Telehealthcare
in Rural Communities
Introduction
Reason
for selection
The
family system is a basic unit which health behaviours, values and habits are
developed, organized and performed. The knowledge of family structure and
function is the most fundamental element that the nursing process engages in
promotion of healthcare. The professionals need to go beyond the individual and
family functions to effectively reduce health risks in the society. Such risks
may be either, biological, behavioural or environmental (Jabelian,
2008).
Literature
review
According
to Geyman, Norris and Hart (2001), community health nursing is a process that
is realized through application of a series of steps which leads to prescribed
results. The nursing process is a dynamic, systematic, scientific continuous
interpersonal process where nurses and their client are viewed as one system.
This system affect each other and are both affected and are both affected by
other factors within the discipline. The process involves a series of actions
that lead to a specific result. The results maybe in terms of optimal health care
to clients and proper management of health resources to the community.
Home
visits provide a more accurate analysis than the clinical visit. Contracting
with families entails a shift in responsibility and control towards a shared
effort of professionals and their clients, other than the professionals alone.
The cost of healthcare imposes an enormous burden to the economy. This has made
the lawmakers to adjust their regulations to allow for development and
improvement in service delivery to needy patients. Such amendments include
provision for the advancement in service delivery through technologies. Rural patients have now managed to improve
their access to specialists and professional services in a more improved way
(Geyman & Hart, 2001). On a patient’s perspective, access to quality and
state of the art healthcare in under deserved regions is among the promising
advantage of telemedicine.
Over
the last one decade, telehealth is becoming a popular tool in delivering health
care services in the rural and remote environment. This refers to delivery of
healthcare related services and related information through telecommunication
technology. It involves the transmission of voice, data and digital images
between sites using tele-service devices. This assist in providing health
related services like clinical devices, education, training and consultancy
services (Whitley, 2008). Types of telehealth care include; Real-time
telehealth, Remote monitoring, Store and forward.
Real-time
telehealth is a telecommunication service that allows for instant interaction.
In this form of tele-health, video conferencing is the most utilized form.
Remote monitoring on the other end involves a consistent, accurate and reliable
monitoring of patients signs and predetermined health measures. These measures
are such as heart rate, weight, and blood pressure. This is commonly referred
as home telehealth (Geyman & Hart, 2001). Lastly, there is the Store and
forward. In this form of telehealth, digital and clinical data is captured and
recorded in a computer database. They are then securely transmitted to another
clinic at another station which is then studied by specialists. The
specialists’ opinions are then transmitted back to the source.
Benefits
of community telehealth
The usage of telehealth has numerous
advantages especially to clients located in the rural settings. To a client, Telehealth
increases his/her access to vital clinical services which is availed closer to
home. It assists in delivery of healthcare services through a high quality
video links which is quite useful for the doctors to consult with their
informed clients. It enables remote diagnosis through instant transfer of large
files such as medical and lab results, x-ray image and other medical scans.
Due
to increased rate of population with chronic diseases, the health systems have
been greatly challenged. Extension of healthcare services to homes remains the
only opportunity to ease pressure on hospitals and healthcare systems (Tunstall
Healthcare, 2008). Home based tele-monitoring of the old infected with chronic
infections is valuable in several ways including the following:
Timely
identification and attending to conditional changes, risk reduction and
avoidance of unnecessary hospitalization. It assists in improvement of
management of the ongoing monitoring and care in collaboration with providers
of primary health care (Martinez et al,
2005). The assurance and support provided
encourage the patients to stay in their own homes and with familiar
environments for longer. This improves their worth of life and reduces social
isolation by their kinsmen.
Benefits
to a clinician
It
increases access to their professional development, educational opportunities,
their clients and specialized services. It increases the level of information
access and exchange between related inter-professional organizations and
enhancement of proper client service. It reduces the need and the expenses of
clinicians to travel, accommodation and other associated costs (Tunstall
Healthcare, 2008).
Examples
of services provided through the tele healthcare program
Some
of the services provided to the community by this program include, but not
limited to the following. Observing remotely applied healthcare assistance in
order to provide the necessary information.
It enhances consultation with other specialists at other centres in an
attempt to seek second opinion. It provides an easier way to prepare a
discharge plan for patients on discharge from referral hospitals to smaller
ones in the rural setting. This ensures a complete clinical handing over in
client management for patients with complex needs. The clinicians in the rural
hospitals can assess the progress of the client and conduct assessment of
carrying out superior interventions.
Above all, these programs support fabrication, prescription and review
of specialized tests for people with disabilities (Kinsella, 2003).
Possible
recommendations and interventions to improve nursing practices
Despite the existence of several
challenges in Medicare facilities, the following recommendations should be put
in practice for further improvement. Firstly, the government should consider increasing
the Medicare program to over advanced practices that are within the scope of
home nursing under applied state laws (Jabelian, 2008). It should also amend the program to authorize
advanced nursing practices to undertake admission assessment and certification
of patient’s healthcare services and hospice admission in skilled nursing
facilities. Other considerable concerns should be on Medicaid reimbursement for
primary care physicians. The law should be quite clear to clarify the
requirement of hospital participation in these programs to ensure eligibility
of advanced practices to nurses in clinical and admitting privileges.
The
government should also consider expanding the opportunities for doctors and
clinician to diffuse their collaborative efforts of improvement. All
stakeholders such as healthcare organization, private and public funders and
the nursing society should expand opportunities for their professionals and
other members of healthcare team. This is beneficial in the process of
conducting research and design with the aim of improving the working
environment and the healthcare system in general (Martinez
et al, 2005). These entities should also help nursing
opportunities to diffuse successful practices.
Implement
a nurse residency programs- the federal government and other accredited
stakeholders in the nursing society should take supportive actions to complete
transition to practice programs (Jabelian, 2008).This is mostly important to
those who have just completed their advanced practical degree programs and
those who are in the transition to new clinical areas.
Ensure
that nurses engage in long run professional improvement. The schools of
nursing, accredited bodies, healthcare organization, and continuing educators
should collaborate to ensure that nursing students and practitioners continue
in a lifelong learning experience (Halifax, 1995).This is to ensure that they
gain the required competency to provide care to diverse populations in their
lifetime.
Summary
and conclusions
Telehealth services is one of the most developed technology in health
service delivery whose implications is likely to have a far-reaching impact to
the clients especially those with chronic illnesses. This is because of the use
of technology in administering health services. For instance, there are places
which are very local and remote. This means that access to these areas becomes
a problem, for example when transporting seriously ill clients. In this case,
the medical practitioners can use the technology to administer treatment to the
client using the technology.
The use of technology in health care
services can be seen as having advantages on the side of both the clients as
well as the clinician. To the clinicians, technology use increases the level of
information and inter-professional development which is the basis for their
individual development as well as satisfaction. Therefore, telehealth should be
embraced in the modern world.
References
Geyman, J. P.
& Hart, L. G. (2001). Textbook of rural medicine. New York: McGraw-Hill.
Halifax, N.S (1995).
Evaluating telehealthcare needs flexibility. (n.d.). BMJ Publishing
Group Ltd.
Jabelian, S. (2008).
Impact of telemedicine on rural communities:
Tatamagouche, a case study. Technical University of Nova Scotia.
Kinsella, A.
(2003). Home telehealthcare: Process, policy & procedures. Kensington,
Md: Information for Tomorrow.
Martinez A et al. (2005). Analysis of information and communication
needs in rural primary health care
in developing countries. IEEE Transactions on Information Technology in Biomedicine,. 9(1):66–72.
Whitley .B. (2008).
Telehealthcare: Essential information
for health & social care professionals
and carers: Tunstall Healthcare.
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