By Shnese Mills, RN Penn State University Nursing 457.

TELEMEDICINE

By Shnese Mills, RNPenn State University Nursing 457

OBJECTIVES Describe telemedicine Discuss hardware used for telemedicine Discuss software used for telemedicine Discuss information system

components

OBJECTIVES Discuss Advantages of Telemedicine Discuss Disadvantages of Telemedicine Discuss Legal and Ethical Issues Review Nursing Competencies

OBJECTIVES

Describe Informatics Competencies

Review Nurse Informatics Specialist

Summary

DEFINITION Telemedicine is an application of clinical

medicine

Widely associated with populations living remotely or isolated

Hands on physical assessment and history component omitted

Communication/technology combined to provide clinical care (Kurtz, 1994)

Telemedicine Defined

Appointment times set aside for patients to be contacted

Patients receive care advice without leaving home

Care can range from simple to complex

TYPES OF TELEMEDICINE

Telemedicine has three main parts, they include:

store-and-forward

remote monitoring

interactive services

Telemedicine Communication Hardware

PSTN/POTS

ISDN

LAN

GSM

Telemedicine Communication Hardware

GSM/GPRS/G3

Wireless/Satellite links

Software For Telemedicine

DICOM

Video-conferencing Units

PIR (Patient Information Records)

DICOM & Software Used

Digital Imaging and Communication in Medicine

Recognized as medical imaging standard

Specific software required for DICOM usage

DICOM Usability

Ease of use

Ease of learning

Satisfaction with using (Staggers, 2003)

DICOM Usability

Efficiency of use

Error tolerance

Fit of system to the task (Staggers, 2003)

Axioms Evaluated

Axiom 1

Axiom 2

Axiom 3

Information Systems

Telemedicine uses Patient Care Information Systems: Clinical information systems Pharmacy Information Record Laboratory Information Systems Radiology Information Systems

(McGonigle & Mastrian 2009)

Information Systems Cont.

Patient Care information system Used by health providers /

administrative staff Used for downloading medical

records Configured through LAN Data System is Healthlevel 7

(HL7)

Information System Cont.

Classification system

Nursing Classification scheme

Recommendations for future usage

Discuss Advantages of Telemedicine

Medical appointment without leaving home

Decreased anxiety in own home

Reduced expenditure for traveling

Discuss Disadvantages of Telemedicine

No hands on assessment

Insurance Payments

Equipment

Discuss Ethical and Legal Issues

Confidentiality and HIPPA

Medical Providers Licensure

Professional Liability

Describe Nursing Competency Case Management and Triage skills

Knowledge of computer systems

Review Informatics Competencies

Beginning Nurse

Experienced Nurse

Informatics Nurse Specialist

Informatics Innovator (McGonigle & Mastrian, 2009)

Review Nurse Informatics Specialist Functions Project Manager

Consultant

Educator

Researcher (McGonigle & Mastrian, 2009)

Review Nursing Informatics Specialist Roles Cont.

Product Developer Decision Support/Outcomes Manager Advocate/Policy Developer System Specialist Entrepreneur (McGonigle & Mastrian,

2009)

Summary

Computer Centered Care

Future of Telemedicine

REFERENCES

Bidgood , W, Horii, S, Prior, F, & Van Sckyle, D. (1997). Understanding and using DICOM, The Data Interchange Standard for Biomedical Engineering . JAMIA, 4(3), 199-212

Kurtz, GL. (1994). The Future of telecommunications in rural healthcare. Healthcare Information Management, 8(3), 5-9.

REFERENCES

McGonigle, D, & Mastrian, K. (2009). Nursing informatics and the foundation of knowledge. Sudbury: Jones and Bartlett Publishers.

Perednia, DA, & Allen, A. (1995). Telemedicine technologies and clinical applications. JAMIA, 273(6), 483-8

REFERENCES

Staggers,N. ( 2003). Human factors: Imperative concepts for critical care. AACN Clinical Issues 14(3), 310-319