Will telehealth help reduce Nurses workload…
Tele Medicine also called Telehealth involved delivering healthcare services, education or information to patients from a distance. TeleHealth includes electronic communication, video chat and remote monitoring. (EMU, 2021)
Telehealth has effectively replaced over 17% of all outpatient/office visit claims with evaluation and management (E&M) services. This utilization spiked to over 32% during the pandemic and since then stabilized to around 17%. Consumer and provider attitudes toward telehealth have improved since the pre-COVID-19 era. (Mckeinsey and Company, 2021).
During the peak of the pandemic, many healthcare providers rushed to set up some form of digital care delivery. As COVID increases the chance of infection during face-to-face meetings, patients and clinicians needed a way to interact in order to address the COVID and non -COVID related illness. This ranged from not so secure form of video communications to a fully developed telehealth platform that involved full traceability, audit trails and secure access to patient records.
Impact on nurses and care delivery while using telehealth.
Nurses and nursing services form an integral part of care delivery and patient management irrespective of the clinical specialty. It was interesting to note that nurses faced an increase in workload when telehealth was used as an alternative for a face-to-face visit.
In one particular study, where telehealth was used for the treatment of chronic diseases like diabetes or hypertension, the use of telehealth led to twice as many nursing activities compared to traditional care models (University of Missouri, 2021). While the author observed increased nurse workload due to additional tasks like data re-entering into medical records, identifying abnormalities with the recorded data, reminding patients to self-monitor, requesting input from primary care providers and making referrals, she also observed better care delivery due to better guidance, better monitoring and timely medication adjustments leading to a better outcome.
While this certainly feels like an increased workload for nurses, let us look at how the telehealth technology has fast evolved during COVID times and if it can support a reduction in nurses’ workload instead of adding more.
Better device integration
Many telehealth platforms offer direct data integration from off-the-shelf devices like SPO2, BP, blood glucose monitors and digital thermometers. Patients who need chronic disease management at home are often prescribed a standard set of devices that captures data digitally and populates all the measured parameters on a dashboard. This can eliminate the nurse’s data re-entry needs and helps direct visualization of near time if not live measurements.
Smart Critical alarms
Many platforms offer smart alarms set up for critical parameter breaches. These alarms trigger alerts either to the caregiver or the caretaker prompting them to intervene. These alarms can be individual parameters or a combination of multiple parameters. Very advanced telehealth platforms even offer a predictive score which is an indication of upcoming adverse events. This technology can further reduce nurses’ need to continuously monitor patients’ clinical data and avoid observation fatigue and alarm fatigue.
Patient support system
Many telehealth platforms today include some form of patient reminders for follow-up appointments, and medication management including SMS, emails and social media integration. Moreover, the caretaker can also be notified if the patient misses a medication or fails to appear for a follow-up meeting. Substantial management workload is removed from nurses with the use of the right technology and patient training.
Role of nurses when telehealth becomes even more widely accepted.
Telehealth is still evolving and today it can only replace less than 20% of the face-to-face care model. The reason being a large portion of hospital care revolves around cardiology, dental, ophthalmology, accident and emergency where telehealth’s role is negligible if not nonexistent. The benefits of efficiency and elimination of travel and waiting times outweigh the technology costs and adaptation challenges and we expect telehealth to become part of the mainstream care delivery.
In a busy outpatient department, nurses are continuously managing the patient queues, patient escorts, unruly behavior, patient record management challenges and overcrowded receptions. In many cases, nurses become the gatekeepers for doctors’ appointment keeping and effectively manage doctors’ worklists while offering reassurance and comfort to patients by explaining the care process.
In a digital environment, the system takes over many of the above activities allowing nurses to truly focus on care delivery and support the healing process. The modern-day platform enables the nurses to digitally engage with the patient pre and post-consultation with higher efficiency and less stress.
Going forward, the role of nurses within a telehealth platform will be highly focused on the healing process rather than operations management. An evolved telehealth platform will make nurses an important stakeholder in care delivery while reducing nonvalue add work for nurses.
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EMU. (2021, September 08). Eastern Michigan University. Retrieved from Eastern Michigan University: https://online.emich.edu/articles/rnbsn/telemedicine-will-transform-nurses-role.aspx
Mckeinsey and Company. (2021, July 9). Telehealth: A Post-COVID-19 reality? Retrieved from www.Mckinsey.com: https://www.mckinsey.com/industries/healthcare-systems-and-services/our-insights/telehealth-a-quarter-trillion-dollar-post-covid-19-reality
University of Missouri. (2021, April 29). Telehealth increases nurses’ workload. Retrieved from SHOWMEMISSOU: https://showme.missouri.edu/2021/telehealth-increases-nurses-workload/