Tele-medicine and Tele-nursing

PRESENTED BY :-
SRADHANJALI BISWAL
TUTOR
KALINGA INSTITUTE OF NURSING SCIENCES
KIIT DEEMED TO BE UNIVERSITY
BHUBANESWAR

 The field of medicine during the recent years has
made an explosion in the recent years in collaboration
with the field of technology. When considering
medicine and technology separately they have proved
to be strong enough to stand alone as different
science helping the economic growth of our country.

 In today’s health care environment, the health care
workers have to be flexible, innovative and
informative, able to solve complex client problems by
utilizing the best available resources. For this, newer
technologies are being introduced day by day and it
has grown to such an extent that it can be termed and
treated as a separate field.

DEFINITION:-
 Tele-health is defined as “the use of electronic
information and telecommunication technologies to
support long-distance clinical health care, patient and
professional health related education, public health
and health administration” (Hutcherson, 2002,)

 Tele health is such a field where the delivery of
health-related services and information via
telecommunications technologies. Tele health
encompasses
Tele-medicine
Tele-nursing
And tele-education

 The term telemedicine is derived from the
Greek word ‘tele’ meaning at a distance and the
present word medicine which itself derives from the
Latin ‘mederi’ meaning healing.

Telemedicine is any healthcare provided to patients via
technology across a distance
( Remmes, Thompson and Williams, 1996)
The World Health Organization (WHO) has
defined Telemedicine as ‘the delivery of
health care services, where distance is a
critical factor by all health care professionals
using ICT for the exchange of valid
information for diagnosis, treatment and
prevention of disease and injuries, research
and evaluation and for continuing education
of health care providers, all in the interests of
advancing the health or individuals and their
communities.’

1906: ECG Transmission
1920: Help for ships
1924: The first
exposition of Tele-care
1955: Tele-psychiatry
1967: Massachusetts
General Hospital
1970s: Satellite
telemedicine

 To make high quality health care available to
traditionally under privileged population.
 To save the time wasted by both providers and
patients in traveling from one geographic location
to another to avail services on time.
 To reduce costs of medical care.

1. Real –time
(Synchronous)
2. Store-and-
forward
(asynchronous)

Other
types of
tele-
medicine
Tele-
nursing
Tele surgery
Tele
radiology
Tele cardiologyTele pathology
Tele
dermatology
Tele
ophthalmology

For clinical
services
Educational
services
Administrative
application

Reaching more
patients
Providing better
care
Research and
training

Tele-medicine and Tele-nursing

 Telemedicine can be used when healthcare professionals
and patients are unable to meet face to face due to
geographical distances, convenience or practicality.
 Providing individualised health information;
 Enhancing decision making in clinical management;

 Facilitating communication between healthcare
professionals.
 Offering support,
 Educating patients, carers and relatives on managing
health problems by facilitating remote monitoring and
information delivery.

 Poor infrastructure and inadequate regulation of
telecommunications.
 Costs for services.
 Policies/protocols regulating the use of telemedicine.
 Licence regulations for practising telemedicine.

 Maintaining quality of care.
 Professional regulation activities and
implementing healthcare policies.
 Confidentiality due to increased (unauthorised)
access to patient records.

 FOR THE PATIENT
 Advanced medical facilities.
 Reduction in travel to distant referral medical centers.
 Reduction in cost of medicare.
 Better monitoring of chronic cases.
 Tele-counseling of selected psychiatric cases .

 FOR THE GROUP
 For a rural group 24 hr advice of specialist is a great support .
 Better diagnosis of diseases due to availability of specialist
opinions.
 FOR THE STATE:-
• Improved preventive health care measures
• reduction in urban migration from villages due to better care.
• early notification of communicable diseases.
• reduced cost of care.

 FOR THE DOCTOR:
 Doctors licensed to practice all over India.
 Motivation for computer literacy among doctors.
 Maximum Utilization of resources.(save time, money
&travel

 Tele-nursing refers to the use of telecommunications and
information technology for providing nursing services in
health care whenever a large physical distance exists between
patient and nurse, or between any numbers of nurses. As a
field it is part of tele-health, and has many points of contacts
with other medical and non-medical applications, such as tele-
diagnosis, tele-consultation, tele-monitoring, tele-care etc.

 The practice of nursing over a
distance using telecommunication technology
(National Council of State Boards of Nursing NCSBN, 1997)
 Nurse/Patient interaction through a
telecommunication device

 Telenursing – is the delivery, management, and coordination
of care and services provided via telecommunications
technology within the domain of nursing.
( American Association of Ambulatory Care Nursing
(AAACN), 2004)

 Telenursing ‐is the use of telemedicine / telehealth
technology to deliver nursing care and conduct nursing
practice.
( Encyclopaedia of Nursing Research, Fitzpatrick J. ed., 1999)

 Phone
 Interactive Video
 Phone Triage
 Internet Support
 Remote Telemonitor

Tele-nursing has been used as a tool in home nursing.
For example people who are immobilized or far away
places, or living in difficult to reach places
Citizens who have chronic aliments such
COPD,DM,CHD etc
Still other applications in home care is patients after
surgeries with wound dressings, ostomies, handicapped
etc. can be assisted in care with help of telenurisng.

Telenursing help to extend the nursing service to more
patients. In home care delivery, a nurse is able reach and
care for 5-7 patients, but telenursing help her to attend
more in same amount of time.
A common application of tele nursing is also used by call
center separated by managed care organizations which are
staffed by managed care organizations, which are staffed
by nurse managers

To perform patient triage in emergencies through call
centres
Expert assessment and intervention by specialist clinical
nurses
Discharge services
To do counselling and guidance services

Hardware (physical computer body)
 Computers (laptops, desktops)
 Palm computers
 Telephones
 Graphic’s card
 Sound cards
 Internal Memory ( RAM)
 External Memory ( flash drives)

 Wireless technology increases a computer’s
portability
 May be used in hospitals or other community
nursing settings
 Allow nurses remote access to medical
records
 Allows electronic documentation in remote
locations
 May be used in two way audio/video
conference

 Monitor, keyboards, mouse, printer
 Web cameras, speakers, microphone
 Email, database, word-processing, internet,
browsing, conference calls
Example: Digiscope-program to collect patient
info related to diabetes.

 Provides wireless networking between
hospital computers
 Allows for wireless Internet access
 Used in Video conferencing between nurse
and patient
 Used in emails, Instant messaging, and

 Efficiency strongly depends on server
 Software design varies between medical
facilities
 Usability is dependant on internet access at
home

 Ring sensor worn by patient 24hrs/day
 Transmits wireless data
 Home computer analyzes data
 Sends warning signals to telenursing center
 Signal provides diagnostic information

Review of System
 Used for clinical purposes
 Used by medical professionals (doctors,
nurses, ect)
 Monitoring and diagnostic function
 Local Area Network

 Collecting data from Patient
 Assessing data using knowledge
 Document all retrieved data
 Utilize critical thinking skills
 Provide nursing interventions
 Continue to monitor and utilize available
technology

 FOR THE PATIENT
Monitoring vital signs on daily basis at home setting
and informing the care specialist provides opportunity
for early intervention.
Reduces the number of visits to the doctor or
emergency department
Avoids unnecessary visits to or by providers
Provides patient education
Removes geographic barrier - Nursing can be
provided to remote locations

 FOR THE PROVIDER
Increases the Competencies and scope of practice
More venue for monitoring Client safety in home care
facilitates easy client decision-making
Creates Professional practice environment
Able to provide expert and specialized care from
experienced staff and care managers
Able to take joint decisions regarding care by
consultation with staff even at far of places

 FOR THE HEALTH CARE SETTING
Initial expense up front but as health improves the system
will save money
Decreased number of in-hospital days for patients with
chronic illness who have access to supportive telehealth
Decrease number of in-hospital days reduces the required
number of staff (nursing in particular)
Remove barriers of time and distance
Proper training and administrative support is an vital
responsibility for the system

Home care
Telephone
triage
Case
management

 Increase public access to health care
 Provide access in rural areas
 Decrease wait times
 Decrease unnecessary hospital visits
 Decrease Healthcare costs
 Increase continuity of care
 Increase patient compliance with aftercare

 Decreased face-to-face interaction
 Risk of decreasing quality of care
 May increase liability
 Concerns with security
 Concerns with maintaining confidentiality

 Maintaining patient privacy
 Verifying consent
 Compliance with HIPAA regulations
 Nursing Licensure across state lines
 Maintaining compliance with scope of
practice

 Maintaining autonomy (identity, privacy)
 Maintaining patient’s integrity
 Prevent harm to a patient

Ongoing development of new
Technologies provides endless
Possibilities in the future of
Nursing care.

• Advances in Tele communication and technologies are
revolutionizing education & health services globally,
including the provision of nursing services. Decreasing
time and distance, these advances increase access to
health and health care, especially underserved populations
and those living in rural and remote areas. They help to
manage the demand for services, ensure more effective
use of human and health resources and facilitate
education and research activities.

Tele-medicine and Tele-nursing

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