TELEHEALTH TECHNOLOGIES

8/7/2019 TELEHEALTH TECHNOLOGIES

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TELEHEALTH TECHNOLOGIES


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y Clinical telehealth applications enable healthcare professionals to haveface to face meetings with patients. They can see images and hear

patient output as it is occurring or at a later time.y These applications allow professionals to view, send, or store video and

digital images for a patient assessment, diagnosis, treatment, andevaluation over video conferencing technology and computerapplications.

y In the homecare environment, telehomecare technologies assist homecare nurses to monitor a patient's vital signs, including heart and lungsounds.

y These applications also enable a nurse, who is in a remote locationrelative to the patient, to identify changing trends in the patient'sphysiological state.

y This type of technology can also assist with medication compliance anddecrease the need for in-home care or office visits.


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y It can be of great value to patients in remote locations.

yIt can help nurses in their everyday practice and provide themwith an expanded set of career choices.

y It makes it possible to share medical skills, information, andknow how.

y

It can provide nurses -- be they novices, experts, or somewherein-between -- the opportunity to play an important role in thedevelopment, deployment, and utilization of telemedicine andtelehealth applications in patient care.

y It allows clinicians to conduct remote physical assessment and

consults, as well as capture and store patient information (with astore-and-forward software application) for further evaluationand sharing with a consulting physician or nurse practitioner.


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Six areas that are important to

master in clinical telemedicine:

y Learning how to use the telemedicine medical devices as wellas audio, video, and digital software applications over phone,Integrated Services Digital Network (ISDN), or InternetProvider (IP) communication networks

y Becoming techno-savvy in using other software applicationsfor entering patient demographic data, saving, sending, andretrieving information to or from the consulting physician ornurse practitioner

y

Collaborating with information technology staff, biomedicalengineers, and telehealth physicians and nurses in one'shealth care system or hospital as atelemedicine/telehealth/e-health team.


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y Assisting in the development of telehealth guidelines,

policies, and procedures

y Reviewing and understanding the applicable Health Insurance

Portability andA

ccountabilityA

ct (HIPAA

) laws with use oftelehealth applications

y Learning the evolution of telehealth/telemedicine/e-health

technologies and how they are being used in healthcare


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The eLearning

y A Learning Management System (LMS) to automate theprocesses associated with learning management

administration, educational content development and

program delivery provides a centralized, web-based portal

for registration, course and curriculum management, studenttranscripts, testing, as well as activity tracking and reporting.

eLearning Centre to ensure that nurses across have access to

the latest information when and where they need it, nurses

can participate in online learning through the eLearning

Centre.


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TELENURSING

y The branch of telehealth that involves actual nursing and

client interaction through the medium of information

technology.

y

The nurse must strive to envision and experience the client'sthree dimensional body and being in order to accurately

advise, assess, diagnose, and interact fully and dynamically.

This perceiving must occur within the virtual network

environment, where both body-sense and body-awareness are

combined with digital information.


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THE ROLE OF TECHNOLOGY IN THE

MEDICATION USE PROCESSy Computerized provider order entry (CPOE), i s a

process of electronic entry of medical practitioner

instructions for the treatment of patients (particularly

hospitalized patients) under his or her care. These orders are

communicated over a computer network to the medical staff

or to the departments (pharmacy, laboratory, or radiology)

responsible for fulfilling the order. CPOE decreases delay in

order completion, reduces errors related to handwriting or

transcription, allows order entry at point-of-care or off-site,provides error-checking for duplicate or incorrect doses or

tests, and simplifies inventory and posting of charges.


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BAR-CODE ENABLED POINT OF CARE- Barcode scanningand wireless mobility technologies at point-of-care improvepatient safety by greatly reducing the possibility of human error.

y MedicationAdministration

Wireless mobile computers equipped with barcode scannersenable healthcare professionals to scan the patient wristband andthe medication to verify the five rights -- the right medication isgoing to the right patient at the right time at the right dose usingthe right method of administration.


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y Specimen Collection

True positive specimen identification begins at the point of

collection. Whether its blood, tissue, or fluids, accurate test

results and speedy diagnoses depend on specimens beingclearly and positively identified. Barcode scanners, wireless

data terminals and portable barcode label printers enable

healthcare professionals to positively identify specimens at

the bedside as they are collected.


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y Blood Transfusion Verification

Accurate matching of blood to patients is critically important

to avoiding life-threatening errors. Barcode scanners, mobile

computers and barcode label printers assure accuracy inidentification of blood, from the moment it is drawn to when

it is given to the laboratory.


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y An automated dispensing cabinet (ADC) is a

computerized drug storage device or cabinet designed for

hospitals. ADCs allow medications to be stored and dispensed

near the point of care while controlling and tracking drug

distribution. They also are called unit-based cabinets (UBCs),

automated dispensing devices (ADDs), automated

distribution cabinets or automated dispensing machines(ADMs). ADCs are designed to meet the exact needs of the

nurses and pharmacists that use them. When ADCs are

purchased for a facility, the order is customized for whatever

the cabinet will be specifically used for.


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y Smart pumps are designed to offer extra bedside

protection against mistakes. The pumps' software can hold an

extensive drug library that includes pre-established

maximum and minimum range doses for each medication. A

warning sounds if a staffer tries to exceed these doses. The

pump may give a "soft alert," which asks users to reconsider

whether they want to program that particular dose. A "hardalert" will not allow users to override the machine and

administer a dose outside of the library's limits.


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y A failure modes and effects analysis (FMEA) is a

procedure in product development and operations

management for analysis of potential failure modes within a

system for classification by the severity and likelihood of the

failures.


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y personal digital assistants (PDA), offer great potential

as portable communication tools that can provide

information and decision support. In one study, these devices

were shown to improve the detection and prevention of

adverse events in an ICU setting.


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y Smart cards are electronic devices the size of credit cards that

store and process medical information on a microprocessor

chip. The Department of Defense has been a leader in the use of

this technology. In much the same manner that ATM cards allow

consumers to access banking services from virtually anywhere

in the world, these smart cards would give patients a portable

means of carrying their medical information, which could thenbe accessed electronically by providers or healthcare facilities at

disparate locations. Interactive smart cards could also generate

alerts about potential adverse events resulting from medication

and other types of errors. While promising, this technologyremains in development and has not been utilized or evaluated

to a significant degree in the clinical setting.


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y High-alert medications are drugs that bear a heightened

risk of causing significant patient harm when they are used inerror. Strategies like improving access to information about

these drugs; limiting access to high-alert medications; using

auxiliary labels and automated alerts; standardizing the

ordering, storage, preparation, and administration of these

products; and employing redundancies such as automated or

independent doublechecks when necessary could decrease the

risk.

Ex. ISMPs LIST OF HIGHALERTMEDICATIONS


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y eMAR/Medication Order Entry/Administration

(MOE/MAR)

The MOE/MAR project implemented both electronic

medication order entry and an electronic medication

administration record as part of the Electronic Patient Record.

The redesign of workflow and the elimination of transcription

have improved patient safety.

Electronic Medication Administration Record (eMAR), a fully-

integrated software, eMAR with two technologies: Bluetooth(r)

wireless and hand-held scanners to read bar codes: the same bar

code technology used in supermarkets.


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TheMedication Administration Process Using eMAR

y A Physician writes the order, which is sent to the Pharmacy.

y A Pharmacist enters the order in Meditech (a specialized

healthcare software provider)

y The Pharmacy bar codes the medication and distributes to the

floors.

y The nurse views the eMAR screen and reviews the patient's

medication list and verifies with the physician orders.

y eMAR alerts the nurse about the next dose due, overdue doses,

or cautions about medications

y Nurse takes the cart to the patient, scans the medication and the

patient's wristband.

Documents

TELEHEALTH TECHNOLOGIES