The Nurses of Future Past: A Telehealth Briefing

By Janea Loper

Nurses are like the innovators of yesteryear. Their constant rising to the challenge to adapt to new frontiers is nothing new. They operate in a space of constant transformation. Like in the past two centuries, whether in wartime, peacetime or a pandemic time, their work has contributed to sustained patient care. That same ingenuity is evident in how those in the nursing profession have prepared and adjusted to the steady integration of technology and healthcare aka, “Telehealth.”

The American Nursing Association noted that “nurses are leading the charge” with the use of telehealth services to enhance health care delivery.

Types of Telehealth services vary and can include...

• Lab tests, Imaging, Physical Therapy

• Virtual therapy and counseling services

• Monitoring patients' symptoms and conditions

• Virtual office visits and consultations

Fifty years ago, nurses started interacting with patients by phone to address health concerns. As this expanded beyond that modality to internet, wireless and satellite options the moniker, “Telehealth Nurses” was coined.

Telehealth Nurses leverage technology to help patients by...

• Sharing data in real time to doctors

• Supporting with self-management of illness

• Advocating for pursuing wellness

• Assessing patient care outcomes

• Assisting in managing chronic conditions

The Challenge to Rise to the Occasion

Often, technology comes with a love/hate dichotomy. It offers the promise of convenience and increased headaches. According to a Sage Growth Partners report, private practices shared that telehealth increased the workload for support staff. A little over 25% said it made the workload for nurses greater.

Specific challenges that came up in the workplace for nurses who used telehealth included...

• Lack of training

• Inadequate telehealth etiquette

• Addressing patient discomfort in using telemedicine services

• Patient concern over privacy and disclosing sensitive information

This has required nurses to level-up to assist with workflow efficiencies and patient support, as this article cited that “limited digital literacy and limited access to technology” were barriers for patients.

In a 2021 HealthStream survey, healthcare leadership stated that “a second priority...was a renewed focus on technology” as a key area to improve healthcare organizations. The rapid adoption of technology to address continuity of care during this time was too quick. It lacked the proper structure.

Leadership advocated for technology investment for the purpose of...

• Enhancing patient care

• Increasing the use of telehealth

• Making services more economical

• Implementing safeguards for security purposes

However, leaders understood that new technology cannot be addressed without first fixing burnout and mental health concerns among employees, which included nurses.

Other disadvantages to telehealth found, according to a 2021 NIH report included...

• Regulatory requirements

• Legal apparatus

Heading in the Right Direction

Things have changed. More institutions are advocating for healthcare and technology as part of a nurse’s formal education. It is not considered an academic specialty but is recognized as a vital component of a nurse’s training. In an article by St. Catherine University, it was noted that academic programs have started to offer guidance regarding best practices for healthcare delivered remotely.

Other ways that nurses are learning about telehealth include...

• Listening to relevant podcasts

• Reading articles about best practices

• Engaging with discussion groups

• Participating with telehealth organizations

Development in telehealth has a standard. A few years ago, the American Nurses Association approved an update to the Principles of Connected Health. The organization added "the delivery of care through technology” as an aspect of one of the principles.

The Telehealth Nurse's role goes much deeper than just patient care and monitoring. It extends to a variety of roles that support the telehealth ecosystem. They are best equipped to implement the shift to virtual care. The American Telemedicine Association described Telehealth Nurses as “designers, developers, implementors, administrators, educators, and researchers” who have contributed to the transition of the healthcare paradigm towards telehealth.

Evidence of this shift is supported by newcomers to the market. Many companies in the digital health market have formed partnerships to provide services to healthcare entities such as physician groups, health plans, employers, and hospital systems. One such product is SimplePractice, a turnkey EHR for private practices looking for a technology solution to make business easier. And there are more players entering the market every year.

However, this is not expected to stimulate the integration of technology and healthcare, according to a Deloitte Center for Health Solutions and American Telemedicine Association report. But all is not a loss, as healthcare industry executives predicted that the utilization of virtual health will increase by more than 25% over the next 10 years, according to the report.

This infographic shows five areas that will move further towards telehealth to add value to the healthcare delivery system and patient experience.

Half of the executives surveyed believe this would reduce burnout for physicians. Although, the report does not indicate that this will stem the tide of burnout for nurses. The shift towards a virtual delivery system seems promising, but it is a fine balance. Increased stress due to telehealth learning on the job can be the catalyst for burnout and lessen mental wellness. As noted earlier, nurses are also responsible for patient education on telehealth capabilities. In the Journal of mHealth, nurses' use of technology to care for patients is considered “the new key to improved patient education, experience, and outcomes” to reduce costs and hospital readmissions.

The Steady Tide to Future Change

Miles Romney, chief technology officer at CTO, explained his vision of a telehealth first world to Healthcare IT News. In his opinion, telehealth will cease to exist as the digitization of the healthcare system is viewed as just “care” and no longer “telehealth care.” Our world has not arrived at a seamless integration of technology and healthcare across all dimensions of care. However, we have glimpses of what the future may look like. The “Telehealth Nurse” may no longer apply, and just “nurse” will suffice in this future.

Can the past collide with the future? Or vice versa? The nurses of today and those of the past have adapted to the changing environment in healthcare. They have molded the way they work to forge better outcomes for those they serve. Embracing the evolution of healthcare is the common tie to the nurses of the future and the past.

Janea Loper has worked in health and wellness for several years. She is a certified health coach focused on supporting clients to cultivate a healthy lifestyle through building effective strategies around goal setting and behavioral change. She is a health writer.