Telehomecare Telehomecare

Presented by Sheree Miller, Presented by Sheree Miller, RNRN

ObjectivesObjectives• Describe telehomecare Describe telehomecare • Describe and evaluate the hardware and Describe and evaluate the hardware and

software utilized with this trendsoftware utilized with this trend• Describe and evaluate the information Describe and evaluate the information

system used with this trendsystem used with this trend• Discuss the advantages and Discuss the advantages and

disadvantages with this trenddisadvantages with this trend• Examine related ethical issuesExamine related ethical issues• Discuss the informatics competencies Discuss the informatics competencies

required by a professional nurse working required by a professional nurse working with this trendwith this trend

• Assess the role and functions of the nurse Assess the role and functions of the nurse informatics when working with this trendinformatics when working with this trend

TelehomecareTelehomecare• Home health monitoring in a primary care Home health monitoring in a primary care

settingsetting• Estimated 1.5 million home care visits every Estimated 1.5 million home care visits every

day (Elford, 2005)day (Elford, 2005)• Chronic disease managementChronic disease management

– DiabetesDiabetes– Congestive heart failureCongestive heart failure– Chronic obstructive pulmonary diseaseChronic obstructive pulmonary disease

• Continuum of careContinuum of care– Clinical servicesClinical services– Social supportSocial support

TypesTypes

• Electronic house Electronic house callscalls– Home care visitsHome care visits– ScheduledScheduled– Clinician initiatedClinician initiated

• Healthcare call Healthcare call centerscenters– Urgent mattersUrgent matters– Patient initiatedPatient initiated– Non-scheduledNon-scheduled

HardwareHardware

• Adaptable Adaptable applicationsapplications– Blood pressure cuffBlood pressure cuff– ThermometerThermometer– Oxygen sensorOxygen sensor– PT/INR coagulation PT/INR coagulation

metermeter– Glucose meterGlucose meter– ScaleScale– Peak flow meterPeak flow meter– ECGECG

(Elford, 2005)(Elford, 2005)

HardwareHardware

• AMD-1500AMD-1500– Capture imagesCapture images– VideosVideos– Vital SignsVital Signs– Record dataRecord data– Touch screen Touch screen

interfaceinterface

(AMD, 2010)

SoftwareSoftware

• Records and tracks all health Records and tracks all health information collectedinformation collected

• ExamplesExamples– Second opinion standardSecond opinion standard– Second opinion professionalSecond opinion professional– Network serverNetwork server– Doctor terminalDoctor terminal– tConsulttConsult

SoftwareSoftware

• tConsulttConsult– Any microsoft workstationAny microsoft workstation– Interface with medical Interface with medical

devicesdevices– User-friendlyUser-friendly– DependableDependable– Extensive color codingExtensive color coding– Touch screenTouch screen– One-button captureOne-button capture

Patient

Clinician

Usability of the SoftwareUsability of the Software

• Axiom 1: users must be an early and Axiom 1: users must be an early and continuous focus during interface continuous focus during interface designdesign

• Axiom 2: design process should be Axiom 2: design process should be iterative, allowing for evaluation and iterative, allowing for evaluation and correction of identified problemscorrection of identified problems

• Axiom 3: formal evaluation should take Axiom 3: formal evaluation should take place using rigorous experimental place using rigorous experimental and/or qualitative methodsand/or qualitative methods(McGonigle & Mastrian, 2009)

Electronic Medical Electronic Medical RecordRecord

• Electronic warehouse of client Electronic warehouse of client informationinformation– StoreStore– ProcessProcess– TransmitTransmit– AssessAssess

Medinformatix’s EMR Medinformatix’s EMR

• ““Market leading software solution for the Market leading software solution for the medical industry” (Acentec, Inc 2010, medical industry” (Acentec, Inc 2010, Medinformatix Electronic Medical Record, Medinformatix Electronic Medical Record, ¶1)¶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 EMRMedinformatix’s EMR

• Administrative systemAdministrative system• All health personnelAll health personnel• Multiple user functionsMultiple user functions• Mainframe configurationMainframe configuration• Certification commission for Certification commission for

healthcare information technology healthcare information technology certifiedcertified

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

ReferencesReferences• AMD Global Telemedicine, Inc. (2010). The future AMD Global Telemedicine, Inc. (2010). The future

of medicine…now? Retrieved from of medicine…now? Retrieved from http://www.amdtelemedicine.com/..

• Acentec, Inc. (2010). Medinformatix Electronic Acentec, Inc. (2010). Medinformatix Electronic Medical Record. Retrieved from Medical Record. Retrieved from http://www.acentec.com/products/medinformatix-http://www.acentec.com/products/medinformatix-emr emr

• AFHCAN (2009). AFHCAN Telehealth Solutions. AFHCAN (2009). AFHCAN Telehealth Solutions. Retrieved from http://www.afhcan.org/.Retrieved from http://www.afhcan.org/.

• BNP Media (2010). “Panasonic Announces Tele-BNP Media (2010). “Panasonic Announces Tele-Homecare System”. Retrieved from Homecare System”. Retrieved from http://www.appliancedesign.com/Articles/Breakinghttp://www.appliancedesign.com/Articles/Breaking_News/c381e4edf9938010VgnVCM100000f932a8c_News/c381e4edf9938010VgnVCM100000f932a8c0____.0____.

• Dansky, K.H., Yant, B., Jenkins, D., Dellasega, C.(2003). Qualitative analysis of telehomecare nursing activities. JONA, 33(7/8), 372-375.

ReferencesReferences• Elford, R. (2004). An Introduction to Telehome Care. Elford, R. (2004). An Introduction to Telehome Care.

Retrived from Retrived from http://www.telehealth.ca/intrototelehomecare.htmlhttp://www.telehealth.ca/intrototelehomecare.html

• Landers, D (2000). Issues surrounding TeleHomeCare. Landers, D (2000). Issues surrounding TeleHomeCare. Retrieved from Retrieved from http://iml.jou.ufl.edu/projects/Fall2000/Landers/issues.htmhttp://iml.jou.ufl.edu/projects/Fall2000/Landers/issues.htm#reimbursement#reimbursement

• Liddy, C., J. J. Dusseault, Dahrouge, S., Hogg, W., Lemelin, Liddy, C., J. J. Dusseault, Dahrouge, S., Hogg, W., Lemelin, J. & Humber, J. (2008). "Telehomecare for patients with J. & Humber, J. (2008). "Telehomecare for patients with multiple chronic illnesses: Pilot study." multiple chronic illnesses: Pilot study." Can Fam PhysicianCan Fam Physician 54(1): 58-65.54(1): 58-65.

• McGonigle, D. & Mastrian, K. (2009). McGonigle, D. & Mastrian, K. (2009). Nursing Informatics: Nursing Informatics: A Foundation of KnowledgeA Foundation of Knowledge (1st ed.). Jones & Bartlett (1st ed.). Jones & Bartlett Publishers. Publishers.

• Second Opinion Software, LLC. (2007). Image Second Opinion Software, LLC. (2007). Image Management and Communication Software. Retrieved Management and Communication Software. Retrieved from from http://www.2opinion.com/medindex.htm..