Question

 

1. Discuss your understanding of the trend Telehealth (or telenursing)/virtual healthcare in healthcare and its potential impact on your practice as a nurse.

2. What are the legal, privacy, and ethical considerations of this trend?

Answer 1

1. Through telenursing, a registered nurse is able to provide nursing services through remote telecommunications. While aiding the patient and family with virtual learning, the telenurse provides the best practice to achieve optimal outcomes for the patient. Telehealth nursing practice is now considered to be a subspecialty of nursing. Telenursing has both advantages and disadvantages. Patients benefit from decreased hospital readmission, prevention of complications related to the disease process, and lower healthcare costs. Hospitals increasingly are turning to telehealth as a tool to increase patient access to care, manage care better and lower healthcare costs. Barriers to telenursing include communication failure; disadvantages related to resources in the home environment and confidentiality concerns.

2. As with conventional healthcare, confidentiality, consent and non-maleficence are basic principles in telemedicine. An efficient service meant a better service in terms of quality of care, mainly by increasing accessibility by minimising traditional barriers created by time and location. However, only people with the resources to gain access benefit.There are potential ambiguities in practitioners’ responsibilities, in terms of loyalty to patients or the employer. For example, if staff do not have physical/live contact with patients so are not aware of their holistic needs, this could cause them to focus on investigating the health problem rather than establishing a rapport. Staff could therefore become more committed to their employer than to patients. Telemedicine relies on transmitting data. This means secure networks and data transmissions are critical to confidentiality and privacy. The legal issue is not whether electronic systems can provide airtight security, but whether they can protect privacy as well as or better than paper systems.

Patient privacy during telehealth consultations should be maintained as much as possible, although it is understandable that privacy might be limited when such technology is used. Healthcare professionals should ask patients if they have any questions that might require more privacy than provided. It is important to explain to patients that privacy and confidentiality cannot be guaranteed in telemedicine, as medical records can be shared with other practitioners involved in their care. The nature of the professional-patient relationship changes dramatically, as telemedicine challenges traditional concepts of privacy and confidentiality.