While telemedicine is not a new concept, it came to the forefront during the COVID-19 pandemic. It's unlikely to return to pre-pandemic limited availability once the threat of the virus eases up.
What does that mean for future nurse practitioners (NPs) entering the healthcare field?
Disconnect Between Preparation and Practice
During the pandemic, hospitals and clinics had to pivot quickly in order to offer telehealth services to their patient populations. For the most part, they were able to sufficiently meet the accelerated demand. In fact, in the early months of the pandemic (March through May of 2020), the use of telemedicine more than doubled across the U.S.
However, a disconnect remains between preparation and training among healthcare professionals and the actual implementation of telehealth services.
Research published by the National Center for Biotechnology Information (NCBI) indicates that a multimodal approach to telehealth education among NPs allowed students to develop the "comfort, knowledge, and skills needed to embrace the utilization of telehealth in healthcare."
Why Telehealth Is "Bigger" than the Pandemic
Telehealth services aren't just valuable when a deadly virus threatens patient health and safety. Individuals living in rural or underserved areas struggled to obtain care long before COVID-19.
The Chartis Center for Rural Health reports that 120 rural hospitals have closed over the last decade — a trend that doesn't seem to be slowing. And once a rural healthcare facility closes, it is unlikely to reopen.
Recruitment in these areas also proves challenging, despite incentives to attract healthcare professionals. Payment structures dictate revenue, so if a provider isn't getting patients in their offices due to geographical or transportation barriers, they can't make money under a "fee-for-service" arrangement.
For all of these reasons, telehealth is a viable solution.
Key Components of Telehealth Training
It's important to understand that telehealth and telemedicine are not just about technology or the latest digital innovations. Technological components are necessary, but a great deal more goes into a comprehensive telehealth offering. Here are some considerations:
Healthcare providers learn how to conduct an effective telehealth visit. Eye contact, proper positioning of the camera and elimination of distractions like noise and objects all contribute to a good experience for patient and provider alike.
- Interprofessional Collaboration
Healthcare professionals can provide telehealth services to patients who may not live nearby, giving NPs opportunities to provide care in rural/underserved areas. Nurse practitioners working in these conditions might collaborate remotely with other healthcare providers in the care continuum.
Governance surrounding telehealth offerings varies state by state. Items like licensure, implementation and informed patient consent must all be considered and adhered to.
As if the insurance arena wasn't already complicated enough, adding telehealth to the mix further muddies the waters. NPs will need to be well-versed in laws and regulations driving telehealth reimbursement and insurance coverage.
Security is another sticky area within telehealth. The NCBI study states, "Beyond safeguarding the privacy and confidentiality of private-protected personal health information (PHI), telehealth providers are responsible for ensuring that the 'space' or environment where the encounter takes place is secure at both the originating location and the distant site and that the transmission between the originating site and distant site is secure." Violation of HIPAA could result in monetary fines, civil penalties and even criminal charges.
- Ethical Practice
Beyond security, an ethical approach to telehealth must take priority among providers and patients alike. NPs need to be aware of a potential erosion of the provider/patient relationship. There have also been concerns about patients shopping around to find providers who can expedite care or even prescribe desired medications.
Each of these areas deserves thoughtful examination, whether an NP is in training or already established in their career. By voicing their own concerns and desire to be more informed, NPs can contribute to the accelerated progression toward telehealth care.
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