Definition of telehealth
the use of electronic information and telecommunication technologies to
support long-distance healthcare, education, heath administration, and public
health
Telehealth history
Began as radio in the 1920s; used in disaster medicine and space in the 80s;
specialties adopted before primary care; COVID-19 caused huge disruption to
the system and changed telehealth overnight
Nursing role in telehealth
triage, case management, chronic disease management, tele-ICU, remote patient
monitoring (glucose, pacemakers)
Current issues related to telehealth nursing
May be helpful in expanding access to healthcare; Unsure if it reduces burn out
(high satisfaction but may have to move from pt to pt quicker); usually requires
3 years of nursing experience; fighting for medicare reimbursement; Artificial
intelligence
Types of telehealth platforms
live video, telephone, messaging, E-visit, store and forward (pts send health info
to provider and they review and respond), hybrid (combo from same network of
providers)
How are telehealth modalities evaluated?
Based on
Health outcomes: Physiological measures and
, patient-reported outcomes
Process of care: Treatment adherence, accuracy
of diagnoses, and alignment with clinical practice guidelines
Utilization of other health care services: specialty care, outpatient, ED,
hospitalizations
Evidence in support of telehealth
Evaluating health outcomes, processes of care, and decreased utilization of
other health care services
Live video effective on all; telephone, chat, and e-visits found limited evidence
for health outcomes and inconclusive for processes and other care; hybrid
effective for health outcomes
Drawbacks to telehealth
could exacerbate health disparities (benefits younger, commercially insured
urban adults with low acuity conditions, not those who have low-digital literacy
or require interpreters); security concerns (HIPPA); increased out of pocket
costs (esp for mental health)
Best practices for providing telehealth to older adults
Person-centered (asking about goals for care and additional concerns), equitable
and accessible (understanding SES factors); integrated and coordinated
Tips for interacting with older adults via telehealth
Ask open-ended questions, face the camera with entire face visible, write down
key information, repeat and review important information, provide extra time
How to increase accessibility on telehealth
ensure contrast between self and background, share your screen, room should be
well-lit and zoom in on face, ask for verbal repeat to ensure understanding and
don't pretend to understand if you don't, introduce self and role, speak in normal
tone even for HOH patients (don't shout)
What colors are easiest to see for those with low vision?
bright solid colors
Which states have the highest older adult populations?
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