Over the last year, I have witnessed healthcare technology increase significantly due to the pandemic. Starting in the fall of last year, patients at my hospital that were quarantined due to Covid-19 were given the option to use iPads to communicate with their family. Research has proven that timely psychological interventions for these isolated patients make a big difference in preventing long-term psychological harm (Sun, N., et al., 2021). I have personally had patients who saw their loved ones for the last time on one of these video calls. I believe that this intervention allowed the patient and family to navigate the stages of grief associated with death and dying easier than if it were not offered.
Another way technology changed our interactions was by moving meetings to an online forum. At first, members of our Unit Practice Council were using Zoom video conferencing to conduct meetings but quickly changed to Microsoft Teams. This change occurred after our facility determined that using an MS Teams account attached to our work email and a double verification system, was more efficient at protecting patient information. My facility was one of many to make this transition during the pandemic. Using a protected platform like MS Teams allows a facility to conduct meetings and educational courses, while using features such as screen sharing, text discussions, virtual Powerpoint presentations, and more in a protected, socially distanced environment (Henderson, D., et al., 2020).
Of course, these technologies do not come without risks. For example, while using video conferencing staff must ensure the patient does not inadvertently video another patient, violating their HIPAA rights. The iPads could also present a potential infection control issue if not appropriately disinfected between patients. As stated previously, these technologies also provide cybersecurity challenges. In 2020 alone, cybercriminals in the U.S. got away with an estimated $15.6 million in ransom from healthcare organizations (Penden, S. & Rezek, M., 2021). My facility gives annual training to prevent successful cybersecurity attacks, ensures all devices are up to date on anti-malware, and blocks potentially harmful websites, to prevent this very real threat.
I look forward to seeing how these and other technologies advance healthcare in the coming years. There is a possibility that, in the future, all inpatients will have secure tablets with apps that link to videoconferencing with family and other consulting physicians, real-time laboratory results, and more. My facility will also be getting eICU technology to meet in real-time with other intensivists. The possibilities are endless!
Henderson, D., Woodcock, H., Mehta, J., Khan, N., Shivji, V., Richardson, C., Aya, H., Ziser, S., Pollara, G., & Burns, A. (2020). Keep calm and carry on learning: using Microsoft Teams to deliver a medical education program during the COVID-19 pandemic. Future healthcare journal, 7(3), e67–e70. https://doi.org/10.7861/fhj.2020-0071
Penden, S. & Rezek, M. (2021). Clinical treatment of ransomware in healthcare. Security Magazine. https://www.securitymagazine.com/articles/95381-clinical-treatment-of-ransomware-in-healthcare
Sun, N., Wei, L., Wang, H., Wang, X., Gao, M., Hu, X., & Shi, S. (2021). Qualitative study of the psychological experience of covid-19 patients during hospitalization. Journal of Affective Disorders, 278, p. 15-22. https://www.sciencedirect.com/science/article/abs/pii/S0165032720326458?via%3Dihub
Good post xxx. Hosting online monthly meetings has become huge since COVID. The facility I work at still does them and the charge nurse meetings are after. It seems convenient unless you work night shift because they are usually scheduled at 1pm. The number of employees participating in online staff meetings has increased as well. There is even talk about keeping the online portion up and running when in-person meetings are approved again so more staff can attend. Online staff meetings allow for more ability for communication, better time-management, increased attendance, and helps make it easier to share information with everyone. The downside of them is that they limit personal contact, requires equipment and internet connection to be up and running and there can be a chance of getting hacked (MyOwnConference, 2021).
Providing a video conference call at the facility I work in for a COVID patient, could be very time consuming. There was only 1-2 designated people who scheduled calls on an I-pad for patients. Some of the physicians would not even come in to see the patient in person, he/she wanted a video appointment. The tele health appointments obviously helped with the spread of COVID-19. Some systems displayed the providers you could see with your insurance along with what the co-pay would cost and medications. It is always nice to know this information in advance as well (Sesame, 2021).
MyOwnConference. (2021). Advantages and Disadvantages of Online Meetings. https://www.
Sesame, Inc. (2021). Covid19 Screening & Tests in Hagerstown, MD. https://www.sesame
sample discussion post essay 2
Healthcare technology is advancing every day. Initially, this technology was used within healthcare facilities but has made its way into the patient’s home. Healthcare technology includes continuous glucose monitors (CGM), insulin pumps, apps, and patient portals, to name a few. CGMs are becoming more widely available to patients with Type I Diabetes allowing for more concise control and data tracking. CGMs record a patient’s glucose level every 3-15 minutes depending on manufacturer and settings, and this information can be shared (Garnica et al., 2020). The CGM alerts the patient when glucose levels are outside of parameters so action can be taken. The continuous glucose monitor can be used in conjunction with an insulin pump or traditional subcutaneous insulin injections (Garnica et al., 2020)
Potential challenges or risks with the CGM exist as the machines can malfunction, and troubleshooting is required to determine the cause. Sensors go bad and require replacement; it is best to keep a traditional glucose monitor for backup. The insulin pump technology does not detect defective insulin, which can lead to a patient being under-medicated.
There are many potential benefits regarding data safety, including real-time glucose monitoring and updates to providers, outreach by the manufacturer team when extreme high or extreme low recordings occur. Legislative programs such as CMS cover the CGM, given that the patient meets the criteria (Smith, 2021). Continuous glucose monitors significantly impact patient care as the system allows for passive glucose monitoring and data collection, allowing the patient to enjoy a higher quality of life. Education regarding the device and the diagnosis promote patient involvement in their care, allowing them a sense of control.
As with anything, there are also potential risks associated with the devices. Data safety potential risk includes a breach of information or ransomware. The potential risk associated with legislation regarding the CGM includes the process for such devices to be covered by Medicare and Medicaid as the criteria are complex. The process for approval may be lengthy (Provider compliance tips for glucose monitors & diabetic accessories/supplies, 2020). Potential risks related to patient care are that the device can malfunction, or the insulin can be defective. The patient confides in the machines for accurate glucose readings and appropriate insulin dosing; this flaw can cause a potential hospitalization.
Promises for the Future
I believe patient portals are most promising for impacting healthcare technology in nursing practice. It puts a responsibility on the patient and promotes shared decision-making between the patient and the provider. This promise will improve patient care outcomes as the patient will ideally be more compliant to care when they are involved in decision making, and many patient portals allow the patient to message the provider, increasing patient involvement in their care. Data management and efficiency will also be positively impacted by this promise as the patient portal houses data and promotes the efficiency of information being shared.
Garnica, O., Lanchares, J., Velasco, J. M., Hidalgo, J. I., & Botella, M. (2020). Noise spectral analysis and error estimation of continuous glucose monitors under real-life conditions of diabetes patients. Biomedical Signal Processing and Control, 61. https://doi-org.ezp.waldenulibrary.org/10.1016/j.bspc.2020.101934
Provider compliance tips for glucose monitors & diabetic accessories/supplies. (2020, September). https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/ProviderComplianceTipsforGlucoseMonitors-ICN909465Print-Friendly.pdf.
Smith, R. (2021, March 12). Is Dexcom covered by Medicare? Dexcom. https://www.dexcom.com/faqs/medicare.
sample discussion post essay 3
A healthcare technology trend that I have witnessed become widely utilized over the past year and a half is the use of telemedicine. The trend with telemedicine is mostly because of the global pandemic that so many healthcare organizations have dealt with regarding information being passed back and forth between provider and patient without having to come into physical contact with one another. The challenges that arise out of the technology trend is that in rural areas of the country, such as North Alabama, there is no access to high-speed internet or reliable cell phone service for the patient to be able to access these services. According to Harper et al. (2021), access to services is a large factor in the health differences between remote and metropolitan areas. I think that telemedicine is promising to the impact on healthcare technology because it allows practitioners to connect with their patients when the in-person assessment is not possible for a multitude of reasons: future pandemics, patient’s health, or access to specialists that the patient might otherwise not be able to see. I think this will contribute to improvements in patient care outcomes by, as previously stated, allowing patients access to health specialists that the patient might not have the option of seeing given to access to telemedicine. Some patients do not have the financial means to travel cross country for the top specialist that may can help them with their disease process and telemedicine will allow patient and provider to connect for a better outcome for the patient. This is also true in the aspect of patients that require palliative care, they cannot get to their provide for assessment. In palliative care patients, telemedicine was a solution for various specialties such as cancer care and palliative care (Biswas et al., 2020).
Benefit/Risk Table: Potential Benefit: Potential Risk:
Data Safety: If there is no data being transferred from patient to provider or from provider to patient, this is a safe means of communication. If there is patient information such as health record data being transferred from patient to provider, this potentially provides data hackers with access to the patient’s information.
Legislation: There could be legislation enacted to help patients in rural areas have access to this vitally important healthcare technology. The potential risk of telemedicine and legislation is that, in my opinion, the potential for government to over regulate the usage and make it more difficult for the provider to offer as a service to the patient.
Patient Care: It would allow patients access to healthcare specialists that they might not otherwise have access to. Such as in the event of financial means to travel to the specialist. I would imagine that a potential risk of telemedicine is in the detachment from person-to-person interaction with your healthcare provider. According to Grindle (2021), noted that a barrier to telemedicine is that the video consultation can be impersonal.
Biswas, S. Adhikari, S. D., Gupta, N., Garg, R., Bharti, S. J., Kumar, V., Mishra, S., & Bhatnagar, S. (2020). Smartphone-based telemedicine service at palliative care unit during nationwide lockdown: Our initial experince at a tertiary care cancer hospital. Indian Journal of Palliative Care, 26, 31-35. https://doi-org.ezp.waldenulibrary.org/10.4103/IJPC.IJPC_161_20
Grindle, K. R. (2021). Impact of technology on community nursing during the pandemic. British Journal of Community Nursing, 26(3), 110-115.
Harper, C., Bourke, S. L., Johnson, E., Green, J., Anish, L., Muduwa, M., & Jones, L. (2021). Health care experiences in rural, remote and metropolitan areas of Australia. Online Journal of Rural Nursing and Health Care, 21(1), 67-84. https://doi.org/10.14574/ojrnhc.v211i1.652
sample discussion post essay 4
When I used to work on my previous unit, most of our patients had to have psychiatric telehealth visits with psychiatrists or psychiatric nurse practitioners via a mobile screen that looked like a TV on wheels. We called them telepsych consults and successful cooperation depended on the patients’ mental state or mood. Telehealth is when telecommunication is used to help doctors or other health care professionals communicate with patients and provide care via a phone or video chat etc. (Health Resources & Services Administration, n.d.). Some general trends in communication are via secure messaging, email, chat messaging, and secure file exchange or doctors can monitor patients remotely while patients are at home (Health Resources & Services Administration, n.d.). For instance, patients can wear devices that collect information on vitals or ECG data that the doctor can actively track (Health Resources & Services Administration, n.d.).
Some challenges that telehealth present include the possibility of “fragmented” care (Mayo Clinic, 2020, para.20). This means that there may be unintentional gaps in care or use of medication, or unnecessary overlaps in care (Mayo Clinic, 2020). Insurance and reimbursement for using telehealth services is a difficult subject too because policies are not the same in different states and can affect patients’ abilities to pay for telehealth related care (Mayo Clinic, 2020). Moreover, the broadband connection needs to be affordable and efficient for health data to be adequately shared via telehealth technologies (Board on Healthcare Services, 2012). This must be established so that patients can have the best possible quality of care and access whenever they need it as well (Board on Healthcare Services, 2012). However, there are difficulties attaining this, and broadband connectivity gaps do occur in rural or underserved populations (Board on Healthcare Services, 2012). Furthermore, supposedly telemedicine reduces healthcare costs, but despite there being laws stating that there is reimbursement and coverage for its services, they are not adequately enforced (Board on Healthcare Services, 2012). This makes it hard for healthcare providers to administer telehealth services because they cannot be sure that they would be paid for the service (Board on Healthcare Services, 2012).
To protect data safety, data encryption is a security measure that is used in which the sensitive data is locked and only accessible if the right person has the technological key to access it (Hall & McGraw, 2014). The data could be encrypted while it is stored or being transmitted and the software for these types of methods of encryption are not included in the same telehealth software (Hall & McGraw, 2014). This ensures that an unauthorized hacker cannot access and use the data, whether it is stored or during transit (Hall & McGraw, 2014). Some patients are introduced to the personal health record system, or PHR, which houses their personal health information (Mayo Clinic, 2020). They can access it through a PHR application on any device that uses the internet like laptop computers, tablets, and smartphones (Mayo Clinic, 2020). I think the risk with this is if the person loses one of these devices and a stranger manages to get into the device and find the information.
As far as legislation, there has been an increasing demand for telehealth-related care and services, and the government has stepped in and acknowledged this (University of Illinois Chicago, 2020). They have been trying to pass legislation such as CONNECT (Creating Opportunities Now for Necessary and Effective Care Technologies) (University of Illinois Chicago, 2020). CONNECT “expands the availability of services provided through telehealth under medicare” (University of Illinois Chicago, 2020, para.6). One downside to telehealth communication that involves patient to provider interaction as far as legislation is regarding what HIPAA can protect (Hall & McGraw, 2014). If the information is going straight to the patient via a health app or an implantable device, this can make that data vulnerable to potential privacy issues (Hall & McGraw, 2014). The fact that the information is going to the patient causes the data to fall outside of the clinically controlled boundaries that HIPAA can regulate (instead of a more secure endpoint with a healthcare provider) (Hall & McGraw, 2014).
Telehealth is beneficial because besides offering more access to healthcare closer to patient towns and homes, it can enhance care coordination. This can all contribute to a more heightened quality of care (Mayo Clinic, 2020). However, a risk that telehealth poses is a higher rate of accidental misdiagnoses compared to those from health care services in person. This may happen because it is hard to guarantee the quality of the health care providers because there is supposedly no clear legislative standard of care. Also, as a result, the health care system would suffer in costs because of the additional new drugs and prescriptions that have to make up for mistakes derived from misdiagnoses (The University of Illinois Chicago, 2020).
I think remote monitoring is the most promising. Different types include devices that measure blood pressure, lung function, or blood glucose and devices that can be worn that provide data about heart rate, posture control, or sleep patterns (Mayo Clinic, 2020).
Remote monitoring may be most promising as far as patient care outcomes. Remote patient monitoring can lead to a decreased rate of hospitalizations and for those with chronic conditions, help facilitate a better quality of life (Leading Age, 2021). Some of those conditions are diabetes, COPD, hypertension (when it needs consistent monitoring), and heart disease etc. (Leading Age, 2021). Studies have shown that remote patient monitoring has been especially advantageous for heart disease and COPD patients (Leading Age, 2021). A 2011 meta-analysis of telehealth studies found that there was a 42 percent decrease in hospitalizations for heart disease patients (Leading Age, 2021).
Board on Health Care Services. (2012, November 20). Challenges in telehealth. The role of
telehealth in an evolving health care environment. https://www.ncbi.nlm.nih.gov/books/NBK207146/
Hall, J.L., & McGraw, D. (2014, February). For telehealth to succeed, privacy and security risks
must be identified and addressed. https://www.healthaffairs.org/doi/10.1377/hlthaff.2013.0997
Health Resources & Services Administration. (n.d.). What is telehealth?
Leading Age (2021). Telehealth and remote patient monitoring for long-term and post-acute
care: A primer and provider selection guide. https://leadingage.org/white-papers/telehealth-and-remote-patient-monitoring-long-term-and-post-acute-care-primer-and#5
Mayo Clinic. (2020, May 15). Telehealth: Technology meets health care.
University of Illinois Chicago. (2020, July 9). Challenges facing the telehealth industry.
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