Nursing through a Computer Screen
We have established in the previous post that it is indeed hard to be a nurse, yet be so far from our loved ones. This is more so true when those family members are in need of healthcare. Our nursing instincts kick in almost instantaneously and we want updates every step of the way. We feel that despite our absence, we still need to have our say. Thus, we turn to the computer screen to continue our life-saving crusade!
The Advent of Telehealth
The United States Department of Health and Human Services (DHHS) defines telehealth as the ability of the provider to take care of the patients without seeing them in person. The wide availability of computers, mobile devices, and the internet makes it accessible and usable for patients and providers alike. A telehealth platform that is interoperable with the patient’s electronic health record (EHR) system promotes integrated care. As a result, we recognize better outcomes and improved clinician-client communication, among others.
In first-world countries with advanced health information technological (HIT) tools, this is revolutionary! The Covid 19 pandemic highlighted the importance of telehealth all the more.
But why did I just mention first-world countries? We’ll get back to this later…
Cybersecurity is one of the concerns when it comes to using a computer and other HIT tools, particularly in healthcare. The patients’ protected health information (PHI) is a valuable commodity in the black market. Thus, organizations take precautionary measures in ensuring that the PHIs of their clients don’t end up in the wrong hands.
Telehealth Hardware and Software
As mentioned earlier, telehealth makes use of available computers and other mobile devices. At the same time, it also uses software and applications such as Zoom.
I used it myself once when I scheduled a video visit with my primary doctor instead of a face-to-face one. As a healthcare consumer, I can honestly say that telehealth has its pros and cons.
Pros
- It is convenient
- It is easy to use.
- Patients save time because they don’t have to commute.
- In the era of Covid 19, this prevents patients’ exposure to potential infection.
- Sometimes, this costs less than the traditional in-person visit.
Cons
- Providers don’t get the clients’ real picture. For example, physical assessment cannot be done over the screen.
- When doctors ask a patient to check their vital signs prior to the video visit, there is no way to verify that the information shared was the truth.
- This may result in improper management of the patients’ conditions.
- The real threat of hackers and cybercriminals waiting to inappropriately access the PHI.
The Developing Countries’ Version of Telehealth
Understandably, telehealth in developing countries is not up to par with that in first-world nations. Ironically, it is in those developing countries where clients will really reap the benefits from telehealth due to the scarcity of healthcare providers and clinics in far-flung locales. Sadly, the same locales also have sporadic internet access, if at all. This makes the implementation of telehealth challenging at the very least.
Thankfully, there are policies that are proposed. Some have already been enacted. Developers have already introduced some healthcare compatible applications for consumer use. Needless to say, education on how to use these health information technology (HIT) tools is an immediate need. This education should be geared towards providers and clients alike.
Challenges
- There is a lack of legal frameworks or policies for implementing telehealth.
- Some countries have poor internet connectivity.
- Consumers may lack technological literacy. Also, they may even have limited access to the HIT tools necessary for telehealth.
- Providers need formal training in the use of a computer and software to conduct a video visit similar to an in-person one.
- Cybersecurity concerns.
- Some providers and patients use social media platforms such as Messenger and applications such as WhatsUp as means of telehealth channels.
Nursing Through a Computer?
Now that we have established the premise for telehealth, let us go back to our initial story.
As nurses, we want to advocate for and take care of our family members even if we are literally miles or even oceans apart. We keep watch over them through Zoom or messenger 24/7 if at all possible. We want to discuss options and plans of care with the doctors whenever they conduct their rounding.
Me? I just don’t stop there!
I suggest diagnostic procedures, present therapeutics, and even ask for a second provider’s opinion if I don’t agree with the diagnosis or management. Unlike in first-world countries where the provider only discusses the patient’s case with immediate family members, I ask to be updated whenever there are new orders or new medications prescribed.
Expectations versus Reality
Obviously, with the lack of interoperability, providers have to use social media as a means of updating curious relatives like me. We talk over Messenger or Zoom nonchalant about the fact that those platforms are not really the best routes to take when we talk about sensitive patient information.
Sure healthcare clinicians abide by the Health Insurance Portability and Accountability Act (HIPAA) in the US. Unfortunately, there may not be a similar law that protects patient privacy in developing countries. So, yes, while relatives talk to clinicians, cybercriminals may just be listening on the other end of the line.
It then becomes a balancing act on addressing the information need of family members who are afar and cybersecurity.
The Role of a Computer and an Informaticist
This brings me back to one of the reasons why I pursued nursing informatics as my grad school specialization. Aside from advocating for age-appropriate HIT tools for my Pediatric patients, I also dream of one day implementing a comprehensive and interoperable EHR for use in the Philippines.
If and when that happens, families from afar will be able to have quick access to technology to check on their sick loved ones. In addition to that, facilitating patient transfers or availing of services that are not offered at one site will be easier and less time-consuming.
For the time being, however, I am back to emailing the diagnostic imaging department for an official reading of a test. This is so that I will be able to explain the medical jargon to the rest of the family in a language that they can fully understand. Times like this, my computer, and being an informaticist are my saving grace just so I can somehow feel that I also render care as a nurse despite my distance.
What about you? How are you able, as a nurse, to render care if a member of your family is sick back home and you cannot readily come home?