The driving force of telehealth is nursing and healthcare worker shortage, chronic diseases and condition, the new educated consumer, and excessive cost of healthcare services are increasing in need and kind. Clinical uses of telehealth are: 1) transmitting images for assessment and diagnosis ex wounds for assessment, 2) Transmitting clinical data for assessment, diagnosis or disease management ex remote patient monitoring and transmitting patient subjective and objective data. 3) Providing disease prevention and promotion of good health example case management provided via a telephone or smartphone. 4) Using real time video example exchanging health services via videoconferencing. 

Telenursing is the use of telecommunication and information technology to provide nursing services in health care and enhance care whenever a physical distance exists between patient and the nurse. The patient populations are those who are immobilized, live in remote or difficult to reach places, have chronic disease, and have debilitation disease such as Parkinson’s disease and Alzheimer disease. 

A home health nurse can see up to 7 patients a day depending on the travel involved. With telehealth a nurse can televisit 12-16 patients in a day. Another outpatient application of Telenursing is telephony-based call centers which maybe operated by managed care organization, hospitals, and other health organization. The patient can use telehealth devices to transmit biometric and other medical information back to the call center. Monitoring can be intermittent or continuous. This technology allows clinicians to evaluate patient status and use the data to make decisions to better manage health conditions. Some home based telecardiology program involves the patient, the family, the physician and a specialized cardiac monitoring center, A multidisciplinary approach to manage the patient. Tele-intensive care nurse provides an extra set of eye to look for trends indicating that an intervention is needed alerting the bedside nurse. Some sources have predicted that home care will soon become the hub of all patient activity. Telehealth services are used for prison population to promote public safety by not having to transport prisoners to health care facilities. One of the largest potential markets for home telemonitoring is patients and families who want to have reliable and objective information that allows for their involvement in healthcare decision-making.

Tools for home telehealth consist of Central station, peripheral biometric devices, telephones, video cameras and videophones, personal emergency response system, sensor and activity monitoring system and medication management devices. Central station and web servers are key components of telehealth that can be as minimal as a single screen display or as comprehensive as software applications that provide various functions including triaging the data based on medical alerts, which allows clinicians to quickly identify those patients requiring immediate attention. Peripheral biometric devices can consist of fully integrated systems, such as vital signs monitor, or they maybe stand alone telecommunication ready devices such as blood pressure cuffs and blood glucose meters. This data can use a telephone jack to send data to the central server location. 

            The telehealth tools does not replace the nurse, but gives the nurse more information on the patient to make more informed clinical decision and a comprehensive picture of the patient’s status. Using telehealth regular data gives nurses more targeted information than seeing a patient on scheduled visit. Also it lets patient in control of their care. Patient confidentiality and the privacy and safety of clinical data must be given special consideration. Informed consent release to receive telehealth services area a critical first step. Informed consent is obtained from all person living in the household because there is potential privacy consideration. All telehealth providers should have appropriate training in privacy and confidentiality. Telehealth research focuses on effectiveness of telehealth compared to usual care, cost effectiveness of telehealth intervention, and patient and family satisfaction. There was no difference reported between visit from the standard care group and telehealth visit.