Telehealth nursing is a relatively new concept that is radically changing the state of our healthcare system.
The recent COVID-19 climate has caused an upsurge in telehealth use, with 46% of U.S. consumers now using remote care in lieu of in-person appointments. In response to this demand, healthcare providers have scaled their offerings. They are seeing anywhere from 50 to 175 times their original patient visit capacity.
This reliance on telehealth will likely continue in our country with telehealth nursing quickly adapting to forefront challenges.
In this blog, we’ll discuss telehealth nursing, the overall impact of telehealth, and how you can contribute to an impactful future as a nurse leader.
What is Telehealth Nursing?
Telehealth nursing is a practice by which technology is used to deliver nursing care remotely.
Some benefits of telehealth nursing include improving the accessibility of healthcare and easing some of the burden felt by nurses who are pressed for time. This is due to cutting out “lost time spent traveling, registering, and waiting like there would be with traditional appointments and visits.”
Telehealth nursing also promotes immediate access to care. Some health systems allow patients the ability to connect to a nurse via phone 24 hours a day, seven days a week.
On-call nurses not only calm patients but also dispatch ambulances in the case of an emergency. For patients with general questions about symptoms, telehealth nursing serves as a quick, reliable source and is more trustworthy than the internet.
In rural communities, telehealth nursing has also been shown to increase the efficiency of the healthcare system, especially among specialists. This perk is essential, given nursing staff shortages are exceptionally high in these areas.
What are some of the responsibilities in telehealth nursing? We’ve listed a few below:
- Answer inquiries about symptoms
- Calming nerves of patients
- Guide patients to the emergency department (ED) visits
- Clarify appropriate treatment options
- Educate patients about self-care at home
- Assist with appointment scheduling
Telehealth vs. Telemedicine: What’s the Difference?
Telehealth is a broader definition of virtual care that encompasses clinical and non-clinical healthcare services, including:
- Mental health counseling
- Primary care, which includes telehealth nursing
- Specialists, like nutritionists, etc.
- Home healthcare
Telemedicine is specific to delivering remote clinical services only. Clinical healthcare services commonly involve a physician (MD), a hospitalist (MD), or a nurse practitioner (NP) and focus on medical treatment.
Telehealth and telemedicine share similar ways to administer services to patients, including video conferencing, remote monitoring, electronic consults, and wireless communication.
When conducted within the appropriate standards of care, both telehealth and telemedicine are considered efficient means of improving health.
As we dive into what challenges have shaped telehealth—mainly, telehealth nursing—we’ll discover how today’s pandemic has shifted our country’s use of remote healthcare.
The Biggest Challenges Facing the Healthcare System
Before the global presence of COVID-19, the United States healthcare system was facing many challenges. As our country moves through today’s climate, five issues have become more apparent with our healthcare system.
As a result of the pandemic, 5.4 million Americans have lost their health insurance, according to the New York Times. This is 40% higher than the previous record during the country’s 2008 recession when 3.9 million adults lost their insurance.
Low-income Americans disproportionately lack medical coverage. Even though nearly half of uninsured adults may be eligible for subsidized insurance through the marketplace, according to The CommonWealth Fund, many remain uninsured. When asked why they did not try to get insurance through the marketplace, more than one-third (36%) reported they didn’t think that they could afford it.
This demonstrates the opportunity to raise public awareness around the cost and accessibility of health coverage, especially among low-income communities.
Inaccessibility to healthcare services has been a prevalent issue that has worsened due to recent times.
Timely use of medical services is essential to promoting better patient outcomes. In fact, studies show three distinctive steps must be taken to create healthcare accessibility:
- Insurance coverage: Gaining entry into the healthcare system
- Geographic availability: Accessing a location where required healthcare services are provided
- Personal relationships: Finding a healthcare provider whom the patient trusts and can share information
Access to care often varies based on a variety of factors, including socioeconomic status, geographical location, race, ethnicity, age, gender, disability status, and more.
Several barriers prevent access to timely care, including but not limited to:
- No medical insurance
- The cost of health care
- Lack of available services, especially in rural areas
- Lack of culturally competent care
- Delays in receiving appropriate care due to staff shortages
The escalating cost of medical services is a challenge for many Americans faced with the burden of debt after healthcare.
A recent study found that “almost a third of working Americans currently have some kind of medical debt, and about 28% of those who have an outstanding balance owe $10,000 or more on their bills.”
Reports also show that Americans spend approximately $5,000 a year on healthcare costs such as insurance, prescriptions, and medical supplies.
There’s a correlation between medical financial hardship and continuing material and psychological hardship among Americans. For those with complex health conditions, this is evident, as “more than 50% of cancer survivors [reported] problems paying medical bills, financial distress, or delaying/forgoing medical care in the past year.”
Chronic stress puts adults at risk for developing mental health issues (e.g., depression, anxiety), additional health conditions, and avoidant behaviors.
Aside from trying to avoid more medical debt, nearly half of Americans have also delayed medical care due to COVID-19, with 11% reportedly experiencing worsening conditions as a result.
Chronic Health Conditions
Chronic health conditions, such as heart disease, cancer and diabetes, may limit a patient’s ability to engage in daily activities and require ongoing medical attention. They may also need a healthy lifestyle intervention and routine patient monitoring.
Below is a summary of the presence of chronic health conditions in the U.S.:
- 6 in 10 adults have a chronic disease
- 4 in 10 adults have two or more chronic diseases
- The leading causes of death and disability are heart disease
- The key risk factors for developing a chronic disease include tobacco use, excessive alcohol use, poor nutrition and lack of physical activity
- Chronic diseases are the leading driver of $3.5 trillion in healthcare costs
Americans living with chronic conditions such as asthma, diabetes, or a weakened immune system, also have a higher risk of experiencing severe illness if exposed to COVID-19.
These individuals need to continue to manage their chronic conditions without risking exposure. Healthcare resources, like the Minnesota Department of Health, recommend that individuals with chronic conditions talk to their healthcare provider about telehealth.
Telehealth nursing allows high-risk populations to set up medical appointments online or over the phone to limit in-person exposure while continuing to manage their health.
Shortage of Healthcare Providers
According to Human Resources for Health, “Improving the quality of care, increasing access to care, and controlling healthcare costs depend on the adequate availability of healthcare providers.”
As the need for providers outgrows our nation’s supply, the U.S. will experience nearly 122,000 physician vacancies by 2032. Many factors contribute to this shortage, including:
- The aging population of the workforce and increased retirements among physicians
- Rising demand for more complex and frequent medical services, particularly among the Baby Boomer population
- The aftermath of COVID-19’s effect on individual and community health, as well as other contributing factors
How are Remote Services, Like Telehealth Nursing, Impacting Healthcare?
Events in 2020 have led to a demand in services such as telehealth nursing.
In 2019, only 11% of consumers were using telehealth services. Since the COVID-19 outbreak, however, the majority of in-person medical visits were canceled, with 76% of consumers showing continued interest in using telehealth moving forward.
Telehealth nursing and telemedicine have shown improved levels of patient satisfaction, as well as greater accessibility and affordability.
Healthcare providers have also started to lean favorably towards telehealth, with 64% reporting that they are now more comfortable using telehealth technology.
While the COVID-19 pandemic has exposed many cracks in the healthcare system, it has also shown viable opportunities within telehealth.
Here are some ways telehealth nursing is shaping a new future.
Insurance companies are supporting the adoption of telehealth, intending to lower costs, and improve accessibility for their customers.
In fact, telehealth nursing and other remote services have generated enough cost savings to interest stakeholders. According to Deloitte, “Healthcare stakeholders are implementing payment reforms, such as value-based payment models, that help providers, payers, and patients achieve the best outcomes at the lowest cost.”
Starting in 2020, Medicare Advantage Plans may offer more telehealth benefits than Original Medicare. Medicare telehealth services have expanded to include psychotherapy, consultations, and other health services provided by an eligible healthcare provider.
This means telehealth coverage goes beyond medical services and will extend to other areas such as mental health needs, psychotherapy, consultations, and more.
As health insurers expand coverage, this will likely help alleviate inaccessibility issues for many Americans.
Accessibility and Remote Service Delivery
Insurance coverage, geography, and personal relationships with healthcare providers are all elements of healthcare accessibility.
Telehealth nursing can address all of these touchpoints.
- When medically appropriate, insurance companies are more likely to cover low-cost telehealth visits than emergency room visits.
- Telehealth nursing provides routine care for patients with limited travel ability or those living in remote areas.
- Telehealth nursing offers the opportunity to connect to patients in meaningful ways. InTouch Health says, “nurses are more accessible to patients with telehealth, creating an adequate amount of care performed with fewer nurses.”
With telehealth nursing, patients can also limit their exposure to contagious illnesses, such as COVID-19, which is particularly important for high-risk groups.
Remote telehealth nursing can also save time for providers and patients alike. Aside from removing commute time, telehealth consultations are typically 20% shorter than in-person appointments, allowing time for more patient visits.
Telehealth nursing increases financial savings in several ways, including:
- Improving time efficiency
- Decreasing emergency department visits
- Reducing hospital admissions
- Allowing fewer nurses to provide more care
According to Forbes, “Research shows access to telehealth can decrease emergency room trips. The average emergency room visit costs $1,734, and the average doctor’s visit is $149, while the average telehealth visit costs $79.”
Teri Oelrich and Bryan Langlands, a nurse, healthcare programmer, and contributors at Forbes acknowledged the benefit of remote service delivery, saying, “unused exam rooms can be converted to support higher revenue-generating procedural care.”
Virtual visits also mean patients will experience:
- Reduced wait times
- Shorter consultations
- Less time away from work
- No travel time required, resulting in cost savings for patients, their employers and their insurance companies
The accumulated financial savings produced by telehealth's efficiency could help Americans emerge from the aforementioned medical debt.
Telehealth is also playing a role in reinventing healthcare systems. According to Deloitt’s 2020 Global Healthcare Outlook, telehealth helps providers respond to the need for financial sustainability in healthcare in the following ways:
- Adopting value-based care
- Establish universal health care systems
- Pricing controls on pharmaceuticals and medical technology
- Investing in population health management
Improved Patient Monitoring
Nurses can engage in remote patient monitoring (RPM) to enhance patient care via telehealth.
RPM is typified by the use of digital technology to “to gather patient data outside of traditional healthcare settings.” RPM helps reduce the readmission rate of patients and allows providers to offer treatment and feedback remotely, improving quality of life and containing costs.
According to The Center for Connected Health Policy (CCHP), RPM is capable of reducing:
- The number of hospitalizations
- The number of hospital readmissions
- The length of stay in hospitals
Remote patient monitoring and telehealth nursing are especially relevant when treating patients with chronic health conditions.
Patients with one or more chronic health conditions must continually manage their health and are therefore likely to have more frequent doctor appointments. They may even take time off work to accommodate for these appointments.
Telehealth allows consumers to be monitored remotely—this flexibility lets patients with chronic conditions manage their health from the comfort of their home, offsetting cost, and time.
Due to efficiency, remote management such as telehealth nursing will likely continue to be a vital touchpoint for individuals with chronic conditions long after COVID-19.
Soften the Nursing Shortage
Telehealth nursing can help alleviate the nationwide nursing shortage without reducing the quality of care patients receive. This is especially important, as the presence of COVID-19 has increased the demand for services when healthcare staff is already stretched thin.
Telehealth nursing does not forgo quality. Telehealth nurses “spend more time with patients that would otherwise be spent traveling, charting, or running from one patient to another on-site.”
Telehealth nursing also increases time efficiency overall. According to a study by Deloitte, “The digital workforce is already underway as organizations [adopt] advanced technologies that accelerate decision-making and eliminate routine administrative tasks.”
Moreover, telehealth nursing can help keep nurses, healthcare professionals, and other patients safe by limiting in-person contact and offering virtual screenings.
As nurses face shortages of personal protective equipment (e.g., N95 masks, etc.), telehealth nursing also reserves health safety gear for essential in-person appointments.
Patient Comfort And Satisfaction
Additionally, patients have reported high satisfaction with telehealth nursing and virtual care.
A recent large-scale study called The Rapid Transition to Telemedicine: Insights and Early Trends found that even with technical issues, patients are overwhelmingly positive about their virtual interactions.
The chairman and CEO of Press Ganey Patrick Ryan went on to say, “the rapid adoption of telehealth has enabled caregivers to meet the needs of patients with the levels of attentiveness, expertise, and empathy provided during an in-office visit.”
As healthcare providers use telehealth to check in with patients during COVID-19, reports of improved technology and quality care demonstrate positive patient experiences.
According to a study by Deloitte, 77% of individuals that have tried virtual visits report a high level of satisfaction, and consumers with a chronic condition are even more likely to report high satisfaction with virtual visits.
These promising results indicate that consumers will be interested in using telehealth to manage their healthcare after COVID-19 has passed.
The Future of Telehealth Nursing and Virtual Healthcare
Healthcare is changing at a rapid pace, and COVID-19 has altered the way providers work within the healthcare system while encouraging stakeholders to invest in comprehensive remote care.
Forbes sheds light on trends to keep an eye out for in telehealth nursing and virtual healthcare:
- The Federal Communications Commission (FCC) has established a $200M COVID-19 Telehealth Program to help healthcare providers continue to treat patients and make telehealth more accessible
- There will be less regulatory barriers in place to encourage telehealth use
- Medicare will expand coverage for telehealth services and increase reimbursement for virtual healthcare
- Telehealth-connected devices will become increasingly advanced and use new technologies such as cloud computing, 5G, Artificial Intelligence (AI), Natural Language Processing (NLP) and Internet of Medical Things (IoMT) to improve quality of care
What does this mean for Americans and healthcare providers in the US?
Telehealth is here to stay. During COVID-19, Americans have grown more comfortable and satisfied while using virtual healthcare technologies. As a result, offering telehealth has become an expectation rather than an option.
Healthcare providers that offer telehealth can offset many of the challenges traditional practices face, such as inaccessibility, poor chronic health management, or healthcare worker shortages.
Although COVID-19 was the catalyst to the adoption of telehealth services, it is likely the beginning of telehealth’s presence in the healthcare industry.
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Creating sustainable change in the healthcare system starts with education.
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