Telehealth and Personal Health Management Systems

by Rhonda Lawes, PhD, RN

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    00:00 We've had multiple conversations about the power of technology and how it can create connections between patients and the health care environment.

    00:08 But in this section, we're going to talk about three types of specific connections: telehealth, personal health management systems, and wearable technology.

    00:20 Now, the complexity and use of telehealth technology has exploded since the recent pandemic and is greater than ever before.

    00:28 I mean, what used to be a simple modem based telephone, or maybe even a landline based telephone call now includes specialized touch screen tablets, smartphone applications and video meetings.

    00:40 I mean, being able to meet, consult and monitor from a distance is transforming what health care can do, especially in underserved and remote regions.

    00:50 Telehomecare. Now this becomes like a safety net for our clients.

    00:55 This provides remote monitoring and support for patients with chronic illnesses.

    00:59 For example, say a patient has significant mobility challenges.

    01:04 The amount of effort it takes to arrange a ride travel to the location.

    01:08 This puts the patient at potential risk of their symptoms becoming even worse due to all the energy caused to go to a health care center.

    01:18 Tele mental health is like a digital therapist's office now this provides mental health services remotely.

    01:25 Now these systems can be set up all different kinds of ways, but some of these systems can be set up to ask the patient to check in a specific time intervals. They can do this for suicide or other mental health check-ins.

    01:37 Now with these check-ins, it will trigger the care teams if the client doesn't complete them or perform a phone, text or physical wellness check on that client.

    01:49 E-intensive care units is on the other end of the spectrum.

    01:53 So we have e intensive care units and teletrauma care.

    01:58 Now this is used to provide real-time critical care and trauma support without geographical boundaries.

    02:05 So what does this look like? Imagine you arrive at the scene of a massive motor vehicle accident, and you're involved in decisions about which patient should go to which trauma center.

    02:16 Consider having the option to use a tablet video to show the trauma surgeon what is happening, and they can assist with on-site triage.

    02:25 All the potential time, resources and loss of life could be reduced.

    02:30 Moving on to personal health management systems, think of them as digital health journals that store, manage, and relay personal health information. These personal health management systems help patients to actively participate in their own care because they provide them with a comprehensive overview of their health status, thus promoting their own self-management with an informatics perspective.

    02:58 You can anticipate that the usefulness of a personal health management system is highly dependent on the technological literacy level of the system, the providers, and the patients using them.

    03:12 It's great to be able to email for an appointment or ask a simple medical question using this technology, but if you don't have the internet, the actual equipment, or the skill to use it, it can create a barrier.

    03:24 When organizations and providers become overly reliant on using them to communicate with their patients.

    03:31 When you're in conversations about this technology, anticipate ways to overcome this potential barrier.

    03:38 Next we have wearable technology.

    03:41 This is like having a personal health coach strapped to your wrist.

    03:44 From monitored heart rate and sleep patterns to tracking physical activity and blood glucose levels.

    03:50 These devices provide a wealth of real-time health data.

    03:54 Here's a real-life example with my own mother.

    03:57 She has an implanted defibrillator and a pacemaker.

    04:01 Now she has a monitor in her home.

    04:03 She doesn't have to do anything with it, which is great because mom is not good with technology. As long as she spends 30 minutes a day within the proximity of that monitor, data is sent back to her healthcare provider.

    04:17 Now they run consistent checks.

    04:19 Watch for Dysrhythmias.

    04:20 See how much the pacemaker is working on and on and on.

    04:23 They can address these issues earlier, so if there's any reason that she needs to seek health care or go to the clinic, she can do that.

    04:32 But what really helps is this prevents unnecessary clinic or hospitalizations.

    04:38 So how might this impact the quality of care for a pediatric patient? Well, let's think about a newborn infant with apnea.

    04:45 Okay. With this technology, the infant can be sent home much earlier with an apnea monitor rather than having to stay as an inpatient.

    04:54 Getting into the home environment earlier promotes independence, family and patient health, and has significant financial implications for the cost of inpatient versus outpatient care.

    05:06 All this technology can be useful and exciting, but there are some bigger issues that you need to consider regarding implementation.

    05:14 First on our list is reimbursement.

    05:16 The financial lifeblood of the health care services.

    05:20 In the realm of telehealth, it's like trying to navigate a river with ever-changing currents. Policies vary across insurers, states, and services. Many providers face challenges in getting reimbursed for telehealth services.

    05:35 That's a hurdle that can deter the adoption of this innovative model.

    05:39 Next, medical legal concerns, such as licensing and credentialing of providers to patient privacy and data security are challenging to know and keep current with.

    05:49 Having a strong relationship with your privacy official and information technology team can help you navigate these.

    05:58 Technical difficulties will always be an issue.

    06:01 Poor internet connectivity, inadequate equipment or software glitches can hinder the delivery of care, so this can be particularly challenging for rural or under-resourced communities.

    06:13 Your knowledge of informatics and technology is crucial in not only understanding these issues, but working towards solving challenges as the relationship between technology and the healthcare environment continues to grow.

    About the Lecture

    The lecture Telehealth and Personal Health Management Systems by Rhonda Lawes, PhD, RN is from the course Healthcare Informatics.

    Included Quiz Questions

    1. It can help prevent unnecessary hospital visits.
    2. It is less expensive than hospital technology.
    3. It replaces the need for clients to have a dedicated healthcare provider.
    4. It replaces the need for laboratory testing.
    1. The client currently living in a shelter and does not have reliable internet access.
    2. The elderly client who describes themselves as “technologically illiterate.”
    3. The unhoused client with a cell phone that they do not know how to use.
    4. The client with a stable internet connection and feels comfortable using technology.
    5. The client with stable internet and can borrow a tablet computer from a relative.
    1. Remote monitoring for clients with chronic illnesses who have difficulty leaving their homes.
    2. Digital remote mental health care takes place in a client’s home.
    3. Temporary remote care for clients on a waiting list for in-person home care.
    4. Remote wound monitoring for clients who have yet to have a home care nurse assigned to them.

    Author of lecture Telehealth and Personal Health Management Systems

     Rhonda Lawes, PhD, RN

    Rhonda Lawes, PhD, RN

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