RUFAIDA COLLEGE OF NURSING

JAMIARUFAIDA
HAMDARD (DEEMED
COLLEGE OFTO BE UNIVERSITY)
NURSING
JAMIA HAMDARD (DEEMED TO BE UNIVERSITY)

Panel discussion
On
telehealth

SUBMITTED TO: SUBMITTED BY:

RAJLAKSHMI MAAM AKRITI

TUTOR M.Sc. NURSING 1ST

YEAR
 TELEHEALTH
Telehealth refers to the use of digital communication tools, such as video conferencing, phone calls,
mobile apps, and secure messaging, to deliver healthcare services remotely. It enables healthcare
providers to diagnose, treat, and monitor patients from a distance, which can be especially beneficial
for individuals in rural or underserved areas, or those who have difficulty accessing in-person care.

Telehealth is the distribution of health-related services and information via electronic information
and telecommunication technologies. It allows long-distance patient and clinician contact, care,
advice, reminders, education, intervention, monitoring, and remote admissions. Telemedicine is
sometimes used as a synonym, or is used in a more limited sense to describe remote clinical services,
such as diagnosis and monitoring. When rural settings, lack of transport, a lack of mobility,
conditions due to outbreaks, epidemics or pandemics, decreased funding, or a lack of staff restrict
access to care, telehealth may bridge the gap as well as provide distance-learning; meetings,
supervision, and presentations between practitioners; online information and health data management
and healthcare system integration.

Telehealth could include two clinicians discussing a case over video conference; a robotic surgery
occurring through remote access; physical therapy done via digital monitoring instruments, live feed
and application combinations; tests being forwarded between facilities for interpretation by a higher
specialist; home monitoring through continuous sending of patient health data; client to practitioner
online conference; or even videophone interpretation during a consult.
Telehealth can encompass various healthcare services, including:
1. Telemedicine: The remote diagnosis and treatment of patients via technology (e.g., video
consultations with doctors).
2. Remote Patient Monitoring (RPM): The use of devices to track a patient’s health data, such as
blood pressure, glucose levels, or heart rate, and transmit it to healthcare providers for ongoing
monitoring.
3. Health Education and Counseling: Providing guidance, support, and education to patients through
virtual platforms.
4. Mental Health Services: Offering therapy, counseling, and psychiatric services via video or audio
calls.
- Telehealth has become increasingly popular due to its convenience, cost-effectiveness, and ability to
reach individuals who might otherwise have limited access to healthcare. It also gained significant
momentum during the COVID-19 pandemic, as restrictions on in-person visits led many healthcare
providers to adopt virtual care solutions.
 NEEDS FOR TELEHEALTH
 Telehealth lets you take care of your health in different ways, like:
Telehealth lets you take care of your health in different ways, like:
 Talking to someone about your feelings or problems with issues like alcohol or drugs
 Checking results from lab test or x-rays
 Checking on common problems like headaches or infections
 Looking at skin problems
 Managing your medicines
 Getting help for common sicknesses like colds or an upset stomach
 Checking in with your provider after surgery
 Doing physical or occupational therapy
 Using remote patient monitoring tools to track your health.

TELEHEALTH BENEFITS
1) Reduces barriers to access
2) Increases efficiency for providers
3) Reduces overall health care costs.
4) Reduces delays in care
5) Increases patient’s satisfaction
6) Improves health outcomes
7) Virtual accessibility
8) Improves quality of care

Telehealth and Quality of Care

The relationship between telehealth and the quality of care has been the subject of much research and
debate. In general, telehealth has the potential to enhance the quality of healthcare, but its
effectiveness depends on various factors such as the type of service, the technology used, and the
quality of the patient-provider interaction. Below are some key considerations regarding telehealth
and the quality of care:
1. Improved Access to Care
 Telehealth significantly improves access to healthcare services, especially for patients in rural or
underserved areas where there may be a shortage of healthcare providers. This improved access can
lead to earlier diagnoses, better management of chronic conditions, and timely interventions, all of
which contribute to improved outcomes.
 Reduced travel time and costs make healthcare more accessible to individuals with mobility
challenges, elderly patients, or those in remote areas.
2. Convenience and Continuity of Care
 With telehealth, patients can more easily schedule and attend appointments, which can lead to
greater continuity of care. Consistent follow-ups for chronic conditions like diabetes, hypertension,
or mental health issues can help prevent complications and promote better disease management.
 Remote monitoring allows for ongoing data collection, which can lead to better management of
conditions without the need for frequent in-person visits.
3. Patient Satisfaction
 Studies have shown that patients tend to report high levels of satisfaction with telehealth services.
Many appreciate the convenience, reduced waiting times, and the ability to receive care from the
comfort of their own homes.
 Telehealth can also reduce the stress of visiting a clinic, which is particularly beneficial for patients
with chronic illnesses, disabilities, or mental health conditions who may find traditional in-person
visits challenging.
4. Quality of Clinical Outcomes
 Telehealth can provide high-quality care, especially for certain conditions like mental health,
dermatology, and follow-up consultations. For example:
o In mental health care, teletherapy and telepsychiatry have been shown to be just as effective
as in-person visits for treating conditions like depression, anxiety, and post-traumatic stress
disorder (PTSD).
o In dermatology, telemedicine consultations using images of skin conditions have been
effective in diagnosing and treating patients.
 For chronic disease management, telehealth allows healthcare providers to monitor patients' health
status continuously, adjusting treatments as necessary, leading to better outcomes.
5. Limitations and Challenges to Quality
Despite the advantages, telehealth does have limitations that can affect the quality of care:
 Technical Barriers: Poor internet connection, insufficient digital literacy, or lack of access to
necessary devices can limit the effectiveness of telehealth for some patients.
 Lack of Physical Examination: Some conditions require a physical examination for accurate
diagnosis, and telehealth cannot fully replace the hands-on assessment by a healthcare provider.
 Privacy and Security Concerns: Ensuring patient data security and confidentiality in telehealth
consultations is a critical issue. Inadequate encryption or improper handling of health information
could undermine trust and the quality of care.
 Limited Scope for Complex Cases: Telehealth is most effective for routine consultations or follow-
ups. For complex medical cases that require detailed examination, imaging, or lab tests, in-person
visits may still be necessary.
6. Integration into Traditional Healthcare Systems
 Telehealth works best when integrated into existing healthcare systems, including Electronic
Health Records (EHRs) and data-sharing networks. This ensures that healthcare providers have a
complete view of the patient's medical history, improving clinical decision-making and reducing the
chances of errors.
 However, lack of integration between telehealth platforms and traditional medical systems may lead
to fragmented care, making it harder for healthcare providers to deliver high-quality service.
7. Cost-Effectiveness
 While telehealth can lower healthcare costs by reducing unnecessary hospital visits, travel expenses,
and wait times, it’s important that it doesn’t compromise the quality of care. For instance, telehealth
consultations are often less expensive than in-person visits, but the savings must not come at the cost
of reduced clinical oversight or inaccurate diagnoses.
8. Regulation and Standards
 Telehealth quality can also be affected by the regulatory environment. Different regions and
countries have varying regulations regarding telehealth services, and a lack of clear and standardized
guidelines can lead to inconsistent care.
 Accreditation and quality assurance processes for telehealth providers can ensure that standards
are met, and patients receive the same level of care that they would in traditional settings.

DIFFERENT APPROACHES FOR VARIOUS NEEDS

1) Live interactive
2) Store & forward
3) Emergency response
4) Patient education kiosks
5) Home health monitoring
6) Educational services
7) Video-conferencing

 Store and forward

- Store-and-forward telemedicine involves acquiring medical data (like medical images, bio-
signals etc.) and then transmitting this data to a doctor or medical specialist at a convenient time for
assessment offline.[8] It does not require the presence of both parties at the same time.
- A properly structured medical record preferably in electronic form should be a component of this
transfer. The 'store-and-forward' process requires the clinician to rely on a history report and
audio/video information in lieu of a physical examination.
  Remote monitoring

A blood pressure monitor

Remote monitoring, also known as self-monitoring or testing, enables medical professionals to monitor a
patient remotely using various technological devices. This method is primarily used for managing chronic
diseases or specific conditions, such as heart disease, diabetes mellitus, or asthma. These services can
provide comparable health outcomes to traditional in-person patient encounters, supply greater satisfaction
to patients, and may be cost-effective. Examples include home-based nocturnal dialysis and improved joint
management.

 Real-time interactive

Electronic consultations are possible through interactive telemedicine services which provide real-time
interactions between patient and provider.[13] Videoconferencing has been used in a wide range of clinical
disciplines and settings for various purposes including management, diagnosis, counseling and monitoring
of patients.[17]

 Videotelephony / videoconferencing

Videotelephony comprises the technologies for the reception and transmission of audio-video signals by
users at different locations, for communication between people in real-time.[18]

At the dawn of the technology, videotelephony also included image phones which would exchange still
images between units every few seconds over conventional POTS-type telephone lines, essentially the same
as slow scan TV systems.

Currently, videotelephony is particularly useful to the deaf and speech-impaired who can use them with sign
language and also with a video relay service, and well as to those with mobility issues or those who are
located in distant places and are in need of telemedical or tele-educational services.

An example of telehealth in the field is when EMS arrives on scene of an incident and is able to take an
ECG that is then sent directly to a physician at the hospital to be read. Therefore, allowing instant care and
management

 Common Telehealth Challenges and How to Overcome Them

  State Specific Licensure Requirements. Each US State has its own set of unique licensure
requirements and regulations. ...
 Telehealth Reimbursement. ...
 Patient and Provider Adoption and Engagement. ...
 Internet Access. ...
 Electronic Medical Record Integrations.

Cons of Telemedicine
 Regulatory and Industry Barriers. Telemedicine regulations vary from state-to-state, and can be hard
to decipher. ...
 Physical Examination is Limited. ...
 Telemedicine Equipment and Technology.

TYPES / BRANCHES
 Tele – medicine
 Tele – pharmacy
 Tele - nursing

Telenursing is the practice of nursing over distance using telecommunications technology, such as phone,
video conferencing, and messaging apps. It involves providing nursing care, education, and support to
patients remotely.

Benefits of Telenursing
1. Increased access to care: Telenursing expands access to healthcare services, especially for rural or
underserved populations.
2. Convenience: Patients can receive care from the comfort of their own homes, reducing the need for
hospital visits.
3. Cost-effective: Telenursing can reduce healthcare costs by minimizing hospitalizations and emergency
department visits.
4. Improved patient engagement: Telenursing enables patients to take a more active role in their care,
improving health outcomes and patient satisfaction.

Types of Telenursing
1. Telephonic Telenursing: Providing nursing care and support over the phone.
2. Video Telenursing: Using video conferencing technology to provide face-to-face nursing care.
3. Store-and-Forward Telenursing: Sending and receiving patient data, such as lab results or medical images,
through secure messaging systems.
4. Remote Monitoring Telenursing: Using digital devices to monitor patients' vital signs and health status
remotely.

Telenursing Roles and Responsibilities

1. Assessment: Conducting virtual assessments to identify patients' needs and develop care plans.
2. Education: Providing patients and caregivers with education and support on disease management,
treatment, and self-care.
3. Care Coordination: Coordinating care with other healthcare providers, such as physicians and specialists.
4. Support: Offering emotional support and counselling to patients and caregivers.

Telenursing Skills and Competencies

1. Communication: Effective communication and interpersonal skills.

2. Technical: Proficiency in using telecommunications technology and digital devices.
3. Assessment: Ability to conduct virtual assessments and develop care plans.
4. Critical Thinking: Critical thinking and problem-solving skills to manage complex patient situations.

Telenursing Settings
1. Home Healthcare: Providing nursing care to patients in their homes.
2. Telehealth Clinics: Delivering nursing care through telehealth clinics.
3. Hospitals: Providing telenursing services to hospitalized patients.
4. Community Health: Offering telenursing services to community health organizations.

Telenursing Challenges and Limitations

1. Technical Issues: Connectivity problems, poor video quality, and equipment malfunctions.
2. Patient Engagement: Encouraging patients to actively participate in their care.
3. Confidentiality and Security: Ensuring the confidentiality and security of patient data.
4. Licensure and Regulation: Navigating varying licensure and regulatory requirements across states and
countries.

Future of Telenursing
1. Expansion of Services: Increasing the scope of telenursing services to include more specialized care.
2. Integration with Emerging Technologies: Incorporating emerging technologies, such as artificial
intelligence and virtual reality, into telenursing practice.
3. Increased Focus on Prevention: Emphasizing preventive care and population health management through
telenursing.
4. Globalization of Telenursing: Expanding telenursing services globally to address healthcare disparities
and improve health outcomes.
Telemedicine is the use of electronic communication and information technologies, such as telephone,
videoconferencing, and messaging apps, to provide healthcare services remotely.

TELEPHARMACY
Tele pharmacy is the use of telecommunications technology to provide pharmaceutical care remotely. This
involves pharmacists delivering services such as medication counseling, drug therapy management,
prescription verification, and dispensing advice to patients in locations far from a physical pharmacy.
Key Components of Telepharmacy:
1. Remote Consultation: Pharmacists can communicate with patients via video calls, phone calls, or
chat. This allows them to provide personalized counselling about medications, their side effects,
interactions, and usage.
2. Prescription Verification: Through secure online platforms, pharmacists can verify prescriptions
electronically and ensure that medications are dispensed accurately.
3. Medication Dispensing: Some tele pharmacy models allow the remote dispensing of medications
using automated machines or through local pharmacies that receive instructions via
telecommunication systems.
4. Drug Therapy Management: Pharmacists monitor patients' drug regimens to ensure they are taking
their medications correctly, follow up on the effectiveness, and adjust treatments if necessary.
5. Patient Education: Telepharmacy allows patients to receive educational materials about their
medications and health conditions without needing to visit a pharmacy in person.

Benefits of Telepharmacy:
 Increased Access: Telepharmacy bridges gaps for patients in rural or underserved areas, where
access to a physical pharmacy may be limited.
 Cost-Effective: Reduces travel costs for patients, while helping to alleviate the burden on physical
pharmacy locations.
 Convenience: Patients can consult pharmacists at times that suit them, improving overall access to
healthcare.
 Improved Medication Adherence: Patients are more likely to follow prescribed medication
regimens with the support of telepharmacy services.
  Efficient Use of Resources: Pharmacists can manage multiple patients remotely, which can help
address staffing shortages or high patient volume.

Challenges of Telepharmacy:
 Technology Barriers: Patients may lack the necessary technology or internet access, especially in
rural areas.
 Regulatory Issues: Telepharmacy is subject to state or country-specific regulations, which can limit
where and how services can be provided.
 Privacy Concerns: There are risks related to the confidentiality of patient information, which must
be safeguarded in telecommunication systems.
 Lack of Physical Presence: In some cases, the inability to physically inspect patients or their
medications might limit the ability of pharmacists to provide the best care.

Applications:
 Rural and Remote Areas: Telepharmacy allows individuals who live far from traditional
pharmacies to receive advice and services.
 Hospitals and Clinics: Telepharmacy can support hospitals and outpatient clinics by providing
remote pharmacist consultations, helping hospitals manage medication therapy for patients without a
pharmacist on site.
 Long-Term Care Facilities: In settings like nursing homes, telepharmacy allows pharmacists to
monitor patient medication regimens and provide consultations remotely.
In short, telepharmacy is transforming how pharmaceutical care is delivered by enhancing accessibility,
convenience, and efficiency, but it also faces challenges related to technology, regulations, and privacy
concerns.

Benefits of Telemedicine
1. Increased access to care: Telemedicine expands access to healthcare services, especially for rural or
underserved populations.
2. Convenience: Patients can receive care from the comfort of their own homes, reducing the need for
hospital visits.
3. Cost-effective: Telemedicine can reduce healthcare costs by minimizing hospitalizations and emergency
department visits.
4. Improved patient engagement: Telemedicine enables patients to take a more active role in their care,
improving health outcomes and patient satisfaction.

Types of Telemedicine
1. Real-time telemedicine: Providing care in real-time using videoconferencing or phone.
2. Store-and-forward telemedicine: Sending and receiving patient data, such as lab results or medical
images, through secure messaging systems.
3. Remote monitoring telemedicine: Using digital devices to monitor patients' vital signs and health status
remotely.
4. Mobile health telemedicine: Using mobile devices to provide healthcare services.

Telemedicine Applications
1. Primary care: Providing routine check-ups, health screenings, and preventive care.
2. Specialty care: Providing specialized care, such as dermatology, cardiology, and psychiatry.
3. Chronic disease management: Managing chronic conditions, such as diabetes, hypertension, and
asthma.
4. Mental health services: Providing mental health services, such as counseling and therapy.

Telemedicine Technologies

1. Videoconferencing platforms: Platforms that enable real-time video communication, such as Zoom and
Skype.
2. Telemedicine software: Software that enables healthcare providers to manage patient data, communicate
with patients, and provide care remotely.
3. Mobile devices: Mobile devices, such as smartphones and tablets, that enable healthcare providers to
provide care remotely.
4. Remote monitoring devices: Devices that enable healthcare providers to monitor patients' vital signs and
health status remotely.

Telemedicine Regulations and Standards

1. HIPAA: The Health Insurance Portability and Accountability Act (HIPAA) regulates the use of protected
health information (PHI) in telemedicine.
2. Telemedicine licensure: Healthcare providers must obtain licensure to practice telemedicine in certain
states.
3. Standards for telemedicine: Organizations, such as the American Telemedicine Association (ATA), have
established standards for telemedicine.

Challenges and Limitations of Telemedicine

1. Technical issues: Connectivity problems, poor video quality, and equipment malfunctions.
2. Patient engagement: Encouraging patients to actively participate in their care.
3. Confidentiality and security: Ensuring the confidentiality and security of patient data.
4. Reimbursement and payment: Navigating reimbursement and payment models for telemedicine services.

Future of Telemedicine

1. Expansion of services: Increasing the scope of telemedicine services to include more specialized care.
2. Integration with emerging technologies: Incorporating emerging technologies, such as artificial
intelligence and virtual reality, into telemedicine practice.
3. Increased focus on prevention: Emphasizing preventive care and population health management through
telemedicine.
4. Globalization of telemedicine: Expanding telemedicine services globally to address healthcare disparities
and improve health outcomes.

Conclusion

Advances in Tele communication and technologies are revolutionizing education & health services globally,
including the provision of nursing services. Decreasing time and distance, these advances increase access to
health and health care, especially underserved populations and those living in rural and remote areas. They
help to manage the demand for services, ensure more effective use of human and health resources and
facilitate education and research activities.

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publishers. Page no-664-678
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3. Selvashekhran. Essentials of Computers for Nurses. New Delhi. Jayeebrothers medical publishers,
2008.
4. Armer J.A. A Case Study of the Use of Telemedicine by Advanced Practice Nurses In Rural Missouri.
The Journal of Continuing Education in Nursing, Volume 34:5, 2003.