We all want our healthcare system to deliver high quality care with maximum efficiency and minimum cost. When telehealth is deployed strategically, we see dramatic improvements to efficiency and cost control while patient outcomes and satisfaction hold steady or go up.
And telehealth is getting better. The improvements are stimulated by advances in telecommunications technology, such as faster and more-powerful Smartphones and more reliable broadband connections. At one time, telehealth meant calling a nurse, describing symptoms, and getting advice. Today, as we’ll see below, telehealth is much more.
And as telehealth improves, consumers use it more. According to a 2019 White Paper from FAIR Health, national use of telehealth services grew 53% from 2016 to 2017.
In this article, we’ll look specifically at telehealth as nurses perform it. Known as telehealth nursing, or telenursing, it’s impacting the role – and careers – of nurses.
But before we explore the pros and cons of telehealth nursing, we need a quick definition to ensure we’re clear about what we’re discussing.
The prefix “tele” means “at a distance,” so telehealth is simply providing healthcare services from a different location than where the patient is. And in telenursing, these services are provided by nurses – typically Nurse Practitioners (NPs) and Registered Nurses (RNs).
In telehealth and telenursing, the distance between provider and patient is overcome by telecommunications technologies, organized into three common forms:
Let’s look at the pros of these three telehealth systems used in nursing. How do they improve our healthcare system?
Any discussion of the pros and cons of telehealth nursing must address quality of care and cost. So that’s where we’ll start.
When a patient needs to manage a chronic condition like diabetes or COPD, Remote Patient Monitoring (RPM) replaces many routine in-person visits. RPM means more frequent contact between patient and nurse, so there’s less fragmentation of care that occurs when a patient lapses with their responsibilities. More frequent contact also results in fewer ER visits and hospital readmissions that occur when a patient mismanages their chronic condition.
In one study, participants in a behavioral health intervention telehealth program had 31% fewer hospital admissions and 48% fewer hospital days than patients who did not participate.
“The national average for readmission to hospitals within 30 days following a heart failure episode is 20%. Telehealth monitoring programs have reduced that level to less than 4%.” – California Telehealth Resource Center
Perhaps the most significant advantage of telenursing is for patients who live in rural areas and therefore have challenges getting essential primary care services. They may be 200 miles from the nearest hospital or urgent care center, but when at home they’re likely just 200 feet from their computer or Smartphone – which means they’re 200 feet from a virtual office visit.
Telenursing can overcome physical barriers to reach patients and provide easy access to care. It doesn’t matter if the patient is behind prison walls 50 miles away or at home planning to ride out an imminent hurricane. Telenursing technology can reach them, 24/7, to improve patient care.
Because patients stay home, they avoid the risk of having an accident while traveling, especially during unpredictable winter conditions. Patients also avoid the risk of infection from other patients.
With telehealth nursing, patients don’t spend any time waiting in a doctor’s office. They don’t waste any time traveling by car or bus or plane. A survey of University of Pittsburgh Medical Center (UPMC) patients found that if they had no access to a virtual visit, 40% would have forgone care to avoid traveling.
Regence Health Plans reported that consumers save an average of $100 per visit when using telehealth instead of in-person office, urgent care, or emergency room visits. The cost savings are associated with medical claims, mileage, and time spent waiting in traffic and a waiting room. Patients also save money by avoiding parking fees, extra meals out, and perhaps even airfare and hotel stays.
Nurses can practice telenursing without traditional location and time requirements. They can provide medical care wherever they have a fast, reliable Internet connection, and at whatever time is most convenient for patient and nurse.
Now let’s look at the other side of the pros and cons of telehealth nursing. In what ways does it weaken our healthcare system?
With a simple video conference visit, the nurse cannot feel the patient’s stomach, or run fingers delicately over a mole, or swab a throat, or hear the heart or lungs. The nurse does not have access to all the common diagnosis tactics.
Now, some of this risk is alleviated by advanced telehealth equipment available from mature programs, such as blood pressure cuffs and stethoscopes. But if the patient doesn’t have access to those add-ons, then the nurse may need to see the patient in person.
Smartphones and fast, reliable broadband connections are more and more common, but not everyone has these essential telenursing components.
Typically, nurses can provide care only in the state(s) in which they are licensed to practice.
Insurance coverage for telehealth services is a work in progress. Thirty-five states have “parity laws” that require insurance companies to reimburse for telehealth services. Only 21 states require private insurers to cover video visits. State Medicaid programs vary in paying for telemedicine services. Nurses who offer telemedicine need to stay informed of the regulations and insurance plans in their geographic area.
We’ve explored the pros and cons of telehealth nursing, listing six advantages and four disadvantages.
We must remember, though, that telenursing is a relatively new health care option. The underlying technology improves each year, and the drawbacks become less and less acute.
Some of the most recent game-changing technological advancements come from the telecommunications industry. Smartphones are more powerful each year, bolstering telehealth technology with increasingly clear audio and crisp video, along with more reliable hardware and software.
One of the most reliable and innovative companies providing telehealth solutions is TigerConnect. As you investigate telenursing for your health organization, look into their TigerTouch system. It integrates with their robust Clinical Communications & Collaboration system and emphasizes engagement between patients and care teams through voice, video, and text. For example, after surgery, a nurse can follow up with the patient regarding pain management, healing of the incision, and mobility.
“Whether a patient is in a hospital room, an urgent care center, or at home, care team members can participate in group video sessions or text-based conversations to collaborate, share information in real-time, and reach consensus around treatment options.” – TigerConnect