The Rising Role of Telemedicine and What It Means to Nurses

Telehealth services can be delivered by a variety of health care professionals, ranging from physicians to psychologists to nurses. With telehealth services, patients can talk with a health care provider on any connected device.

Nurses across the nation are affected by the increased demand for telehealth services. Here’s how telehealth and nursing work together to optimize patient care.

What Is Telehealth in Nursing?

Telehealth is using telecommunications technologies such as video conferencing to provide health care, health education and health administration. Telehealth also involves communicating health information via electronic channels, such as the internet, virtual imaging and streaming media.

According to a 2019 report in the journal Nursing, office nurses have communicated health care knowledge to patients in remote settings, such as over the phone, since the 1970s. Labor and delivery nurses have also talked with mothers about possible labor symptoms and infant health over the phone, while emergency department nurses have communicated about injuries and illnesses.

What is telehealth nursing? It is any type of health care that nurses provide using remote technologies. Telehealth nurses, or nurses who are using telehealth technologies, can:

• Discuss health care issues with patients, such as medication refill needs and lab results
• Clarify treatment options and answer questions about medications
• Provide patients with education about self-care at home, such as how to treat a minor burn or dress a wound
• Assist with appointment scheduling
• Guide patients prior to visits and provide post-procedure insights

Since telehealth practices debuted several decades ago, the impact of telehealth on nursing practice has increased. An important component for how telemedicine is used in nursing is that telehealth services must abide by the same legal and ethical standards all health care is delivered by. According to the American Nurses Association (ANA) Core Principles on Connected Health, updated in June 2019, these standards include:

• All care is grounded in the Nurses Code of Ethics and focuses on providing high-quality personalized care.
• All telehealth care provided is subject to the same health care laws that govern in-person care.
• All telehealth provided must meet state-specific regulatory and institutional requirements.
• Telehealth services should be congruent with in-person care and must adhere to the best available evidence that represents current and emerging interdisciplinary standards of care.
• Patient health information, privacy and confidentiality must be maintained throughout electronic information transmission and communication.

Patients can rest assured that however nurses provide health care, whether it’s in person or via online channels, their best interests are always prioritized.

The Roles of Nurses in Telenursing

The nurse’s role in telehealth is wide-ranging. According to the American Nurses Association, a role of a nurse in telenursing might look like:

• Live (synchronous) video conferencing, including the transmission of recorded health history to a specialist or health practitioner
• Remote patient monitoring (RPM), using connected electronic tools to record personal health and medical data in one location for review by a provider in another location, typically at a different time
• Mobile health (mHealth), providing public health information and health care via mobile devices, including notifications about disease outbreaks, general education information and targeted texts

Today, telehealth is an extension of many health care providers’ health plans, offices and hospitals. Telehealth services may be provided by nurses working remotely from their homes, in independent nursing practices, or for corporations where multiple telehealth nurses work in a single location.

Sometimes telehealth nurses are available 24/7 to answer questions about symptoms and provide evidence-based guidelines. Telehealth nurses may also assist with ambulance dispatch in life-threatening situations.

Since telehealth is becoming a more popular option for patients and health care providers, experience in telemedicine may be helpful for nursing professionals. RNs who are working on a Bachelor of Science in Nursing (BSN) can learn about telehealth in their programs, including the latest technologies and best practices to employ.

The Benefits and Drawbacks of Telehealth

Telehealth provides some convenient benefits to both patients and providers. As technological capabilities evolve, so does patient comfort with getting health care via remote channels.

Telehealth is becoming increasingly popular. According to SYKES research:

• Prior to the COVID-19 pandemic, more than 56% of Americans said they didn’t believe they could receive the same level of care from telehealth services as they could in person. In 2021, nearly 80% of Americans believe high-quality health care via telehealth is possible.
• In March 2020, 19.5% of Americans had experienced a telehealth appointment. In March 2021, more than 61% of Americans had.
• More than 87% of telehealth patients want to continue using telehealth services for non-urgent consultations in the future.

But telehealth isn’t appropriate for every situation. Sometimes medical professionals need to meet patients in person for proper treatment.

In the best interest of patient safety, here are some benefits and drawbacks of telehealth and telemedicine to consider.

The Benefits

Telehealth increases patient access to health care in an on-demand setting. Here are some benefits contributing to its increase in popularity for health care options.

• Improves nursing care efficiency. Telehealth can assist with patient retention, decrease on-call hours for health care providers and offer care around the clock, including after hours and on weekends.
• Financial savings. Telehealth enables financial savings for both patients and the health care system. With telehealth, for example, a patient can avoid the expense of an unnecessary emergency department visit, which also relieves the burden of a health care provider. Also, telehealth can eliminate overhead costs, such as having a certain number of patient rooms or employing front desk staff.
• Peace of mind for patients. Telehealth nurses provide support and encouragement and instill health care confidence for patients. The increased availability of health care via telehealth can also encourage individuals to take a more proactive approach to their health care and improve their preventive care, which benefits their long-term health.
• Decreased risk of illness spread. For patients experiencing a contagious illness such as a cold, accessing health care virtually can prevent the spread of that illness to other patients and health care providers in a medical office.
• More convenience. In-person health care visits can place numerous other burdens on both patients and health care providers, such as having to find childcare or transportation to a medical office. Telehealth eliminates these burdens, as well as increases access to care for people who have disabilities or are geographically isolated.

When patients benefit from telehealth, they may also be more satisfied with their health care provider. For nurses, telehealth services may lead to a stronger patient-nurse relationship.

The Drawbacks

While more patients and providers are embracing telehealth, there are also some potential drawbacks to consider for patient health and safety. These include the following:

• Telehealth may not be appropriate. In life-threatening situations, a delay in in-person care could lead to health problems or death.
• Lack of insurance coverage. Telehealth services may not be covered under certain insurance plans. Patients should check about coverage before seeking telehealth services. Health care providers can proactively check for insurance coverage before providing care to avoid increased costs to the patient.
• Health care fraud. Medical data that’s stored online is susceptible to hackers and digital theft, especially when a patient receives telehealth services on an unsecured network.
• Compromised treatment. There are some accuracy risks to telehealth treatment. For example, if a physical, in-person symptom might have indicated a different type of health care need.

Telehealth capabilities may also face some limitations due to licensing issues. Some health care providers may not be able to legally provide services across state lines, so it’s important for health care providers to always operate according to the laws where the patient is located.

How Nurses Can Prepare for Telemedicine Roles

Nurses who work in telehealth typically have experience working with patients in person. There may be on-the-job training programs to help nurses learn telehealth technologies and practice providing telemedicine services in a supervised environment.

Online nursing education programs, such as the ones offered by Purdue University Northwest, can also help. These programs cover telehealth subjects and provide relevant telehealth education.

As for credentials, there is currently no telehealth nursing certification exam. However, the American Academy of Ambulatory Care Nursing (AAACN) does cover telehealth nursing content on its ambulatory care nursing certification exam for the AMB-BC Ambulatory Care Nurse-Board Certified credential.

According to the AAACN, telehealth is an integral part of ambulatory nursing care. The AAACN recommends all telehealth nurses take the ambulatory care certification exam to ensure up-to-date knowledge on best practices in telehealth nursing.

In-Demand Skills for Telenursing

Nurses who know they want to work in telehealth can also work on cultivating skills that help them in this unique role. Telenursing requires many of the same skills in-person nursing requires, as well as a sense of familiarity and comfort using technology. Some skills to practice if you want to work in telenursing include:

• Communication skills. Telehealth nurses must effectively communicate with patients to provide optimal care. Telehealth nurses rely on gathering information, listening closely and clearly communicating recommendations so patients understand their health care and follow best practices.
• Technology skills. Telehealth technology is constantly evolving. Nurses who work in telehealth must be comfortable with learning new technology systems and using software and applications such as video conferencing to deliver efficient and effective care.
• Critical-thinking skills. Telehealth nurses must always work in the best interest of the patient. They must use a high-level methodology to provide effective remote care, must determine when corrective action is necessary and must coordinate treatment plans to provide the best possible outcomes.

Telehealth nurses must also have strong collaboration skills since they typically work with other health care providers, such as physicians. Like other nursing settings, qualities such as empathy and relationship-building can also benefit those who work in telenursing.

Find Out More About Online Nursing Programs

If you’re interested in a nursing career in telehealth, advancing your education may help. The online RN-to-BSN nursing program at Purdue University Northwest teaches nursing students about current health care technologies. We also offer an online master’s in nursing, with nurse educator and nurse executive concentrations. Contact us today for more information.