TELEMEDICINE

Maria Licari
Nurs 450

OBJECTIVES
Describe what technologies encompass telemedicine
Identify two theorists that support the use of telemedicine
Assess the health care environment and its readiness for telemedicine
Discuss the future of telemedicine
Evaluate the health care environment in relation to telemedicine
Identify possible complications of telemedicine
Describe ANA and QSEN competencies that support the use of
telemedicine
Recommend quality and safety improvements

WHAT IS TELEMEDICINE &

TELEHEALTH?
Telemedicine and telehealth are terms used interchangeably
Eliminate the geographical distance between provider and patient
Enhance the nursing process using technology
Reduce hospital admissions & emergency department visits
Provide access to care & reduce healthcare costs
There is already a framework in place set out by the American
Telemedicine Association (ATA)
(ATA, 2012)

NURSING THEORY

ROZZANO LOCSINS THEORY OF TECHNOLOGICAL

COMPETENCY IN CARING IN NURSING

Practicing technological knowing, wholeness of

persons is appreciated thus maintaining the persons
humanity in a high-tech world of nursing practice
(Locsin, 2013)

Barriers to embracing technology:

Belief that working with technology distances nurses
from their patients
Unfamiliarity with technology
Fear of change
(LOCSIN, 2013)

BEHAVIORAL THEORY

CHANGE THEORY: ROGERS THEORY OF

INNOVATION DIFFUSION
Four Elements in the Diffusion of Innovations
Innovation
Communication Channels
Time

Everett Rogers
1931 - 2004

Social System

(ROGERS, 1983)

The Innovation-Decision
Process

(ROGERS, 1983)

ASSESSMENT OF THE
HEALTH CARE

The American Telemedicine Association (ATA) provides an analysis of

ENVIRONMENT
each state and how telemedicine is paid for, what it covers, and what
laws are in place. The ATA gives each state grades A-F to describe how
well they stand.
Strict HIPAA policies are in place for protected network to allow videoaudio conferencing
Services:
Specialist
Monitoring
Consumer Medical and Health Information
Medical Education
Michigan:
Private Insurance & Medicaid
(THOMAS & CAPISTRANT, 2015))

FUTURE OF THE HEALTH

CARE ENVIRONMENT

ROOT CAUSE ANALYSIS

Equipme
nt
Staff unfamiliar
with how to use
equipment

Unclear
policies
are
written to
use
telemedici
ne

Policies/Proced
ures

Environm
ent
Computer
is kept in
a closet

Poor confidence /
Fear to contact a
doctor they do not
know

Staff

2-way video and

audio
conferencing is
available but not
Staff isused
poorly
educated on how to
use equipment

IMPLICATIONS &
COMPLICATIONS
Fear of Change
Impaired patient-to-caregiver relationship
Lack of Education
Licensure Issues
Lack of Resources

(BREWSTER ET. AL, 2013)

RECOMMENDATIONS FOR
QUALITY & SAFETY
IMPROVEMENTS
QSEN
Teamwork &
Collaboration
Informatics
Patient-Centered Care
Evidence Based
Practice

ANA

Education
Collaboration
Resource Utilization
Evidence Based
Practice & Research
(ANA, 2010) & (QSEN, 2014)

REFERENCES
American Nurses Association (ANA) (2010). Nursing: Scope and Standards of Practice
American Telemedicine Association (ATA) (2012). Retrieved from: http://www.americantelemed.org/
Brewster L., Mountain G., Wessels, B., Kelly, C., & Hawley, M., (2013). Factors Affecting Frontline Staff
Acceptance of Telehealth Technologies: A Mixed-Method Systematic Review. Journal of Advanced
Nursing
Locsin, R.C., (2013). Technological Competency as Caring in Nursing: Maintaining Humanity in a HighTech World of Nursing. Journal of Nursing and Health Sciences, 7 (1). Retrieved from: CINAHL
Public Broadcasting Company (2015). Telemedicine Puts a Doctor Virtually at your Bedside. InTouch
Health. Retrieved From: http://www.pbs.org/newshour/bb/telemedicine-puts-doctor-virtually-bedside/
Quality of Safety Education for Nurses (QSEN) (2014). Pre-Licensure KSAs. Retrieved from:
://qsen.org/competencies/pre-licensure-ksas/

http

Rogers, E.M., (1983). Diffusion of Innovations (3rd). The American Center Library. Retrieved from:
CINAHL
Thomas, L., & Capistrant, G., (2015). State Telemedicine Gaps Analysis: Coverage & Reimbursement.
American Telemedicine Association. Retrieved from: http://
www.americantelemed.org/policy/state- policy-resource-center#.VaWDdflVg4N
Thomas, L., & Capistrant, G., (2015). State Telemedicine Gaps Analysis: Physician Practice Standards
& Licensure. American Telemedicine Association. Retrieved from:
http
://www.americantelemed.org/policy/state-policy-resource-center#.VaWDdflVg4N