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ARTICLE - Website - Telehealth … rural population

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ARTICLE - Website - Telehealth … rural population

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Written by Bob Gold, Clinical Behavioral Technologist, GoMo Health; Shelley Schoenfeld, chief strategist at GoMo Health, a division of Gold Group; and Tom Toperczer, director of product management at Brother OmniJoin |

Rural populations pose a unique challenge and opportunity for hospitals and health systems.

The main challenge being simple geography - the average distance between them and their patients is farther away. There are also health disparities between urban and rural populations, which can make managing these patients more difficult.

Expanding care access, while the right thing to do, comes at a cost, so it must be conducted strategically and efficiently. Many healthcare organizations in rural areas are finding video-based telehealth services integrated with a mobile-focused population health management strategy "shortens" geographical distances while cost-effectively expanding access and improving engagement and outcomes.

By automating simple, but highly personalized outreach and interactions with patients through mobile and offering video-based telehealth services, organizations can motivate rural patients to act in-the-moment, and give them the ability to initiate their own provider interaction, saving healthcare professionals time and enabling them to scale quality services across broader markets.

Rural healthcare needs are extensive
Although rural populations pose logistical and financial challenges to providers, these regions have significant needs. For example:
* Rural areas have more frequent occurrences of diabetes and coronary heart disease than non-rural areas 1
* Nearly 20 percent of adults describe health status as fair or poor, compared to less than 16 percent in urban areas ²
* Rural youth are twice as likely to commit suicide. ³

To treat both physical and behavioral health conditions, patients in rural communities often face hours of travel and potentially time away from work, both of which add to their personal costs. This is especially the case for consultations from specialists where there are 30 such physicians per 100,000 residents in rural areas, compared to 263 specialists per 100,000 residents in urban areas. ⁴

Rural populations independent and community focused
Despite these disparities, rural populations tend to be less inclined to visit a healthcare provider, not due to greater skepticism of healthcare, but more so due to tradition and trust. With a history of being isolated from urban areas and services, rural areas have tended to look within their own communities to solve challenges, including healthcare. Living in a rural area also requires people to be independent and self-sufficient.

Trust is another major factor. Urban and suburban populations are more accustomed to faster, market-driven growth in their neighborhoods, resident influx and new businesses and companies opening their doors. Since rural communities are tight-knit and less accustomed to change, establishing trust is more challenging, especially for healthcare organizations.

To demonstrate their dedication to patients in the area and help build that trust, it is essential for healthcare organizations to offer highly targeted and personalized communication, information and care services to designated patient populations. Presenting care access in this way forges a patient-provider relationship while helping patients manage their health and eliminate the travel challenges associated with seeking care in their area.

Essential components of a telehealth-integrated engagement plan
While patients may have commonality in their chronic conditions, each patient profile is unique. Additional factors including family health history, comorbidities, circle of support, condition knowledge and treatment plan-adherence commitment should be factored in to promote positive health and wellness decisions and enable ongoing engagement that is effective for each individual.

To ensure optimal adherence, principles of BehavioralRx™, are applied to leverage a behaviorally-based scientific approach to first connect and build trust and credibility with the patients. These cognitive and behavioral methods establish the belief that the telehealth resources provided will further patients' health and wellness and credibility that by following directives, patients will not be put in harm's way and their outcome will be positive. Once achieved, condition-specific and wellness education must be delivered in easy to follow "snackable bites" at the right moments throughout the day, with timings and delivery of resources triggered through automated mobile surveys and ongoing bi-directional feedback and assessments with patients. Based on responses to automated outreach, organizations can then create a path for patients to take immediate action, such as scheduling appointments, filling prescriptions, or requesting a live provider encounter through a video-based online visit. This on-demand access to live providers is another motivator that encourages engagement with the treatment plan. This highly personalized and customized approach motivates patients to more effectively self-manage their conditions.

Not only are on-demand telehealth encounters from a remote setting convenient, but they can potentially save patients in rural areas the travel, costs and disruption to their schedule. Delivering care and boosting engagement through mobile and telehealth can also alleviate the healthcare organization from opening a new brick-and-mortar facility or adding staff, which saves costs without sacrificing compassionate, high-quality care to patients who need it.

Expanding care access to rural areas can be a challenge. When done correctly, however, using a highly personalized strategy that creates a nurturing experience within a patient's lifestyle, it can drive satisfaction across rural populations and establish the trust that is so crucial between patients and providers.

About the authors:
Bob Gold, who started and owned an organic farm in a rural area in New Jersey, is founder of Gold Group Enterprises. Shelley Schoenfeld grew up in Kingston, PA, population ~12k, where it wasn't uncommon to make trips in excess of 2 hours to access specialized healthcare. Shelley is Chief Strategist, GoMo Health, focused on creating engaged solutions to support remote healthcare delivery.
Tom Toperczer is director of product management for Brother. With more than 20 years of experience in the video conferencing industry, Toperczer supports the company's OmniJoin division that develops video web conferencing solutions with a growing healthcare segment.
¹ National Rural Health Association. "About Rural Health Care" Web page. Accessed May 7, 2018. https://www.ruralhealthweb.org/about-nrha/about-rural-health-care#_ftn1
² Ibid.
³ Ibid
⁴ Ibid.
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Bob Gold, Clinical Behavioral Technologist, GoMo Health; Shelley Schoenfeld, chief strategist at GoMo Health, a division of Gold Group; and Tom Toperczer, director of product management at Brother OmniJoin

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Telehealth a good fit for rural population health management and engagement

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Written by Bob Gold, Clinical Behavioral Technologist, GoMo Health; Shelley Schoenfeld, chief strategist at GoMo Health, a division of Gold Group; and Tom Toperczer, director of product management at Brother OmniJoin | Rural populations pose a unique challenge and opportunity for hospitals and health systems. The main challenge being simple geography - the average distance between them and their patients is farther away.

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TELENURSING and Home Healthcare_The Many Facets of Technology

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TELENURSING and Home Healthcare_The Many Facets of Technology

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This article states that Telehealth is "Bridging the Gap" in healthcare.  The improvement in patients health is reflected in this article and also click on the video that included in the article.

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NEW ORLEANS - A telehealth program developed at the University of Mississippi Medical Center is helping bridge gaps in care to meet the health needs of a high-risk population of patients with uncontrolled diabetes in the state's rural delta region.

"For you and I an hour may not be a big trip, but some of these patients never leave their communities, so if they need to see endocrine or ophthalmology because they are losing their eye sight, chances are they are just going to lose their eye sight," Tearsanee Carlisle Davis, DNP, NP-C, of the Center for Telehealth at the university told The Clinical Advisor.

One of the most important facets of the program, called the Mississippi Diabetes Telehealth Network, has been allowing rural patients to continue to see the local providers that they know and trust. The only difference is that local providers are using technology to work in partnership with small community hospitals and an academic medical center to increase the quality of the care.

"The community hospital manages patient care. However, if a patient needs endocrine we set up the appointment. The patient simply shows up at the primary health clinic's office and has an endocrine visit via telehealth," Davis explained. "The only time they actually have to drive in to the academic medical center, is if a procedure is taking place."

Another facet of the program is that each patient who is enrolled undergoes an automatic diabetic retinopathy screening, because many locations are so remote patients do not have access to an ophthalmologist.

"We've trained a staff member to be in each clinic. They have a special camera that takes the images. They then forward the images to the ophthalmologist at UMC, who reviews, makes recommendations and transmits them back, the same way radiology tests are done," Davis said.

Since the program was first implemented in Aug. 2014, outcomes have been excellent among the first 100 patients.

"The average HbA1c decrease has been 1.7% from an average start of 10. The first patient who was ever enrolled came in with an HbA1c that was 12.6, and now it's down to 6.8," Davis said.

Overall medication compliance is at 96%. The program has saved patients approximately 9,451 miles driven, and nine new cases of diabetic retinopathy were identified.

"We're proving that having that constant communication - patients having an easy in to be able to ask a question and healthcare providers knowing what's going on with a patient - can improve diabetes outcomes," Davis said.

Reference

Davis TC, Henderson KA. Poster Session. "Nurse Practitioners and Telehealth: The Impact on Healthcare Delivery." Presented at: AANP 2015. June 10-14; New Orleans, Louisiana.

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Nicole Blazek, Senior Clinical Content Editor

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Diabetes telehealth initiative bridges care gaps in rural settings

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NEW ORLEANS - A telehealth program developed at the University of Mississippi Medical Center is helping bridge gaps in care to meet the health needs of a high-risk population of patients with uncontrolled diabetes in the state's rural delta region.

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As the healthcare paradigm continues to shift from fee for service to value-based care, population health initiatives have gained in popularity. Population health seeks to proactively change the clinical outcomes of a patient cohort. One study suggested that population health should include patient health outcomes, the patterns of health determinants, and clinical policies and treatments that link the two together.
An interdisciplinary, customizable approach that allows health departments to connect practice to policy for change to happen locally. This approach utilizes non-traditional partnerships among different sectors of the community - public health, industry, academia, health care, local government entities, etc. - to achieve positive health outcomes. Instead of connecting one person to one person for a single interaction, they connect to many, on an ongoing basis. To address system challenges like access, quality and dissemination of best practices, we need these more powerful linkages.
When we begin to imagine expanding care to entire populations by creating non-traditional partnerships, it seems logical to leverage the digital technology at our fingertips. By using smartphones and the Internet clinicians can begin to open new avenues of providing care to entire populations no matter where they are while creating new collaborative partnerships across a broad geography.

While we think of telehealth technology as a way to bring a remote clinician together with a patient in a virtual visit, it's clear that there is a broader application for the technology at the forefront of population health management. Telemedicine uses the Internet to bring together providers and patients in our fragmented healthcare system. Virtual care can help clinicians manage patient populations in ways that improve health outcomes for an entire group. A recent Modern Healthcare article said:

What are the benefits of telemedicine in a population health initiative? Are there specific populations that can benefit from the use of the technology?

Benefits of Telehealth for Population Management

We know that population health can reach people in new ways that can eliminate the stresses of traveling to a remote care provider. We also know there are cost savings with telehealth that have been demonstrated repeatedly in clinical studies and anecdotal articles. But how can the virtual visit benefit specific population cohorts?

By increasing access to clinical care.
Population health seeks to improve outcomes by eliminating barriers to treatment while ramping up preventative care to a vulnerable population. Increasing healthcare access points and removing barriers means that an at-risk patient population may be more likely to receive treatment. Simply put, if you bring healthcare to the patient, they will be more likely to engage with the clinician. We know this because there is a corresponding drop in no-show visits when telemedicine is utilized. It is in this way that telehealth is being used to help fight the nation's opioid crisis. The technology is also being used to connect more frequently to elderly patients with chronic care conditions. While these are just two examples, telehealth is one way for us to use technology to extend care to vulnerable populations and ultimately change their health outcomes.

Improve care continuity by bridging care gaps.
Population health seeks to influence populations by bridging care gaps between community services. We know that telehealth can eliminate some of the silos between service lines. It can also extend care to populations that run the risk of being neglected, such as rural communities. While care coordination has been a persistent problem in America's health systems, telehealth can bridge geographic distances easily, bringing together specialists, primary care providers, ancillaries, social workers, and other providers. It is in this way that telehealth technologies can extend our reach by allowing care managers to talk directly to patients to counsel them on preventative treatments. Specialists can be consulted in a virtual visit that works just as well for the primary care provider as it does for the patient. Population health recognizes that to change health outcomes across an entire patient population, all of the systems within a care continuum must be brought to bear on the problem.

Engaging patients in their own health outcomes.
Population health programs ultimately seek to engage patients in changing behaviors that will improve their health. Patient Engagement HIT says this is precisely how to leverage telehealth to improve outcomes. Disease managers and health coaches can do remote monitoring and patient counseling via the virtual visit. Without telemedicine, patients can wait weeks between clinical visits. With telehealth, clinical providers can access real-time biometric data between visits to watch for negative trends.

It is in this way that telehealth reaches more patients more quickly, eliminating bottlenecks caused by a lack of provider access. Telemedicine Magazine predicts telehealth will eventually foster "100% reach" by engaging patients with wearable devices, remote monitoring, and virtual visits. When you consider that 90% of our $3.3 annual spend on healthcare is for people with chronic diseases, you can start to see the value of telehealth to manage long-term disorders. One study showed a corresponding drop in inpatient volumes for diabetic patients when telehealth was used to provide treatment for these chronically ill patients.

While there is enough evidence to show that telemedicine has delivered on these benefits, in fact, it is the population health initiatives themselves that have failed to reach their true potential. Telemedicine Magazine reports:

Population health ought to refer to approaches that improve health outcomes for entire groups of people. But it doesn't. At least not yet. Rough estimates indicate program penetration rates of less than 10 percent in any given population. While this may appease the C-suite and shareholders, it won't address the ever-increasing burden of chronic disease on the healthcare system. As diagnoses of diabetes and other diseases like hypertension and cancer multiply, employers, private insurers, and government-sponsored health programs are scrambling to care for their sickest, costliest members.

Is the problem that we've failed to make use of technology to extend our reach beyond 10% of a given population? Could telemedicine technology give population health initiatives the push they need to extend care further into the communities we serve?

OrthoLive offers a telemedicine application for orthopedic providers. Contact us to see a demo of our product.

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Telehealth and Population Health Management

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As the healthcare paradigm continues to shift from fee for service to value-based care, population health initiatives have gained in popularity. Population health seeks to proactively change the clinical outcomes of a patient cohort. One study suggested that population health should include patient health outcomes, the patterns of health determinants, and clinical policies and treatments that link the two together.

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Questions for the Audience:  *What advances or uses for telehealth do you anticipate in the future?     *Could telehealth be harmful in any way?     * Is telehealth more, or less, personal or satisfying for patients?

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Questions for the Audience:  *What advances or uses for telehealth do you anticipate in the future?     *Could telehealth be harmful in any way?     * Is telehealth more, or less, personal or satisfying for patients?

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VIDEO - Minute Clinic Exam using Telehealth 

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VIDEO - Minute Clinic Exam using Telehealth 

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Cllick below to watch the video of the patient exam being done using latest technology and the provider is present via computer monitor.  It is so amazing.

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Telemedicine and Telehealth Services: MinuteClinic Connect™

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Care Challenge Website is a sharing website that nurses can connect with their ideas or visions.  This post is about TeleNurse service.

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Bridging the Gap Between Patients, Nurses, and Telemedicine < Care Challenge

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An idea shared can change the world. The Care Challenge is an international online initiative dedicated to showcase nurse creativity

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ARTICLE - Website       Telehealth Nursing- "What are the Advantages and Disadvantages?

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ARTICLE - Website       Telehealth Nursing- "What are the Advantages and Disadvantages?

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As technology advances, telemedicine has become a popular healthcare delivery system. Telehealth nursing offers a unique career path for nurses who want to provide patient care in a hands-off way.

Patients and healthcare providers throughout the world are enjoying the benefits of telemedicine. Along with the benefits of telehealth comes many barriers. This article will highlight the pros and cons as well as provide insight to telemedicine as a nursing care model.

What is Telemedicine?
"Tele" meaning "at a distance" is the prefix to many of the "away from the office" jobs. This can include nursing, billing, physician visits, and counseling. Telenursing is defined as "the use of technology to deliver nursing care and conduct nursing practice." Combining the two words creates telemedicine, which is delivering nursing care and practice at a distance. Telehealth is the combination of telenursing, doctor care, and healthcare records available online.

Advantages of Telemedicine
Our culture is evolving at a rapid pace with technology, and medicine is no exception. Healthcare providers see the benefits telemedicine can bring causing an increase in telemedicine use.

Evidence-based research has proven that telemedicine can help in:

Diagnosis of Disease - Through face-to-face video chat, doctors and nurse practitioners can see the patient to assess health needs. This allows for increased access to care, by seeing the patient wherever they are, and not face to face in an office.

Education - Telehealth allows clinicians to educate patients on chronic health conditions and self-care. This allows the patient to stay in the comfort of their home and receive the education they need to care for themselves.

Nurse Productivity - More patients can be seen when the nurse uses advanced telehealth technology. An added bonus is that money can be saved with telehealth nursing because travel time is nonexistent.

Remote Health Monitoring- My local hospital uses a device like this when a newborn is born with complications and has to be transferred to a higher level NICU for care. We participate in the live video with the neonatologist, and they can hear the breath sounds
and heart sounds through the built-in stethoscope. It's pretty incredible to use as a nurse. The infant can be transferred to that neonatologist without the neonatologist leaving their home base NICU.

Barriers to Telemedicine
The benefits of telemedicine are incredible. However, barriers exist and include:

Internet access and initial set up - Some patients may lack internet access, and cannot connect for face-to-face video visits. The initial set-up can be difficult for patients who are not tech savvy.

Patient privacy - The patient should be alone during their consultation with the physician or nurse. If not, their health privacy is in jeopardy. The clinician needs to be in a private place for all consultation calls and patient visits.

Malfunction of equipment - Sometimes, technology can fail. This is a barrier that telemedicine brings, that is usually able to be fixed. It is a good idea to always have a backup method in place.

Telemedicine has benefits and barriers. It is recommended to have hands-on experience before becoming a telehealth nurse to be able to be confident in your role and assessment skills. Telemedicine is for nurses who can critically think without touching the patient. Telemedicine is the healthcare delivery system of the further. It can offer a win-win way to treat patients by saving healthcare systems and their patients time and money.

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Telehealth Nursing - What are the Advantages and Disadvantages?

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As technology advances, telemedicine has become a popular healthcare delivery system. Telehealth nursing offers a unique career path for nurses who want to provide patient care in a hands-off way. Patients and healthcare providers throughout the world are enjoying the benefits of telemedicine. Al

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This video shows how telenursing/telemedicine is being used to help elderly patients with chronic illness who do not have any local access to a hospital.

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голос америки

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Telemedicine Helps Greek Elderly Stay Healthy

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Health care for elderly patients living far from hospitals has always been problematic. But modern communications technology is helping bridge the distance and technological gap between doctor and elderly patient. VOA's George Putic reports.

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This is you tube video from Cincinnati Childrens Hospital.

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I Am a Telehealth Nurse | Cincinnati Children's

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ARTICLE - Telehealth – The Future of Healthcare?

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ARTICLE - Telehealth – The Future of Healthcare?

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Computers, and the technology associated with them, are virtually indispensable in all aspects of our daily lives - healthcare being no exception.
As the population ages, grows and spreads out to remote areas, we must constantly look at ways of improving healthcare and preventing disease in the most cost-effective manner possible. Telehealth (or eHealth) offers us just that - new opportunities for communicating with patients and to serve people who are in poor health, live in remote areas and do not have adequate access to health care.

Definitions:

Telehealth can be described as a wide range of services coordinated, delivered and managed using telecommunication techniques and the exchange of electronic technologies.

Telemedicine is the term that describes diagnosis and treatment assisted by this technology.

As with anything new, there are both positive and negative aspects associated with telehealth. To begin, let's look at some of the applications and/or advantages of telehealth.

Telenursing

Telenursing is a sub-category of telehealth in which nurses use telecommunication devices to deliver care to patients who live alone, live in remote areas, or who may be unable to travel to doctor's appointments. Patients can be monitored remotely in order to better manage their chronic conditions. Telenursing allows for fewer nurses to deliver more care; a win-win situation for nurses and patients, and a measure that saves money across the board.

Chronic Disease Management

The increase in the use of telecommunication has generated the realisation that many patients can be managed effectively from a distance using electronic capabilities. Many chronic conditions have become the focus of management, including diabetes, hypertension, heart failure and chronic lung conditions. Monitoring these patients remotely saves money and also increases the likelihood that an exacerbation of the chronic disease can be recognised and treated before hospitalisation becomes necessary. Such measures increase the patient's confidence in managing their condition and improves their quality of life by keeping them in their homes.

Collaboration Between Providers

One benefit of telehealth is the ability to allow professionals to consult each other regarding patient care without the necessity of travelling to see patients, saving time and money for both healthcare providers and patients. Technology allows professionals to send data, view data, speak to each other face-to-face, and collaborate together, to determine the best plan of care for the patient in question. Wound care is one area that has benefited from telehealth. Patient's wounds can be viewed remotely on camera, allowing a distant professional to make recommendations regarding treatment. Follow-up can be done on a consistent basis, allowing for quicker healing of chronic wounds and increased quality of care.

Safety

One of the major benefits of telehealth is that it promotes safety in healthcare. Patients are being discharged from the hospital earlier than ever before, with numerous medications, and often lacking the knowledge they need to care for their condition adequately. Telehealth allows these patients to return home earlier (which saves money) whilst still allowing them to be supported by a professional until they are well, or manage their condition with confidence. Post-operative patients benefit from support as they often have questions regarding what is 'normal', and these questions can be easily handled by nurses who can determine whether a patient is experiencing a complication or a normal consequence of their surgery. Telehealth provides a safety net for patients who may be struggling with managing their condition at home, preventing complications that could result in re-hospitalisation.

As with any new technology, there are a few kinks that need to be ironed out in order to make telehealth a viable proposition for everyone. Some of the areas that need further study and/or attention are acceptance, reimbursement and privacy/security.

Acceptance

Telehealth can be a hard pill to swallow for older professionals who are not used to computers and technology as a companion to knowledge and practice. Rather than feeling that they are being replaced by computers, these professionals should be encouraged to view telehealth and telecommunication as an adjunct to professional practice. Studies have shown that most patients are very accepting of telehealth, but some professionals have been slower to embrace this technology.

Reimbursement

Reimbursement may be one of the biggest stumbling blocks to a more widespread use of telehealth. Many providers have no avenue to reimburse for services provided through telehealth, and until these reimbursement issues are dealt with, telehealth will never be used to its fullest capacity.

Privacy and Security

Patient confidentiality and the security of private information must be safeguarded, regardless of the collection method used to extract information. Privacy and security is an important consideration in telehealth, and patients and professionals must both feel assured that information is collected and stored safely.

Telehealth is here to stay, and nurses can either embrace it or fight it, but in fighting the possibilities inherent in this technology they may be doing their patients a disservice. Telehealth offers many advantages, and the disadvantages will likely decrease in number as telehealth develops and reimbursement and privacy issues are addressed. Nurses of the future will leave school with a sound background and understanding of how telehealth can help them be more effective in caring for their patients, with an emphasis on disease prevention and management.

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Jennifer is a registered nurse and a professional medical writer. Recently, Jennifer completed co-authoring a microbiology textbook for first-year university allied health students, which is published by McGraw-Hill.

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Computers, and the technology associated with them, are virtually indispensable in all aspects of our daily lives - healthcare being no exception. As the population ages, grows and spreads out to remote areas, we must constantly look at ways of improving healthcare and preventing disease in the most cost-effective manner possible.

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Renee Crocco:

1) Research Nursing Aspects of Telehealth and Patient Population. Post research to Padlet.
2) Respond to questions posed by other students if needed.
3) Respond to one of the other student Padlets.

Jodi Day

1) Research Driving Forces for Telehealth and Overview of our Telehealth. Post research to Padlet.

2) Respond to questions posed by other students if needed.

3) Respond to one of the other student Padlets.

Susan Fleck

1) Setup Padlet, give access to team members to collaborate, share link with class.

2) Assist team as needed with adding content.

3) Make APA Reference Page.

4) Monitor and respond to general questions; alert team members, if needed, to respond to posts regarding content they posted.

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Doctors can assess patients without physically being in the hospital

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In the 1990’s NASA and medical professionals created telemedicine to monitor the health of astronauts in space.

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In the 1990’s NASA and medical professionals created telemedicine to monitor the health of astronauts in space.

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ARTICLE  -  Telehealth and telenursing using simulation for pre-licensure USA students            

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ARTICLE  -  Telehealth and telenursing using simulation for pre-licensure USA students            

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https://search-proquest-com.ju.idm.oclc.org/docview/2014386885?accountid=28468