Since COVID-19 hit the world and the healthcare sectors in general, there have been rapid developments in innovations to improve delivery while still minimizing costs. Nurse informatics have had to collaborate with other specialists to ensure that the disruptions that resulted from the pandemic did not entirely cripple the services. One of the areas that has exponentially developed over a relatively short time is telehealth. Even though it began way before the pandemic hit the country, the few years of the pandemic were characterized by increased usage. For instance, according to Shaver (2022), from January to April 2019, telehealth usage by people increased from 0.3% to 23.6% of all patients. Even after the pandemic, telehealth usage still remains prevalent because of its contributions to cost reductions and efficiency improvement (Lee et al., 2023). Telehealth usage remains relatively high because of its benefits. However, our facility still lags behind in the implementation of innovative telehealth technologies. So far, the facility uses audio media for telehealth visits. The usage of audiovisual systems will further improve the benefits and application of telehealth to offer care. Therefore, the proposal is for the organization to implement an audiovisual system for telehealth services to improve its service delivery and competitiveness.
Project Description
The project’s aim will be to design and implement an audiovisual telehealth system that will improve patient and provider experiences when delivering telehealth services. Even though the facility, like others, had depended on audio telehealth during and after the pandemic, the system has had several challenges. First, audio communication depends on people’s ability to communicate their problems and solutions without involving their sight (Esper et al., 2020). Therefore, patients and professionals only explain but cannot illustrate efficiently. Introducing audiovisual technologies like teleconferencing may enable people to speak and illustrate what they say. It will also enable professionals to better assess their patients by looking at them. For instance, video communication may enable a nurse to see yellow eyes rather than ask the patient to say the color of their eyes (Esper et al., 2020). The previous system, therefore, led to the exclusion of many patients from care. It also reduced the care quality because of the communication limitations involved. The recent developments in policies about usage and reimbursement should be applied in the new system to make it efficient. Videoconferencing will enable healthcare teams to better serve patients’ needs by enabling teamwork and improved data sharing among members.
Patient Outcomes
One outcome that audiovisual telehealth will enable is improved care accessibility. Accessibility determines the number of people who can get services. Currently, the audio technologies that enable care from home or anywhere else improve patients’ connectedness to the organization. It enables more people to consult or continue their care without visiting the facility. People with chronic issues benefit more because they usually have to deal with emergencies and may need care more frequently than others. The fact that telehealth usage increased more than 700% three months after COVID-19 shows the potential that telehealth, and especially optimal telehealth, may have in improving accessibility. Adding the video aspect of the communication to the system will allow more people who need to reach the facility in person to be visually assessed to be assessed from home. Currently, a very small percentage of patients use the telehealth system. Therefore, it should be improved to allow the facility to reach more people.
Another patient outcome that may improve is the financial outcome. Care affordability is impacted by the costs involved (Esper et al., 2020). allowing more people to access care through audiovisual systems will enable more access from home and, therefore, significantly cut costs, especially for chronically ill people. Chronically ill people may suffer symptoms that they may not notice. Reducing travel needs will, therefore, cut travel costs and add to care affordability. The distance of patients from the providers also impacts costs (Esper et al., 2020). Using technologies that allow holistic experiences between professionals and patients is therefore necessary for cutting healthcare costs for chronically ill people.
Finally, audiovisual assessment will have significant positive implications on assessment quality. Patients’ physical assessment depends on providers’ ability to see the negative changes and symptoms of diseases. For instance, during assessments, it is important to assess the skin, eye color, and other subjective issues (Esper et al., 2020). Therefore, looking at patients may help professionals better characterize them. However, using audio technologies does not allow people to see their patients. Effective patient assessments are important in creating accurate diagnoses and, therefore, improving the success of treatments.
Technologies Required
Various technologies. Some of which already exist in the organization will enable the changes. First, the organization will have to acquire compatible hardware that is needed to facilitate communication. Computers and cameras are required to enable video calls between professionals and patients (Clair et al., 2019). the visits will require both patients and their providers to have the necessary hardware that can take videos and voice. It will also be important to acquire internet connection devices that are necessary for the care processes to happen. The additional technologies that will be acquired, like computers and cameras, should be compatible with the systems that are already in place or upgraded to limit the costs and improve connectivity. It is also important to acquire internet connectivity technologies. Even though the facility is already connected, the current system may not handle seamless video data (Esper et al., 2020). They may allow for lagging that may adversely affect patient experiences. Therefore, it will be important to buy routers that will enable video communication between providers and patients.
Software technologies will also be necessary. Software is programs that enable humans to interact with hardware. They may also enable cloud storage and other functions that must be available for audiovisual communication. It will be important also to expand the cloud storage capacity to enable more storage and easier handling of video and other data forms (Clair et al., 2019). Also, because of the need to handle audiovisuals, having streaming software that enables the exchange of various data forms and is connected to other systems like electronic records is also important. Software should also follow the HIPAA requirements that determine the legalities of data handling and the ethics involved. When acquiring software, the team should consider the compactibility with the available hardware and other software that may include databases and others (Clair et al., 2019). they should also be considerate of the types of data that will be handled. For instance, audiovisual telehealth will require multimedia technologies to handle all data effectively.
Project Team
The project team should include various disciplines that should play different roles. For instance, there should be executive champions in the team. The champions should include directors who will support and advocate for the other members in executive meetings. An example of a professional who can fit the role is the chief nurse officer (CNO). CNOs are leaders who are qualified nurses. They usually have enough understanding of technologies and issues that affect nursing. Having a CNO as an executive champion may help improve decision-making (Conroy et al., 2021). Their role will be to communicate the advancements that the team will make and the challenges that it may face. The CNO should influence other members to support the project. Their representation will be important during budgeting and other executive functions. The executive must give oversight. Hence, their decisions and directions are important to projects’ success (Conroy et al., 2021). They may give more resources or withdraw it. Hence, having enough support from them is vital for the project’s success.
The team should also include clinical champions. The champions will be professionals in the clinical setting who understand what needs to be covered in the system (Esper et al., 2020). Members of the group should include nurses and physicians who will give their perspectives about how the technology should be designed. Involving clinical professionals in the implementation of the system will ensure operational efficiency (Esper et al., 2020). For instance, involving nurses in the design is necessary because they know what aspect of the user interface should included and how it may impact care delivery. They can contribute to issues like prescription and ensuring patient confidentiality.
Nurse informaticists should be an important part of the clinical champions. Nurse informaticists have both clinical and information science knowledge. They are usually trained in data management and handling and the technologies involved (Esper et al., 2020). Therefore, it will be necessary to determine the capabilities that the software should have. They will help the team ensure HIPAA rules are followed. HIPAA prevents the usage of insecure systems. When designing the audiovisual telehealth system, nurse informaticists will also ensure that they are connected to resources that handle patient data (Sipes, 2016). for instance, they will ensure that professionals can search patient information systems and other databases that can help ensure care delivery to patients. Nurse informaticists will also bridge the gap between the information technology resources that will be in the teams and other professionals because of their dual qualifications.
It is also important to have a project manager. The manager should be a professional who is competent in healthcare informatics. The project manager will implement the policy and be responsible for decisions that will concern the project. The project manager should also be responsible for the procurement of the resources that will be needed (Lee et al., 2023). While other members should be included in decisions, they should be answerable to the manager. The manager should also ensure that all stakeholders are adequately connected to the resources that they need.
Conclusion
Telehealth improvements are needed in the organization to improve care. While the current usage of audio technologies facilitates some telehealth, lots of patients are excluded from getting care. Using audiovisual systems will enable better communication and, therefore, better care experiences. It will improve patent assessment by allowing professionals to look at their patients and collect more accurate subjective data. Audiovisual telehealth should include video conferencing technologies like personal computers and software that enable the communication and assessment of patients. It is important to use an interdisciplinary team that will give different perspectives on the issue. Having a nurse informaticist as one of the clinical champions will ensure that nurses’ perspectives and ethics will be incorporated into the design and implementation. Nurse informaticists will help make the system as operational as possible and ensure that it improves patient experiences without adversely affecting nurses’ experiences.
References
Clair, M. S., Murtagh, D. P., Kelly, J., & Cook, J. (2019). Telehealth a game changer: closing the gap in remote Aboriginal communities. Medical Journal of Australia, 210, S36-S37. https://www.mja.com.au/system/files/issues/210_06/mja250036.pdf
Conroy, C. A., DuBois, S., Hudson-Jinks, T., Mombrun, C., Raymond, N., Waddell, A., & Oberlies, A. S. (2021). Taking a Stand: Developing a Nurse’s Pledge to Champion Diversity, Equity, and Inclusivity. Nurse Leader, 19(1), 19-21. https://doi.org/10.1016/j.mnl.2020.12.001
Esper, G. J., Sweeney, R. L., Winchell, E., Duffell, J. M., Kier, S. C., Lukens, H. W., & Krupinski, E. A. (2020). Rapid systemwide implementation of outpatient telehealth in response to the COVID-19 pandemic. Journal of Healthcare Management, 65(6), 443. doi: 10.1097/JHM-D-20-00131
Lee, E. C., Grigorescu, V., Enogieru, I., Smith, S. R., Samson, L. W., Conmy, A. B., & De Lew, N. (2023). Updated National Survey Trends in Telehealth Utilization and Modality (2021-2022). US Department of Health and Human Services. https://aspe.hhs.gov/sites/default/files/documents/7d6b4989431f4c70144f209622975116/household-pulse-survey-telehealth-covid-ib.pdf
Mosier, S., Roberts, W. D., & Englebright, J. (2019). A Systems-Level Method for Developing Nursing Informatics Solutions: The Role of Executive. JONA: The Journal of Nursing Administration, 49(11), 543-548. DOI: 10.1097/CIN.0000000000000445
Shaver, J. (2022). The state of telehealth before and after the COVID-19 pandemic. Primary Care: Clinics in Office Practice, 49(4), 517–530. doi: 10.1016/j.pop.2022.04.002
Sipes, C. (2016). Project management: Essential skill of nurse informaticists. Studies in Health Technology and Informatics, pp. 225, 252–256. https://pubmed.ncbi.nlm.nih.gov/27332201/
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