The Role of Telehealth in Nursing

Nurses are on the front lines of patient care and act as key drivers of healthcare change, including the use of telehealth technology. As medical technology improves, the role of telehealth in nursing continues to grow, giving nurses new tools to improve patient outcomes and increase access to quality healthcare.

Telemedicine is on the rise as an aging population puts increased demand on the healthcare system and nursing shortages make meeting those demands a challenge, the Agency for Healthcare Research and Quality said.

The trend has accelerated since the start of the coronavirus pandemic, according to the U.S. Department of Health and Human Services (HHS PDF source).

Incorporating telehealth services into nursing can help lower healthcare costs and improve patient outcomes by ensuring that more individuals are able to receive timely nursing care, an article in the National Library of Medicine (NLM), titled "Telehealth Benefits and Barriers," said.

“Across the entire patient experience, and wherever there is someone in need of care, nurses work tirelessly to identify and protect the needs of the individual,” said Dr. Lisa Bechok, DNP, RN, CNE, clinical faculty for Southern New Hampshire University (SNHU) nursing programs. “From ensuring the most accurate diagnosis and treatment options to the ongoing education of the public about critical health issues, nurses are indispensable in safeguarding public health.”

Bechok has been in the nursing department at SNHU since 2015. She is a Certified Nurse Educator with experience in curriculum development. In addition to educational skills, Bechok has won various awards in her career, including the Clint Jones New Hampshire Nurse of the Year Award.

As the role of telehealth in nursing continues to grow, Bechok said it’s important to accept telehealth technology. Understanding its benefit to patients, nurses and the healthcare field is a good place to start.

What is Telehealth and Telemedicine?

Telehealth is defined by the National Institute of Biomedical Imaging and Bioengineering (NIBIB) as using communication technology to provide medical care at a distance. Telehealth services can replace face-to-face visits with video conferencing or phone calls, allowing patients to stay home when sick. Telehealth nurses can also receive information on patient vital signs, such as blood pressure or heart rate, that patients measure on their own at home.

Across the nursing field, the use of telehealth is growing. Telehealth visits increased 766% in the first three months of the pandemic, according to an article in the NLM, "The State of Telehealth Before and After the COVID-19 Pandemic. The article said telehealth will be present long term because of its convenience and efficiency for patients with chronic and acute medical conditions.

An article from the Research in Nursing & Health journal said that it's unlikely for telehealth appointments to fall to pre-COVID levels with patients and providers having a new sense of awareness and interest in the technological advancement.

As more hospitals and other medical facilities use telehealth to level-up their patient care, the role of telehealth in nursing continues to evolve.

Understanding The Role of Telehealth in Nursing

Nurses have assumed many positions within telehealth, according to The Online Journal of Issues in Nursing. Telehealth nursing spans various areas of healthcare including:

• Acute care
• Chronic care
• Follow-up
• Hospice
• Palliative
• Primary care

Incorporating telehealth services into daily operations has given nurses new tools to reach patients and improve healthcare access for all, said Bechok.

“While there is an abundance of healthcare resources in the United States, the feasibility of patients connecting to care remains an issue, especially for those who are underserved,” she said. “Telemedicine can remove geographical barriers, so that those in rural areas without easy access to care can still get the services they need.”

Telehealth can be used to support in-patient care, giving nurses a way to monitor patient health after they are discharged from the hospital or while managing a chronic illness at home.

Self-measurement devices can help nurses monitor vital signs like blood pressure, blood glucose or heart rate remotely, alarms can alert nurses when patients need help at home and video conferencing can be used to monitor injury recovery.

For some nurses, telemedicine may be the primary way that care is provided, Bechok said. Nurse hotlines, telemedicine websites and online chat technologies can all connect nurses with patients remotely for day-to-day health questions or symptom management.

Telehealth technology can also allow nurses to share patient data with doctors and specialists in real-time, connecting patients to the best care from anywhere in the world.

After a natural disaster or other emergency, telehealth is a critical tool to help treat minor injuries and illnesses during recovery efforts, Bechok said.

No matter the role of telehealth in nursing, telehealth technology acts as a key connection between in-patient care and at-home health management.

“The great thing about technology and telehealth is the flexibility it offers to design services that work best for the work environment or an individual on a case-by-case basis,” said Bechok.

What Are the 4 Ps of Telehealth Nursing?

According to an article published by Nurse Educator, with telehealth rapidly growing, using the Four Ps of Telehealth framework will aid nursing education. These domains of telehealth are:

• Planning: Plan for the implementation of a telehealth program by being able to identify relevant issues, technology and needs of the patient.
• Preparing: Obtain equipment, select a vendor, set up technology support, establish protocols and workflow and train personnel at this stage.
• Providing: Set the stage for the visit, complete a history of the patient, perform a physical examination and relay diagnosis and treatment.
• Performance Evaluation: Evaluate the impact and outcomes of the program on the provider, patient, setting, and services.

How Can Telehealth Improve Nursing Care for Patients?

The increasing role of telehealth in nursing has resulted in many benefits across the healthcare system.

According to National Institutes of Health, about 20% of Americans live in rural areas and suffer from a shortage of providers and healthcare facilities. Telehealth services can help more patients get the care they need when they need it, improving health outcomes.

Telehealth services can also help patients better manage chronic conditions, such as heart failure, respiratory disease and diabetes, by minimizing trips to the doctor and better monitoring symptoms to reduce hospitalizations, said Bechok.

Telemedicine can help providers reduce healthcare costs, too. By keeping patients in their homes and allowing nurses and doctors to see more patients in less time, patients and medical institutions can save money.

As reported by the National Cancer Institute, using telehealth services was associated with an average of $147 and $186 in savings per visit for patients.

“It is important for both providers and patients to embrace telehealth because of its ease of use, its ability to improve outcomes, improve communication and reduce costs,” said Bechok. “The ability to provide high quality service and increased access to care is critically important, especially in light of the current financial challenges of our healthcare system.”

The Future Role of Telehealth in Nursing

The future of telehealth in nursing continues to evolve. While the benefits of telehealth are many, there are still challenges to implementing telemedicine more widely.

Insufficient access to broadband internet can limit telehealth services in rural areas, where additional healthcare is often needed. Telemedicine is also affected by limits of medical licensure to provide telehealth services across state lines, online prescribing regulations and patient privacy concerns, said Bechok.

The outbreak of the COVID-19 virus, however, pushed providers, insurers and policy makers to accelerate the integration of telehealth into medical care, according to Bechok.

Telemedicine allowed healthcare providers to triage COVID-19 patients before they arrived in-person, making it easier to keep coronavirus patients isolated and allowed for more at-home care for patients with less serious symptoms, reducing the strain on hospital systems.

Telemedicine continues to evolve following the pandemic with nurses having access to new tools and technology to educate and provide healthcare to patients efficiently and effectively.

“The role of the nurse in telehealth is no different than face-to-face nursing, it is just done in a different way using technology,” Bechok said. “Whether a nurse is performing telehealth work with patients or working directly face-to-face with patients, nursing is the glue that holds a patient’s health care journey together.”

Danielle Gagnon is a freelance writer focused on higher education. She started her career working as an education reporter for a daily newspaper in New Hampshire, where she reported on local schools and education policy. Gagnon served as the communications manager for a private school in Boston, MA before later starting her freelance writing career. Today, she continues to share her passion for education as a writer for Southern New Hampshire University. Connect with her on LinkedIn.