Introduction
Emerging technologies in the healthcare industry have improved the provision of healthcare services to patients across the world. Most health care centers have focused on improving telecare services within their organizations. The global health research agenda has also focused on improving collaboration between countries on identifying and testing new technologies in health care. Some of the telehealth technologies include video conferencing, which has been adopted in most telecare services.
Moreover, the use of telephones in monitoring patients has been important in telehealth. New research studies have also been focused on improving telehealth services. Essentially, telehealth is useful across all units of caregiving facilities. This paper will perform a literature review on new technologies in healthcare. Specifically, the paper will examine the use of telehealth in healthcare (White, Krousel-Wood, & Mather, 2001).
Literature review
The health care sector is believed to be more than a decade behind other sectors in computing. However, this trend has changed. New computer and communication technologies are congregating to develop useful computing tools for the healthcare sector. According to White, computer and communications have enabled professionals to experiment using numerous applications that provide opportunities or achieving clinical demands.
Moreover, the authors posit that increasing demand for physician productivity has brought about the need to utilize technology in enhancing healthcare (White, Krousel-Wood, & Mather, 2001). Moreover, the authors believe that the use of telehealth has enabled health professionals to participate in crucial educational and research activities. According to the authors, telehealth can be defined as an inclusive term for describing support for long-distance clinical healthcare.
Moreover, they argue that telehealth is utilized for long-distance professional and patient health-related education. Additionally, they argue that telehealth also enhances health administration and public health. According to the authors, educational opportunities are increasing exponentially for individuals who have limited access to traditional courses. In this regard, telehealth has come in handy in improving opportunities for studies in medicine. Telehealth has enabled instant transmission of research and medical information across the globe. The authors argue that telehealth has narrowed the gap previously seen in data transmission (White, Krousel-Wood, & Mather, 2001).
Almost every federal agency has a website that provides health data. Moreover, healthcare facilities have integrated clinical management systems, which are aimed at assisting in the management of patient information. Additionally, integrated clinical management systems can also be utilized to monitor and manage patients with chronic illnesses. Moreover, telehealth can be utilized to provide professional ways of integrating patient education and monitoring.
Furthermore, telehealth can be utilized to provide capable ways of integrating consultations and follow-up with patients (White, Krousel-Wood, & Mather, 2001). Telehealth is also important in providing ways of integrating patient support during and after caregiving. Besides, the use of technology in health care can enable the interface of clinical management and administrative functions to provide healthcare practitioners with the opportunity to systematize their activities and services. The authors argue that increasing capacities and capabilities in information systems are the forefront of promoting telehealth (White, Krousel-Wood, & Mather, 2001).
Another article by Bashshur provides an evaluation of new technologies in the healthcare sector. The paper examines the status of evaluation research in telemedicine. Moreover, it examines the context of research in telemedicine. In the process, the author proposes two main strategies for meeting the significant policy in telemedicine. Also, the authors provide ways of dealing with programmatic issues in telemedicine (Bashshur, Shannon, & Sapci, 2005).
Moreover, the authors explain the evolution of evaluation research in the United States. Additionally, the authors describe an exclusive typology and the requirements for a successful evaluation. The authors also discuss the limitations of a successful evaluation. Furthermore, the authors give detailed information on major trends that exist in empirical studies. Importantly, the authors proposed two main strategies that could be utilized to come up with definitive findings.
The two strategies were found to be able to assess the existing empirical evidence. These were noted as large-scale experimental studies for assessing the evidence. Besides, it also consisted of empirical and theoretical triangulation for assessment purposes. The authors noted that the emergence of telemedicine came in to substitute in-person medical care. Moreover, telemedicine came in as an integrated system for providing medical care. The need for telemedicine was supported by many experimental data.
These were from different settings across the field. Moreover, clinical applications utilized proved that telemedicine was useful to society although it had not been accepted universally. The authors also argue that rigorous scientific studies in the health sector have shown the need for ultimate adoption as well as diffusion of telemedicine in medical care (Bashshur, Shannon, & Sapci, 2005). Telemedicine has been found to evolve at a fast pace to such an extent that it encompassed all clinical areas. Moreover, it has proliferated to include clinical areas in public health and medical education. Besides, telemedicine has made strides into health education.
Essentially, telemedicine has grown as an important component of telehealth. The authors evaluate telemedicine, its benefits, and its applicability. The authors also discuss the fundamental issues and requirements needed for a successful scientific valuation of telemedicine. They also argue that the evaluation of healthcare programs involves both political and scientific realities. While scientific modalities deal with the requirements, political realities deal with public policies (Bashshur, Shannon, & Sapci, 2005).
Home telehealth has also been found to reduce healthcare costs. Essentially, the use of telehealth in remote settings can greatly reduce costs incurred in healthcare (Noel, Vogel, Erdos, Cornwall, & Levin, 2004). This is according to Noel et al., who conducted a study on the effectiveness of telehealth at home. This study was conducted to determine if home telehealth could reduce the cost of healthcare as well as improve the quality of life.
This study was conducted by integrating telehealth with the health facility’s electronic medical records system. Moreover, the study was done in comparison with the usual home healthcare services done for elderly people with complex co-morbidities. During the study, patients enrolled as participants in the study were identified through the medical center’s information database. Patients enrolled in telehealth received home telehealth units, which were integrated with standard phone lines for communications with the medical center. Moreover, peripheral devices for monitoring crucial signs as well as valid questionnaires were utilized in evaluating the quality of life during the study.
Essentially, these peripheral devices were FDA approved for quality purposes (Noel, Vogel, Erdos, Cornwall, & Levin, 2004). In the process, data that was found to be out of range triggered alert responses to nurse case managers. It should be noted that live video or audio was not incorporated in the study. However, templated progress notes were utilized to enable seamless data entry of patient records electronically (Noel, Vogel, Erdos, Cornwall, & Levin, 2004).
104 participants were involved in the study. These participants had complex heart failure, diabetes mellitus, or a chronic lung infection. These participants were assigned randomly to the control group or intervention group for between 6 and 12 months. Additionally, both parametric and non-parametric analysis was done on the results of the study. The outcomes were costs, health resource use, and subjective/objective quality of life.
As expected, the intervention group recorded significant improvements as compared to the control group. For instance, there was a reduced number of days in bed-care for the intervention group. Moreover, there were reduced emergency room visits. Moreover, patient satisfaction levels improved. Eventually, it was concluded that integrating home telehealth with the medical center’s electronic database considerably reduced the cost of healthcare (Noel, Vogel, Erdos, Cornwall, & Levin, 2004).
The next article compares patient outcomes and costs for home healthcare provided through telemedicine and traditional means (Finkelstein, Speedie, & Potthoff, 2006). The authors utilized patients receiving skilled nursing care from home. The study utilized a randomized control trial for three groups of participants. The first group was named control group C. this group received traditional skilled nursing care from home. In contrast, the second group was named video intervention group V. this group received traditional skilled nursing care from home through virtual visits which utilized videoconferencing technology (Finkelstein, Speedie, & Potthoff, 2006).
The third group was named the monitoring intervention group M. this group received skilled nursing care from home through virtual visits which utilized videoconferencing technology. For the third group, physiological monitoring was also done to observe patients’ underlying chronic state (Finkelstein, Speedie, & Potthoff, 2006). The outcome of the study showed that discharge to a higher level of caregiving in about six months showed 42% for group 1, 21% for group 2, and 15% for group 3. Besides, the resting outcome showed little or no difference in mortality between the groups in the study.
In this case, morbidity was evaluated in terms of changes in knowledge, status sales, and behavior as provided for in the Omaha Assessment Tool (Finkelstein, Speedie, & Potthoff, 2006). This assessment also showed no significant difference between the groups. However, there were increased scores for daily living activities among the second and third groups. The average cost for traditional home visits was $48.27 while that for video conferencing group was $22.11. Additionally, the average cost for monitoring group visits was $32.06, for congestive heart failure patients (Finkelstein, Speedie, & Potthoff, 2006).
Moreover, the average cost for monitoring group visits was $38.62, for chronic pulmonary disease patients. From the results observed, it was clear that groups 2 and 3 utilized fewer resources as compared to the first group (Finkelstein, Speedie, & Potthoff, 2006). In essence, the study confirmed that virtual visits that occurred between home healthcare nurses and chronically ill patients from home were important in improving patient outcomes. Also, this was done at a lower cost than that of traditional skilled nursing care that required face-to-face visits (Finkelstein, Speedie, & Potthoff, 2006).
On the other hand, Postema et al. argue that the introduction of home telecare has the propensity of bringing mixed results in practice. The authors investigate crucial factors that influence the success of implementing telecare. Consequently, the investigation finds that financial and technical stability is crucial to achieving success (Postema, Peeters, & Friele, 2012). Moreover, the investigation also finds that implementation strategy as well as the alignment of goals is essential to the success of telecare. Moreover, the authors emphasize a comprehensive rollout for initial implementation.
This research was conducted to establish the key factors that would influence se of video communication in healthcare (Postema, Peeters, & Friele, 2012). The authors argue that crucial factors for implementation success of telecare are found in three main organizational climates namely technology available, the strategy of implementation, and telecare implementation at home. This research was conducted through interviews in 3 caregiving organizations in which 27 respondents were interviewed (Postema, Peeters, & Friele, 2012). The respondents were from different levels inside and outside the caregiving organizations.
Moreover, the study utilized implementation determinants from previous research (Postema, Peeters, & Friele, 2012). These were used to categorize and organize a framework for interviews. The resulting outcomes conveyed the fact that successful implementation of telecare relied on the stability of both external and technical environments. Moreover, it was found that the implementation strategy was crucial to the success of telecare.
Furthermore, it was found that the methods of aligning the organization concerning its goals were also important in helping achieve success (Postema, Peeters, & Friele, 2012). Essentially, it was realized that video communication was becoming increasingly important in telecare. Moreover, the fact that experimenting with video communication was giving mixed results did not stop further scrutiny on its viability.
Organizing telecare was found to be imperative especially when key factors that influence its implementation are considered. The authors suggested that workable strategies be utilized in helping the implementation process for successful telecare service. The article showed that home telecare is increasingly becoming important in helping nurses discharge their duties. Moreover, the successful implementation of home telecare through video conferencing was found to improve the quality of life for patients under telecare intervention (Postema, Peeters, & Friele, 2012).
In another study conducted in Florida and Puerto Rico, Use of technology and care coordination was experimented to show the usefulness of telehealth (Kobb, Hoffman, Lodge, & Kline, 2004). On e of the chosen initiative for this study was the rural care project, which involved clinical demonstrations pilots. This was an initiative of the Veteran health Administration through its Sunshine network in Puerto Rico and Florida.
This project involved three care coordinators namely one social worker and two nursing practitioners (Kobb, Hoffman, Lodge, & Kline, 2004). The three healthcare practitioners collaborated with primary health care providers to manage high risk as well as high-cost veterans who had multiple chronic illnesses. Some of the illnesses covered in the study included heart failure and diabetes, among others (Kobb, Hoffman, Lodge, & Kline, 2004).
During the study, health care practitioners utilized telehealth devices to monitor patients to prevent possibilities of health crises. Moreover, the health practitioners utilized telehealth devices to educate patients on ways of improving their quality of life (Kobb, Hoffman, Lodge, & Kline, 2004). This research was conducted using the quasi-experimental design, which utilized the nonequivalent control group.
The control group was composed of usual care veterans. Information for the study was got through interviews with the subjects as well as providers. The outcome was analyzed statistically using a series of repeated-measure of covariance modeling (Kobb, Hoffman, Lodge, & Kline, 2004). The University of Maryland’s research team had designed the statistical analysis utilized in the study. The resulting outcome showed that care coordination using technology was significant in reducing hospital admissions. Also, it was found that telehealth is important in reducing the number of bed days of care patients take in hospitals (Kobb, Hoffman, Lodge, & Kline, 2004).
Besides, the study also found that care coordination using technology helps reduce emergency room visits (Kobb, Hoffman, Lodge, & Kline, 2004). Besides, care coordination utilizing technology was found to reduce prescriptions for patients. Furthermore, care coordination using technology was found to offer high provider and patient satisfaction. In essence, veterans were found to have improved perception of physical health because of care coordination using technology (Kobb, Hoffman, Lodge, & Kline, 2004).
According to one of the latest global research agenda on healthcare, personalized telehealth is one of the most important issues seriously considered in current and future health plans (Dinesen, Nonnecke, Lindeman, Toft, Kidholm, Jethwani, Young, Spindler, Oestergaard, Southard, Gutierrez, Anderson, Albert, Han, & Nesbitt, 2016). Telehealth plays a significant role in global healthcare service (Dinesen et al., 2016).
Moreover, the authors argue that it will be increasingly significant for the development of a strong evidence base of practicable telehealth solutions. Moreover, these solutions should be successful and innovative telehealth solutions. In essence, the study wanted a sustainable and scalable telehealth program. The research was aimed at two main tasks (Dinesen et al., 2016). The first task was to describe the challenges that hindered the promotion of telehealth implementation. This task was aimed at enabling advanced adoption of effective telehealth programs. The second task was to present a global investigative agenda for tailored telehealth (Dinesen et al., 2016).
Specifically, this task was aimed at managing chronic illnesses. This study utilized evidence from the European Union and the United States. In essence, the study provided a global overview of the existing state of telehealth services as well as its benefits to patients and society (Dinesen et al., 2016). Also, the study provided fundamental principles that need to be addressed to proceed with the status quo. Furthermore, the study provided the framework for existing and future research programs in telehealth that focuses on personalized care.
The study also emphasized the need for a framework that initiates research on telehealth for personalized treatment and prevention of chronic illnesses. In this regard, the authors agreed that a broad, global research agenda is necessary to provide a standardized framework for recognizing and speedily reproducing best practices (Dinesen et al., 2016). Moreover, the broad research agenda is required to foster global collaboration in the development of new telehealth technologies.
Additionally, global collaboration is required to help in the thorough testing of new telehealth technologies to improve the quality of healthcare delivery (Dinesen et al., 2016). In conclusion, members of the Transatlantic Telehealth Research Network (TTRN) provided a twelve-point research agenda for future telehealth use when dealing with the management of chronic ailments (Dinesen et al., 2016).
This research study gives evidence of past research on telehealth in the 1970s. The study examines early telemedicine project, which involved NASA, the Space company, the Indian health services, and the Papago. Other stakeholders involved in this study were the department of health and welfare (Freiburger, Holcomb, & Piper, 2007). It is worth noting that the Papago tribe is the one currently known as the Tohono O’odham Indian Nation.
These groups collaborated in the study to explore the possibilities of using technology to provide enhanced health care to a remote population, which was located in Southern Arizona. This project was known as STARPAHC referring to Space Technology Applied to Rural Papago Advanced Health Care. The project occurred in the late 20th century (Freiburger, Holcomb, & Piper, 2007). The study was conducted in the 1970s. This study tried to show the viability of initiating collaboration between groups of consortiums from both public and private sectors in providing enhanced health care to people in remote areas of Arizona using telecommunication technology.
This program was a success and its activities were archived in Arizona Health Science Library. Materials from the university’s library showed important progress in telehealth practices. These materials were acquired and archived at the Arizona Archive of Telemedicine (Freiburger, Holcomb, & Piper, 2007). These materials contained crucial facts on the STARPAHC project, which was done in collaboration with the Arizona Telemedicine Program.
This study gives evidence of past attempts aimed at utilizing technology to improve health care in various remote areas throughout the United States and the world. The study also clarifies the fact that research on telehealth is relatively new in the health sector as compared to other sectors of the economy. In essence, the study also shows that despite late attempts to use technology in improving health care, the field has taken use of telehealth seriously (Freiburger, Holcomb, & Piper, 2007).
Numerous researches have been conducted to help improve health care through technology. Delivering health care at a distance as undergone various transformations since its initiation in the 20th century. This research is of great interest to individuals studying early attempts to use telehealth in delivering health care in remote areas. Moreover, it has been utilized in studying the sociological consequences of scientific and technical projects among indigenous populations (Freiburger, Holcomb, & Piper, 2007).
Care coordination utilizing technology is effective in improving the quality of life for patients. Another research was conducted to evaluate a care-coordinated project, which was assisted by technology in the form of a screen phone (Dang, Remon, Harris, Malphurs, Sandals, Cabrera, & Nedd, 2008). This evaluation was done mainly to support caregivers as well as educate them. From the study, 113 caregivers were recruited for evaluation.
These caregivers were from home-dwelling veterans with dementia. Among the caregivers recruited for the study, 72 were White while 9 were Hispanic. Additionally, the remaining 32 were African American. During the study, each caregiver underwent assessment for depression, burden, and quality of life (Dang et al., 2008). Moreover, the caregivers were also assessed on knowledge, coping, and satisfaction.
However, it is worth noting that none of the outcome measures changed significantly even after 12 months of monitoring. Nonetheless, it should also be noted that 40 care-recipient and caregivers dyads gave a response within the 12-month telephone satisfaction survey (Dang et al., 2008). In this regard, it was found that over 90% of respondents were satisfied by the quality of care coordination part of the program. Besides, results from the respondents also showed that 77% were satisfied with the education part of the program. On the other hand, 50% of the respondents were satisfied with the monitoring part of the program (Dang et al., 2008).
This evaluation showed that more respondents were satisfied with coordination than education or monitoring parts of the program. Even though a systematic study was not done at the time, the study showed that care coordination helped improve the quality of services provided by caregivers. Moreover, it was quite evident from the results of the pilot research project that care coordination in combination with screen phones would be vital for supporting caregiving in controlled care settings (Dang et al., 2008). This study also showed the importance of telehealth in improving caregiving in managed care settings.
Moreover, it also showed that telehealth was essential in caregiving because its benefits traversed across the various departmental units of caregiving centers (Dang et al., 2008).
This research conducted a literature review to get an inclusive view of the benefits of telemedicine in the management of five common chronic illnesses (Wootton, 2012). The illnesses considered in the research included hypertension, diabetes, and asthma. Also, the research included COPD and heart failure (Wootton, 2012). During this study, randomized controlled trials (RCTs) were done. The study identified 141 RCTs. The study also tested 148 different telemedicine interventions for 37,695 patients. In the process of testing, the value of outcome from each intervention was classified by the outcomes detailed by the individuals conducting the trial (Wootton, 2012).
In essence, each intervention tested was viewed and classified independently. That is, the investigators did not explore a common outcome for all the trials. Essentially, the practice in the conventional meta-analysis was not utilized in this research study. In summary, the resulting outcomes were found to convey positive effects. Specifically, 108 interventions brought a positive effect while just 2 interventions brought a negative effect (Wootton, 2012).
Wootton suggested possible publication bias in this case. Moreover, he claimed that there was no significant difference between chronic illnesses. That is, telemedicine conveyed equal results in all the illnesses without differentiating each case. Essentially, telemedicine was effective in the 108 interventions equally and was ineffective in the two interventions equally. Additionally, the author argued that most studies were relatively short term. Essentially, the author believed that the median duration of the study was six months (Wootton, 2012). Therefore, he argued that interventions couldn’t be realized on a short-term basis, especially for chronic illnesses.
Wootton believed that the interventions would be more effective when applied over a long period. Wootton also blamed inconsistent results on a few studies emphasizing cost-effectiveness. The author concluded that the evidence base that tried to evaluate the value of telemedicine was generally weak and contradictory (Wootton, 2012). Moreover, he believed that more research studies should be done to establish the cost-effectiveness of telemedicine. However, Wooton was quite specific that the duration of the study was short for the study of the use of telehealth in the management of chronic illnesses (Wootton, 2012).
Conclusion
Attempts to utilize technology in healthcare began in the 20th century. Since then, many benefits have been derived from telehealth and telemedicine. Patients can now receive remote assistance from home using telehealth and telemedicine devices. Moreover, the literature review above has shown that incorporating technology in health care can save time and resources. The review has also shown that telehealth and telemedicine are increasingly becoming important in the healthcare industry.
Moreover, several literature materials reviewed have proved that coordinated caregiving and support for patients using technology can improve the quality of care. Moreover, it has been shown that telehealth improves the quality of care for patients from remote areas. It has also been proved that telehealth provides educational benefits to patients and caregivers alike. Further revelations from the literature review have shown that telehealth is essential to the growth of the healthcare industry.
Moreover, it has also been established in the literature that telehealth devices are crucial in the management of chronic illnesses in a controlled healthcare setting. The use of video conferencing and screen phones are some of the new technologies that have been adopted for utilization in telehealth and telemedicine. Moreover, the use of the telephone has also been listed as helpful in telecare. Health care providers and patients have been found to show satisfaction with coordinated care, which utilizes technology. In this regard, telecare has become an integral part of caregiving. Furthermore, remote telecare has flourished because of improved technology in video conferencing.
This has resulted in the building of smart homes for caregiving when patients receive personalized telecare. However, it should also be noted that some authors have also proposed further studies in the field of telehealth and telemedicine. In particular, Wooton was not convinced that the current studies are adequate for establishing the benefits of telecare. However, most authors concluded that telehealth and telemedicine are cost-effective. Moreover, the authors agreed that telehealth is educative and it improves service delivery to patients.
Reference List
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