal cord dysfunction has increased significantly in recent years. Depression is also another common secondary condition for people who are living with spinal cord dysfunction. With telehealth emerging there has been studies done to try and help these people who suffer from SCD with pressure ulcers and depression to see if they are able to help their patients. The study took place in a general community in Massachusetts and Connecticut.

The study consists of 106 subjects who have SCD that participated in seeing if telehealth helped them improve their overall health from pressure ulcers and depression. The study had a 6-month duration. The purpose of the study was to see if the telehealth intervention ‘CareCall’ could help on reducing pressure ulcers and depression in patients.   The study showed that the ongoing care to treat secondary conditions such as pressure ulcers and depression in SCD patients was reduced. This is one of the first studies to demonstrate how efficient telehealth can be in helping people with SCD.

At first I was very skeptical about telehealth. I had a lot of doubts of it not being efficient in today’s society. Personally, I like the one-on-one contact with a doctor. After reading this study, and reviewing the results it showed that telehealth can help people. Society is evolving and technology is becoming a huge part in everything we do, advancing with telehealth I think would be a great opportunity for the healthcare system.

Houlihan, B. V., Jette, A., Friedman, R. H., Paasche-Orlow, M., Ni, P., Wierbicky, J., . . . Williams, S. (2013). A pilot study of a telehealth intervention for persons with spinal cord dysfunction. Spinal Cord,51(9), 715-720. doi:10.1038/sc.2013.45

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Patient Perceptions of Telehealth Primary Care Video Visits

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Patient Perceptions of Telehealth Primary Care Video Visits

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Erika Clark – HSC 360 10 am

Telehealth is not a new concept in the world of medicine, but it is at a point of rapid growth within the current system. The recent push hopes to increase the number of patients that can be seen, as well as limit travel and financial hassles for individuals. “Studies of video visits have demonstrated these benefits in specialty settings including wound care, prenatal genetic screening, family planning, cardiovascular care, and home care” (Powell, Henstenburg, Cooper, Hollander, & Rising, 2017, p. 225). Studies though are fairly limited to these practices. Powell and her colleagues expand the research to the field of primary care.

This article looks to better understand patient feelings about telehealth in the form of video visits with their primary care provider. This study was first implemented in 2015 at Thomas Jefferson University in 2015, where coordinators offered the video option to patients. Participants that were willing to test the new system set up appointments and had virtual visits with their current primary care doctor. After each visit, patients were contacted again and interviewed about their feelings and attitudes towards the video visit. The questions asked prompted discussion about their beliefs of future success of such programs on a widescale basis. A small sample size was used in this study, but the overall consensus was positive for the patients that took part in the trial. Some issues noted were technical difficulties with audio/video lag, internet connection issues, and the log-on process.

This article interested me because I had posed this question in a previous class meeting. I have a great relationship with my primary care provider, but am unable to see her when it is needed because I am going to school in Vermillion. Seeing doctors here is not really an issue, but I often have to relay messages, have files sent between the 2 locations, and have a follow-up with her when needed. Having the ease of a video appointment with her, limiting the middle person, would be beneficial for me, as well as many other people restricted by distance. I will be interested to see if this aspect of telehealth takes hold within the ever-changing world of health care.

Powell, R. E., Henstenburg, J. M., Cooper, G., Hollander, J. E., & Rising, K.L. (2017). Patient perceptions of telehealth primary care video visits. Annals of Family Medicine, 15(3), 225-229. doi: 1370/afm.2095

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Early Identification, Rapid Response, and Effective Treatment o f AcuteStroke: Utilizing Teleneurology to Ensure Optimal Clinical Outcomes

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Early Identification, Rapid Response, and Effective Treatment o f AcuteStroke: Utilizing Teleneurology to Ensure Optimal Clinical Outcomes

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Cole Uithoven: 11am HSC360
Telehealth can be defined as the use of electronic care and technology to improve health care. Telehealth will continue to grow as technology does and we need to be able to learn how to use it. One area where telehealth can have a major impact is in the field of teleneurology which focuses on telestroke, epilepsy, parkinson's disease, etc. Patricia Bowen wrote an article that highlights where teleneurology can have a huge positive impact on health. Bowen's article gives a good look at what teleneurology can do and its easy to evaluate what she says and how it might be related to the future of healthcare.

Bowen's article covered what teleneurology is and gave a good in depth look at what it can do for acute stroke. Bowen summarizes acute stroke and the fact that it is a global concern and affects plenty of people in the U.S. The article also highlights the different kinds of strokes as well as how genetics and lifestyle choices are key reasons for strokes. In the article, Bowen says that 3% of people over the age of 20 could be diagnosed with stroke. It also says that a higher percentage of men than women have a chance of getting it (Bowen 2). Bowen also talks about managing stroke and the challenges that have to do with it, including hospital locations and the availability of stroke neurologists. In reference to teleneurology, Bowen explains how it can be an effective way to help the issues surrounding stroke. She talks about how it is cost effective, still gives expert diagnosis, and gives the stroke neurologists online an easy way to give patients individualized plans. All in all, Bowen gave a great example of what teleneurology could help with.

I thought that Bowen wrote a solid article and gave a pretty good idea of some of the things that teleneurology could benefit. I think that stroke is an issue that affects a lot of Americans and due to hospital locations, people can't always get the best help possible for their loved ones right away. So having teleneurologists that can get on a video conference right away to help in early stages of a stroke would be a huge benefit to decreasing the effect it might have. I also think that it would have a positive influence on costs too and agree with many of Bowen's points. Bowen wrote a good article that highlights the concerns surrounding stroke, and gave a good example of how teleneurology can be used and make a positive impact on healthcare and cost.

Bowen, P. (2016). Early Identification, Rapid Response, and Effective Treatment of Acute Stroke: Utilizing Teleneurology to Ensure Optimal Clinical Outcomes. MEDSURG Nursing, 25(4), 241-243.

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Telehealth: Applications for Complex Care

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Telehealth: Applications for Complex Care

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Myles Taylor: 10am HSC 360
The move for healthcare is to provide best quality of care and be more accessible, and affordable for all patients. Healthcare has always been very expensive and many patients struggle to make payments on the medical services provided for needed care. Although the ACA was created for patients to have healthcare services more affordable and available. Satisfaction, wait time and quality of care has not improved. Many people have started to not seek out medical care because of the fear of not improving their illness. The change that is needed to meet patients need and keep more patients out of the hospital by using telehealth nursing. Telehealth nursing is using telecommunication and informational technology to provide nursing services to deliver medical care to patients over distance and does include remote areas (McKnight). This would help many patients understand the healthcare needed while staying in their own home. This would help keep patients out of the hospital so nurses and doctors can spend more time working with more serious medical cases.

Through three steps telehealth nursing can help patients with their medical needs in their home. The first step is through a method of using a telenursing program for simple or complex patient’s starting with an assessment that identifies the patient, their illness, and the environment around them. The second step is to further identify the illness through primary care in their home setting. The third step is to create a telehealth nursing plan that guides the patient through interventions in their home to improve their illness. Using their telehealth technology, patients can monitor their progress and have home care check-ups (McKnight). The opportunity to use telehealth nursing is a great choice and is hands on keeping patients more satisfied and less worried about their conditions.  All that is needed is a computer with internet and wifi capabilities and a phone to be able to contact nurses, doctors and IT with any issues either medical or technology based. The more time spent learning and using telehealth services the better off patients will recover.

Reading this article over telehealth nursing was very interesting. I find telehealth nursing a great option for patients to use instead of having to make a visit to a doctor’s offices or hospitals. Being able to stay in my own home to recover while receiving instructions on how to better myself seems like a great advancement and move for the future of healthcare. A problem I feel may occur using telehealth nursing is not understanding how to use a computer to view cares needed and having to call a help service where it still is not clear on how to use this services. Another issue is computers crashing and calls being drop when trying to get information for healthcare services. Older generations of people may have a difficult time us the medical cares over the computer and not understand the technologies. I feel expanding telehealth nursing to get more people familiar with it may help with these issues because then family members and friends can help one another out to use telehealth properly.

Reference:

McKnight, S. (2012). Telehealth: Applications for Complex Care. Online Journal of Nursing Informatics. Retrieved from http://ojni.org/issues/?p=2034

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Telehealth- Remote Access to Behavioral Healthcare

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Telehealth- Remote Access to Behavioral Healthcare

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The Use of Deployable Telehealth Centers by Military Beneficiaries to Access Behavioral Healthcare: An Exploratory Evaluation in American Samoa

Jordon Haefs

My article regarding telehealth had to do with the behavioral health aspect of the topic. It is about the implementation of relocatable telehealth center (RTeC) which can be used soldiers and beneficiaries for their behavioral health. It was essential a shopping container repurposed to be an office for physiatrists to remotely contact soldiers in areas lacking the proper resources. With everything being contained in a shipping container, it allows the whole office to be moved and attached to any FOB in the middle east or any combat area. This allows soldiers to have contact with a physiatrist within their time on a deployment rather than put more strain on their resources already over there.

According to the survey, over 96% of the participants of this system said the would use this again and with over 92% said they were satisfied with the amount of help they received (Mishkind, Martin, Husky, Miyahira, Gahm, 2012). This is great results because it shows how effective it is in providing those who need it with excellent behavioral health solution. In addition to effectiveness, this is a much more cost-effective method that can reach more patients than rather having those doctors travel around to each RTeC location. This could be part of the answer in helping veterans with PTSD and transition back to life back in the states. Though that is pure speculation, it is safe to assume access to behavioral health in remote would be very helpful.

While the system is being used in the military, according to the article, this system has used even in the United States. In the US, it is estimated that 89 million people live in a Mental Health Provider Shortage Area. So, with some obvious modifications to the structure, this could be implemented to provide mental health solutions to those in need (Mishkind, Martin, Husky, Miyahira, Gahm, 2012).  This is another great example of telehealth and more specifically for telebehavioral healthcare. It provides a more personal solution to telehealth compared to a hotline. It is not to say these services are bad in any way but there is always room for improvement.

Reference:

Mishkind, M. C., PhD, Martin, S., M.H.A., Husky, G., B.S., Miyahira, S. D., PhD, & Gahm, G. A., PhD. (2012). The Use of Deployable Telehealth Centers by Military Beneficiaries to Access Behavioral Healthcare: An Exploratory Evaluation in American Samoa. TELEMEDICINE and e-HEALTH , 18(10), 729-735. Retrieved January 1, 2018, from http://online.liebertpub.com.ezproxy.usd.edu/doi/pdf/10.1089/tmj.2012.0023

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Telehealth Implementation in a Skilled Nursing Facility: Case Report for Physical Therapist Practice in Washington

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Telehealth Implementation in a Skilled Nursing Facility: Case Report for Physical Therapist Practice in Washington

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Brittani Clark

Telehealth is definitely on the rise right now as the world keeps successfully advancing in technology.  Soon, we’ll be able to do things with technology that we never thought we’d be able to do and in some cases, have the technology do it for us.  It’s crazy to think about and things to be cautious about but I do believe that the benefits outweigh the drawbacks.  In Washington, the implementation of telehealth was put into place in a Skilled Nursing Facility where in their case, physical therapy plays a huge role in determining the residents’ health.

Because there was a shortage of physical therapist services in the Washington area, the residents were not receiving the best care that they possibly could.  It doesn’t only hurt the physical therapy businesses but the patients as well, and patient-centered care is a hard concept to meet when there aren’t enough physical therapists to do so.  Infinity Rehab paid the itinerant physical therapist more than 30% of the salary of a regular employee, which also was less efficient due to travel and time required to become familiar with the facility, staff, and residents of the SNF (Lee, A. W., & Billings, M. 2016).  Frustrations rose and because of the shortage, the facility thought it would be a great idea to look into telehealth pilot program to try to fix their problems.

After a successful completion of the pilot, the facility adopted telehealth language for physical therapy.  What does this mean for health care delivery?  Not only did the adoption of the telehealth program help the shortage of physical therapists in the area, but it to helped with cost savings and the patients were quite satisfied.  Telehealth does a lot of positive things for the delivery of health care and some of them include increasing the access to health care, improving health outcomes, reducing healthcare costs and in the case of my article, assisting to reduce the shortages the healthcare workplace.  The impacts of telehealth are almost too good to be true but with the right steps, I believe every facility is going to adapt and use it to their advantages.

Reference:

Lee, A. W., & Billings, M. (2016). Telehealth Implementation in a Skilled Nursing    Facility: Case Report for Physical Therapist Practice in Washington. Physical Therapy, 96(2), 252-259. doi:10.2522/ptj.20150079

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Telehealth delivery of Rapid Syllable Transitions (ReST) treatment for childhood apraxia of speech. -Janessa Milbrodt

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Telehealth delivery of Rapid Syllable Transitions (ReST) treatment for childhood apraxia of speech. -Janessa Milbrodt

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Telehealth is defined by the use of electronic information and telecommunications technologies to support long-distance clinical health care, patient and professional health-related education, public health and health administration. This article discussed how Telehealth was used to help pediatric patients with an apraxia of speech.  Childhood apraxia of speech (CAS) is an uncommon speech disorder in which a child has difficulty making accurate movements when speaking. In CAS, the brain struggles to develop plans for speech movement. With this disorder, the speech muscles aren't weak, but they don't perform normally because the brain has difficulty directing or coordinating the movements.

The article described the treatment plan as meeting four times a week for three weeks with a Adobe Connect. The subjects were children with apraxia between the ages of five to eleven. They described the treatment as testing and working on the child’s capability to perform pseudo-words, generalize the skills in real world, and maintain the new skills they had learned. A pseudoword is a fake word or  a string of letters that resemble an actual word. Some examples would be heth, lan, nep, rop, sark, shep, spet, stip, toin, and vun.

The results of this “experiment” with telehealth were actually really good! Of the five children that took place in this study, all five showed significant progress! Also, two of the children actually improved not only with singular words but phrases. Four of the children maintained growth even four months after the study had finished! I think this is a great way of utilizing technology and there is a hige future for this type of telehealth. Imagine being able to work with a speech pathologist from home, or even having pre-recorded lessons to be able to work on their speech more!

Thomas, D. C. (2016). Telehealth delivery of Rapid Syllable Transitions (ReST) treatment for childhood apraxia of speech. . International Journal of Language & Communication Disorders .

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Automated Telehealth for managing psychiatric instability in people with serious mental illness

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Automated Telehealth for managing psychiatric instability in people with serious mental illness

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Jorgan Erdahl

Our medical world has come so far and become so advanced, and we are constantly finding new, innovative ways at becoming more efficient. Telehealth is one way that we are advancing, and it is benefiting so many aspects of the medical field. Psychiatric patients and people with serious illnesses are at such a high risk of rehospitalization and relapses, which can cause a burden and unnecessary stress on the patient's family and the physicians that work with them. Intervention that promote recovery and stability in the patient's lives is what can determine how the quality of their life will be. Constant face-to-face interaction with a physician can be so beneficial, yet so costly and time consuming. Implementing the idea of Telehealth into these patient's lives can really cause improvements in their everyday lives, and the physician does not even need to be present, which is an amazing advancement.

Through Telehealth, there are automated programs that are able to run everyday tests and diagnostics when immediate attention is vital to the patient, and there is not a physician on hand. This can also be helpful in helping those patients that live on their own, in rural areas or areas that are hard to reach on an everyday basis. This approach not only cuts down on travel time, but every other cost because Telehealth is an overall cheaper approach to so many fields of medicine, including this one. The patient's physician is able to interact with them everyday, run tests on them through the technology, and physicians are even able to write prescriptions and have them sent straight to the pharmacy! As stated, the main goal of implementing the Telehealth into these patient's lives was to, hopefully, avoid relapse and rehospitalization. Apart from this, the study was conducted to find out if other symptoms were lessened through this approach, such as a decrease in depressive symptoms, the ability to perform general health behaviors more properly and the subjective mental health, not just a patient's physical health.

Although practical and helpful, the idea of Telehealth in patients with psychiatric instability or serious mental illnesses still requires expensive professional involvement. Physicians will need to have the correct training to be able to sense when something is wrong when they are not physically there. A lot of people have serious doubts about Telehealth and the lack of face-to-face interaction that is so important in some patient's lives. Although the study conducted proved to decrease a lot of symptoms in patient's with mental illnesses, there are still certain logistics to be determined, such as how the patients, themselves, feel about the idea of their physician over the monitor, instead of with them in person.
Overall, Telehealth medicine can improve the lives of patients, and cause the patient, and their families less stress, and leave them with less to worry about, which is an advancement that everyone can be excited about.

Pratt, S. I., Naslund, J. A., Wolfe, R. S., Santos, M., & Bartels, S. J. (2015). Automated telehealth for managing psychiatric instability in people with serious mental illness. Journal Of Mental Health, 24(5), 261-265. doi:10.3109/09638237.2014.928403

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Personalized Telehealth in the Future:  A Global Research Agenda

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Personalized Telehealth in the Future:  A Global Research Agenda

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Eden Gramm
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Telehealth has been playing a bigger and bigger role in health care delivery, meaning, it will become more important to create a strong evidence base of innovative and successful telehealth solutions that can lead to sustainable programs for telehealth.

There were two main points in this article; to present a global research schedule for chronic disease management within telehealth, and to share challenges that occur when trying to promote telehealth.  There is evidence used from the European Union and United States that provides an overview of telehealth benefits and services and provides principles that need to be addressed to advance telehealthh and allow future research for personal care, prevention, and treatment.

Research suggests that creating a broader, “multinational” research agenda, they can find and replicate the best types of practices and they can test the new telehealth technology.

Dinesen, B., Nonnecke, B., Lindeman, D., Toft, E., Kidholm, K., Jethwani, K., … Nesbitt, T. (2016). Personalized Telehealth in the Future: A Global Research Agenda. Journal of Medical Internet Research, 18(3), e53. http://doi.org/10.2196/jmir.525