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A comprehensive overview of telehealth concepts and practices, including definitions, types, benefits, risks, and applications. It explores the impact of telehealth on social determinants of health and communication strategies for virtual care. The document also includes a section on the four habits model for telehealth visits and a case study demonstrating how telehealth can enhance patient care. This resource is valuable for students and professionals seeking to understand the evolving landscape of telehealth.
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What is Telehealth? Telehealth: The Institute for Healthcare Improvement defines telehealth as the delivery of health- related services and information via telecommunications technologies. It's a broad category that encompasses patient care, administrative activities, and health education (IHI, 2021). What is telemedicine? Telemedicine: The Institute for Healthcare Improvement defines telemedicine as the diagnosis and treatment of patients through telecommunications technologies (IHI, 2021). This term is more specific, and we can understand telemedicine as falling under the broader umbrella of telehealth What does Synchronous mean? Synchronous: The US Department of Health and Human Services defines synchronous telehealth as care that happens in live, real-time settings where the patient interacts directly with a clinician, usually via phone or video; this is the most common form of real-time, virtual, direct-to-patient appointment (HHS, 2021). What is Asynchronous? Asynchronous: Asynchronous telehealth is care that does not happen in real time, but still allows the exchange of important information; for example, a patient may submit a photo of their wound through an online care portal, and the provider may review that photo several hours later and prescribe a medication or other treatment through the online care portal. Asynchronous telehealth care is also known as 'store-and-forward.' What is tele? Tele: Over a distance
What is store and forward? Store and forward: An asynchronous telehealth technology that obtains and stores data at the source site, then transfers, or forwards the data to the remote intended site what is a virtual visit? Virtual visit: Clinical interactions in health care that do not involve the patient and provider being in the same room at the same time What is remote patient monitoring? Remote patient monitoring (RPM) and Remote therapeutic monitoring (RTM): Often used interchangeably, these acronyms refer to "the use of connected electronic tools to record personal health and medical data in one location for review by a provider in another location, usually at a different time" (Lee, et al, 2022). What is an e-consult? E-consults: Typically asynchronous, store-and-forward clinician to clinician consults, including patient case information as well as other assessment data, such as photographs or pathology reports What is a tele-assessment? Tele-assessment: Patient, community, or student assessment, asynchronous or synchronous, performed at a distance what is mobile health? Mobile health (mHealth): The patient-originated use of mobile technology, including but not limited to phones, tablets, watches, and activity trackers to optimize health
What are telehealth risks?
What is the four Habits model?
Invest in the beginning a. Establish rapport b. Fully investigate patient concerns c. Create a clear structure for the visit
Elicit the patient's perspective a. Determine how patients perceive their symptoms or illness Identify patient requests b. Explore the impact of the symptoms or illness on the patient
Demonstrate empathy a. discern empathetic opportunities b. express empathy
invest in the end a. Deliver diagnostic information b. Provide education and joint decision making c. Close the visit For each stage, what are some key components you will consider: Screening Pre-visit planning Preliminary elements Assessment and care Post visit
o If you have a computer o If you have a phone o Telehealth could create more jobs for people o Telehealth can be more cost efferent · Social and community context o increasing the proportion of adolescents who have an adult they can talk to about serious problems o increasing the proportion of children and adolescents who communicate positively with their parents · Healthcare access and quality o Access to online medical records § Is the site easy to use? o Access to non-judgmental mental health care via phones o Greater access to healthcare for those who don't drive or work multiple jobs o Telehealth can help increase yearly adolescent preventive care, or increase treatment for substance abuse. o Can help with getting women prenatal care o Overall better access to health care o Is the platform used for telehealth good quality and easy to understand What are some ways you will need to adjust your communication when conducting care through telehealth? Review what you learned about communication in Riley Chapters 6-14. Consider each chapter and whether telehealth will affect how you demonstrate each aspect of therapeutic communication discussed. Give specific examples of how you will adjust. · Demonstrating warmth- reassuring the patient with a smile and eye C\contact · Showing respect- making sure I am actively listening on the video · Being genuine- honest and authentic with a patient of forming a relationship · Being empathetic- using facial expressions to convey concern curiosity as well as using therapeutic phrases
· Using self-disclosure- Sharing your own views and beliefs but asking consent to share them first · Being specific- being detailed and clear in the information you give to the patient as well as through the plan you create with the pat · Asking questions- ask open any questions and prepare questions before the appointment · Expressing opinions- give the patient your positive opinions and critical opinions as well but ask consent first · Using humor- laugh at yourself, be joyful, and a jokes that the patient may make How could telehealth help alleviate health disparities? I think telehealth can help alleviate health disparities because people can have visits with their doctors more regularly without having to waste driving time going in. I think this is helpful for low-income people who are working multiple jobs or all the time. I think telehealth is more accessible to those who don't drive like the elderly or low-income families. Also some people just want to be in the comfort of their own home and telehealth allows for this. As you transition from student to clinician, what is one way you think telehealth could help you strengthen your ability to deliver person-centered care? I think being able to give access to health care visits to those who don't drive like the elderly populations or those with disabilities will allow me to assess the person and won't make them feel like a burden. I know that the fact I can't drive makes me feel like a burden on my driver when I must be driven to the hospital or doctor's office. As a nurse, how can you build inclusive digital spaces for your patients? What barriers do you think you might encounter as a new nurse? As a nurse I can provide an inclusive digital space by entering the appointment with an open mind and not having biases against their culture or beliefs. Some barriers I may encounter is miscommunication through the digital space and privacy issued for the patient if they don't have a private area to do the appointment. What is one unintended consequence of telehealth expansion you might encounter as a new nurse?