1.0 Abstract
This paper outlines the benefits that has come with the development of technology in the healthcare industry. The research is based on consultation of a wide spectrum of sources in the field of telemedicine. It gives an analysis of several aspects that have changed such as the quality, cost and access to healthcare due to the development of telemedicine. The limitations of the practice are pointed out and finally the recommendations for sustainable telemedicine practice are made.
2.0 Dedication
I would like to dedicate this bachelors research to my family who have always supported me through my entire education journey. They have been with me in ups and downs, helping me with all the financial and social support to complete my studies. Without their continued support and guidance, I would not have come this far.
3.0 Acknowledgements
I would also like to acknowledge the support I have received from my professor in this course. He has offered all the necessary support and guidance in my pursuit of this course, provided all the materials and corrected me whenever I did the wrong thing. Without forgetting my co-workers who have beeeen of great help to me since I joined the healthcare industry up to this time. They have offered any information on the topic whenever I needed it and always advised me on how to conduct a successful research.
4.0 Introduction
I have been a part of the healthcare field for the last eight years, and I have never seen healthcare professionals become so easy to reach and accessible without the assistance of telemedicine/telehealth. This paper will basically sum up how telemedicine can conveniently extend the communications between doctors and patients by using secured messaging through two-way video, text, and email.This may also involve the use of live interactive video or the use of store and forward transmission of diagnostic images, vital signs and/or video clips along with patient data for later review.
5.0 Background
I feel that if more of the general population knew more about telemedicine, we could possibly open up more doors other than the VAMC and more throughout the community based healthcare facilities such as the small free clinics in the rural areas.
The general problem is based on the technology itself and the strength of Internetsignals.Technology is only as reliable as the electrical current that keeps it running. Inclement weather and other annoyances can cause a power outage or disrupt an internet connection, complicating online consultation with a doctor. The majority of the issue would affect the rural areas without any kind of wifi or internet reception.
The bulk of resistance comes from doctors struggling to comfortably use the new technology, but if we could possibly have one doctor from every field investing time in learning how to cross over the needed consults with telemedicine we could extend the reach within the healthcare. At the same time, their interest has been piqued a little bit when they think about how they might begin to use this to better manage patients with chronic illnesses or be able to expand access to rural areas in particular.
The purpose of this research is to close in the gap that we have with improving the technology and pushing for more healthcare professionals to learn the basics of using telemedicine to provide the initial assessments needed for opening and closing patient consults.
In my manuscript I plan to explain the importance of telehealth and telemedicine, and why it’s important to find a way in exploring the various methods that could be used in opening more doors into the healthcare industry as a whole.
Background
The following section will discuss the background of telemedicine, and why I chose it for my capstone. I have been working with telehealth a little over three years and I can’t get over how far we have truly come through the achievement of technology and medicine. I am pushing for telemedicine and telehealth to be practiced more by family practices or physician practices so that the patient can get the best care without having to leave their home but still receiving a thorough virtual consultation.
6.0 General Problem Statement
The general problem is that a large number of doctors and nurses aren’t ready to commit to telehealth or telemedicine, and that most of the resistance seems to come from the healthcare professionals who are simply set in their ways with doing their consultations the traditional way vs. Telemedicine.
6.2 Specific Problem Statement
The specific problem is decreasing the difficulty of allowing physicians to have easier access to their telemedicine credentials without the struggle of excess paperwork. Another side of the issue is finding ways on how we can make telemedicine more accessible without spending more overhead charges toward HIPAA and furthering high security and firewall networks.
7.0 Purpose Statement
The purpose of this research is to find different ways to make telehealth more accessible for doctors who may not be as hip to technology as their younger counterparts. The purpose of this research is to demonstrate how healthcare professionals can lessen their workload by allowing telemedicine to assist with health services, education and healthcare training. By using telemedicine the healthcare professionals will be able to use the sources remotely from using the telecommunications technology.
8.0 Research Questions
RQ1: How can we make Telehealth/Telemedicine easier for the healthcare professional?
RQ2: Can Telehealth/Telemedicine be used to cut down wait time and travel expenses?
9.0 Hypotheses
RQ1: Based on the initial impact of thorough training, I believe that with training and practice, healthcare professionals will be able to infuse telemedicine with the rest of their in house consultations and assessments.
RQ2: Based on my own personal observations here at the clinic in Jackson Tn, our mental health providers are able to see patients from home using the CVT Telehome program, which allows patients to communicate with their therapist on a secured network at minimum cost using the jabber software and laptops mounted with web-cameras. By using this method we are able to cut down on travel cost and expenses.
10.0 Definition of Terms
Telehome- It uses two-way videoconferencing to provide access to care for patients in every hospital and hundreds of other health care locations across the nation.
10.1 Telehealth- telehealth itself is a method that encompasses a broad variety of technologies and tactics to deliver virtual medical, health, and education services. Telehealth is not a specific service, but a collection of means to enhance care and education delivery.
10.2 Telemedicine- is the use of telecommunication and information technologies in order to provide clinical health care at a distance. It helps eliminate distance barriers and can improve access to medical services that would often not be consistently available in distant rural communities.
11.0 Impacts of Telemedicine
The continued research and use of technology in medicine have seen the growth of telemedicine where the use of telecommunication helps to share information on healthcare. This approach has had several impacts on the operations and patient satisfaction from the use of telemedicine. This literature review intends to demonstrate some of the specific impacts that telemedicine has had on the healthcare practice. Some of the impacts to be addressed include the cost of healthcare, the quality and access to healthcare by the patients. The analysis seeks to demonstrate how the three aspects have changed with the adoption of telemedicine as Kvedar, Coye and Everett (2014) demonstrate.
11.1 Concept 1
Telemedicine and cost effectiveness
Over time, studies have indicated that patients, service providers have parted with large amounts of money to ensure good healthcare. According to Polk andO’Gara (2015), with the introduction of different applications for telemedicine, there has been a significant reduction in the cost of healthcare. One aspect that has contributed to reduced cost of healthcare is the introduction of patient-centered services in place of primary care provision as Rho et al. (2015) demonstrates. The cost reduction has made it easy for patients to receive treatment and healthcare services that meet their needs at a relatively low cost. Many developed countries have embraced the use of patient-centered medical homes that have cut down the cost and processes that would delay healthcare provision. Despite the fact that many health systems do not have these services, patient-centered medical homes approach has gained acceptance among many patients and healthcare practitioners. According to Ruxwana, Herselman and Conradie (2010), places that have embraced the practice have had few readmissions of patients back into hospital as compared to those that have not adopted it. Those that have embraced the use of patient-centered medical homes contracts have reported reduced cost for acquiring medicine from pharmacies. According to Stowe and Harding (2010), the need for emergency medical services and facilities has also reduced among people who have joined the scheme. The patient-centered medical homes allow sharing of information related to patients through telecommunication that makes it easy for service providers to offer required support effectively. From VanDerHeijden (2010) point of view, it is essential for governments and any mother stakeholder in the healthcare industry to join hands in supporting patients to enter the patient-centered medical homes contracts for reduced cost of healthcare provision. The practice is critical in linking health providers with patients in places where a one on one doctor visit may not be possible according to Wilcox and Adhikari (2012).
The other aspect of health care that has led to reduced cost for patients includes the hospital at the home initiative. Some individuals may not afford the cost of having a patient in the hospital. This makes it necessary to have the hospital at home plan for patients as compared to the in-patient approach. The hospital at home has saved the lives of many patients especially the old age individuals that find it difficult in staying in a hospital for a long duration of time. The initiative has also reduced the demand for lab tests as compared to patients that are in hospital admissions according to Wootton (2012). The quality of the hospital at home has also proven to be better than the one provided at the hospital due to the high number of patients that the provider is serving. Many patients have also shown satisfaction by the hospital at the home plan as compared to the in-patient practice.
Telemedicine programs have also contributed to better treatment and management of chronic diseases. Studies indicate that telemedicine has made it easy for care providers to serve chronically ill patients without many difficulties. Many chronic diseases require consistent checkups and administration of medication based on the right dosage. Care providers have been able to serve patients with these conditions using several programs for healthcare management. The approach has also contributed to reduced mortality rate for people with chronic diseases.
Telemedicine has been essential in supporting the endeavors of healthcare providers across the world, which in turn has made it possible for patients to save on the cost of healthcare. With different telemedicine applications, healthcare providers can access emergency rooms for patients in critical conditions as Shiferaw and Zolfo (2012) indicate. This has helped reduce cases of patients’ mortality rates. Telemedicine applications have also been essential in securing correctional facilities for healthcare providers. It may be costly for healthcare providers and the patient’s family to move around looking for correctional facilities. The use of telemedicine has made this possible at a relatively low cost. Another aspect with improvements through telemedicine is the transfers involved in nursing homes according to Wootton and Bonnardot (2010). Telemedicine has made this approach much easier for the patients and reduced the cost that is involved in securing emergency services in nursing homes. Telemedicine has contributed to the easy coordination of healthcare services across different departments among service providers. This has made healthcare provision cost effective, and patients can afford the services as compared to the traditional approaches. The use of technology should be highly embraced in healthcare provision since it has reduced the cost of treatment significantly.
11.2 Concept 2
Healthcare quality and telemedicine
The quality of healthcare is also an essential aspect when it comes to telemedicine. Patients need to get quality healthcare at a reduced cost. The cost reduction because of telemedicine has also come with improved services to the patients. Telemedicine has led to efficient and effective monitoring of patients across different regions according to World Health Organization (2010). This has made it necessary for patients from diverse backgrounds to acquire quality services similar to those that are financially stable regardless of their location. There has been a conception where financially stable families and individuals are the only groups that received quality healthcare. With the introduction of telemedicine, individuals from disadvantaged families can receive same quality healthcare according to Zhang, Ansari and Tsunoda (2010). Studies have indicated that the use of telemedicine produces the same results as the in-person services if properly used by both patients and healthcare providers according to Whited (2010). Some of the areas that telemedicine has proved to provide sustainable and quality services include in the management of people with diabetes. The use of telemedicine has helped people living with diabetes through professionals and use of peers. The approach has helped in patients with diabetes to manage the disease effectively with minimum difficulties. Patients that have been able to manage diabetes successfully help professionals in supporting new patients overcome the challenges. Through the exchange of information between patients and professionals using telemedicine, patients have been able to manage diabetes with minimum challenges.
As Gherardi (2010) states, telemedicine has been an essential aspect of ensuring quality health care among communities across the globe. One case demonstrating the success of telemedicine includes the reduced health conditions disparity by Indians living in the United States. India has embraced the use of information technology in healthcare provision for its population in the United States. More than two million of Indians living in the United States can receive quality healthcare through telemedicine as Johansson and Wild (2010) demonstrate. Cases of lipoprotein cholesterol have reduced among this population sect living in the United States according to Grabowski and O’Malley (2014). Similarly, cases of diabetes among Indians living in the United States have reduced through management programs that embrace the use of telemedicine in sharing information among patients. The improved quality of healthcare has also resulted in high life expectancy among this population.
Telemedicine has also shown a positive impact in the treatment of patients with heart diseases and psychological disorders. The diagnosis carried out on these conditions provided reliable information for the right treatment similar to that of in-patient approach according to Meier, Fitzgerald, and Smith (2013). Telemedicine has also made it necessary for schools and other institutions of learning to offer pediatric services with minimum difficulties. The approach has received support from parents, teachers and stakeholders in the education sector because of the quality healthcare provided using telemedicine. According to Battrick (2014), televisual approaches to medication have reported more than 95% accuracy findings in consultation services. Despite the fact that there have been several cases of patient disappointments, the approach has proven to give similar results to the face-to-face consultation services. Telemedicine has improved the communication rate between patients and their healthcare providers. This is easy since different forms of communication platforms can be used by the two parties to interact. Patients can adhere to medication because healthcare providers constantly monitor them. It is also possible for patients to engage in self-care services because they have the right information from professionals and peers.
Telephonic Stethoscope has contributed to the detection of heart diseases among children. The approach has made it easy for patients to get treatment at an early age to avoid further complications as Simonson and Zvacek (2014) demonstrate. Patients with mental health have a chance to benefit from the use of telemedicine since their health information and diagnosis conducted with minimum difficulties. The clinical outcome of telemedicine and that of face-to-face consultations and treatment have proven to have no or insignificant difference. According to Bujnowska-Fedak, Puchała and Steciwko (2011), telemedicine has played an essential role in improving the quality of healthcare for patients from diverse regions and different age groups. This has seen the healthcare conditions improve, and the life expectancy of individuals improve. It is essential for all stakeholders to help put in place initiatives and measures to promote telemedicine in the society according to Le Goff-Pronost and Sicotte (2010).
11.3 Concept 3
Telemedicine and access to healthcare
Access to healthcare is necessary for any individual, family, and community. Healthcare access is what ensures improved standards of living and increased life expectancy. With telemedicine, many people in different locations and regions have been able to get healthcare services. According to Ekeland, Bowes andFlottorp (2012), doctors and physicians can provide healthcare services to a large pool of patients at a short time. Many patients benefit from consultation services by professional healthcare providers. The information offered by healthcare providers has been essential for patients across different regions since they can administer self-care with professional support. Some regions are inaccessible making it difficult for providers to reach the patients. Such patients are likely to lack health care services if they rely on in-patient support. From Doukas, Pliakas and Maglogiannis (2010) point of view, telemedicine has made this much easier since patients in inaccessible areas can get professional care and support without necessarily visiting the doctor’s office. The scarcity of healthcare facilities in the rural areas has also been a problem in the healthcare provision and disparity in health standards. As Mantas and Hasman (2013) state, telemedicine has bridged the gap between people living in rural areas and access to healthcare services. There have been several barriers contributing to the lack of proper healthcare access among many people in the society.
The distance to health facilities is one problem partially solved by the adoption of technology in healthcare provision. As Ekeland, Bowes and Flottorp (2010) demonstrate, the limited transportation facilities problem is dealt with by the invention of telemedicine in the current healthcare practices. For a long time, people have had difficulties in servicing insurance plans for healthcare due to the cost involved. This has made it impossible for many from less privileged and unemployed to access quality services. Telemedicine has made it easy for people to access the services due to reduced cost. Educational and cultural backgrounds have also played a role in the level of healthcare provision in society according to Anderson, Annett, and Bischof (2010). People with low levels of education are likely not to seek for proper medical attention. The processes involved in securing appointments from the doctor and service providers made it difficult for people to seek medical attention. Telemedicine has made it easy for patients to get the needed support from healthcare providers since they can use their phones and computers to reach specialists. The main barriers to proper health care provision are phased out using telemedicine.
The invention of technology has contributed to improved healthcare provision and services. One aspect that is rapidly growing in the healthcare industry is telemedicine where patients and healthcare providers share information through communication technology. The practice has seen many positive impacts in the health service provision. Some of the positive impacts that are present in telemedicine include cost reduction. Patients can get good service at a reduced cost. Monitoring processes and management of patients with chronic diseases has also been made cost effective. Unlike the traditional services delivery that requires in-person visits to the doctor, telemedicine has made it easy to access healthcare. The barriers to good health care such as distance are reduced since patients need not travel to get medical attention. The quality of medical services through telemedicine is similar to that offered by a face-to-face visit to a doctor. Telemedicine has several challenges, but the positive side of the practice is far much beneficial as compared the negative sides. Different stakeholders need to join hands and help in the implementation of telemedicine. Studies indicate that the practice has gained acceptance by patients, providers and families to the patients due to the positive impacts. By embracing the practice, there will be minimum discrepancies regarding health standards, mortality rates, and hospital admissions.
Establishment of the high level of quality care to a lot of customers, the availability of the patients to the nearest health care institutions, and the opportunity of the physicians to offer a qualified treatment are among one of the most valuable achievements of the healthcare system of the USA. Actually, due to the variety of socioeconomic factors, including remoteness, some clients cannot obtain a qualified medical examination. It may cause a rapid deteriorating of their condition and, as a result, health in general. However, these problems can be solved by the newly-appeared technologies that give people an opportunity to obtain a medical treatment and examination. Thus, telehealth is considered to be the use of telecommunications technologies with the aim to provide patients with the informational support and qualified health care services. Telemedicine is a use of effective medical data by dint of communication technologies with the aim to improve the health status of the patient (Sharma, Shimp, & Shin, 1995). A core factor of the use of telecommunications is the conditions of urban and rural settings, that is why it provides a possibility of health care services that may assist in managing the health issue or relieve the occurred symptoms in order to prevent complications, and chronic conditions.
Various methods are used in order to apply telemedicine. We are going to consider the most important of them, such a population, sampling frame, and analyzed data. While recognizing the significance of telehealth technologies, it is possible to improve health care for the urban and rural areas that do not have access to particular health care specialties. Besides, in order to use the Mixed-Method Secondary Study (Brodowsky, 1998), that analyses current clinical records, survey date, and population, it is important to concentrate attention on the chronic illnesses, such as cardiovascular disease or depression risk. The second method is the sampling frame that is used to depict the methods for determining particular sample size. Finally, the third method is analysis of the data that is used in order to describe a rationale for choosing the data collection methodology. Frequently the scientists use TECH (Netemeyer, Durvasula, & Lichtenstein, 1991). Besides, statistical tests can be used in order to analyze the data, such as survey of patients and qualitative study.
Thus, we came to a strong conclusion that methodologies associated with Telemedicine serve as a great contribution to the health care sphere. The impact of the telemedicine on the healthcare is considerable that can be easily understood from the provided in this article analysis and considered methodologies.
Impacts of Telemedicine
This manuscript outlines the recommendations to practitioners and stakeholders in the healthcare industry based on the findings of a study conducted on the impacts of telemedicine. The analysis will also demonstrate the limitations of the study and application of the findings to ensure better healthcare services to people in society.
12.0 Findings
The findings of the study are based on three areas of healthcare provision that seem to have recorded a significant change due to the adoption of telemedicine. According to Kvedar, Coye and Everett (2014), among the three aspects that have improved over time due to the introduction of telemedicine include the cost of medication, the quality, and access to healthcare services. Doctors and practitioners can use telemedicine applications to secure essential requirements such as emergency rooms and ambulances an incident that has reduced the cost of healthcare.
There has been the adoption of patient-centered health care homes where the patients can get treatment services and cases of readmission reduced hence contributed to the reduction of cost of healthcare. According to the study findings, the quality of healthcare has also improved due to the introduction of telemedicine. Similarly, access to healthcare services by patients has also been made easy in the healthcare industry since patients can get a doctor's support through their mobile phones. The barrier to proper healthcare services that existed due to distance and inaccessible areas has been eliminated with the introduction of telemedicine.
13.0 Limitations
The study findings could also not go without shortcomings, given that there are other people in society who are illiterate and cannot read the prescription and directions of the doctor. Some patients cannot afford mobile phones and computers; this makes them left out of these essential services. Language barrier is also another problem when it comes to telemedicine. The languages that are used by doctors may also not be understood by the patients. A lot of resources need to be invested in telemedicine to facilitate translation and doctor services based on several languages as Grabowski and O’Malley (2014) suggests. Internet and network services that are usually relied on for efficient services may also be a shortcoming to the practice. While conducting the study, the researchers did not get a chance to have enough views of people from the remote areas and people from urban areas and surroundings base the study findings on majority views.
14.0 Applications of the findings
The findings of the study are essential in the healthcare services provision industry. They demonstrate that people can get quality medication through the use of technology in that the services of doctors and physicians are accessible using gadgets such as mobile phones. The ease of accessibility places a challenge to healthcare institutions, stakeholders and government to put in more efforts to support healthcare services for a healthy society. Health institutions and doctors can use the platform to offer patient-centered services to their clients. To promote efficient healthcare services delivery to the society, the government and stakeholders can engage the internet service providers and telecommunication companies to improve connectivity in remote areas to ensure all people get efficient healthcare services regardless of where they are through telemedicine.
15.0 Recommendations
15.1 Recommendation 1: Increased technological advancement and innovation
Development in technology has demonstrated that service provision in the healthcare industry can be cost effective and access. The finding sends a message to the healthcare industry and all the stakeholders on the need to increase the level of innovativeness. By increasing innovation and continued improvement of technology more and cheaper ways of offering patients quality services could be unveiled. The move will contribute to having a healthy society that engages in productive activities for economic and personal development according to Mars (2013). The government, well-wishers, and hospitals should have the aspects of continued technological development in the healthcare industry considered. However, all the ethical aspects as related to healthcare services should be observed.
15.2 Recommendation 2: Continued research
The success of any new course of actions depends on consistent and quality research. Hospitals, scientists, and practitioners in the healthcare industry should continue with research on better healthcare services provision. According to Dye, Reeder and Terry (2013), it is also essential to note that advanced technology comes with several limitations such as swindles and unethical use of the platforms. Continued research will be critical to help tackle the challenges that come with the use of technology in healthcare services provision. Through research, practitioners can find the best ways of covering the populations in remote areas and those that are illiterate.
15.3 Recommendation 3: Adherence to the code of ethics
While telemedicine has proven to give a positive outcome in the provision of quality healthcare services similar to that offered face to face to patients, it is essential for practitioners to observe all the code of ethics. As Chretien and Kind (2013) demonstrate, ethical practices in healthcare services provision are critical, failure to which practitioners are likely to face legal charges or a damaged reputation. It is recommended for practitioners to stick to their professional obligations when using telemedicine services since they are likely to be accountable for any damages and negative effects caused to the patients.
16.0 Conclusion
According to studies, telemedicine has proven to have more merits in the provision of healthcare services compared to demerits. However, bears some shortcomings such as a low representation of people from rural areas to approve the merits of the practice. Language barrier, poor connectivity and lack of electronic gadgets among the poor are some of the gaps in the use of telemedicine. On the other hand, quality, access and reduced cost of healthcare are the merits of the practice according to Ekeland, Bowes, and Flottorp (2010). Stakeholders, the government, and hospitals should direct more resources towards technological advancement and continued research to ensure the society continues to enjoy the benefits of telemedicine. While the practice has proven to be effective, it is necessary for practitioners using it to embrace all aspects of healthcare ethics to avoid reputation damage and legal liability.
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