Telehealthcare in Rural Communities


Reason for selection

The family system is a basic unit which health behaviours, values and habits are developed, organized and performed. The knowledge of family structure and function is the most fundamental element that the nursing process engages in promotion of healthcare. The professionals need to go beyond the individual and family functions to effectively reduce health risks in the society. Such risks may be either, biological, behavioural or environmental (Jabelian, 2008).

Literature review

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According to Geyman, Norris and Hart (2001), community health nursing is a process that is realized through application of a series of steps which leads to prescribed results. The nursing process is a dynamic, systematic, scientific continuous interpersonal process where nurses and their client are viewed as one system. This system affect each other and are both affected and are both affected by other factors within the discipline. The process involves a series of actions that lead to a specific result. The results maybe in terms of optimal health care to clients and proper management of health resources to the community.

Home visits provide a more accurate analysis than the clinical visit. Contracting with families entails a shift in responsibility and control towards a shared effort of professionals and their clients, other than the professionals alone. The cost of healthcare imposes an enormous burden to the economy. This has made the lawmakers to adjust their regulations to allow for development and improvement in service delivery to needy patients. Such amendments include provision for the advancement in service delivery through technologies.  Rural patients have now managed to improve their access to specialists and professional services in a more improved way (Geyman & Hart, 2001). On a patient’s perspective, access to quality and state of the art healthcare in under deserved regions is among the promising advantage of telemedicine.

Over the last one decade, telehealth is becoming a popular tool in delivering health care services in the rural and remote environment. This refers to delivery of healthcare related services and related information through telecommunication technology. It involves the transmission of voice, data and digital images between sites using tele-service devices. This assist in providing health related services like clinical devices, education, training and consultancy services (Whitley, 2008). Types of telehealth care include; Real-time telehealth, Remote monitoring, Store and forward.

Real-time telehealth is a telecommunication service that allows for instant interaction. In this form of tele-health, video conferencing is the most utilized form. Remote monitoring on the other end involves a consistent, accurate and reliable monitoring of patients signs and predetermined health measures. These measures are such as heart rate, weight, and blood pressure. This is commonly referred as home telehealth (Geyman & Hart, 2001). Lastly, there is the Store and forward. In this form of telehealth, digital and clinical data is captured and recorded in a computer database. They are then securely transmitted to another clinic at another station which is then studied by specialists. The specialists’ opinions are then transmitted back to the source.

Benefits of community telehealth

The usage of telehealth has numerous advantages especially to clients located in the rural settings. To a client, Telehealth increases his/her access to vital clinical services which is availed closer to home. It assists in delivery of healthcare services through a high quality video links which is quite useful for the doctors to consult with their informed clients. It enables remote diagnosis through instant transfer of large files such as medical and lab results, x-ray image and other medical scans.

Due to increased rate of population with chronic diseases, the health systems have been greatly challenged. Extension of healthcare services to homes remains the only opportunity to ease pressure on hospitals and healthcare systems (Tunstall Healthcare, 2008). Home based tele-monitoring of the old infected with chronic infections is valuable in several ways including the following:

Timely identification and attending to conditional changes, risk reduction and avoidance of unnecessary hospitalization. It assists in improvement of management of the ongoing monitoring and care in collaboration with providers of primary health care (Martinez et al, 2005). The assurance and support provided encourage the patients to stay in their own homes and with familiar environments for longer. This improves their worth of life and reduces social isolation by their kinsmen.

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Benefits to a clinician

It increases access to their professional development, educational opportunities, their clients and specialized services. It increases the level of information access and exchange between related inter-professional organizations and enhancement of proper client service. It reduces the need and the expenses of clinicians to travel, accommodation and other associated costs (Tunstall Healthcare, 2008).

Examples of services provided through the tele healthcare program

Some of the services provided to the community by this program include, but not limited to the following. Observing remotely applied healthcare assistance in order to provide the necessary information.  It enhances consultation with other specialists at other centres in an attempt to seek second opinion. It provides an easier way to prepare a discharge plan for patients on discharge from referral hospitals to smaller ones in the rural setting. This ensures a complete clinical handing over in client management for patients with complex needs. The clinicians in the rural hospitals can assess the progress of the client and conduct assessment of carrying out superior interventions.  Above all, these programs support fabrication, prescription and review of specialized tests for people with disabilities (Kinsella, 2003).

Possible recommendations and interventions to improve nursing practices

Despite the existence of several challenges in Medicare facilities, the following recommendations should be put in practice for further improvement. Firstly, the government should consider increasing the Medicare program to over advanced practices that are within the scope of home nursing under applied state laws (Jabelian, 2008).  It should also amend the program to authorize advanced nursing practices to undertake admission assessment and certification of patient’s healthcare services and hospice admission in skilled nursing facilities. Other considerable concerns should be on Medicaid reimbursement for primary care physicians. The law should be quite clear to clarify the requirement of hospital participation in these programs to ensure eligibility of advanced practices to nurses in clinical and admitting privileges.

The government should also consider expanding the opportunities for doctors and clinician to diffuse their collaborative efforts of improvement. All stakeholders such as healthcare organization, private and public funders and the nursing society should expand opportunities for their professionals and other members of healthcare team. This is beneficial in the process of conducting research and design with the aim of improving the working environment and the healthcare system in general (Martinez et al, 2005). These entities should also help nursing opportunities to diffuse successful practices.

Implement a nurse residency programs- the federal government and other accredited stakeholders in the nursing society should take supportive actions to complete transition to practice programs (Jabelian, 2008).This is mostly important to those who have just completed their advanced practical degree programs and those who are in the transition to new clinical areas.

Ensure that nurses engage in long run professional improvement. The schools of nursing, accredited bodies, healthcare organization, and continuing educators should collaborate to ensure that nursing students and practitioners continue in a lifelong learning experience (Halifax, 1995).This is to ensure that they gain the required competency to provide care to diverse populations in their lifetime.

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Summary and conclusions

Telehealth services is  one of the most developed technology in health service delivery whose implications is likely to have a far-reaching impact to the clients especially those with chronic illnesses. This is because of the use of technology in administering health services. For instance, there are places which are very local and remote. This means that access to these areas becomes a problem, for example when transporting seriously ill clients. In this case, the medical practitioners can use the technology to administer treatment to the client using the technology.  

The use of technology in health care services can be seen as having advantages on the side of both the clients as well as the clinician. To the clinicians, technology use increases the level of information and inter-professional development which is the basis for their individual development as well as satisfaction. Therefore, telehealth should be embraced in the modern world.

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