The Future of the Healthcare Industry

Introduction

At present, humanity is in the middle of an electronic information revolution. Although industries across the spectrum of human activity utilize electronic information, no industry has been affected more using this information than the healthcare industry. Much like electronic information sharing enables distance learning, so too does it enable healthcare delivery at a distance. One would think that caring for patients via a digital monitor and microphone is counter intuitive, particularly given the caring environment and holistic care nurses now deliver to patients. However, there are some instances where there are no other options. The Health Resources and Service Administration (HRSA) promotes telehealth as a healthcare option in rural areas where there are no doctors, hospitals or clinics. 

In terms of the electronic information revolution, the terms “telehealth” and “telenursing” describe two different functions in the healthcare industry. The prefix “tele” means “at a distance”. As noted by the HRSA, “telehealth is defined as the use of electronic information and telecommunication technologies to support and promote long-distance clinical health care, patient and professional health-related education, public health and health administration.” Supported by the Office for the Advancement of Telehealth (OAT), the federal government through HRSA promotes telehealth programs that serve citizens in rural areas. Telenursing is similar in that care is delivered at a distance. The Encyclopedia of Nursing Research defines telenursing as: “the use of telecommunication technology to provide nursing services to clients at a distance” (p. 504). Notice in this definition the term “telecommunication,” which today means high-definition CCTV feeds delivered over the Internet. With telenursing it is the professional scope of the nurse that matters. In other words, in telenursing the professional must extend care beyond the bedside and create the caring environment at a distance. While modern telecommunication technology helps manage the distance, the nurse must reach beyond the screen and develop trust and the therapeutic bond without personal physical interactions.

Impacts

The impact of telehealth on the healthcare industry has been monumental and progressively reformative. It was already noted that through OAT HRSA promotes telehealth programs for rural areas of the country. As an extension of “being online”, people that live in rural areas are no longer cut off from the rest of the country. This means that from a public health perspective, these citizens contribute to the larger context for the delivery of national health initiatives. Program such as Healthy People 2020 reach into these rural communities using telecommunication technology.

Another impact is the use of the electronic health record (EHR) as promoted by the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009. Under HITECH, the federal government provides incentives to move to an all-electronic record format, or EHR. Patient records follow patients from cradle to grave and allow for insights into things such as preventative medicine. That said, telehealth has promoted the dissemination of these records into single sources of information. A patient’s EHR contains records from all healthcare industry related items the patient encountered. Lab reports and prescription orders are now part of the same record. HITECH promoted EHRs are part of the federal government’s initiative to reduce the cost of healthcare. This is important to telehealth because the telecommunication equipment used by healthcare professionals must be HITECH compliant regarding patient privacy. 

Benefits and Barriers

Benefits for telehealth encompass three categories that have plagued the healthcare industry: access, cost, and delivery. Stern (2017) noted telehealth delivers “immediate, around-the-clock access to physicians, specialists and other health care providers that otherwise would not be available in many communities” (p. 4). Moreover, because of telehealth, patient can be monitored without leaving their homes. Telehealth cuts costs of healthcare because much of the monitoring can be accomplished without the presence of humans. A primary barrier is that many older healthcare professionals may not trust the efficacy of telehealth. This is generally because they hold fast to the physical care aspect of care, believing hands on is the best way to treat patients (Kayyali, Hesso, Mahdi, Hamzat, Adu & Nabhani-Gebara, 2017).

Privacy and Security

As noted above, patient privacy and security is an issue imbedded into EHRs and their use. A primary reason the Obama Administration passed the HITECH Act was the protection of patient records in the larger cybercriminal perspective. EHRs are not the property of patients; they are owned by the healthcare system that created them. This means that patients do not have complete control over their EHRs, which in cybercrime-ridden world means protecting patient privacy is a function of the healthcare system using the EHRs. That said, HITECH is used in conjunction with the Health Insurance Portability and Accountability Act of 1996 (HIPPA). Every aspect of care from the administration of the healthcare system to the delivery of care using telehealth processes must conform to both laws. This means that users must be ethical in using EHRs. 
        

Conclusion

As a new DNP I will champion the use of EHRs. This means that in everything aspect of healthcare, I will encourage and depend on their use to manage things such as shrinking budgets and promoting preventative care. From a research perspective, I believe it is crucial that DNPs embrace telehealth to improve health outcomes in an evidence-based practice format driven entirely by electronic information. Nurses under my supervision will learn and understand the organizational work culture needed to promote telehealth and telenursing. In this way I will be a servant leader that promotes responsibility and leadership in other nurses.

References

Kazen, M. W. & Fitzpatrick, J. (Ed.). (2012). Encyclopedia of Nursing Research. Springer Publishing Company.

Health Resources and Service Administration (HRSA). (n. d.). Telehealth Programs. Retrieved from https://www.hrsa.gov/rural-health/telehealth/index.htmlKayyali, R., Hesso, I., Mahdi, A., 

Hamzat, O., Adu, A., & Nabhani Gebara, S. (2017). Telehealth: misconceptions and experiences of healthcare professionals in England. International Journal Of Pharmacy Practice, 25(3), 203-209. doi:10.1111/ijpp.12340

Stern, A. (2017). Exploring the Benefits of Telehealth. Trustee, 70(10), 4.