Amy●

 

            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

 
          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

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

            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)

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.

 

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

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

                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

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

            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

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

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)

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.

 

 

 

 

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

      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

            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/.

 

                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

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. 

 

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