Telehomecare Presented by Sheree Miller, RN

Objectives Describe telehomecareDescribe telehomecare Describe and evaluate the hardware and software utilized with this trendDescribe and evaluate the hardware and software utilized with this trend Describe and evaluate the information system used with this trendDescribe and evaluate the information system used with this trend Discuss the advantages and disadvantages with this trendDiscuss the advantages and disadvantages with this trend Examine related ethical issuesExamine related ethical issues Discuss the informatics competencies required by a professional nurse working with this trendDiscuss the informatics competencies required by a professional nurse working with this trend Assess the role and functions of the nurse informatics when working with this trendAssess the role and functions of the nurse informatics when working with this trend

Telehomecare Home health monitoring in a primary care settingHome health monitoring in a primary care setting Estimated 1.5 million home care visits every day (Elford, 2005)Estimated 1.5 million home care visits every day (Elford, 2005) Chronic disease managementChronic disease management –Diabetes –Congestive heart failure –Chronic obstructive pulmonary disease Continuum of careContinuum of care –Clinical services –Social support

Types Electronic house callsElectronic house calls –Home care visits –Scheduled –Clinician initiated Healthcare call centers –Urgent matters –Patient initiated –Non-scheduled

Hardware Adaptable applicationsAdaptable applications –Blood pressure cuff –Thermometer –Oxygen sensor –PT/INR coagulation meter –Glucose meter –Scale –Peak flow meter –ECG (Elford, 2005)

Hardware AMD-1500 –Capture images –Videos –Vital Signs –Record data –Touch screen interface (AMD, 2010)

Software Records and tracks all health information collectedRecords and tracks all health information collected ExamplesExamples –Second opinion standard –Second opinion professional –Network server –Doctor terminal –tConsult

Software tConsulttConsult –Any microsoft workstation –Interface with medical devices –User-friendly –Dependable –Extensive color coding –Touch screen –One-button capture Patient Clinician

Usability of the Software Axiom 1: users must be an early and continuous focus during interface designAxiom 1: users must be an early and continuous focus during interface design Axiom 2: design process should be iterative, allowing for evaluation and correction of identified problemsAxiom 2: design process should be iterative, allowing for evaluation and correction of identified problems Axiom 3: formal evaluation should take place using rigorous experimental and/or qualitative methodsAxiom 3: formal evaluation should take place using rigorous experimental and/or qualitative methods (McGonigle & Mastrian, 2009)

Electronic Medical Record Electronic warehouse of client informationElectronic warehouse of client information –Store –Process –Transmit –Assess

Medinformatix’s EMR “Market leading software solution for the medical industry” (Acentec, Inc 2010, Medinformatix Electronic Medical Record, ¶1)“Market leading software solution for the medical industry” (Acentec, Inc 2010, Medinformatix Electronic Medical Record, ¶1) Streamlined workflowStreamlined workflow Digitizes documentationDigitizes documentation User-friendlyUser-friendly AdaptableAdaptable Compliant with standards and protocolsCompliant with standards and protocols 24/7 support available24/7 support available

Medinformatix’s EMR Administrative systemAdministrative system All health personnelAll health personnel Multiple user functionsMultiple user functions Mainframe configurationMainframe configuration Certification commission for healthcare information technology certifiedCertification commission for healthcare information technology certified

Advantages Patient’s Perspective –Seen quicker –Seen more often –Stay home –Self-monitor Health professional perspective – –Decreased travel time – –Seen patient more often – –See more patients – –Assess patient’s condition

Disadvantages Cost and reimbursement Technology issues Healthcare provider resistance Lack of privacy

Ethical and Legal Issues Ethical issues – –Confidentiality – –Data security Legal issues –Accountability for practice –Potential for malpractice (McGonigle & Mastrian, 2009)

Informatics Competencies Computer knowledge Operate telehomecare equipment Computerized charting system (Dansky, Yant, Jenkins & Dellasega, 2003)

Informatics Nurse Consultant Educator Researcher Project Manager (McGonigle & Mastrian, 2009)

Summary Not for all patients Increases efficiency and productivity of clinicians Promote independence Home health monitoring Accessibility

References AMD Global Telemedicine, Inc. (2010). The future of medicine…now? Retrieved from Global Telemedicine, Inc. (2010). The future of medicine…now? Retrieved from Acentec, Inc. (2010). Medinformatix Electronic Medical Record. Retrieved from Inc. (2010). Medinformatix Electronic Medical Record. Retrieved from AFHCAN (2009). AFHCAN Telehealth Solutions. Retrieved from (2009). AFHCAN Telehealth Solutions. Retrieved from BNP Media (2010). “Panasonic Announces Tele-Homecare System”. Retrieved from 1e4edf VgnVCM100000f932a8c0____.BNP Media (2010). “Panasonic Announces Tele-Homecare System”. Retrieved from 1e4edf VgnVCM100000f932a8c0____. 1e4edf VgnVCM100000f932a8c0____ 1e4edf VgnVCM100000f932a8c0____ Dansky, K.H., Yant, B., Jenkins, D., Dellasega, C.(2003). Qualitative analysis of telehomecare nursing activities. JONA, 33(7/8),

References Elford, R. (2004). An Introduction to Telehome Care. Retrived from R. (2004). An Introduction to Telehome Care. Retrived from Landers, D (2000). Issues surrounding TeleHomeCare. Retrieved from eimbursementLanders, D (2000). Issues surrounding TeleHomeCare. Retrieved from eimbursement eimbursement eimbursement Liddy, C., J. J. Dusseault, Dahrouge, S., Hogg, W., Lemelin, J. & Humber, J. (2008). "Telehomecare for patients with multiple chronic illnesses: Pilot study." Can Fam Physician 54(1): Liddy, C., J. J. Dusseault, Dahrouge, S., Hogg, W., Lemelin, J. & Humber, J. (2008). "Telehomecare for patients with multiple chronic illnesses: Pilot study." Can Fam Physician 54(1): McGonigle, D. & Mastrian, K. (2009). Nursing Informatics: A Foundation of Knowledge (1st ed.). Jones & Bartlett Publishers.McGonigle, D. & Mastrian, K. (2009). Nursing Informatics: A Foundation of Knowledge (1st ed.). Jones & Bartlett Publishers. Second Opinion Software, LLC. (2007). Image Management and Communication Software. Retrieved from Opinion Software, LLC. (2007). Image Management and Communication Software. Retrieved from