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Nyatik Joseph

This article was written to discuss the state of telehealth and some of its current trends. Telehealth exists to shape health care with a combination of telecommunication tools such as phones, video connection, and other forms of technology. One of the main goals for a patient is increased access to health care, especially for communities that do not have immediate access to health care. The internet is allowing telehealth to reach new lengths by enabling a more convenient delivery of care.

One of the concerns with telehealth is limited reimbursements, which is partly one of the things preventing widespread use of telehealth. There are many states that include laws that require private insurance companies to cover telehealth services only us they person is receiving care in person. There are some health care systems are reimbursed by Medicare for using telehealth services if they are in an area that there is a shortage of clinicians. Many different organizations are working towards integrated finance and the delivery of care.

Personally, I believe Telehealth is moving in the right direction for medicine. One thing that I think about constantly with the flu season being as bad is it is this year, is the control that Telehealth can provide to patients. If someone is home sick with the flu, it could be more beneficial for them to stay home and receive care so they avoid and other sickness they could get in a hospital due to being around other sick people. There is a lot of details when it comes to the financing of Telehealth that need to be sorted out, otherwise it is a very great thing for health care. One of the only concerns I have is how this could impact patient care.

Dorsey, E.R., Topol, E.J. (2016). State of Telehealth. The New England Journal of Medicine, (375), 154-161. doi: 10.1056/NEJMra1601705

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Telehealth: Implications for Social Work Practice

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Telehealth: Implications for Social Work Practice

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Cori Nath

Telehealth communication started in the profession of Social Work in the late 1950’s. The first use of telehealth in social work was an interactive video therapy, performed at the University of Nebraska (McCarty & Clancy, 2002). From then telehealth has come a long way in the field of social work. Social workers are now able to counsel over video chat, email, and voice calls. This adjustment towards telehealth comes with both negative and positive effects.

Interactive video is the most common form of telehealth communication in social work. It allows the social worker to see and hear the client, while letting the client be in the comfort of their own environment (McCarty & Clancy, 2002). A practitioner can see up to 15 patients in one day, compared to the normal 5 or 6 (McCarty & Clancy, 2002). With telehealth communication, the client can comfortably and safely be able to receive counseling and the care that is needed. As the client’s needs are met so are the social workers, they can see more clients and offer more services.

While those are positive effects, telehealth also has some negative effects like a possible security breach and cost of equipment and visits. As McCarty and Clancy explain, “There is no such thing as a perfectly secure telecommunication” (2002). Even with secure browsers and passwords, there are people who can hack people’s records, emails, and watch the interactive videos of the clients. Except for Medicare, Medicaid, and insurance companies, most require a face-to-face contact for payment (McCarty & Clancy, 2002). The cost of technology for an interactive video is also an issue for telehealth communication. Clients and social workers must pay the cost of a program, computer, and video camera.

I think telehealth communication in the field of social work will have both a positive and negative effects. Clients can talk and be seen over interactive video by their social worker in their own home. While social workers can see more clients. But there is a problem with cost of telehealth communication. The client would have to pay for the equipment, and insurance does not always cover visits, unless they are face-to-face.

McCarty, D., & Clancy, C. (2002). Telehealth: Implications for Social Work Practice. Social Work, 47(2), 153-161.

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Emily Heumiller

As this world and society becomes more technologically advanced, healthcare has been attempting to jump on board. The healthcare system continues to trial different forms of telehealth to make tasks and services easier for patients. This also allows patients to be more involved with their own care. In an article by Brooke Ingersoll and others, telehealth use allows parents of children with autism spectrum disorder (ASD) to easily communicate with therapists of both the child and the parent. This trail was referred to as “self-directed and therapist-assisted telehealth-based parent-mediated intervention for young children with ASD” (Ingersoll, 2016, p.1).

In this article, the focus was on how parents learn to care for their children with autism through the use of telehealth. Therapists were able to assist parents through technology, and therefore parents learned new techniques on how to help their child if they were to ever go through a behavior or episode. The children themselves were also able to use technology to do their own therapies as well. For example, communication and language therapies were administered. Through randomization the families were split into two groups. One used therapist-assisted care while the others used self- directed. While both groups did see improvements, the families who had therapist-assisted care saw greater improvements.

In this scenario, telehealth can be seen as helpful and efficient. Although it can help to improve care, it should not be the only form of treatment used. Face to face contact with therapists allows them to gain more knowledge about their patients. Every patient is an individual first so therapy can vary even with a similar diagnosis. Telehealth would be a great addition to already existing therapies in order to enhance what is already known. This will allow patients and families to have the best of both worlds and remain involved while also keeping the convenience.

References:
Ingersoll, B., Wainer, A. L., Berger, N. I., Pickard, K. E., & Bonter, N. (2016).
Comparison of a self-directed and therapist-assisted telehealth parent-mediated intervention for children with ASD: A pilot rct. Journal of Autism and Developmental Disorders, 46(7), 2275-2284. doi:10.1007/s10803-016-2755-z

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Morgan Lauritsen

Telehealth is defined as, “the use of information and communication technologies to deliver healthcare at a distance and to support patient self-management through remote monitoring and personalized feedback”, according to the US National Library of Medicine. This method of health care is organized to deliver care in convenient environments for both the patient and provider. The article, The Impact of Telehealthcare on the Quality and Safety of Care: A Systematic Overview, summarizes the pros and cons of telehealth and how effective it actually is. Telehealth is a growing field and supposedly the future of health care.

Within the research of this article, it was found that telehealth will potentially reduce healthcare costs and improve patient outcomes. A study was conducted to compare patients who used telephone contact for consultations to ordinary face-to-face consultations. Patients who used telehealth were largely satisfied, “They also reported reduced travel time and costs and increased convenience” (McLean, 2013). Telehealth is convenient for individuals living in rural or remote areas. It is much easier to pull out your electronic device at home and video-chat your physician, than it is to travel to your health clinic.
I support telehealth because there are a ton of benefits to it. It is great for people who are unable to travel or for people who don’t have to the time to.  Along with saving time, it also saves the patient money. The only downside to telehealth is that you lose that face-to-face connection with your physician, which could make it difficult to accurately diagnose you. For the most part, telehealth will definitely have a positive impact on health care delivery in todays society.

Reference:
McLean, Susannah, et al. “The Impact of Telehealthcare on the Quality and Safety of Care: A Systematic Overview.” PLoS ONE, Public Library of Science, 19 Aug. 2013. Retrieved from: www.ncbi.nlm.nih.gov/pmc/articles/PMC3747134/.

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Cynthia Luna

According to The New England Journal of Medicine, telehealth, also known as telemedicine, is defined as, “the use of medical information that is exchanged from one site to another through electronic communication to improve a patient’s health,” (Tuckson R., Edmunds M., Hodgkins, M.) The authors then state the purpose of the article, which is to, “present policy-relevant trends in telehealth adoption, to describe the state of the telehealth evidence base, and to assist physicians, other healthcare professionals, and researchers in identifying key priorities for telehealth research,” (Tuckson et. all, 2017).

Within the authors’ research, in 2013, The Department of Health and Human Services has estimated about 60% of all healthcare institutions and 40% of all hospitals within the United States have a system for telemedicine. An indication from the National Business Group on Health, private insurers have been providing settlements for telemedicine. “All large employers will cover telehealth services for their employees by 2020. Currently, all states cover teleradiology, 49 cover telemental health, and 36 cover various home-based telehealth services,” (Tuckson et. all, 2017). Currently, the Agency for Healthcare Research and Quality holds a technical brief, providing a valuation of the evidence of telemedicine support.

I fully support telemedicine. I think it is a great new innovation, especially when it comes to those who cannot simply travel to a primary doctor or there is no clinic nearby. Beneficially, it saves patients a lot of money and time as there is no waiting. This will also reduce the spread of any kind of communicable disease. On the downside from the doctor’s perspective, I think it will be a bit more difficult to diagnose a patient because he/she is not physically in front of the patient, not being able to feel or touch what the problem could be.

Reference:
Tuckson, Reed V, MD; Edmunds, M. PhD; Hodgkins, Michael L, MD, MPH (2017). The New England Journal of Medicine: Telehealth
Retrieved from: https://search-proquest-com.ezproxy.usd.edu/docview/1952634045?OpenUrlRefId=info:xri/sid:primo&accountid=14750

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Elizabeth Richter

Telehealth has enabled physicians to deliver care to patients from convenient locations for both parties. It is used to enhance the care and health of patients. Through video phone calls, patients can see and communicate with their physician from the comfort of their home. Along with cutting costs, it is a fairly easy method of seeing a physician. It also allows for the patient to avoid travel, and it gives the physician the opportunity to increase supervision on patients and to allow emergency evaluation.

Studies were done to test the advantages and disadvantages of video phone calls between patients and physicians. Results showed that telehealth allowed for more flexibility. Telehealth also showed to improve functionality in daily activities. According to Patricia Flatley Brennan of the School of Nursing and College of Engineering at the University of Wisconsin, telehealth is “a successful demonstration of the application of information and communications technology to the complex challenge of managing persons with chronic illnesses.” She ends her article by encouraging telehealth advances because of the advantages it brings to health care delivery.

The article mostly discussed video phone calls between patients and physicians. I think this is a convenient way of delivering care; however, I do believe it may be difficult for physicians to truly see what is wrong with a patient thought a video. As we saw in class, it would be difficult to look into a patient throat through a video phone call. Despite that, it allows for patients to comfortably stay in their homes and receive the care they seek. It could also help to reduce the spread of infectious diseases. Overall, I do think this is an efficient and convenient way for physicians to see patients and vice versa.

References:

Brennan, P. (1999). Telehealth: Bringing Health Care to the Point of Living. Medical Care, 37(2), 115-116. Retrieved from http://www.jstor.org/stable/3767216

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January 28, 2018

Rachel Bruening

Telehealth is a growing field of health care administration and has only become increasingly popular in today’s technology forward society. To help highlight some of the benefits and effectiveness of telehealth this summary will evaluate an article over Teledermatology. It is especially important to note that there is an overall shortage of practicing dermatologists in the United States, which has increased the need for telehealth in this field. Overall this article highlights four critical elements needed in order to reduce face to face appointments without sacrificing their efficiency. The four elements necessary for dermatology units to successfully integrate telehealth are: effective preselection of patients (for teleconsultation), high quality photographic images, dermoscopy, and effective infrastructure and culture.

The focus of teledermatology is to extend the knowledge of dermatologists to as many patients as possible over as many areas as possible. Teledermatology is successful in doing this when they preselect patients with less critical cases to receive appointments online. Not only does this help doctors see more patients, but also it helps them to help critical patients quicker. Even though crucial patients are usually seen faster as a result of teledermatology, this is not always the case and sometimes it is true that “[teledermatology] has not solved access problems like long waitlists”. It is also interesting to note that places that have both teledermatology appointments and face to face appointments are not always as effective as they claim. These units have had a history of providing slower care at increased costs.

Teledermatology has greatly improved the amount of patient appointments with dermatologists. It has cut down on travel time and expenses not only for the patient but also for most health care programs. Studies have found that patients are usually more pleased with teledermatology appointments and have been more receptive too their dermatologists when receiving information online.  Physicians are also becoming more receptive to the idea of teledermatology. Overall, Teledermatology has been proven to be successful and efficient as long as patients are: pre-selected, images are taken by trained professionals, programs refuse Teledermatology referrals that contain images of moles that may be cancerous, and doctors and the people involved are accepting of teledermatology appointments. (Shoshana M.Landow MD, 2014)

References

Shoshana M.Landow MD, A. M. (2014). Teledermatology: Key factors associated with reducing face-to- face dermatology visits. Journal of the American Academy of Dermatology, 570-576.

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Hallie Jerome

In the scholarly article, “The Impact of Telehealth care on the Quality and Safety of Care: A Systematic Overview” a summary is given of what telehealth is, and how it is supposed to benefit patients. According to the text, Telehealth care allows for patients to receive care from afar by technology, communication, and information. It helps the patient manage themselves and report their own type of feedback through remote monitors. The main goal of telehealth is to help people with health problems from a distance, so they can stay in their own comfortable environments for as long as possible. It also states that telehealth has many positive and negative sides to it.
The most positive outcome or gains that telehealth may receive is for patients who are at high risk for serious outcomes. They can work with a healthcare professional from a distance, rather than having to drive to a hospital.  It allows them to get medicated at their house or wherever they live, instead of practically living in a hospital for the rest of their lives. On the upside, it has also improved the convenience, excellence, safety and cost of healthcare. On the downside, an investment in telehealth will not have clinical or economic benefits.

In my own opinion, I think the pros outweigh the cons when discussing telehealth. I think telehealth may be “the next big thing” in the world. An interesting point made in the article is that, many government and industry leaders said that the benefits of telehealth care include reduction of mortality, morbidity, frequency of hospitalizations and number of days people spend in hospital beds. The strongest evidence that reduced mortality was Chronic Heart Failure. I am excited to hopefully someday work in the healthcare field, and I can’t wait to see where telemedicine leads us.

References

McLean, S., Sheikh, A., Cresswell, K., Nurmatov, U., Mukherjee, M., Hemmi, A., & Pagliari, C. (2013). The Impact of Telehealthcare on the Quality and Safety of Care: A Systematic Overview. PLoS ONE, 8(8), e71238. http://doi.org/10.1371/journal.pone.0071238

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Telehealth and Veteran Health Administration

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Telehealth and Veteran Health Administration

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Taylor DeBoer
The implementation of telehealth in Veteran Health Administration has been seen to have various pros and cons the last few years. Telehealth is a system to deliver health care services at any distance, through the use of any communication device with the appropriate electronic application. Whether it be your smart phone or lap top, all your health records and physicians can be accessed at any time. This can be beneficial to allow the patient to track and manage their own chronic illness’ and disabling diseases from the convenience of their own home. Many patients even reported that the systems were easy to use and understand.

Although telehealth has many benefits, there are many aspects of it that may be aggravating to the aging and disabled community. Many patients and physicians have found flaws with the programs when it comes to the effectiveness of the system randomizing the correct or appropriate questions for the patient. Some patients skipped questions that seem to be repeated and often had questions that were not relatable for their condition. When working smoothly, the system can be useful to provide both patients and physicians with accurate information in a timely manner. There is some concern of the patient being able to understand and access the necessary technology and software the systems run on.

I think all information offered in the studies available within this article could be useful in the future to help create an even easier and helpful system to be used by the aging community. It could also help to increase the timeliness. I think telehealth has good potential to be connected to many online systems that could help patients receive information faster and more understandable. This article focusses mainly on the aging veteran population and how we can improve and lower the cost of their healthcare. The system offers help for the veterans and their caregivers so they can get help within their homes faster and deduce the visits to emergency departments and clinician visits.

References

Chumbler, N., Haggstrom, D., & Saleem, J. (2011). Implementation of Health Information Technology in Veterans Health Administration to Support Transformational Change: Telehealth and Personal Health Records. Medical Care, 49(12), S36-S42. Retrieved from http://www.jstor.org/stable/23053719

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Carlie Hanson
Many people in the world are in need of healthcare services but struggle to receive it. People living in rural areas find it especially hard to receive the medical attention they need. The introduction of telehealth to rural health care facilities is becoming a convenient and affordable option. Although there are both positive and negative aspects of telehealth, the use of this technology in rural areas could positively affect those in need. Numerous studies have been done in order to get feedback on this topic. The article I read focused on telehealth in the psychological area of health care.

This study examined the difference between meeting in-person vs using telehealth services when conducting neuropsychological assessments. The study included 98 patients with cognitive disabilities. One group of 49 individuals utilized the telehealth option while the other 49 individuals met in-person with a psychologist. After each evaluation, patients and psychologists rated their experiences by answering a questionnaire. The results of the study showed no preference for in-person care over telehealth care. Patients reported feeling just as relaxed when using the telehealth service as they would in-person. The study also found that patients using telehealth were more likely to want to repeat the experience than those who met in-person. The psychologists, however, reported less satisfaction with telehealth and would rather meet in-person.

I think telehealth will impact health care delivery in the future because patients will have the choice whether they want to meet in-person or use a telehealth service instead. Telehealth offers an alternative that is more convenient to both patients and clinicians, or psychologists in this case. For example, the study revealed that patients were pleased to be able to receive health care services closer to their homes at a more affordable cost. Telehealth would save rural patients the hassle of traveling long distances to receive proper care. As the costs of health care continue to rise, the affordable cost of telehealth is appealing to many people.

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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Telehealth delivery of Rapid Syllable Transitions (ReST) treatment for childhood apraxia of speech

This article was a research report done on the effectiveness of a certain type of therapy given via telehealth. The mode of telehealth was video conferencing. Five children diagnosed with childhood apraxia of speech (CAS) were able to participate in this study. The therapy was a treatment called Rapid Syllable Transitions (ReST), which is the use of made up words containing random syllables to work on the muscle movement and the rhythm of speech it takes to be able to pronounce these and regular words. Telehealth in speech pathology is becoming more common because speech professionals can be few in number and hard to visit for some families. This is one of the first studies completed about telehealth and children with CAS.

Overall, the results of this article showed decent findings. All five children performed better than before the treatment, when a baseline performance was determined. Four of the five maintained their skills four months later as well. Based off this one study and situation, videoconferencing seems to perform about the same as face-to-face treatment. There were technical difficulties in almost every single call, but both the provider of the treatment and the families found the telehealth component satisfying and convenient. Only one call was ever lost, but connection and lagging were issues.

When considering telehealth’s implications for the future, connection of signal comes to mind. This may be an issue for a long time, and that may deter a lot of people from utilizing telehealth. As always, the rest of the issues that can be present when dealing with technology are factors as well. Also, it is possible that many people would rather see a professional face-to-face especially when dealing with speech issues because one would want the professional to see everything going on in the speech process. Though this article is one of the first of its kind for children with CAS, I do think telehealth for this category is going to continue to grow as the technology age continues.

Thomas, D. C., McCabe, P., Ballard, K. J., & Lincoln, M. (2016). Telehealth delivery of Rapid Syllable Transitions (ReST) treatment for childhood apraxia of speech. International Journal Of Language & Communication Disorders, 51(6), 654-671. doi:10.1111/1460-6984.12238

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The Development of Telehealth as a Strategy to Improve Health Care Services in Zambia

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The Development of Telehealth as a Strategy to Improve Health Care Services in Zambia

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Brie Satre
In today’s society telehealth is a turning key factor in the medical field that can impact all types of populations. Most find this type of health care intriguing and use it for minor health fractions but for some it may be the only hope or access they have. In the article above, it discusses the value of providing health information and knowledge to health practitioners and patients in rural parts of Africa. In many countries in Africa, such as Zambia all the medical equipment and expertise are located in major cities. Implementing telehealth in these rural areas can have a positive effect on these communities.

In this study, the method they used to gain all of this information was based off of literature, news reports, and the personal experiences. The goal by the end of this research was to get higher numbers for those getting access to health care and medicines. I chose this article because this is just one rural place in Africa, there are thousands of places across the world that need help even in the United States. Getting all of the technology needed in to these remote places will be a huge barrier that might hold some back from getting telehealth care.

Personally, I believe that telehealth has already impacted our health care system immensely. There are positives and negatives to this system and not everyone will agree on if it is the best way or the worst. I do think hands on patient care is very important, and you get a better connection with the patient but the telehealth is a great way to save money and time. It will be interesting to see where telehealth will go in the future!

Chanda, K.L., & Shaw, J. G. (2010). The Development of Telehealth as a Strategy to Improve Health Care services in Zambia. Health Information & Libraries Journal, 27(2), 133-139.
http://web.a.ebscohost.com.ezproxy.usd.edu/ehost/pdfviewer/pdfviewer?vid=9&sid=737d1d4b-3462-4805-b489-7981356f7d58%40sessionmgr4009

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Innovative models for providing clinical pharmacy services to remote locations using clinical videotelehealth 

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Innovative models for providing clinical pharmacy services to remote locations using clinical videotelehealth 

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Brittany Hamann
Clinical pharmacy specialists (CPSs) at a regional VA telehealth base in Boise VA Medical Center have started to provide telehealth services for rural areas. They have spread to 16 clinics. The main goal is to provide veterans with the best care. The job of telehealth is to provide timely care! About 40-45% of veterans live in rural areas. Rural areas usually lack access to highly trained care professionals. Clinical video telehealth (CVT) helps meet the needs of these veterans that live in the rural areas by bringing care to people who cannot travel, live too far away, or have other barriers. CVT is cost efficient, so they decided to include the knowledge of pharmacists to improve the veterans access to medication also.

Veterans living in urban areas are more likely to have access to clinical pharmacy specialist (CPS) services than those who live in rural areas. Access to CPSs can provide follow-ups between regular primary care visits and start, adjust , or stop the use of medications. This helps improve the outcome of patients with chronic diseases. The most common chronic diseases are diabetes, hyperlipidemia, hypertension, and pain management.

There are two options of care. The first option is to have a primary care team that consists of a medical provider, medical support assistant, psychologist, a licensed clinical social worker, and a CPS all located at one facility, while the patient and the LPN or RN are in the rural area. All the members rely on the nurses with the patient for additional care.
The second option is to have a CPS that works remotely from the rest of the care team and uses CVT to provide services.

There are a total of 16 VA clinics that CPSs have provided care to, along with over 1,200 patients. In the future I hope to see this spread to all VA hospitals and also expand to provide services for everyone. I think this can help regulate medications and chronic conditions, and provide services for people who have to travel far to get any help. I think this could also help educate veterans about their medications and make sure they are taking them correctly, and hopefully it will help all citizens.

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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Efficacy of Telehealth Treatments for Posttraumatic Stress-Related Symptoms: A Meta-Analysis

Dasashe Gelaw

Almost every individual experience at least one traumatic event during their lifetime.  Although majority of the people that experience a traumatic event are resilient, they develop a psychological difficulty that case distress impairment. However, those people that are suffering from traumatic do not receive or get the treatment such as depression and post traumatic stress disorder(PTSD). Some of the reason they are not getting the psychological treatments is due to the distance away from mental health care services, cost because some people can’t afford it, time and limited access to specialized trauma. To solve this barrier research have developed and tested Telehealth.

Researchers developed telehealth intervention that relates psychopathology for posttraumatic stress to assistance people. Some of the treatment they came up with is internet based on self-management and therapist-assisted. This intervention also involves educating individuals strategies to manage and cope their reaction through the using cognitive behavioral by delivering through the internet.  Telehealth is described as telecommunication technologies. For example, video conferencing, telephone, and the internet to deliver service for health care.  During individual’s treatment, they do writing assignment describing the tragic event and the impact it has on their life’s. Which I think it’s very helpful because not everyone wants to talk it out with people what exactly is going on . However, it will make it easier for others to write out instead of talking through it. Another method  that was tested was the efficacy cognitive behavior with video conferencing, which is very helpful because sometimes people don’t feel conformable sharing the tragic event faces to face.

I think this will have an impact on the health care delivery system in the future by providing options for people that are going through traumatic events. It will save peoples time, money and easier access. Telehealth can make it easier for people who physically can not to go the clink or get outside treatment. Individuals can be able to receive treatment from their comfortable home. Also, sometimes it gets very difficult when it comes to communication with the person that is in the same room as you but if you're using  the internet or video conferencing it's easier to talk to someone that not in the same room as you.

Sloan, D. M., Gallagher, M. W., Feinstein, B. A., Lee, D. J., & Pruneau, G. M. (2011). Efficacy of Telehealth Treatments for Posttraumatic Stress-Related Symptoms: A Meta-Analysis. Cognitive Behaviour Therapy, 40(2), 111-125. doi:10.1080/16506073.2010.550058

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Employment of Telemedicine inEmergency Medicine

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Employment of Telemedicine inEmergency Medicine

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-Riley Ackerman

Emergency Medical Services face challenges such as the opioid crisis, rural/demographic change, rising co- morbidity and an increasing number of emergencies. To combat death, highly-trained professionals and well-suited ambulances are paramount. However sometimes one-two highly trained EMS personnel are not enough to work on multi-systematic intricate emergencies. Thus, telemedicine has been deployed into EMS. Telemedicine then allows Paramedics/EMTs/RN's to have visual and verbal feedback from a specialty physician/PA anywhere and anytime.

While feasibility could be an issue, about 76% of the time calls were established even in rural areas. "Jump-Packs" were mounted on the ambulance to increase network strength and telemedicine reliability. The cornerstone of telemedicine is its function, which are even more reliable in field test conditions. With telemedicine technologies and network strengths becoming stronger, the reliability of telemedicine will only increase. Telemedicine may be a hurdle for developing countries, but it is already in action in the United States.

Personally, I think telemedicine is a great resource in the field. One of the two rural ambulances I serve on has telemedicine and it can, literally, be a "life-saver". It is reliable and is a resource that puts a physician in the back of your pocket.I can see how telemedicine can be difficult to adjust to for older generations, but our generation has no problem face timing on an iPad. I hope more EMS agencies adopt Telemedicine.

Czaplik, M., Bergrath, S., Rossaint, R., Thelen, S., Brodziak, T., Valentin, B., ... & Brokmann, J. C. (2014). Employment of telemedicine in emergency medicine. Methods of information in medicine, 53(2), 99-107.

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Ubiquitous Tele-health System for Elderly Patients with Alzheimer’s

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Ubiquitous Tele-health System for Elderly Patients with Alzheimer’s

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Tiffany Timmermann

Tele-health is becoming more and more present in our society today. With the use of wearable and wireless ECG’s and RFID’s getting information to a physician is not so hard anymore. These technologies are coming in handy for the elderly especially those with disabilities like Alzheimer’s.  The King Fahd University of Petroleum and Minerals (KFUPM) Medical Centre in Saudi Arabia did a study on how using wearable and wireless RFID’s and ECG’s can help elderly patients with Alzheimer’s. Through this study they found that using these technologies the patients and send information to their physician faster and more efficiently.  It also helps caregivers and physicians know where the patient is and what their vital signs are at any giving point.

Personally, I think this new tele-health technology is great and will help hundreds of people in the future. Although there will always be some flaws like data bases crashing or not working properly or sending false information. But even with these flaws I still think that this technology will help patients more than it would hurt them. I hope more people get to use telehealth in the future and it becomes a great resource for everyone.

Raad, Sheltami, & Shakshuki. (2015). Ubiquitous Tele-health System for Elderly Patients with Alzheimer's. Procedia Computer Science, 52, 685-689.

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Treatment of Depression Using Telehealth Care

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Treatment of Depression Using Telehealth Care

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Allison Behrendt
Treatment of depression in the U.S., in my opinion, isn’t very helpful to those suffering. I’ve noticed that most primary care physicians prescribe a pill to help alleviate their emotions about their depression or thoughts of suicide. Some physicians may make it mandatory to have patients report to support group but it is more forced than willing. I think we have a lot of room for improvement in this area of healthcare. We need to understand why depression is present in patients lives and how we can start healing the patients. Find ways to stop or alleviate their pain and emotions. This article explains the randomized trial that was conducted comparing usual care, telehealth care, and telehealth care plus peer support. There was a total of 302 patients starting antidepressant drug therapy. The objective was to evaluate the efficacy of 2 augmentations to antidepressant drug treatment. In the trial, it was hypothesized that having nurses and peers assist in the treatment of depression is an efficient way to improve outcomes. During this randomized trial they tested 3 hypotheses but only one hypothesis was correct. The hypothesis was that depressed patients who receive nurse telehealth care experience greater reduction in depressive symptoms, greater improvement in functioning, and greater satisfaction with their care for depression compared with those receiving usual physician care only
The results of this study concluded that telehealth care improved patient’s depression and that this treatment was more effective than the other forms of treatment. Adding peer support to telehealthcare did not improve any primary outcomes so it’s unnecessary. Conclusion includes nurse telehealth care improves clinical outcomes of antidepressant drug treatment and patient satisfaction and fits well within busy primary care settings.

My thoughts about using telehealth as a treatment for depression is that it can be useful and beneficial for the recipient. This article talked about how the telehealth nurses made phone calls to the patients every week, to once every two weeks, etc. This is beneficial because then those who are struggling with depression can have someone to talk to about their condition or what may be bothering them each day. On the phone, the nurses asked the patients about what happened that week and the week before and how they could change what happened and turn it into a positive outlook.

Scholarly Peer-Reviewed Source

Archives of Family Medicine (2000, August) Efficacy of Nurse Telehealth Care and Peer Support in Augmenting Treatment of Depression in Primary Care Retrieved from https://triggered.clockss.org/ServeContent?url=http://archfami.ama-assn.org%2Fcgi%2Fcontent%2Ffull%2F9%2F8%2F700

(Archives of Family Medicine.2000)

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Voice Therapy Using Telecommunication Technology

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Voice Therapy Using Telecommunication Technology

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Gabi Stenzel
In the United States alone, about 14 million people suffer from having a voice, speech, or language disorder. If the people with these disorders are not able to get the help that they need, their conditions may ultimately worsen. Therefore, accessibility to treatment for these impairments are critical. Many places like the Pacific Rim, which include Japan and Korea, have trouble gaining access to treatment for their impairments. By implementing telehealth, we could find ways to provide treatment for those not able to travel or go to an actual facility.

A study was done by Tripler Army Medical Center in Honolulu, Hawaii. They gathered 72 patients with diagnosed voice disorders. There were both males and females with the average age being 45. They then randomly split up the participants into either the conventional group or the video teleconference group (VTC). Participants in the conventional group received face to face treatment with a clinician in the same room. The VTC group received treatment from a clinician in separate rooms through a video monitoring system. All the techniques used on the participants were the same only difference being the medium through which they received their treatment; face to face or through video. In the end, they found out that just as many people had success through the VTC therapy as the conventional face to face way.

This study showed that telehealth can be very beneficial to our healthcare system. Telehealth makes it easier for people who physically can not go to a clinic to be able to receive their treatment from the comfort of their own home. If VTC treatment took off, thousands more people would be able to get the help that they need in order to live a stable life. Telehealth would also reduce cost requirements drastically. I believe that the advancements being made in telehealth will only help strengthen healthcare delivery in the future.

Mashima P.,  Birkmire-Peters, D., Syms, M., Holtel M., Burgess L., Peters l.        (2003). Telehealth: voice therapy using telecommunications technology.

American Journal of Speech-Language Pathology, 12(4), 432.

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Client Satisfaction with Telehealth in Assisted Living and Homecare

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Client Satisfaction with Telehealth in Assisted Living and Homecare

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Caitlin Bolte

The growing trend in the U.S. is to remain independent and in their own homes for as long as possible. This study looked at the ways impaired seniors or those with complex medical scenarios are receiving the help they need to stay out of nursing homes as long as possible. The problem, however, is that home health and assisted living centers are facing numerous challenges (from nursing shortages to access in rural areas). Telehealth is helping both providers and patients alike achieve this goal and help overcome these problems by allowing safety monitoring and remotely determining health status. The Good Samaritan Society, a nationwide senior services organization (with headquarters based out of Sioux Falls, SD) introduced the LivingWell@Home (LW@H) program in 2010 and is heading this challenge.

A randomized trial was performed on seniors. From 2011 to 2013 The University of Minnesota collected data and evaluated the efficacy of telehealth services in both Assisted Living Centers and Home Health agencies. The 3 main types of telehealth devices they tested included sensors, emergency response systems, and biometric monitors. Client satisfaction was then measured based on 25 services provided. In general, patients had higher satisfaction rates upon the 6 month and 12 month marks of using telehealth than those who didn’t receive its benefits.

Utilizing telehealth in assisted living centers and in patient’s homes via Home Health will positively effect health care delivery. As the Baby Boomer generation continues to age, nursing homes, assisted living centers, and all other facilities that accommodate elderly patients will continue to overflow. So much so, that patients may be turned away. Turning away these patients puts them at greater risk for enduring problems while not in supervised care. However, implementing telehealth can help providers virtually reach and care for their patients. Just as the article stated, the use of telehealth is helping to extend the amount of time that seniors can remain in their homes. Telehealth can also give patients immediate attention and/or care thus avoiding transportation and waiting times to see a physician in either a clinic or hospital. Telehealth also affects families. They do not have to spend immense amounts of time caring for their elderly family member, rather, they can rest assured that he or she is well cared for. The last benefit of telehealth eliminates patients’ denials regarding their health habits. Denial results as a fear of being relocated to a nursing home. Telehealth can see right through these denials. Potential challenges to telehealth include cost and privacy invasion.

Grant, L.A., Rockwood, T., & Stennes, L. (2015). Client satisfaction with telehealth
in assisted living and homecare. Telemedicine and e-Health, 21(12), 987-
991. doi: 10.1089/tmj.2014.0218

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The effectiveness of telemedicine in the management of chronic heart disease – a systematic review

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The effectiveness of telemedicine in the management of chronic heart disease – a systematic review

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Jordan Adler

Telemedicine, as defined by the World Health Organization (WHO), is the "delivery of health care services, where distance is a critical factor" (2010). "The effectiveness of telemedicine in the management of chronic heart disease – a systematic review", published in the Journal of the Royal Society of Medicine, explores the efficacy and effectiveness of telemedicine in managing chronic heart failure and in reducing hospitalizations and readmissions. Patients with chronic heart disease work to maintain their health after they are discharged from the hospital. Rural patients oftentimes face more difficulty maintaining their health due to the lack of accessibility to care when compared to urban patients who generally have a close proximity to care. For this reason, telemedicine has become a crucial component of not only maintaining the health of rural patients but also urban patients as well. As authors Kruse, Soma, Pulluri, Nemali, and Brooks describe, "telemedicine [is] a natural extension of the clinical walls and enables a patient-to-provider link regardless of proximity to care" (2017). An increase of self-management was recorded as a result of the increased use of telemedicine in patients with chronic heart disease.

Telemedicine is also shown to reduce hospitalizations and readmissions of patients with chronic heart disease. Data from 20 articles, extracted from a variety of countries, show that "45 percent [of articles] reported a significant reduction in hospitalizations and readmission as a result of using telemedicine" (Kruse et al., 2017). In addition, five articles mention a decrease in the length of hospital stay (Kruse et al., 2017). Telemedicine has made "remote monitoring" of patients a possibility for health care providers, mainly physicians, following hospital discharge and has become one of the main reasons for the reduction in hospitalizations and readmissions seen around the country. Despite the lack of studies on telemedicine, it has already demonstrated its potential to aid in the care of individuals who face proximity barriers to care.

After reviewing this article on the efficacy and effectiveness of telemedicine, I have concluded that telemedicine has a tremendous upside for individuals living in remote or rural areas. In addition to strengthening the relationship between the patient and his/her health care, telemedicine creates opportunities for patients to connect with physicians that may be distant from them and gives physicians the ability to determine ways to manage and/or improve their patient's health. As technology continues to advance and become more accessible, so will telemedicine. As a young adult interested in health care, I am excited to see what telemedicine can offer patients. If the data shown by Kruse et al. is accurate, telemedicine is a step in the right direction for health care and should be embraced by patients and providers as it continues to gain popularity in the industry.

Kruse, C. S., Soma, M., Pulluri, D., Nemali, N. T., & Brooks, M. (2017). The effectiveness of telemedicine in the management of chronic heart disease – a systematic review. JRSM Open, 8(3), 2054270416681747. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5347273/

World Health Organization. Telemedicine: opportunities and developments in Member States: report on the second global survey on eHealth. Geneva: World Health Organization, 2010. Retrieved from: http://www.who.int/goe/publications/goe_telemedicine_2010.pdf

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Cost effectiveness of telehealth for patients with long term conditions (Whole Systems Demonstrator telehealth questionnaire study): nested economic evaluation in a pragmatic, cluster randomised controlled trial

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Cost effectiveness of telehealth for patients with long term conditions (Whole Systems Demonstrator telehealth questionnaire study): nested economic evaluation in a pragmatic, cluster randomised controlled trial

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By: Logan Slack

This scholarly article investigates the costs and how cost effective telehealth is compared to standard support and treatment. This investigation was a randomized controlled trial that took place in three areas in England from 2008 to 2009. Of the participants active in this study, 534 were randomized to telehealth which involves receiving telehealth equipment and monitor services for one year while 431 participants involved normal standards of care. The participants that received telehealth also received standard support and care. The participants in this trial included those with a long term condition which included heart failure, lung diseases, or diabetes.

Telehealth involves “telemonitoring” someone’s vitals and other data either through video or by telephone. The number of individuals with a long term condition is suppose to rise three million by 2025. Telehealth can help by saving valuable time to both the patient and the clinician without having to go to a clinic or hospital for care, but do the costs of telehealth out cost the normal standards of care? The Department of Health found the cost of telehealth along with the normal standard of care and support to be higher mainly due to the technology involved. The equipment, engineering, installation, maintenance, and numerous of other costs increase the cost which does not necessary make it more cost efficient. Telehealth may be the new idea of the future and it already is becoming that but improving the system and cutting down cost will be in focus.

This will impact health care delivery in the future by providing the world with valuable and reliable information about the costs of telehealth and the importance of what telehealth can do in the future. Telehealth systems are beginning to be demonstrated around the world, and I believe it is the next big thing that will be seen in the upcoming decade. This article overall showed us the cost issues that is seen by telehealth and an analysis of the strengths and weaknesses incorporated with telehealth. The ability to pay for telehealth services and having enough clinicians available for telehealth services is still at question. Technology in telehealth can either strengthen health care delivery and provide a better standard of care or make things more complex due to expenses and the availability of clinicians to perform this type of care.

Reference

Henderson, C., Knapp, M., & Fernández, J. et al. (2013). Cost effectiveness of          telehealth for patients with long term conditions (Whole Systems Demonstrator telehealth questionnaire study): nested economic evaluation in a pragmatic, cluster randomized controlled trial. Bmj, 346(Mar28 6). doi:10.1136/bmj.f2065

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A pilot study of a telehealth intervention for persons with spinal cord dysfunction

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A pilot study of a telehealth intervention for persons with spinal cord dysfunction

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Emily Hargreaves

This article was written to show how the telehealth creation ‘CareCall’ affected individuals with a spinal cord dysfunction (SCD). The focus of this study was to see if ‘CareCall’ would prevent or help secondary conditions found in adults with a severe immobility impairment caused by an (SCD). The two secondary conditions that the study focused on were depression and pressure ulcers. The other goal for this telehealth service was to improve the use of health. ‘CareCall’ is an interactive voice response (IVR) system that digitizes speech to allow the telerehabilitation coordinator to collect the data she received during the call.

This study was a randomized control trial that took place in Massachusetts and Connecticut and lasted six months. There were 142 individuals selected to participate in the study. The individuals were then randomly placed in either the control group or the intervention group. The control group saw their health care provider in a normal manner, while ‘CareCall’ sent automated calls once a week to the intervention group for six months. The intervention group was also allowed to call ‘CareCall’ whenever they needed. At the end of the study, they found that ‘CareCall’ dramatically decreased the number of pressure ulcers in women but had no effect on men. It also significantly dropped the number of individuals who suffered from depression. There was no change in the overall use of health care, but it did improve the availability of health care.

I personally think that by using the telehealth invention ‘CareCall’ the lives of individuals facing secondary conditions caused by an (SCD) will be improved. ‘CareCall’ is more affordable for the patient so more people will want to use it. Since ‘CareCall’ was set up to work in multiple settling it allows more people access to the service. I believe that this telehealth invention will be beneficial for people facing secondary health conditions in the future. The development of interactive voice response systems in telehealth will help strengthen and improve today's health care 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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Review one scholarly, peer-reviewed journal article about the efficacy of telehealth. Please choose an original article not summarized by another student. 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). See the course schedule for the specific date. Be sure to include your reference in APA style at the bottom of your initial post. Be sure that your name is on you post. We will discuss these posts in class. This assignment is worth 10 points. See the grading rubric for more specific instructions.

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