As we watch the growth of tech-driven telehealth nursing, we are actually talking about a single solution to three completely independent challenges in the healthcare sector in general, and in defining the role of the registered nurse in particular. As both bleeding-edge startups and established manufacturers innovate with game-changing products for telehealth nursing, the benefits for everyone involved increase and drive further exploration.
Nurses Stretched Too Thin
The first challenge we’ll discuss is a national shortage of nursing professionals that is rapidly getting worse as nurses across the country retire, leaving an insufficient stream of newly trained candidates to take their place. Estimates are that the deficit will soon be almost one million new registered nurses required to satisfy the needs of the US alone. As such, the basic notion of supply and demand applies here; when there aren’t enough registered nurses to go around, each one becomes more valuable. Expanding and enhancing their abilities to do more work (in the same amount of time, of course!) is a top priority among every health care provider. This challenge can be extended even further: saving that time and money while maintaining or improving the patient experience.
Sound like a long shot? Enter telehealth nursing. To solve this first challenge, health care providers around the world are creating telehealth call centers in which registered nurses can handle initial triage and engage with many more patients than they could in a physical clinic setting. While some telehealth solutions are not much more than a video conference, the most advanced (and useful) offer online diagnostic tools to actually collect exam data exactly as a nurse would in preparation for an in-clinic physician consult.
Swiss Health Insurer SWICA implemented such a plan and found that 96% of the calls from patients could be handled by the nurses in this triage phase, by collecting and reviewing data online, and generally diagnosing very predictable, low-risk conditions they recognized well. This meant that telehealth nursing eliminated the overhead and the stress that nurses often suffer as part of the job. They no longer had to travel, deal with logistics like late arrivals to appointments, frustrated patients, and especially in the age of the coronavirus, face-to-face exposure to contagious individuals. Sitting at a telehealth console eliminates all these distractions.
In short, these nurses now use telehealth nursing technology to maximize their effectiveness, and provide service in precisely the job they are especially trained for – to listen, reassure, collect information, and help guide the patient to the next steps of recovery or treatment.
The Limits of the Skilled Nursing Facility
Skilled nursing facilities (SNFs) fill a critical role in the healthcare industry, especially for elder care. The typical nursing home employs very few full-time certified physicians and even fewer specialists. This makes sense as seniors primarily need the specific skillset of trained nurses: monitoring, administration of medication, and sometimes just a willing listener. But this is not to say that specific medical conditions or unexpected episodes do not occur; they do, and they often need immediate attention. Specialists making the rounds of area facilities are not necessarily on hand when a crisis occurs, so more often than not, the patient – even the tired/frail/uncomfortable – must be taken to the specialist at a hospital or clinic, rather than expecting a highly-paid specialist to drop everything and travel to the patient.
Here, then, is an effective second application for telehealth nursing: the nurse can detect and assess the symptoms, and then deploy cutting-edge telehealth tools to bring a remote specialist “virtually” into the room. She can conduct the various exams the physician needs to diagnose the problem, both of them all the while engaging with the patient who has remained on location, without added stress or wait times. Telehealth nursing truly empowers the nurse to remain “at the helm” of the nursing home, confident that she can immediately bring in the support and resources she needs, without bundling the suffering senior into an ambulance for a consult.
Taking Nursing on the Road
It’s a sad reality that remote, rural communities – whether a village on the Amazon, a town in Louisiana, or a hilltop community in Spain – tend to receive only sporadic medical attention. This reality doesn’t stem merely from poverty – even in wealthier countries, populations who live far from cities lack not only the hospitals themselves, but don’t often see travelling doctors whose time is too expensive to spend much of it on transportation. Many are lucky to have a small clinic, staffed only with a GP and a small nursing staff, within an hour’s drive. The result? Symptoms are optimistically ignored as conditions get worse, and periodic visits “into town” don’t necessarily align with the timing needed for optimal treatment. Suffering and high mortality rates have convinced governments around the world that they need to implement a solution for their citizens.
Once again, we see a critical, practical, use for telehealth nursing: going mobile. In a wildly successful experiment last year in Chile, a local medical service provider partnered with TytoCare to send a group of nurses up into a rural village in Chile. The rugged Tyto telehealth solutions they carried with them included equipment to take clinic-quality exam data on the heart, lungs, ears, throat, skin, and more, and immediately spot symptoms of concern. For many of these patients – many of whom were visibly suffering and had appointments scheduled only months in the future – the nurses could immediately transmit the data to a physician or specialist, and conduct a spontaneous face-to-face consult. Telehealth nurses essentially provided a diagnosis and treatment plan on the spot, enabling the team to literally save lives through their mobile telehealth kits.
Is Telehealth Nursing Perfect? Not quite…
With all three of the scenarios above, the process only works when actual exam data is collected; otherwise, it’s like trying to treat someone with your hands tied behind your back, or from behind a window. Indeed, after experiencing a video-only approach, neither the nurse nor the patient will have confidence in the process, or the resulting diagnosis.
In addition, nurses need to develop even more impressive levels of patience as the sick, elderly or panicked parents do not necessarily have the discipline or perseverance to engage with technology, no matter how proven, impressive or time-saving it is. Finally, telehealth nursing – in all its implementations – is a perfect fit much of the time, but cannot replace administration of medications, or support for medical procedures already underway. Though these are typical parts of an RN’s role, telehealth nursing is quickly creating a modern-day sub-specialty designed to streamline nursing tasks and improve patient outcomes.