Annotated Bibliography on Technology in Nursing: Telehealth

            Telehealth refers to all technologies that facilitate the delivery of health-related services using electronic communication. For instance, doctors may use the internet to provide care to a patient at a distance. When such remote services are entirely clinical, the term used is telemedicine. Telehealth has seen an unprecedented rapid adoption in healthcare following the emergence of the COVID-19 pandemic. The pandemic has significantly reduced in-person hospital visits. Telehealth has emerged as the viable alternative for physicians to administer appropriate care while minimizing physical contact. With the increased adoption of telehealth, it is crucial to understand how the technology impacts patent safety, quality of care, and interdisciplinary teams.

            This annotated bibliography describes how four peer-reviewed publications promote telehealth technology to enhance safety and quality of care and improve interdisciplinary teams. PMC and PubMed databases were searched for publications (2016-2021) that reported data on telehealth’s role in promoting patent safety, quality of care, and interdisciplinary teams. The search combined ‘telehealth’ and ‘health-impact’ terms. Telehealth terms include ‘telehealth,’ ‘telemedicine,’ ‘mobile application,’ ‘telephone,’ and ‘digital technology.’ Health-impact terms include ‘patent safety,’ ‘quality of care,’ and ‘interdisciplinary teams.’ The search yielded 30 articles. Articles that were similar, irrelevant, and unavailable as full-text were excluded. Four articles that best addressed the research question were selected for the annotated bibliography.

Bhaskar, S., Bradley, S., Chattu, K., Adisesh, A., & Nurtazina, A. (2020). Telemedicine as the new outpatient clinic gone digital: Position paper from the Pandemic Health System REsilience Program (REPROGRAM) international consortium (Part 2). Frontiers in Public Health, 8(410), 1-16. https://dx.doi.org/10.3389%2Ffpubh.2020.00410

             In this literature review, Bhaskar et al. (2020) examine the current telehealth landscape after the emergence of the COVID-19 pandemic, focusing on its role to improve efficiency, access, and delivery of care in various clinical subspecialties. Since the emergence of the pandemic, teleconsultations have been used to triage patients remotely, reducing strain in emergency departments (EDs). Telecardiology has enabled remote monitoring of heart rhythm and virtual visits of patients with cardiovascular disease. Reperfusion treatment in neurology is now assessed remotely through computed tomography. Tele-education is used to upskill physicians in critical areas such as ventilator management. Multiple telehealth approaches (tele-prescription, videoconferencing, self-management, text reminders, and tele-advice) are used to ensure ongoing monitoring of patients with chronic conditions. Telemedicine is implemented to ensure medication compliance and ongoing rehabilitation. Telehealth is also applied to training patients in palliative care and also to offering mental counseling services (telepsychiatry).

            This article provides a rich source of knowledge for nursing students who wish to understand how specialty fields in medicine, applied telehealth in addressing COVIE-19 challenges. Telemedicine has helped ensure continuity of healthcare services across specialties without compromising the quality or safety of care. At the same time, telemedicine has limited the risk of COVID-19. Additionally, telehealth technology has introduced efficacy and streamlined delivery of services. All these changes contribute to improving the access, quality, and safety of care.

Pariser, P., Pham, T., Brown, J., Stewart, M., & Charles, J. (2019). Connecting people with multimorbidity to interprofessional teams using telemedicine. Annals of Family Medicine, 17(1), s57-s62. https://dx.doi.org/10.1370%2Fafm.2379

            Pariser et al. (2019) analyze telemedicine’s role in linking individuals with multimorbidity to interprofessional healthcare teams. Primary care physicians always find it challenging to manage individuals with multimorbidity because of insufficient time and lack of an enabling structure. Pariser et al. (2019) conduct a feasibility study for an interprofessional telehealth intervention program, Telemedicine IMPACT Plus (TIP). TIP facilitated synchronous connections to team-based care in primary care settings.

            A total of 53 primary care physicians and 74 multimorbidity patients participated in the study for one year. All the patients reported that the TIP intervention increased their access to interprofessional care. Further, 97% of them believed that the TIP intervention was going to improve their conditions. A total of 21 physicians were surveyed. They all reported that the TIP intervention was useful in managing multimorbidity patients. Another 87 interdisciplinary team members revealed that the TIP intervention was effective (97%) in managing multimorbidity patients. The TIP intervention costs were found to be 22% less than the hospital admission charges. No evidence showed that the TIP programs affected patient safety.

            The study is important to the nursing practice because it reveals another critical role of telehealth technology: its unique ability to address complex patients’ healthcare needs. Complex patients often find some of their needs going unaddressed in primary care settings. Telehealth programs enable such patients to meet with a team of specialists who focus on all their morbidities. This allows them to access quality, safe, low-cost, and comprehensive care.

Paterson, C., Bacon, R., Dwyer, R., Morrison, K., Toohey, K., O’Dea, A., . . . Hayes, S. (2020). The role of telehealth during the COVID-19 pandemic across the interdisciplinary cancer team: Implications for practice. Seminars in Oncology Nursing, 36(2020), 1-8. https://dx.doi.org/10.1370%2Fafm.2379

            Paterson et al. (2020) analyze the role that telehealth technology has played since the onset of the COVID-19 pandemic in ensuring that cancer patients continue receiving interdisciplinary care. The study asserts that the pandemic compelled oncology practices to become digital by default. Services such as pre-chemotherapy, symptom assessments, exercise interventions, and diet activity are now delivered via telehealth. Physiotherapists are using telerehabilitation to offer remote musculoskeletal assessments to cancer patients. Clinicians can take high-resolution images using technologies, such as cameras and whole-slide imaging, and send them to pathologists for examination without the need for in-person attendance.

Telehealth has also enabled virtual multidisciplinary team meetings involving specialists such as oncologists, pathologists, clinicians, and physiotherapists. These individuals attend online meetings from their remote locations and offer their high-quality advice on the patient’s health. Such interprofessional collaborations improve patient outcome and clinical performance (enhanced safety and satisfaction). According to the article, telehealth has shown to be a reliable technology, especially to cancer patients, and it should be part of future healthcare systems.

            This article is vital in oncology nursing since it shows the immense contribution of telehealth in care delivery, particularly during the pandemic. Telehealth has emerged as the most viable alternative to in-person hospital visits. This has benefited cancer patients who are among the risk groups for COVID-19. Cancer patients can now access safe and effective care administered by interprofessional teams. Health professionals can manage clinic flow, ensure clear communication, deliver modified services, and guarantee patient and staff safety.

Young, J., & Badowski, M. (2017). Telehealth: Increasing access to high-quality care by expanding the role of technology in correctional medicine. Journal of Clinical Medicine, 6(2), 1-7. https://dx.doi.org/10.3390%2Fjcm6020020

Young and Badowski (2017) analyze the role of telehealth technology in expanding care among inmates. The majority of prisons in the US are located in rural areas, making it hard for inmates to access subspecialty care due to geographical and cost barriers. As such, Young and Badowski (2017) recommend that the US capitalizes on its abundance of healthcare resources to harness telehealth to expand access to subspecialty care to inmates. The article gives literature evidence that suggests several benefits of telehealth technology in prisons. These benefits include increased care access, decreased wait time, reduced costs, high patient satisfaction, better coordination of care, and improved mobility and mortality.

            According to the article, telehealth technology in prisons supports a multidisciplinary approach to specialty care. For example, an HIV-positive inmate may participate in a real-time synchronous interaction with an infectious diseases doctor, a pharmacist, and a case manager, all of whom address the holistic elements of HIV care. Additionally, the prison is exempted from security and transport costs that would have been incurred if the inmate had physically attended their medical appointment. Telehealth has shown promising outcomes in the treatment of hepatitis C and HIV among prisoners. In the latter, telehealth technology was found to suppress viral loads and increase CD4+ counts.

            This article shows the impact of telehealth in one of the most underserved populations globally, prisoners. With the introduction of telehealth, the article reveals that inmates will be able to access quality, timely, and safe care at an inexpensive cost. More importantly, telehealth will open the room for accessing specialty care through an interdisciplinary health care team. Care services that seemed challenging to sick prisoners will now become a reality. With the evidence given in the article, healthcare practitioners can understand the vital role of telehealth technology in opening care to underserved populations.

Conclusion

            The general conclusion from the four publications is that telehealth technology has a positive impact on healthcare systems. First, telehealth technology increases access to care to underserved and at-risk populations. It also strongly supports the interdisciplinary team approach in care delivery. Interprofessional collaboration in care is directly linked to enhanced clinical performance and improved patient outcomes and satisfaction. By providing a viable alternative of delivering remote treatment, telehealth technology promotes patients’ and healthcare providers’ safety, ensures timely interventions, and reduces care costs.

For an organization to adopt an effective telehealth technology, it must consider several factors. First, installing telehealth platforms requires adequate funds. Healthcare organizations must consider their funding sources. Additionally, the organization must consider the availability of key infrastructure requirements such as the internet and network resources to ensure good connectivity and communication. Also, the organization must train the users and staff on telehealth literacy. High literacy ensures that more people embrace and use the technology. Lastly, like all communication technologies, the organization must implement effective policies to address privacy concerns and ensure data safety.

This annotated bibliography reveals that telehealth is assuming an integral role in healthcare systems. The pandemic has shown a glimpse of how the future delivery system will be. How in-person hospital visits will be minimized to ensure that the health systems are not overwhelmed, neither are at-risk patients compromised. How the access of care will expand to reach remote areas. How healthcare costs will be reduced without compromising on quality. From these findings, healthcare institutions must start focusing on making a permanent switch to telehealth technology.

References

Bhaskar, S., Bradley, S., Chattu, K., Adisesh, A., & Nurtazina, A. (2020). Telemedicine as the new outpatient clinic gone digital: Position paper from the Pandemic Health System REsilience Program (REPROGRAM) international consortium (Part 2). Frontiers in Public Health, 8(410), 1-16. doi:https://dx.doi.org/10.3389%2Ffpubh.2020.00410

Pariser, P., Pham, T., Brown, J., Stewart, M., & Charles, J. (2019). Connecting people with multimorbidity to interprofessional teams using telemedicine. Annals of Family Medicine, 17(1), s57-s62. doi:https://dx.doi.org/10.1370%2Fafm.2379

Paterson, C., Bacon, R., Dwyer, R., Morrison, K., Toohey, K., O’Dea, A., . . . Hayes, S. (2020). The role of telehealth during the COVID-19 pandemic across the interdisciplinary cancer team: Implications for practice. Seminars in Oncology Nursing, 36(2020), 1-8. doi:https://dx.doi.org/10.1370%2Fafm.2379

Young, J., & Badowski, M. (2017). Telehealth: Increasing access to high-quality care by expanding the role of technology in correctional medicine. Journal of Clinical Medicine, 6(2), 1-7. doi:https://dx.doi.org/10.3390%2Fjcm6020020

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