Introduction
The landmark of patient protection and affordable health care act has heralded the advent of technology into our telehealthcare and has been proving to provide effective and adaptable solutions to the mental health population. It has gradually innovated from a historical fee-for-procedure orientation prospect embarking on the quality of care centering the patient metrics. Collaborating with mental and behavioral health care in the primary care setting and encouraging interprofessional team-based care will eventually become the future of patient services. During Covid-19, I faced numerous cases when patients refused to visit the psychiatric department – in which I was practicing – due to the pandemic-related restrictions. An identified practice that is relevant in the mentioned department is the utilization of telehealth and eliminating no-show appointments. The purpose of this paper is to justify the implementation of telemedicine into psychiatric practice – as well as provide the associated recommendations – by appealing to emancipatory and personal ways of knowing.
Professional Experience
During my practice in the psychiatric department, I witnessed several cases of patients refusing to visit the facility due to concerns related to the pandemic’s restrictions. Many clients claimed that their mental problems could be abandoned for a while as the hazard to their physical health was more relevant due to Covid-19. For instance, Mr. X said that his depression – specifically, Major Depressive Disorder – was not necessary to treat by professionals, given that the pandemic could simply kill him if he visited the department. Meanwhile, he was not admitting that his state worsened day by day, and it was crucial to figure out a way to help. He got full-spectrum consultations, conversations with the therapist, and mental health treatment via digital platforms such as Zoom and FaceTime, which are associated with telemedicine. Another similar case was related to Ms. Y’s bipolar disorder – the only difference was that she got Covid-19 and could not physically leave her home.
Here, the values, beliefs, and assumptions associated with the presented experience should be formulated. The initial value is patient-centered caring, which implies putting a client’s needs a first place. This was visible from the fact that the classical approach toward treatment was replaced by telehealth activities not inherent to the department’s usual practices. Then, the clinic’s administration paid attention to the customers’ beliefs regarding the appropriacy of telemedicine utilization. Some of them expressed confidence in the success of the described policy and encouraged the healthcare professionals to develop in this direction. Finally, it was assumed that using telehealth standards would result in significant patient outcomes and advanced interprofessional relations in the facility. The administration was sure that the necessity of utilizing digital opportunities would smooth interaction between the departments in general, given the fast data flows associated with telemedicine.
At this point, it seems reasonable to justify the significance of telehealth in terms of improving patient outcomes. Telemedicine is an important component of the global healthcare informatization process. In many ways, its appearance is associated with the development of modern telecommunication technologies (Zhu et al., 2021). Meanwhile, there are a number of objective factors that determine the active use of telemedicine technologies. First, there is a growing need for highly qualified medical care, including among the population living in areas that are geographically remote from medical centers providing such assistance (Bitar & Alismail, 2021). With the high cost of travel to visit medical organizations and receive medical care in person, remote consultations and examinations are the best way to provide medical services.
Secondly, digital technologies are a convenient means of storing and exchanging information related to the health of patients, which is necessary for the joint development of decisions by specialists on further methods of treatment and rehabilitation of the patient (Edirippulige & Armfield, 2017). Thirdly, the need for continuous professional development of medical workers predetermines the importance of telecommunication technologies in the remote development of relevant educational programs.
Fourthly, the management aspect in healthcare is also important: telecommunication technologies provide an opportunity for prompt adoption of coordinated management decisions, which helps to optimize the performance of administrative functions in the healthcare sector. In general, telemedicine technologies are aimed at ensuring the availability of medical care and improving its quality, corresponding to the current state of development of information technology and the healthcare sector. Obviously, the development and wide distribution of telemedicine will help save the budget of medical organizations and ensure the economic efficiency of organizations in the field of healthcare.
Ways of Knowing
The first way of knowing that can be utilized within the scope of the theme is the emancipatory one. It prepares a healthcare professional to promote patients’ rights and social justice (Swift & Twycross, 2020). This aspect is essential to the topic and presented experience, given that some clients expressed concerns regarding their personal data protection while sharing it via digital platforms. Then, the second way of knowing is the personal one, given that the understanding of the issue is founded on my experience to a great extent.
Future Actions
The first recommendation concerns telehealth hardware and software in the psychiatric department. In particular, it is necessary to take into account their cost; that is, they must be economically profitable for the department. In addition, software and hardware must have a simple interface for users, in particular doctors and patients. The department’s team faced some issues in terms of using digital platforms by elderly patients – a problem that was identified through a personal way of knowing. It is worth noting that software and hardware should be chosen depending on the tasks that telemedicine solves.
Via the emancipatory way of knowing, I realized that it is vital to ensure patients’ personal data protection while appealing to telehealth benefits. In particular, to protect the patient’s personal data, it is suggested to use various crypto-algorithms. Moreover, to confirm the diagnosis or the information provided by the consulting doctor, it is recommended to use an electronic digital signature. Some scientists use watermarks to protect images. However, it is worth noting that the security policy should be developed in each specific case of the implementation of telemedicine.
Finally, one of the least researched tasks is the selection of experts for consultations, which was figured out through a personal way of knowing when the process was hindered by the lack of digital expertise of some therapists. A consultant physician must be highly qualified and practice in the relevant field of telehealth. However, it is necessary to take into account that the expert’s opinion is subjective, and sometimes the diagnosis made by him may not correspond to reality. This problem can be solved using the apparatus of fuzzy logic, considering all correct and incorrect diagnoses made by a specific consultant, as well as the possibility of unauthorized access to information during consultations.
Conclusion
To conclude, the above discussion was dedicated to the issue of the utilization of telehealth and eliminating the no-show appointments in the psychiatric department. My telemedicine-related experience was viewed through the prism of two ways of knowing – emancipatory and personal. These ways allowed providing three recommendations in the framework of enhancing data security, choosing appropriate specialists, and using advanced but affordable telehealth hardware and software.
References
Bitar, H., & Alismail, S. (2021). The role of eHealth, telehealth, and telemedicine for chronic disease patients during COVID-19 pandemic: A rapid systematic review. Digital Health, 7(1).
Edirippulige S, Armfield N. (2017). Education and training to support the use of clinical telehealth: A review of the literature. Journal of Telemedicine and Telecare,;23(2), 273–282.
Swift, A., & Twycross, A. (2020). Using ways of knowing in nursing to develop educational strategies that support knowledge mobilization. Paediatric & Neonatal Pain. Web.
Zhu, D., Paige, S. R., Slone, H., Gutierrez, A., Lutzky, C., Hedriana, H., Barrera, J. F., Ong, T., & Bunnell, B. E. (2021). Exploring telemental health practice before, during, and after the COVID-19 pandemic. Journal of Telemedicine and Telecare.