Considerations When Using Telemedicine As the Advanced Practice Registered Nurse

Abstract

Accessibility to health care is crucial to management of chronic and acute conditions. Although the severe acute respiratory syndrome coronavirus 2 pandemic significantly impacts the issue of access to health care, with the introduction of Waiver 1135, telehealth has become a positive strategy in increasing safe access to health care. This report addresses considerations to take into account when advanced practice registered nurses use telehealth to facilitate access to care.

Access to Care: End-to-End Digital Response for COVID-19 Care Delivery

“…The delivery of safe, effective care in a virtual platform requires a competent and educated workforce. 10 The advanced practice leaders in OSF HealthCare were able to strategize and determine the locations and models for the NPs and PAs to serve and quickly transition them to a new virtual model of care. Advanced practice leaders who are practitioners themselves play a critical role in organizations as change agents and advocates, while ensuring workforce optimization with scope of practice considerations that are maintained.…”

“…The director of advanced practice clinical education and fellowships was redeployed to serve as an interim clinical leader in collaboration with the director of education who served as operational leader for several of the newly designed digital platforms. This NP leader in collaboration with the VP of Advanced Practice/CCE put education, competencies, and NP/PA workforce provider roles into place for the digital Covid-19 response 10 . Advanced practice leaders understand the role, educational background, required competencies, and methods needed to evaluate NP/PA performance.…”

Personalized Digital Health Beyond the Pandemic

“…These include remote patient monitoring, mHealth, and the Internet of things (IoT) ( Table 1 ). 7 , 8 …”

“… Mobile health (mHealth) mHealth is the use of smart devices and health-based apps to continually monitor health. 8 These electronic devices have become part of everyday life for many patients. For example, as of 2020, 97% of Americans own a cell phone of some type, and, of those, 85% are smart phones.…”

Telehealth for patients with diabetes

“…29 Further health disparities are seen in those with cognitive disabilities, mental illness, autism spectrum disorder, and auditory and visual limitations. 25,29 The Americans with Disabilities Act addresses the need for expanded physical space in healthcare facilities, but not across virtual spaces or within the context of remote services like telemedicine. 29 Website and mobile application accessibility standards include applied sign language, captions, magnification, color and contrast, manual dexterity, or physical device mobility; however, telehealth accessibility standardization is relatively new and lacking.…”