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Telehealth: Articles, Continuing Education


What is Telehealth?  

 

Telehealth is a broad term that refers to technological expansion (using video, bioteletry, telemonitoring, patient wearables) of remote contacts.  Telehealth also refers to the clinical practice of pre-hospital assessment of symptoms utilizing all of the technologies noted above.  Telehealth emerged nearly overnight during the 2020 COVID-19 pandemic, when remote tele-visits became mandatory during the lock-down. Telehealth is here to stay, and soon telehealth will subsume telephone triage.

Telemedicine is defined as “telephonic medical diagnosis of patients’ problem and their medical treatment”  (Reisman). Telemedicine is typically performed by physicians, whereas telephone triage and telehealth may be performed by RNs.

According to Wikipedia, Telehealth is the “delivery of health-related services and information via telecommunications technologies”. Telehealth,  unlike telemedicine (which narrowly focuses on the diagnosis of symptoms) focuses on pre-hospital symptom assessment and evaluation to prevent delays in care and treatment.  A key function of telehealth (and telephone triage) is that of access to appropriate and timely care.  Both are a form of pre-hospital care and the patients’ initial contact in the health care continuum.

Key Telehealth Trends?

Two recent articles in the Journal of Telemedicine and Telecare (JTT) point out emerging trends that affect sustainable telehealth post-pandemic.   One study noted that reimbursement for telehealth services will significantly affect the future of nurse-based telehealth practice. According to Watkins and Neubrander (2020), “Federal legislation has responded to emergent public-health needs by removing barriers that have impeded widespread adoption of telehealth modalities. This legislation has omitted professional registered nurses (RNs) from delivering reimbursable telehealth services, which is problematic for primary-care practice. RNs historically have led telehealth service delivery and should therefore be included in new legislation as eligible health professionals permitted to provide reimbursable telehealth services.”  

A second JTT article highlights five key requirements for the long-term sustainability of telehealth. These include: (a) developing a skilled workforce; (b) empowering consumers; (c) reforming funding; (d) improving the digital ecosystems; and (e) integrating telehealth into routine care.

Telehealth Standards of Care?

Standards of practice for both telephone triage and telehealth will be similar.  In addition, both will require complete, evidence based systems — Qualified staff, clinical training, guidelines, policies and procedures, documentation — evidence of the quality of care.  Telehealth technologies will need to meet standards for reliability and validity in order to be considered safe.

Research:  Safety of Decision Makers in Telephone Triage (2015)  Sheila Wheeler’s research on Telehealth Decision Maker Safety.  A narrative review based on recent studies of outcomes on safety of  four groups of clinical and non-clinical decision makers. It evaluates current status of systems, by noting the presence of five key components of telehealth systems:  qualifications, experience of staff, clinical training, guidelines, documentation and standards.

Telehealth Articles Sheila Wheeler has served as a thought leader and pioneer in the field of telehealth.   Her early articles present her perspective and reflect the growth and development of a new subspecialty and controversies. 

Telehealth Guideline FAQ

Telehealth Continuing Education Resources

Since 1999, www.teletriage.com has served as an informational clearinghouse rich with resources: articles on telephone triage and telehealth research, clinical courses in telehealth, and RSS feeds to the latest Telehealth news.  Please feel free to explore and link to this page as resources.  


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