Telehealth is a term that refers to providing health care remotely through technologies such as web-based and mobile phone software. Telemedicine is a telehealth subset defined as the methods or means for enhancing public health care and education support and delivery through telecommunications technologies (Ely-Ledesma et al., 2022). Telemedicine is essential since it enhances patients’ connection with their caregivers regardless of geographical location and reduces healthcare spending by decreasing problems such as medication misuse (Haleem et al., 2021; Gajarawala & Pelkowski, 2021). While telemedicine is vital and beneficial, Ely-Ledesma et al. (2022) assert it is not fully integrated into Texan rural and community hospitals as described herein.
Problem/ Issue
The key issue to be addressed in the capstone project is that telemedicine is not fully integrated into Texan rural and community hospitals. According to Ely-Ledesma et al. (2022), physicians in rural and community hospitals in Texas lack the finances, appropriate technologies, and staff to provide comprehensive telemedicine systems. The same issue is also echoed by Adepoju et al. (2021), who found that in Texas, patients prefer in-person visits due to technology accessibility and usability challenges.
Problem Setting
The problem of limited telemedicine integration in Texas primarily occurs in rural and community hospitals. According to Adepoju et al. (2022), telemedicine usage in rural areas has reduced from 36% to 31% due to barriers such as low digital literacy. The highest population in Texas rural areas are Hispanic speakers. Telemedicine services are offered in English, making it difficult for people to use telemedicine. Additionally, the rural population in Texas has older people who find it hard to navigate through telemedicine services, hence avoiding using technological healthcare services (Adepoju et al., 2022). The limited integration of telemedicine in Texas rural areas shows the technology-driven disparities present in the rural and community hospitals that are not existent in urban hospitals.
Description of the Problem
Various elements characterize limited telemedicine in the rural areas of Texas. Ely-Ledesma et al. (2022) mention that in the rural areas of Texas, poor infrastructure is experienced, with poor roads, sewer systems, potable water, and electricity. Most of the people in the region live in poverty, are uninsured, and face chronic conditions such as obesity and diabetes (Ely-Ledesma et al.,2022). Rural hospitals in Texas face inadequate access to primary caregivers, making it hard to conduct telemedicine, let alone in-person visits. The hospitals in the rural areas are limited, making it hard to cover all the people needing healthcare services (Ely-Ledesma et al.,2022). Physical barriers related to telemedicine in a rural hospital in Texas are the lack of required technology to support telemedicine and inadequate funding.
Effects of the Problem
Inadequate integration of telemedicine in rural and community hospitals has adverse effects on the impacted communities. Hirko et al. (2020) state that limited telemedicine implementation has created health disparities for people living in rural areas unable to access healthcare services. Due to poor broadband to implement telemedicine, people in rural areas experience a higher prevalence of chronic illnesses such as diabetes and obesity.
Significance of the Topic and Its Implication for Nursing Practice
Addressing the issue of inadequate telemedicine in rural areas will help the community in general and the healthcare professionals. Butzner and Cuffee (2021) state that improving telemedicine in rural areas increases healthcare satisfaction among the population. It offers convenience and efficiency when it comes to accessing healthcare services. It is cost-effective as people in rural areas access it remotely, lowering onsite health resource utilization (Butzner & Cuffee, 2021). Healthcare professionals get job opportunities to help provide healthcare services to the people. Both healthcare professionals get educated and trained on how to get through telemedicine.
Proposed Solution and its Effect on Nursing Practice
Mobile health clinics should be deployed with appropriate equipment for the course to deal with the limited telemedicine integration in rural and community hospitals in Texas. Bagchi (2019) mentions that healthcare professionals such as nurses should be recruited and trained to communicate with patients using telehealth technology. Due to the broadband challenges, it should be expanded to allow everyone to access telemedicine efficiently and effectively.
References
Adepoju, O. E., Chae, M., Ayadi, M. F., Matuk-Villazon, O., & Liaw, W. (2021). Early impacts of the COVID-19 pandemic on telehealth patterns in primary care, mental health, and specialty care facilities in Texas. Southern Medical Journal, 114(9), 593.
Adepoju, O. E., Tran, L., Agwuncha, R., Chae, M., Franco-Castano, J., Angelocci, T., & Liaw, W. (2022). Associations between patient-and provider-level factors and telemedicine use in family medicine clinics. The Journal of the American Board of Family Medicine, 35(3), 457-464.
Bagchi, A. D. (2019). Expansion of telehealth across the rural–urban continuum. State and Local Government Review, 51(4), 250–258.
Butzner, M., & Cuffee, Y. (2021). Telehealth interventions and outcomes across rural communities in the United States: narrative review. Journal of medical Internet research, 23(8), e29575.
Ely-Ledesma, E., & Champagne-Langabeer, T. (2022, December). Advancing Access to Healthcare through Telehealth: A Brownsville Community Assessment. In Healthcare (Vol. 10, No. 12, p. 2509). MDPI.
Gajarawala, S. N., & Pelkowski, J. N. (2021). Telehealth benefits and barriers. The Journal for Nurse Practitioners, 17(2), 218-221.
Haleem, A., Javaid, M., Singh, R. P., & Suman, R. (2021). Telemedicine for healthcare: Capabilities, features, barriers, and applications. Sensors International, p. 2, 100117.
Hirko, K. A., Kerver, J. M., Ford, S., Szafranski, C., Beckett, J., Kitchen, C., & Wendling, A. L. (2020). Telehealth in response to the COVID-19 pandemic: Implications for rural health disparities. Journal of the American Medical Informatics Association, 27(11), 1816-1818.
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