The future has arrived at Chase County Care and Rehabilitation Center with virtual visits from a physician or nurse practitioner. The telehealth visits are saving long bus rides to the doctor’s office and speeding the delivery of medical care to the elders at Chase County Care and Rehabilitation Center in Cottonwood Falls. The small, family-oriented rural nursing home has initiated the new telehealth service in an effort to improve care delivery to the elders who call the facility home.
The new service has a specially trained Chase County Care telehealth nurse roll a telehealth cart into the elder’s room where vital signs and an exam may be done by the practitioner and nurse partner. The telehealth cart is equipped with an electronic stethoscope, an otoscope and a camera, which can be focused on the resident over-all for communication, or if needed, on a specific area, such as a wound.
The practitioner uses the nurse's hands for the exam, all the while conversing with the elder, and the nurse, via the telemonitor which is about the same size as the screen on a laptop computer. The elder can see the practitioner on the screen so they know they are talking to “a real person.” According to those who are already using the service, it takes about two to five minutes for the elder to lose the feeling of talking to a computer and become comfortable talking with the practitioner via the monitor on the cart.
The same practitioner always makes daily rounds at Chase County Care and Rehabilitation Center so elders become comfortable talking with someone they know.
The telehealth practitioners all act as team members with the Primary Care Physicians and report to them daily when they visit the PCP’s patients. Telehealth adds another layer of immediate healthcare for the elders and prevents them having to take the long bus rides to a doctor’s office, sometimes in inclement weather, when the issue is minor. It is also designed to catch issues sooner, preventing escalation of illnesses. The new service also can prevent re-hospitalizations which are not only difficult for the elder but also costly for the Hospital and Nursing Home, due to new government guidelines and penalties.
The service can also provide Specialist consults within a short time of determining the need, contrary to the long waits, and long drives that are often required when a specialist visit is necessary.
Psychiatric care is provided on a weekly basis.
“We focus constantly on improving the care of our elders,” said Murl Webster, Administrator at Chase County Care and Rehabilitation. “Telehealth helps us to provide, faster, more immediate personal care and eliminates many tiring bus rides. It helps us toward our goal of always improving the quality of life for our elders.”
According to the Telehealth Resource Center of California, "‘Telehealth’ is a more universal term for the current broad array of applications in the field. Its use crosses most health service disciplines, including dentistry, counseling, physical therapy and home health, and many other domains. Further, telehealth practice has expanded beyond traditional diagnostic and monitoring activities to include consumer and professional education."
"Telemedicine" is often used interchangeably, but actually has a stricter definition: the clinical application of technology.
Using video or electronically-transmitted images and diagnostics is common. The American Telemedicine Association notes "... video-based transactions are now becoming commonplace in hospitals and healthcare systems around the country. Patient consultations via video conferencing, transmission of still images, e-health including patient portals, remote monitoring of vital signs, continuing medical education, consumer-focused wireless applications and nursing call centers are just some of the related applications."
The Mayo Clinic has some caveats regarding telehealth's potentials and limitations.
^Technology has the potential to improve the quality of health care and to make it accessible to more people. Telehealth may provide opportunities to make health care more efficient, better coordinated and closer to home.
^Research about telehealth is still relatively new, but it's growing. For example, a 2016 review of studies found that both telephone-based support and telemonitoring of vital signs of people with heart failure reduced the risk of death and hospitalization for heart failure and improved quality of life.
^While telehealth has potential for better-coordinated care, it also runs the risk of fragmenting health care. Fragmented care may lead to gaps in care, overuse of medical care, inappropriate use of medications, or unnecessary or overlapping care.
^The potential benefits of telehealth services may be limited by other factors, such as the ability to pay for them. Insurance reimbursement for telehealth still varies by state and type of insurance. Also, some people who would benefit most from improved access to care may be limited because of regional internet availability or the cost of mobile devices.