Impact Evaluation Of Telehealth On Patients Health Essay

Impact Evaluation Of Telehealth On Patients Health Essay This report will show how telehealth has an impact on patients but before future discussion I would like to define telehealth. Telehealth is the use of electronic information and telecommunications technologies to support long-distance clinical health care, patient and professional health-related education, public health, and health administration, and includes both the use of interactive, specialized equipment, for such purposes as health promotion, disease prevention, diagnosis, consultation, and/or therapy, and no interactive (or passive) communications, over means such as the Internet, e-mail, or fax lines, for communication of broad-based nutrition information that does not involve personalized nutrition recommendations or interventions (Busey Micheal, 2008). There are two more definitions I would like to add as following. Use of telecommunications to provide health information and services that is, a health related activity carried out at distance (Conrick , 2006). Telehealth refers to the use of telecommunication technology to remove time and distance barriers in the delivery of healthcare services (Artinian, 2007). Telehealth enables remote patient management. From many findings, study shows that patients with heart failure problem who get experience in weight increase or blood pressure would likely involve in negative medical outcomes including expensive hospitalization in later stage. But if the patients symptoms can be monitored on daily basis then disease can be diagnosed in early stages which can prevent expensive visit to hospital and patients life can be saved. Telehealth works as following. The evaluation of any information systems especially health information systems are recognized as a complex and challenging activity. There is no agreement on a best way to evaluate, on what and how to evaluate, who to involve, and within what paradigm to proceed (Klecun-Dabrowska Cornford, 2001). There are unique challenges for evaluators in telehealth services because they are not all the same and can be measured in separate and different terms. Technologies those are used in telehealth are not mature yet and some of them are still in prototyping stage. These telehealth services are developed by expert and passionate people who are working in the field of medical and other technologies which are related to telecommunication like recording, video conferencing. Strengths Telehealth has also enabled efficient distribution of information not only with the patients but also between health care providers who are divided either geographically or within the states. The Utilization this type of technology has been shown to be very cost effective and has proved in favorable health outcomes for chronically ill patients. (Fleming, 2007) Telehealth increases access to health care especially in remote areas where normal access of health care is difficult. It can act as a bridge between the patient and health provider to increase the delivery of care. One of the biggest strength of telehealth is its capability to be an extension of basic health care by enhancing access between the patient and their providers. With the help of telehealth we can have access to ultra specialized services without transferring the patient. The idea is not transferring patients if we can offer the service here. It doesnt make sense to transfer a patient only for a diagnosis when it can be done remotely (Gagnon, Duplantie, Fortin Landry, 2006). Telehealth is believed to produce significant savings for remote hospitals and for the health care system. For instance, teleconference can be used to attend administrative meetings, leading to substantial savings on travel costs. However, the redistribution of savings between organizations and levels of care is an important and complex issue (Gagnon et al, 2006). Telehealth can help to systematize on call duties on a regional level specialists like x-ray specialist. Therefore, as an alternative, sharing the responsibility for on call duties between specialists of a hospital, telehealth can allow a large number of specialist persons from different health care centers to cover whole region. According to Artinian (2007) Telehealth helps patients gain more flexibility in scheduling healthcare visits, provides easier and more convenient access to healthcare, and allows patients to have fewer time-consuming clinic visits. It also allows patients to receive care in a location that does not require the burden of transportation, and in an environment that is less threatening than a clinic or emergency department. Weaknesses There are many barriers in telehealth field. Some states do not allow its physicians to practice outside of the state without getting license from those states first. Reimbursement is also a big factor in this field as many insurers will not reimburse. According to Gustke et al (2000, as stated by Brown (2005)) fear of malpractice suites is another consideration for physicians, as is acceptance of the technology and lack of hands on interaction with patients, although most patient satisfaction studies to date find patients on the whole satisfied with long distance care. Lack of telecommunications technology is also a big problem in this field. As normal phone line can not supply high bandwidth and there are many rural areas where they do not have high speed cabling and can not get high bandwidth telecommunication for telehealth. Getting federal funds from the state is also a problem for telehealth projects. Telecommunication companies and technology manufacturers are competing with each other to produce low price tools and bandwidth needed. Need of telehealth Telehealth was developed because Challenges Telehealth has the potential to change healthcare delivery but faces many challenges in adoption. Despite the benefit of telehealth, the lack of reimbursement for telehealth is a major challenge in widespread adoption of telehealth. (Bushell, 2007 as stated by Change, 2007). With no financial incentive for healthcare providers to implement the technology, providers are likely to view telehealth as an increase in workload without a subsequent increase in pay (Bushell, 2007). The ethical issues unique to telehealth relate to the possible impact on the curing relationship which go outside the expected challenges of privacy and confidentially. The loss of touch, the potential for depersonalization, the potential for exploitation, the possible inequity when distributing the benefits of telehealth services, and the potential burden that this form of new technology may impose on sick and dying patients are some of the ethical concerns that should be considered. Future research and educational initiatives should explore areas of ethical concern that pertain to the innovative and burgeoning field of telehealth, and the potential for good and harm that may result. Potential themes include the following: à ¢Ã¢â€š ¬Ã‚ ¢ Improving health care access in underserved populations à ¢Ã¢â€š ¬Ã‚ ¢ Professional expectations in meeting a new, higher standard of car à ¢Ã¢â€š ¬Ã‚ ¢ Telemedicine as a potential new form of access discrimination à ¢Ã¢â€š ¬Ã‚ ¢ Technology as added burden for patients with chronic and terminal illness à ¢Ã¢â€š ¬Ã‚ ¢ When virtual visits replace actual visits à ¢Ã¢â€š ¬Ã‚ ¢ The impact of loosing touch on trust and the healing relationship à ¢Ã¢â€š ¬Ã‚ ¢ The risk of exploitation when using new and expensive technology à ¢Ã¢â€š ¬Ã‚ ¢ Depersonalization in the use of store and forward technology à ¢Ã¢â€š ¬Ã‚ ¢ Privacy and confidentiality issues (Fleming, 2007). The use of telehealth has raised many legal issues as well like licensing, liability and reimbursement. Data security is also a big concern in telehealth. As personal data is being transferred from patient to health provider, there is possibility of loss of data or could criminal access that should be considered and prevented. (Wootton, Patil, Scott and Ho, 2009) Bandwidth is also an issue, especially when high quality images need to transfer from patient to health care provider and getting the technical support needed to make sure telehealth networks are up and running around the clock is a major challenge for rural programs or those in small hospitals and practices. (Brian, 2009) Opportunities The health sector faces two opposing demands: firstly, it should provide extended and reasonable access to high quality health care services; secondly, it should also decrease or at least control the rising costs of health care. Telehealth assures and offers the promise of giving people equal access to high quality medical health care at reasonable and affordable cost. Information and communication technology has developed very rapidly in the last few years. There has been rapid growth of the telecommunication market and very fast circulation of the internet. Many hospitals have developed information systems which help to share information between different health care providers, and now health sharing networks are being developed in many countries to share health information. Population which is increasing very rapidly with insufficient health resources has produced demands to develop telehealth and the rapid development of information and communication technology has provided the opportunities to do so. (Wootton, Patil, Scott and Ho, 2009) A telehealth consortium led by the University of California, Office of the President and the UC Davis Health System was formed to create a statewide broadband system. ATT was selected to build a secure medical-grade telecommunications system as part of the California Telehealth Network (CTN). ATT with a three year $27 million contract will provide the Network Services to support the telehealth initiative (Bloch, 2010). According to Dr. Cathryn L. Nation, University of California Associate Vice President for Health Sciences and Services, the new network is also designed to address healthcare disparities in the state since millions of Californians live in rural and other medically underserved areas in the state where disparities in care exist. CTN will improve their access to quality healthcare services (Bloch, 2010). Plans call for the network to be a peer-to-peer system enabling each member to have reliable, high quality connections with public and nonprofit healthcare providers located in both rural and urban locations. The network will also provide opportunities for continuing education and distance learning for health professionals, along with access to clinical research, and the possibility of access to commercially hosted EHR systems (Bloch, 2010). Positive Impact Telehealth provides benefits to individual patients, their family members, health care providers, community organizations, governments and health care facilities. Telehealth expands health related skills across geographic barriers using information and communication technologies (Benefits of telehealth, 2007). It improves access to health care providers for remote and rural practitioners. It also provides great access to continuing medical education. It increases access to specialty services for rural patients. Using telehealth, patients can stay in their homes or community rather than travelling to hospitals. Telehealth can be used to decrease number of cancelled appointments due to weather and travel conditions. Telehealth reduces time for investigation, diagnosis and treatment through quicker consultations and patients can get real time second opinions (Benefits of telehealth, 2007). It can reduce the cost of healthcare and increase efficiency through reduced patient and provider travel, better management of chronic diseases and fewer as well shorter hospital stays. Remote monitoring and home telehealth have been demonstrated to improve disease management and reduce re-hospitalization and emergency department visits (Benefits of telehealth, 2007). In a study that evaluated cost savings among patients using telehealth services in rural Arkansas, investigators found that without the telehealth services, 94% of patients would travel greater than 70 miles for medical care, 84% would miss 1 day of work, and 74% would spend $75 to $150 for additional family expenses. With telehealth, 92% of patients saved $32 in fuel costs, 84% saved $100 in wages, and 74% saved $75 to $150 in family expenses (Artinian, 2007). Negative Impact There are many barriers in telehealth delivery. Implementation of telehealth infrastructure can be costly, time consuming and complicated initially. There is lack of information and communication technology usage among healthcare professionals in some areas. Telehealth is a complex matter. Organizational factor is another barrier to telehealth. A change is required for doctors and how hospitals operates which could be avoided by some provided by some professionals. There could be lack of staff with appropriate skills for telehealth. A lack of financial support is a major barrier in the research and development of telehealth. Many potential projects, especially in rural areas and in the developing world have been hampered by the lack of an adequate telecommunication infrastructure. Other barriers in telehealth are the legal and ethical issues. These include licensing, privacy and confidentially (Conrick, 2006). Reimbursement or the lack of it is also a barrier for possible telehealth practitioners and there are some ethical and legal issues about telehealth that need to be resolved. Stakeholders The main objective of telehealth today is to develop next generation telehealth tools and technologies to improve delivery of health care services in underserved areas using information and communication technologies. It also helps to decrease the cost of health care services and increase access to medical related services to the public. Key drivers for these tools and technologies are the need and interest to collaborate among telehealth stakeholders, including patients, patient communities, research funders, researchers, healthcare services providers, professional societies, industry, healthcare management/economists, and healthcare policy makers (Ackerman, Filart, Burgess, Lee Poropatich, 2010). Future of telehealth Telehealth is the future of home care. By its nature, telehealth relies on technology and technology is changing very rapidly these days. If we look at the history, new technologies emerged and then used by people to send information across long distances. The high access of mobile devices and different networks on global level means that mobile technologies can be used very efficiently in healthcare field in order to compensate the lack of resources problem. With the proliferation of mobile technologies, mobile health (mHealth) will play a vital role in the rapidly growing electronic health (eHealth) area. (Vatsalan, Arunatileka, Chapman, Senaviratne, Sudahar, Wijetileka Wickramasinghe, 2010). Due to the large number of mobile technologies adoption, telehealth can play a very important role in the rapidly growing electronic health care area and in future lots of the people will be using mobile devices to monitor their health any time. The future of telehealth will give advantages greatly from this technology innovation, especially in undeserved areas and old homes. Recent trends are beginning to push the demand for and the development of new technologies specific to the individual needs of telehealth applications (Brennan, Holtz, Chumbler, Kobb Rabinowitz, 2008) It is 2014 and Mrs Smith has ongoing trouble with her high blood pressure. One morning she wakes with a headache and worries that the reservoir of her implanted drug delivery system may be running down. Her bedside ambient health orb (see www.ambientdevices.com) is a reassuring green, but she turns to her video wall and asks Cyberdoc, how are my recent blood pressure levels? The simulated voice responds Your records show that the drug reservoir needs a refill in three weeks time. Your telemetered blood pressure readings have been under control for the past month and todays figures are normal. Your implanted blood sugar sensor shows normal readings too. Do you have some symptoms that you want to discuss? Meanwhile Mrs Smiths wall graphs her recent blood pressure readings, and a list of the most common 20 symptoms affecting people of her age group in the locality. She responds, No, dont worry. Remind me to book my repeat prescription (for a refill) in two weeks, please. (Wyatt Sulliva n, 2005) Conclusion Telehealth has signification potential to address a variety of healthcare problems especially in undeserved areas. Has significant potential to address a range of healthcare problems Need to resolve ethical issues Need protection of health information and privacy rights Need for higher speed and higher capacity telecommunications Government, professional groups in healthcare, and telecommunications industry need to work together to develop some standards Next-generation telehealth tools and technologies which use internet and its robust computational resources hold big promise for improving healthcare for the persons who are living in undeserved areas Next-generation telehealth tools and technologies that utilize the Internet and its robust computational resources hold great promise for improving healthcare for medically underserved populations, increasing access to specialty services at lower cost, enhancing health literacy, and expanding the healthcare workforce through virtual education and training. Realizing these benefits will require extensive and ongoing collaboration and coordination among stakeholders across the research and healthcare ecosystem. Communication, training, cultural sensitivity, and end-user customization are critical to success. Extending the traditional point-to-point telemedicine model to include newer cell phone and Internet-based telecommunications tools that are increasingly widespread and affordable, even in rural and remote locations, will be key to putting the person in personalized medicine and making research advances available to everyone. Furthermore, we must appreciate system complexity to rea lize the benefits of telehealth as it evolves toward increasing functionality, integration, interoperability, outreach, and quality of service. The balance of benefits and risks of eHealth for individual patients and clinicians over the next two to three years is unclear. Healthcare organisations and policy makers need to consider the issues that will arise. In the long term, eHealth offers many opportunities for prevention, choice, home based care, and chronic disease management, and it will widen access to health care for most patients.We all need to join the discussion and decide what we want for the future before others, who could be guided by commercial motives rather than quality and equity, do so.

Langston Hughes Essay

Langston Hughes had become one of the most resounding names in American Literature. Of course, the primary reason for his success would be his adept use of words and the message he wants to convey. However, his racial profile could have also come into play in his popularity. But no one could deny the talent of Hughes in his work. His works display intricate design and a significant message such as on â€Å"Salvation. † Langston Hughes had become one of the best known writers because the messages that he wants to convey are of great value to the society, particularly the value of being proud of one’s race. He was born into a relatively large family wherein he had eight siblings. His parents had separated and he had to be taken in by his grandmother. Unfortunately, his grandmother died and again he had to be taken in by family friends. This unstable custody of Langston Hughes could direct us to the assumption that he did not live a happy childhood. Although, it could also lead us to the assumption that his unstable childhood had profoundly influenced him to be writer later in life. At a very young age, Langston Hughes was seemingly being trained unknowingly by the people around. As a child, he used to listen to the black American oral tradition of storytelling. His young mind was inculcated with the value of race to an individual. As the young Langston Hughes develops consciousness about the things that are happening around him, he is introduced to the bitter realities of life. During Hughes’ time, racism is a prevalent problem of the society. This aspect of his biography is one of the most likely reason why Langston Hughes had become a writer. His passion to fight racism is one of the main driving force of his writings. His first poem was titled â€Å"Crisis†, which was published in 1921. The concept of salvation had captivated the mind of Langston Hughes. And in relation to his writing, he may have wanted to convey how people like him, who experiences racism, experience real salvation. His works seemingly suggests that salvation could be found from within one’s self. His messages for the young people are seemingly a call for being saved from the oppression set against them by the society. If Langston Hughes did not become a writer, it is likely that he would have become a full time activist against racial discrimination. His concern for the society, especially for Black Americans is something that even he could not dismiss easily. One of his best known work is on the poem â€Å"The Negro Speaks of Rivers. † From the title alone, the readers are already hinted that this poem would be about race, as hinted by the term â€Å"Negro. Although there could be multiple readings about the poem, the point is that it is a beautiful poem. Hughes may have wanted to tell the world that Black Americans are just as good as any race in terms of poetry. The poem is like Hughes’ statement that dares racists to say to question if Black Americans could write beautiful poems. All in all, Langston Hughes had become of the best known writers because he had become the voice for the underrepresented black community. In many respects, he had introduced the black community to the world.

The Virginia Department Of Juvenile Justice - 926 Words

Most of us grow up being taught to protect those who cannot protect themselves. Social workers, especially, are exhorted by their code of ethics to challenge injustice â€Å"particularly with and on behalf of vulnerable and oppressed individuals and groups of people† (National Association of Social Workers, 2008). So why are as many of 70% of those in local and state juvenile justice systems dealing with their illness in correctional facilities (National Alliance on Mental Illness (NAMI), 2016; Shufelt Cocozza, 2006)? These are the national numbers. So what about in our own state of Virginia? The Virginia Department of Juvenile Justice (DJJ) conducted a study of juveniles in detention homes in 2002 and that found that more than 40% of males and almost 60% of females needed mental health services. As many as 7% of the males and 15% of the females needed this assistance urgently (Juvenile Offending, n.d.). Even more disturbing is the fact that nationally up to two out o f three of that 70% was actually a dual diagnosis of more than one mental illness, often including a substance abuse disorder. One in five of those same juveniles were so severely disabled by their illness that they were unable to function as a young person and were seriously in danger of not developing into a functional adult (Hammond, 2007). Juveniles are considered more difficult to treat for mental illness due to developmental issues (Hammond, 2007) and rapidly changing biological and mental makeup.Show MoreRelatedJuvenile Delinquency Is An Increasing Problem Within The United States995 Words   |  4 Pages Juvenile delinquency has become an increasing problem within the United States. According to Siegel and Welsh (2012), more than 1.1 million youth are being arrested each year for various crimes ranging from loitering to murder. There are numerous reasons why there should be programs to help deter delinquency. 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The Racial Of Apartheid And The Significant Historical...

When looking at the racial system of apartheid in South Africa, the question of music must be discussed. The central debate among musicologists and ethnomusicologists is whether the music from black south Africans during this time was a result of the resistance movement against apartheid. The other side of the argument is that the music of this time and place catalyzed the movement itself and without an outlet like music the resistance would not have occurred. I believe that the music is a representation of what people experience and gives voice to how people feel already. Music is a product of society and shows the heart and direction of a group of people. In this essay, I will examine what the background of apartheid and the significant†¦show more content†¦In response to the multitude of racial injustices black citizens began organizing and protesting the current system. This lead to many leaders being imprisoned, and specifically Nelson Mandela being thrown in jail in 1 964 where he would remain until 1990. The imprisonment of Nelson Mandela and the exiling of many other black leaders by the South African government crushed the spirits of the people and stalled the protest efforts. Then in the 1970’s student protests increased once again with the Soweto uprising in 1976. This movement called the â€Å"Black consciousness† contained similar ties to other black movements in the United States at the time. Protests and music continued to fuel the rebellion through the 1980’s until serious traction came from the movement. As stated earlier Nelson Mandela was released from prison in 1990 and eventually elected president in 1994 and changing the racial aspect of South Africa from apartheid to electing a black president. The music of the black South Africans during the apartheid contained many themes of resistance. The first seen example of musical protest for south African came from Miriam Makeba with the popular protest anthem  "Beware Verwoerd†. This song was addressed to the current prime minster of South Africa at the time, Hendrik Verwoerd. The powerful lyrics of the song stated that â€Å"Watch out Verwoerd, The black man is coming, your days are numbered.† The anti-apartheid message is very clear andShow MoreRelatedGlobal Business Cultural Analysis: South Africa6982 Words   |  28 Pageswill discourse the major elements and dimensions of South African culture; tracing them to methodologies employed by local businesses already participating in that economy. 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