On February 17, 2009, President Barack Obama signs into law the American Recovery and Reinvestment Act of 2009. The law promotes electronic health records and infrastructure development to cut costs in health care. While the law does not mandate their use, the federal government has set aside twenty billion dollars to help in the development of a strong health information technology infrastructure. Title IV states, “NO INCENTIVE PAYMENT IF FIRST ADOPTING AFTER 2014” (American Recovery and Reinvestment Act of 2009, 2009). In times of economic turmoil, medical organizations are scrambling to make a profit or just break even. So, the government has successfully made their point; however, clients who use health care suffer by losing personable interactions.
Policy Issues in Telehealth The purpose of telemedicine is to remove distance as a barrier to health care. While telehealth is an accepted resource to bridge the gap between local and global health care, integrating telehealth into existing health infrastructures presents a challenge for both governments and policy makers (HRSA, 2011). Today there are policy barriers that prevent the expansion of telehealth, including reimbursement issues raised by Medicare and private payers, state licensure, and liability and privacy concerns. Reimbursement Issues Reimbursement policies prevent the total integration of telemedicine into health care practice (Prinz, 2008). Today, there is no overall telemedicine reimbursement policy in the federal health care system (HRSA, 2011 & OAT, 2003).
...ions model, Parrinello (2012) described the process of implementing new guidelines to screen for metabolic syndrome in a suburban psychiatric day treatment hospital. Guided by Rogers' diffusion of innovations model, Schaumberg, Narayan, & Wright (2013), developed, implemented, and evaluated a new evidence based practice project, Advanced Practice Nurse (APN) Psychiatric Bridging Intervention. By successful implementation of APN, clients required only 30-minute for initial psychiatric evaluation appointments compared to the typical 60-minute appointment. Moreover, Peeters, de Veer, van der Hoek & Francke (2012) examined the applicability of four perceived attributes in Rogers' diffusion of innovations model, which may influence the adoption of home telecare by elderly or chronically ill people, relative advantage, compatibility, complexity and observability.
psychiatrist must be credentialed at each facility that they provide service at and if the psychiatrist is across a state line, they must be licensed in both states, which is time consuming and costly.
Telehealth is the “use of remote health care technology to deliver clinical services and is becoming increasingly vital to our health care delivery system, enabling health care providers to connect with patients and consulting practitioners across vast distances and/or in a timely manner. “ Telenursing in the video communication aspects is a fairly new field of nursing, nurses have been offering support through phone triage for many years (Schlachta-Fairchild, 2008). Barcode medication scanning is created to reduce medication error. Also, electronic medical records are introduced for coordinated care and improve overall quality of
The purpose of this paper is to describe the program, patient and service level characteristics of the OTN Telehomecare program. Our study reports program users are generally elderly with a high prevalence of diabetes and hypertension, and taking five or more types of medications. Despite the program’s key goal to increase self-management through coaching, our results show patients are coached less frequently than planned at time of enrollment. The descriptive study provides a breakdown of remote monitoring and alert management.
The author outlines telepharmacy benefits and objectives and details the usage of telepharmacy in Kansas, Washington, North Dakota, Idaho, Illinois, California, Connecticut and Nevada. He discusses the legal side of telepharmacy and outlines different policies and laws present in different sates and the effect that this has on the use, method and spectrum of telepharmacy. He also includes state initiatives to implement more widespread use of such programs in order to benefit rural communities.
A., Pomerleau, S. G., & Penner, J. L., “Knowing is a process of perceiving and understanding the Self and the world”. Nurses as caregivers must appreciate each patient for who they are as individuals. The nurse must also know how to provide nursing care with the knowledge he/she gains from experience in the field. Caring is the main component needed for a nurse to give quality care to a patient. The nurse must assess the needs of a patient and direct the patient plan of care around the patient’s ability to engage in his/her own rehabilitation. Nurses must create a genuine relationship with the patient in order to determine how much their patient is willing to participate in their care. Nurses have always used their visual instincts in patient care. There has always been a face to face where the patient is physically in front the nurse. Telenursing is different because nurses no longer can rely on face to face interaction with their patients. In order to facilitate care over the phone nurses need to know their patient to provide individual care and ensure the safety of the patient with the nurses’ judgment. Not only can phone conversations be taken out of context so can emails and text messages. The nurse must have a strong bond with their patients so this type of complication will not occur. Another problem when using any form of communication that is not face to face is that it is not always possible to express empathy or build a sense of unity. Patients need to feel that the person on the other end cares. The tone a person takes on the phone can either make or break a relationship. In some conditions telenursing is not always appropriate, for instance a patient who is suffering from a deadly condition. Telephone and computers cannot provide compassion like a real person. In the end telenursing is a valuable service to patients but it is not
Sevean, P., Dampier, S., Spadoni, M., Strickland, S., Pilatzke, S., (2008). Patients and families experiences with video telehelath in rural/remote communities in northern canada. Journal of Clinical Nursing, 18. 2573-2579.
Older adults are a growing population and currently make up over 13% of today’s population. “Unfortunately, Depression affects more than 6.5 million of the 35 million Americans aged 65 years or older” (Duckworth K., 2009). Depression in older persons is directly correlated with disability (Duckworth K., 2009). “The risk of depression increases with age so that 40% of those over 85 are affected” (Duckworth K., 2009). “Depression is a major health problem that affects many older people, causing significant distress and disability, exacerbating existing medical conditions, and resulting in earlier death and higher use of services” (Frazer, Christensen, & Griffith ,2005 ). Depression in older adults differs from younger adults by a different symptoms and bio-psycho-social factors. “Depression is a mood disorder that causes a persistent feeling of sadness and loss of interest” ( Mayo Clinic, 2014 ). “Different forms of depression vary from, major depression, major depressive disorder or clinical depression, it affects how you feel, think and behave and can lead to a variety of emotional and physical problems” (Mayo Clinic, 2014). Depression makes it difficult to engage in normal daily chores or activities. According to the American Psychiatric Association, depressed mood and lack of interest are the two core symptoms in late life.