The advancement in digital transformation has impacted the normal operation of healthcare facilities in various ways. Currently, different technologies have been developed to facilitate patient care services. The need to promote better care has prompted several healthcare organizations to adopt e-health services to meet the needs of the patients. The process aims to make care delivery inclusive and equitable to different populations. Hospitals use various tools and devices to enhance care services to patients in remote locations. Most healthcare services are being offered using different models of technology in order to enhance the efficiency of service delivery. Rural communities are in an integral part of receiving the care provided by the e-health technology. The paper will discuss factors that influenced the adoption of telemedicine practice within healthcare facilities. Telehealth models such as live video conferences have made it easier for physicians to perform remote operations, saving on cost and time.
Live-Video Conferencing Technology
Currently, most hospitals have implemented telehealth services to provide remote care to their respective patients. Doctors commonly use technological tools such as live video conferencing to deliver advice and treatment to sick persons (Rush et al., 2018). Several factors have played a vital role in influencing the adoption of the e-health practice in healthcare. Some aspects include the infrastructure, workflow, availability of necessary resources and cost.
Generally, before initiating telehealth services, an organization should ensure that the necessary technology is readily available, such as the hardware and the software that will support the program. Some of these items might be a challenge for other healthcare facilities to acquire (Lew and Sikka, 2019). Furthermore, an organization may be forced to modify its physical and technical to promote consistency in using the models (Valentine et al., 2021). Therefore, these factors play a vital role in determining the implementation of e-health services in a healthcare setting.
Cost and Sustainability
The cost of acquiring the devices to facilitate telehealth practices is high. Purchasing the required machines can negatively impact the hospital’s financial performance. To operate within the provided budget limit, healthcare facilities might be forced to venture into alternative sources to fund the program (Almathami, Win and Vlahu-Gjorgievska, 2020). Furthermore, the devices require rapid and consistent maintenance to ensure they remain practical to provide desirable results to the clinic. This will require further financial resources to achieve (Schinasi et al., 2021). It, therefore, necessitates the organizations to increase their investment in the services to hence their sustainability.
Practitioner availability is another central factor that negatively impacts the adoption and implementation of telehealth models. To properly use the devices that provide remote connection, an experienced professional must ensure all the processes and possible breakdowns are eliminated (Haque et al., 2021). Similarly, most nurses are reluctant to use the technology since the system is not within their work scope (Garber and Gustin, 2022). This makes it difficult to implement e-health in the healthcare setting because most staff members will resist the change.
When an e-health program is initiated, the healthcare workflow automatically changes by adding staff roles, training, education and outreach. Therefore, it implies that when an organization implements the application of telemedicine, nurses’ roles are increased, making them have more workload (Van Houwelingen et al., 2021). For instance, the technology requires doctors to manage the referrals, set the machines, coordinate between the care providers and the patients outside the facility and other relevant roles.
Most of the equipment used in the provision of telehealth services is not familiar, and some practitioners do not have adequate knowledge of how to use them. Offering timely and relevant training is essential in ensuring nurses are well equipped with the knowledge and skills to manage the system (Garber and Gustin, 2022). When physicians and other professionals involved in the telehealth program are well educated, they can easily accept the application of e-health in the facilities.
Role of Regulation and Policy
To implement and sustain the application of telehealth services, strong measures and policies are necessary. There are numerous malpractices and liabilities associated with the use of e-health (Becker et al., 2019). Based on the practice, it is a requirement for the service providers to acquire consent from the patient before using the model to offer services (Kaplan, 2020). This will ensure both parties are made aware of the technology and possible security matters. The liability is about the insurance cover whereby the hospitals might be required to cover the services delivered through the practice by paying an additional telehealth insurance policy.
The regulations ensure that all e-health services comply with the Health Insurance and Accountability Act (HIPAA). The HIPAA law guarantees both the providers and the patient their privacy is preserved and cannot be given to a third party without their consent (Peregrin, 2019). The rules will ensure the organization adopt safe practices to enable safe storage of the videos captured during the service delivery. Furthermore, it will facilitate effective encryption of the data transmission between nurses and sick individuals (Balestra, 2018). The strength of such measures includes promoting confidence in patients; thus, they can share personal information to aid in their healthy development (Ahmad et al., 2021). However, in some circumstances, the patients’ information might be accessed by an authorized physician or cyber-attack.
The use of Models of Telehealth
To Increase Access to Care Outside Hospital Settings
Generally, telehealth tools are used to facilitate the ability of patients and other individuals who require care services outside the healthcare setting. Several factors prompt sick people to opt for treatment and disease management virtually in their remote locations. First is limited finances; most patients and their relatives, especially from marginalized communities, do not have adequate resources to facilitate the frequent movement to and from the hospitals (Alencar et al., 2019). Second, some healthcare facilities have scarce room space to care for many sick individuals (Battineni et al., 2021). Lastly, the fear of discrimination based on their health condition prevents some individuals from receiving better care.
The live-video conferencing technology promotes easy engagement of patients with their care providers. The tool allows patients to reach their doctors without travelling to the hospital using computers, smartphones, or tablets (Haleem et al., 2021). The practice facilitates the easy provision of care services to sick individuals in the comfort of their homes. The live video allows the physician to access and assess the condition hence providing proper care to improve the quality of life (Akiyama and Hasegawa, 2018). From the doctors’ perspective, the application of live-video conferencing enables providers in rural areas to consult and receive real-time assistance from advanced specialists, thus enhancing their ability to provide better care plans (Ateriya et al., 2018). Moreover, it ensures physicians obtain necessary help during complex diagnoses by virtually engaging another practitioner with relevant skills (Asiri et al., 2018). Despite the effectiveness of live-video conferencing, some health conditions require physical assessment by the doctor to determine how to manage the disease (Gajarawala and Pelkowski, 2021). This aspect weakens its practice since the result might not communicate the exact situation of the patient.
Increasing Access to Pharmaceutical Services
Rural populations are majorly affected by the limited number of pharmacy services. Using the telehealth approach called telepharmacy enables marginalized communities to reduce the challenges associated with operating a pharmacy, such as a low number of patients and inadequate finances (Crilly and Kayyali, 2020). With the technology in place, the people in need can restore and gain access to qualified practitioners in time. In most cases, telepharmacies are implemented in outpatient and retail settings.
In the basis of doctors, it enhances delivering quality care by recommending the right prescription for patients. The technology allows recording the images and labels of medicines for proper review (Vilendrer et al., 2020) In addition, it enables the pharmacist to guide the patient through the video before issuing the medications. These practices make it easier for sick people with challenges to access hospitals thus able to receive better and appropriate care (Hanjani et al., 2020). However, sometimes issues such as lack of network and reliable devices lower the ability to provide proper care delivery.
The development of digital transformation in healthcare has significantly impacted the nursing practice and the nurses. Generally, doctors are the key professionals involved in applying telehealth services in hospitals (Nes et al., 2021). They engage in different activities such as monitoring the devices and studying and understanding the results of patient-related information. The use of technology is dominating the care delivery system, and several inventions are being made to facilitate safety and quality patient care (O’Connor and LaRue, 2021). Therefore, the ability to properly use and comprehend technology has become an essential part of physicians’ competence.
Based on the advancement, the future of nursing practice requires nurses to have skills and comprehensive knowledge to facilitate effective care delivery. The proficiencies will allow the providers to combine the telehealth practices and the standard provision of care (Pham et al., 2021). With adequate digital literacy, doctors will be capable of using the technology as a significant active tool instead of a passive (Brown et al., 2020). Furthermore, the understanding will enable nurses to be users and participate in the development, implementation, and assessment of the technology in the hospital settings.
The changes resulting from digital literacy have prompted students undergoing nursing practice to focus on nursing informatics. The demand to understand how to effectively apply engineering to facilitate quality care makes students pay much attention to the technology (Terry et al., 2019). With the adoption of telehealth in most healthcare organizations, students are integrating the skills and basic healthcare knowledge to improve their ability to provide quality patient care.
In summary, telehealth practice in the healthcare setting has impacted the outcome of care services to patients. Rapid development influences the use of e-health tools in technology. The model plays a significant role in ensuring sick individuals access the necessary care irrespective of their economic status, health condition or distance. The live-video conferencing allows nurses to remotely connect and assess patients without having an in-person visit (Kong et al., 2021). Furthermore, it allows rural providers to receive real-time guidance when performing complex diagnoses. These aspects make the technology useful for nurses and patients since it promotes the delivery of quality and timely service to the sick person. Despite the importance of telehealth, several factors such as infrastructure, cost and availability of practitioners determine its adoption by the healthcare settings. In addition, the emergence of e-health has facilitated the growth of digital literacy in health sector, prompting nurses to have adequate knowledge.
Ahmad, R.W., Salah, K., Jayaraman, R., Yaqoob, I., Ellahham, S. and Omar, M. (2021) ‘The role of blockchain technology in telehealth and telemedicine,’ International journal of medical informatics, 148, p.104399.
Akiyama, H. and Hasegawa, Y. (2018) ‘A trial case of medical treatment for primary headache using telemedicine,’ Medicine, 97(9).
Alencar, M.K., Johnson, K., Mullur, R., Gray, V., Gutierrez, E. and Korosteleva, O. (2019) ‘The efficacy of a telemedicine-based weight loss program with video conference health coaching support,’ Journal of Telemedicine and Telecare, 25(3), pp.151-157. Web.
Almathami, H.K.Y., Win, K.T. and Vlahu-Gjorgievska, E. (2020) ‘Barriers and facilitators that influence telemedicine-based, real-time, online consultation at patients’ homes: Systematic literature review,’ Journal of medical Internet research, 22(2), p.e16407.
Asiri, A., AlBishi, S., AlMadani, W., ElMetwally, A. and Househ, M. (2018) ‘The use of telemedicine in surgical care: A systematic review,’ Acta Informatica Medica, 26(3), p.201.
Ateriya, N., Saraf, A., Meshram, V.P. and Setia, P. (2018) ‘Telemedicine and virtual consultation: The Indian perspective,’ National Medical Journal of India, 31(4).
Balestra, M. (2018) ‘Telehealth and legal implications for nurse practitioners,’ The Journal for Nurse Practitioners, 14(1), pp.33-39.
Battineni, G., Pallotta, G., Nittari, G. and Amenta, F. (2021) ‘Telemedicine framework to mitigate the impact of the COVID-19 pandemic,’ Journal of Taibah University Medical Sciences.
Becker, C.D., Dandy, K., Gaujean, M., Fusaro, M. and Scurlock, C. (2019) ‘Legal perspectives on telemedicine part 1: Legal and regulatory issues,’ The Permanente Journal, 23.
Brown, J., Morgan, A., Mason, J., Pope, N. and Bosco, A.M. (2020) ‘Student nurses’ digital literacy levels: Lessons for curricula,’ CIN: Computers, Informatics, Nursing, 38(9), pp.451-458.
Crilly, P. and Kayyali, R. (2020) ‘A systematic review of randomized controlled trials of telehealth and digital technology use by community pharmacists to improve public health,’ Pharmacy, 8(3), p.137.
Gajarawala, S.N. and Pelkowski, J.N. (2021) ‘Telehealth benefits and barriers,’ The Journal for Nurse Practitioners, 17(2), pp.218-221.
Garber, K. and Gustin, T. (2022) ‘Telehealth education: Impact on provider experience and adoption,’ Nurse Educator, 47(2), pp.75-80.
Garber, K. and Gustin, T. (2022) ‘Telehealth education: Impact on provider experience and adoption,’ Nurse Educator, 47(2), pp.75-80.
Haleem, A., Javaid, M., Singh, R.P. and Suman, R., 2021. Telemedicine for healthcare: Capabilities, features, barriers, and applications. Sensors International, 2, p.100117.
Hanjani, L.S., Caffery, L.J., Freeman, C.R., Peeters, G. and Peel, N.M. (2020) ‘A scoping review of the use and impact of telehealth medication reviews,’ Research in Social and Administrative Pharmacy, 16(8), pp.1140-1153.
Haque, S.N., DeStefano, S., Banger, A., Rutledge, R. and Romaire, M. (2021) ‘Factors influencing telehealth implementation and use in frontier critical access hospitals: Qualitative study,’ JMIR Formative Research, 5(5), p.e24118.
Kaplan, B. (2020) ‘Revisiting health information technology ethical, legal, and social issues and evaluation: Telehealth/telemedicine and COVID-19,’ International journal of medical informatics, 143, p.104239.
Kong, S.S., Otalora Rojas, L.A., Ashour, A., Robinson, M., Hosterman, T. and Bhanusali, N. (2021) ‘Ability and willingness to utilize telemedicine among rheumatology patients—a cross-sectional survey,’ Clinical Rheumatology, 40(12), pp.5087-5093.
Lew, S.Q. and Sikka, N. (2019) ‘Operationalizing telehealth for home dialysis patients in the United States,’ American Journal of Kidney Diseases, 74(1), pp.95-100.
Nes, A.A.G., Steindal, S.A., Larsen, M.H., Heer, H.C., Lærum-Onsager, E. and Gjevjon, E.R. (2021) ‘Technological literacy in nursing education: A scoping review,’ Journal of Professional Nursing, 37(2), pp.320-334. Web.
O’Connor, S. and LaRue, E. (2021) ‘Integrating informatics into undergraduate nursing education: A case study using a spiral learning approach,’ Nurse Education in Practice, 50, p.102934.
Peregrin, T. (2019) ‘Telehealth is transforming health care: What you need to know to practice telenutrition,’ Journal of the Academy of Nutrition and Dietetics, 119(11), pp.1916-1920.
Pham, D.Q., Golub, S.A., Breuner, C.C. and Evans, Y.N. (2021) ‘The impact of telehealth on clinical education in adolescent medicine during the COVID-19 pandemic: Positive preliminary findings,’ Frontiers in Pediatrics, 9, p.210. Web.
Rush, K.L., Hatt, L., Janke, R., Burton, L., Ferrier, M. and Tetrault, M. (2018) ‘The efficacy of telehealth delivered educational approaches for patients with chronic diseases: A systematic review,’ Patient Education and Counseling, 101(8), pp.1310-1321.
Schinasi, D.A., Atabaki, S.M., Lo, M.D., Marcin, J.P. and Macy, M. (2021) ‘Telehealth in pediatric emergency medicine,’ Current Problems in Pediatric and Adolescent Health Care, 51(1).
Terry, J., Davies, A., Williams, C., Tait, S. and Condon, L. (2019) ‘Improving the digital literacy competence of nursing and midwifery students: A qualitative study of the experiences of NICE student champions,’ Nurse Education in Practice, 34, pp.192-198.
Valentine, A.Z., Hall, S.S., Young, E., Brown, B.J., Groom, M.J., Hollis, C. and Hall, C.L. (2021) ‘Implementation of telehealth services to assess, monitor, and treat neurodevelopmental disorders: Systematic review,’ Journal of medical Internet research, 23(1).
Van Houwelingen, T., Ettema, R.G., Bleijenberg, N., van Os-Medendorp, H., Kort, H.S. and Ten Cate, O. (2021) ‘Educational intervention to increase nurses’ knowledge, self-efficacy and usage of telehealth: A multi-setting pretest-posttest study,’ Nurse Education in Practice, 51, p.102924.
Vilendrer, S., Patel, B., Chadwick, W., Hwa, M., Asch, S., Pageler, N., Ramdeo, R., Saliba-Gustafsson, E.A., Strong, P. and Sharp, C. (2020) ‘Rapid deployment of inpatient telemedicine in response to COVID-19 across three health systems,’ Journal of the American Medical Informatics Association, 27(7), pp.1102-1109.