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Advantages and Disadvantages of Telehealth Nursing

Author: Capella Healthcare

what's covered

In this lesson, you will learn about the advantages and disadvantages of telehealth nursing. Specifically, this lesson will cover:

Advantages
Disadvantages

1. Advantages

Advantages of telehealth nursing include:

Patients Manage Chronic Conditions Better: When patients need to improve their self-management skills for conditions such as diabetes, remote patient monitoring (RPM) replaces many routine office visits. RPM provides more frequent contact with patients to reinforce self-management skills and coach them to make them feel confident in their abilities to control their disease. More frequent contact also results in fewer ER visits and hospital admissions. This in turn helps hospital throughput and lowers costs for patients and organizations. In one study, participants in a behavioral telehealth program had 31% fewer hospital admissions and 48% fewer hospital days than patients who did not participate.
Patients Have Increased Access to Care: The most significant advantage of telehealth nursing is for patients who live in rural areas and underserved populations who may be 200 miles from the nearest hospital or urgent care center. Telehealth nursing can also overcome physical barriers to reach patients such as those in prisons or someone riding out a hurricane in their home. Telehealth nursing technology can reach them, 24/7, to improve patient care.
Patients Avoid Risk: Since patients stay at home, they avoid risks of accidents in inclement weather. Patients also avoid the risk of infection from other patients.
Patients Save Time: Telehealth nursing saves patient travel time and waits in physician offices. A survey of University of Pittsburgh Medical Center patients found that if they had no access to a virtual visit, 40% would have forgone care to avoid traveling.
Patients Save Money: Regence Health Plans reported that consumers save an average of $100 per visit using telehealth instead of in-person visits, urgent care, or emergency room visits. The savings are attributed to medical claims, mileage, and time spent waiting in traffic and waiting rooms. Patients also save money by avoiding child care, parking fees, meals out, and perhaps even airfare or hotel stays.
Nurses Have More Flexibility: Nurses can practice telehealth nursing without traditional location and time requirements. They can provide care wherever they have a high-speed Internet connection, and at the time that is most convenient for the patient and nurse.

2. Disadvantages

Disadvantages of telehealth nursing include:

Some Visits Need To Be In Person: With a videoconference only, the nurse cannot physically examine the patient. The nurse does not have access to all of the common diagnostic tactics. Some of this risk can be alleviated if the patient has telehealth equipment available, 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.
Some Patients Experience Barriers to Care: Smartphones and fast, reliable broadband connections are more and more common, but not everyone has these essential telehealth nursing components.
Licensing Laws Limit the Service Area: Typically, nurses can only provide care in the state they are licensed in. There has been progress in compact licenses (multi-state license), but not all states participate. See the Telehealth: Risk Management course or the Center for Connected Health Policy website for more information.
Reimbursement Is Inconsistent: Insurance coverage for telehealth services is an ongoing process. Thirty-five states have “parity laws” that require insurance companies to cover telehealth services. Only 21 states require private insurers to reimburse for video visits. State Medicaid programs vary in paying for telehealth services. Nurses need to stay informed on the regulations and insurance plans in their geographic region. See the Introduction to Telehealth course for more details.

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The electronic health record, also called EHR, flags significant lab results and sends notifications to health care providers to perform tasks like scheduling follow-up client appointments. An e-iatrogenic error is an illness or injury partly due to mistakes related to using health information technologies like EHRs. They often result from system-related issues stemming from flaws in developing the system and user-related issues from inefficient workflows.

The most common e-iatrogenic errors occur from improper medication ordering, management, and administration. This can happen from ordering within the wrong chart or omitting medications on discharge orders, as well as selecting the inappropriate medication, dose, route, or frequency. Other e-iatrogenic errors include those related to diagnosis and treatment, such as an EHR not sending an alert about a client's critically low white blood cell count. Errors like this can cause a delay in treatment.

Though e-iatrogenic errors that result in serious harm are rare, health care providers can minimize these unintended consequences by remaining vigilant and recognizing situations where they can occur. First, exercise clinical judgment and inquire more thoroughly about any data and information that may seem abnormal or inconsistent, such as continuing anticoagulant medication for a client admitted for gastrointestinal bleeding. In the event of any delays, follow up on ordered tests, medications, and services.

Second, exercise caution in scenarios involving the use of both paper and electronic systems, such as during the transition to EHRs or any unexpected EHR downtime. Keep accurate and complete information readily available so it may be accessed as quickly as possible. Third, use health information technologies only as tools to aid in clinical care, as these tools may not always work as intended.

Lastly, avoid workarounds by limiting the use of the copy and paste function, remaining consistent in documentation across all clients, and paying careful attention to any alerts and notifications. To recap, e-iatrogenic events are client illnesses or injuries related to the use of health information technologies. Minimizing these events requires exercising clinical judgment and constant vigilance.

Authored by Cindy Ebner, MSN, RN, CPHRM, FASHRM and Colleen Harris Marzilli, PhD, DNP, MBA, RN-BC, CCM, PHNA-BC, NEA-BC, FNAP

Support

If you are struggling with a concept or terminology in the course, you may contact TelehealthSupport@capella.edu for assistance.

If you are having technical issues, please contact learningcoach@sophia.org.