Healthcare’s Future is Here: Meet Telemedicine
By Christina Orlovsky Page, Contributor
Welcome to the Information Age – where just about anything you’d need to know is just a keystroke away. Besides storing vast amounts of knowledge in bits and bytes, our digital community has enabled us to expand our ability to communicate – immediately and globally. We can video conference via Skype, text, IM, e-mail, forward, link or post – anytime, anywhere. It was only a matter of time, then, until the healthcare community would jump on board. In fact, as early as 1989, the MedPhone Corporation developed the first interactive telemedicine system. Designed to diagnose and treat cardiac patients, the device communicated defibrillator information remotely via standard phone lines (ICUcare LLC, 2010).
As our population continues to age and the need for health care increases, access to care is becoming a growing need. Location, provider availability, chronic conditions and economic factors are potential challenges; the umbrella of care known as telemedicine is the potential solution.
According to the American Telemedicine Association (ATA), telemedicine is defined broadly as the delivery of any health care service through any telecommunications medium – for example, a patient seeing a doctor, nurse or allied health professional via a video conference, rather than in-person, or a patient with a chronic condition utilizing an in-home device to monitor vital signs and transmit data to a nursing center for assessment and medical intervention. Telenurses work in a wide variety of settings, such as home care, case management and telephone triage / remote monitoring.
The ATA supports the Telehealth Nursing SIG (Special Interest Groups), which provides guidance and information about telenursing and its various emerging roles and settings, policies, educational preparation, competencies, clinical orientation and the use of Telehealth, eHealth and mHealth technologies for patient care (ATA, 2013). This is a valuable resource for nurses considering telenursing as a career option.
According to Cindy K. Leenknecht, MS, ACNS-BC, chair of the ATA Telehealth Nursing SIG, nurses "are reaching into many remote sites using telemedicine, including homes, monitoring for congestive heart failure, diabetes, COPD, hypertension, etc., where they monitor vital signs and question responses, evaluate and call patients to clarify symptoms, and advise on further actions to take, such as call a physician, take a forgotten medicine, etc.,” she explains. “They also deliver timely education and reinforce that education.”
The ATA stresses that telehealth nursing is not a specialty area within nursing. In fact, any nurse who has ever spoken to a patient over the phone has practiced some form of telehealth. As such, the same qualities that attribute to nursing success at the bedside come into play with telemedicine.
“Telehealth nurses need the same nursing skills as all nurses practicing in specialty areas, but with an ability to utilize the technology to the best of its ability to assess and communicate the patient’s physical and mental status,” Leenknecht said. “Excellent organization, critical thinking and communication skills are required also, but the most important skill is to understand the technology and its potential and limitations, and have the intuitiveness in how to utilize it to provide the care needed at the time.”
One health care system that is uniquely positioned to provide telemedicine services to its patients is the Veterans Health Administration (VHA), the health care arm of the U.S. Department of Veterans Affairs. Responsible for the care of 5.6 million American veterans each year, the VHA utilizes telehealth in a number of ways to be able to meet the health care needs of its extensive patient population, spread out across the entire country. The primary use of telehealth for the VHA is through home telehealth, managing chronic conditions like diabetes and depression for 74,000 veterans in their own homes, through the use of telehealth devices that monitor vital signs such as weight, pulse, blood pressure and blood glucose, and ask questions on a daily basis about symptoms and behaviors. A care coordinator (usually a nurse employed in a full-time telehealth role), manages a panel of these patients from a remote location with the goal of educating patients and their caregivers, monitoring their disease symptoms and daily behaviors, and intervening when they’re alerted to warning signs.
With the new changes in Obamacare and the Affordable Care Act (ACA), telehealth is becoming an increasingly important specialty area, as it offers the opportunity to reduce healthcare costs and increase customer satisfaction, while improving patient outcomes (Virtual Care Works, 2013). The anticipated increase in need for care is accompanied by an increased need for care providers, and a related need for specialized training in telehealth delivery.
What does it take to become a telemedicine professional? From a clinical aspect, you’ll use the same skills and competencies required by traditional bedside nursing. You’ll still perform nursing assessments and take on the role of patient advocate, but will use technology to deliver care. Thus, an RN interested in telenursing should be skilled with healthcare informational technology (HIT) and be comfortable using existing and emerging technologies. A certification in nursing informatics is a good place to start.
To help you better understand the role of the nurse in telemedicine and the educational pathways to certification, RN.com offers a one contact hour course on Nursing Informatics. As telemedicine continues to evolve and become an accepted part of the healthcare system, opportunities for nurses will expand at every level. Don’t miss your opportunity to consider this exciting new field of nursing!
American Telemedicine Association, (2013). Telehealth Nursing SIG. Retrieved from http://www.americantelemed.org/get-involved/ata-member-groups/special-interest-groups/telehealth-nursing
ICUcare LLC, (2010). What is Telemedicine? Retrieved from http://www.icucare.com/PageFiles/Telemedicine.pdf
Virtual Care Works (2013). Telehealth is an important part of the Affordable Care Act (aka - Obamacare). Retrieved from http://www.virtualcareworks.com/Google/2013_feb_telemedicine_a
© 2013. AMN Healthcare, Inc. All Rights Reserved.
Christina Orlovsky Page is a freelance writer with a focus on health and wellness. A New Jersey native whose wanderlust lured her out West, she currently lives in San Diego, California, with her husband and two dogs.