Nursing Trends in Telehealth
Homecare
Presented by:
Norma I. Rojas
Objectives
during this presentation we will…
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Describe the trend in telehealth homecare
Describe and evaluate the hardware and software
utilized with this trend
Describe and evaluate the information system used
with this trend
Assess the role and functions of the nurse
informaticist when working with this trend.
Examine related legal issues
Objectives (cont.)
during this presentation we will…
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Discuss the advantages/disadvantages from a
nursing perspective
What is telehealth
homecare?
Telehealth homecare provides patients with
healthcare, health information, and health
education across a distance with the use of
telecommunications technology, and specialty
adapted equipment.
(Telehealth leadership initiative, 2008)
What is telehealth
homecare?
This service allows doctors, nurses, and other
healthcare providers to assess, diagnose and
treat patients without having to be in the same
physical location.
(Telehealth leadership initiative, 2008)
The evolution of healthcare
In order to provide more services to
our growing population, healthcare
will evolve into a highly
community-based industry.
(Auerbach et al, 2009)
Hardware used in telehealth
homecare
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Blood Glucose Meters
 Cardiac monitors
 Electronic stethoscopes
 Blood pressure monitors
 Pulse oximetry devices
 Electronic thermometers
(Liddy et al, 2008)
Hardware used in telehealth
homecare
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Home PC
 Video conferencing devices
 Telephone, fax, Emails
 Specialized telephone adapters
(Liddy et al, 2008)
How to use telehealth hardware
using telephone adapters
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Adapter is connected to a simple telephone line
Patient logs into a system and follows a series of
directions
Voice prompts patient to adhere to medication
regimens and treatments
Patients vital signs, weight, electrocardiogram,
etc. are transmitted to the healthcare provider
This information is used to treat patients at home
(Center for Aging Technologies, 2008)
Types of software used in telehealth
homecare
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AFHCAN Software
CapSure Software
GIGISim
Philips Web-based Clinical Software
Omnivisor
WebVMC and more…
Use of Philips Web-based software
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Software flags patients vital signs if they are out of range
Library of surveys available for patients with various
diseases
Care plans and protocols available
Tracks trends and generates reports
Patient contact information available to facilitate a rapid
response
(Phillips, Inc., 2008)
Philips Web-based software usability
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Easy to use
Easy to learn
Patients reported
satisfaction with its use
Efficient
Error tolerance- minimal
workarounds
The system fit
with the task at hand
(Staggers, 2003)
(Phillips, Inc., 2008)
Cardiocom’s Telehealth Computerbased Clinical Information System

Collects, stores and manipulates healthcare data in
real-time
 Provides secure access by multidisciplinary
healthcare team
 User-friendly system
 Used for observation, interventions and
documentation
(Mastrain, K. & McGonigle, D., 2009)
(Cardiocom, 2008)
Review of the Cardiocom
Information System
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Clinical computer-based information system
Used primarily by doctors, nurses, pharmacists,
etc.
Used to diagnose and treat
Configuration: LAN, microcomputers, etc.
Data standards set by Health Level 7, DICOM and
PACS
(Cardiocom, 2008)
(Tan , J., Cheng, W., & Rogers, W., 2008)
Review of the Cardiocom
information system
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The disease and procedure classification used in
telehealth are SNOMED and ICD10
 Recommended by healthcare providers
(Wikipedia, 2008)
Advantages of telehealth services for
nurses and other healthcare
professionals
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Recommended for the treatment of chronic and
low acuity diseases
More cost-effective
Reduce hospital ER wait times
Provide patients with more autonomy
Increase accessibility (esp. rural areas)
Promote health through comprehensive follow-ups
(Center for Aging Technologies, 2008)
(Cardiocom, 2008)
Disadvantages of telehealth services for
nurses and other healthcare professionals

Possible lack of compliance from patients
 Some patients may seem overwhelmed with the
equipment use (esp. the elderly)
 Lack of human contact
 Nurses fear of being replaced with automation
(Cassin, 2008)
Telehealth legal issues

Privacy issues
 Reimbursement
 Malpractice
 Licensing issues
 Accreditation and
regulations
 Fraud and abuse
(Center for Telehealth and E-Health Law, 2006)
Informatics competencies for
telehealth nurses

Proficient with computers and telehealth
software
 Proficient with the use of specialized
equipment
 Obtain excellent clinical and critical
thinking skills
 Ambulatory care and/or informatics nurse
certification
(American Nurses Credentialing Center, 2008)
Functions and responsibilities of an
informatics nurse in telehealth
Telehealth home care nurses:
 Setting
up telehealth software and hardware
in patients homes
 Assessing and monitoring patients from a
distance
 Providing patients with health education
and education regarding equipment
Functions and responsibilities of an
informatics nurse in telehealth
Telehealth home care nurses:
 Act as a patient advocate and promotes
client health and safety
 Performs accurate documentations of
assessments and care plans
 Provides ethical care and is accountable
for own actions
 Provides evidence-based care
Functions and responsibilities of an
informatics nurse specialist in
telehealth
Telehealth clinical manager/coordinator:
 Administration/management
of facility and
staff
 Theory formulation, design and development
 Testing and selection of telehealth technology
 Oversees training and education
 Research and evaluation of services
(American Nurses Credentialing Center, 2008)
Telehealth Nursing Summary
Telehealth home care provides patients
with healthcare, health information and
health education across a distance with
the use of specialized
telecommunications technology.
Telehealth Nursing Summary

Specialized hardware devices used in telehealth:
cardiac monitors, electronic stethoscopes, etc
 How to use a hardware device (with a telephone
adapter)
 Specialized software used in telehealth:
Omnivisor, Philips Web-based software, etc.
 Review of Philips Web-based software including
evaluating its level of usability
Telehealth Nursing Summary
Review of Cardiocom’s clinical information
system in telehealth
 Advantages of telehealth include: increasing
accessibility, reduce healthcare costs, etc.
 Disadvantages of telehealth include: lack of
human contact, possible lack of compliance, etc.
 Legal issues in telehealth include: licensing,
malpractice, reimbursement, etc.
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Telehealth Nursing Summary
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Informatics competencies in telehealth nursing
include: knowledge of computers and use of
specialized equipment
 Functions and responsibilities of an informatics
nurse in telehealth include: health education,
equipment management, research, etc.
In conclusion
The remarkable advances in technology
continues to change the way that we conduct
healthcare. Telehealth homecare provides
patients with healthcare services in a new and
innovative way. Healthcare professionals should
embrace technology as we continue to improve
our healthcare delivery methods to provide
high-quality care.
References
Auerbach, D.I., Buerhaus, P., Staiger, D.O. (2009). The
future of the nursing workforce in the united states:
Data , trends and implications. Sudbury,MA: Jones
and Bartlett Publishers.
Cardiocom Multi-disease Management. (2005). Health
plans. Retrieved December 5, 2008, from
http://www.cardiocom.com/health_plans.html
Liddy, C., Dusseault, J. J., Dahrouge, S., Hogg, W.,
Lemelin, J., & Humber, J. (2008). Telehomecare for
patients with multiple chronic illnesses. Canadian
Family Physician, 54(1), 58-65.
References
Center for aging services technology. (2006). Economic benefits of
e-technology in managing congestive heart failure.
Retrived October 11, 2008, from http://www.aging
tech.org/documents/EconomicBenefits_of_eTech.pdf
Philips, Inc. (2008). Web-Based clinical software. Retrieved
October 11, 2008, from http://www.medical.philips.com/
main/products/telehealth/products/software.wpd
Telehealth leadership initiative. (2008). What is telehealth. Retrieved
October 11, 2008, from http://www.telehealthleadership.
org/telehealth101.html.
References
Cassin, K (2008). Implementation of home telemonitoring for chronic
disease: A case study of resurrection home health services.
Telemedicine Information Exchange, Retrieved December
1, 2008, from
http://tie.telemed.org/articles/article.asp?path=articles&arti
cle=resurrectionHomeServices_kcassin_tie08.xml
Mastrain, K. & Mcgonigle, D. (2009). Nursing informatics and the
foundation of knowledge. Sudbury, MA: Jones and Barlett
Publishers.
Center for Telehealth and E-Health Law (2006). Nurse licensure.
Retrieved December 05, 2008, from
http://www.telehealthlawcenter.org/?c=143
References
Tan, J., Cheng, W., Rogers, W. (2002). From telemedicine to e-health:
Uncovering new frontiers of biomedical research, clinical
applications & public health services delivery. The Journal of
Computer Information Systems: Special Issue, 42(5), 7-18.
Retrieved November 1, 2008, from ABI/INFORM Global
database.
ICD. (n.d.) Retrieved November 1, 2008, from Wikipedia Web site:
http://en.wikipedia.org/wiki/ICD
Staggers, N. (2003). Human factors: Imperative concepts for
information systems in critical care. AACN Clinical Issues,
14(3), 310-319.
References
American Nurses Credentialing Center. (2008). Informatics nurse
certification eligibility criteria. Retrieved December, 5,
2008, from http://www.nursecredentialing.org/Eligibility/
InformaticsNurseEligibility.aspx