Evaluation Criteria And Questions As defined in Chapter 1an evaluation criterion is a measure, indicator, standard, or similar basis for describing outcomes or making judgments.
Finally, the definition deliberately omits resource constraints on the grounds that judgments of what constitutes excellent, acceptable, or unacceptable quality should be independent of constraints on resources.
How do costs compare? Question about Costs and Cost-Effectiveness Table 7. Other access indicators included rates of vaccine-preventable childhood diseases and rates of immunizations. Cost analyses can address these issues and clarify their implications but cannot definitively resolve them.
Comparisons of clinical interventions or programs should be adjusted statistically to account for differences in patient risk factors.
Telehealth-specific licenses Reciprocity and endorsement with other states Interstate compacts For example, the Interstate Medical Licensure Compact IMLCan agreement between 18 states and 23 osteopathic and medical boards, offers an expedited process for qualified physicians to be licensed to practice in multiple states.
Some of the questions in Table 7. What are the challenges related to telehealth services in rural communities? Kansas, Oklahoma, Arkansas and Texas.
Residents of an area may be considered to have access to available services e. In several telemedicine evaluations, patient satisfaction data appear to be the only patient-level data collected ORHP, Depending, however, on the setting, the clinical condition, the predominant financing mechanism, and other circumstances, one area may warrant more attention than another in a particular telemedicine evaluation.
ConclusionThe field of telemedicine has been around for a while, and even though some think that the growth of this field has been stunted, others believe that the time will come when telehealth and telenursing will be more mainstreamed and utilized. Would they want to use them in the future?
How can telehealth be used to reach patients in their homes? A very large literature has accumulated on categories of health outcomes and the tools for measuring them see, e.
Team-based care Specialists for consults in real time Virtual networks with peers In-home monitoring of patients for follow-up care Continuing education and training, reducing travel and out-of-practice time The implementation of telehealth will necessitate staff training and changes in workflows and policies and procedures.
Questions about Quality of Care and Patient Outcomes As explained above, the committee concluded that it would identify basic questions about quality of care to guide evaluators in devising questions and criteria specific to their telemedicine project, its objectives, and its context. USDA Community Facilities Loan and Grant Program Funding to construct, enlarge, or improve essential community facilities for healthcare, public safety, and public services in rural areas and towns of up to 20, in population.
Patients, systems, and data perspectives. In other cases, evaluators will have to create measures and data collection instruments, with less confidence in their validity and reliability see the last section of this chapter.
Eight studies evaluated the addition of telehealth to usual care and demonstrated no significant improvements in processes of care or surrogate laboratory measures, variable impacts on hospitalization rates, and mixed impacts on some domains of quality of life, including improvement in mental health.
The Department of Veterans Affairs VA is an exception, and VA physicians have license portability which allows them to practice across state lines to wherever the patient is receiving care.
Cat scan and MRI are examples of such newer technologies that have become staples in the medical diagnostic world. What constitutes an undue burden will clearly vary across individuals with differing incomes, insurance coverage, transportation resources, physical limitations, employment situations, and other characteristics.
A related but distinct issue is that if parts of the telemedicine infrastructure are subject to rapid obsolescence and need replacing or upgrading, then costs may not decline as much.
As described in Chapter 5the evaluation domains proposed by the federal Joint Working Group on Telemedicine included the "health system interface. Telehealth use in rural areas has been shown to reduce provider isolation and burn-out, and subsequently improve retention. In addition to providing feedback to clinicians and program administrators, evaluators could explore how such qualitative assessments could provide additional guidance about improving practices that appear associated with negative responses.
Questions about Access to Care Table 7. Further, to the extent that managed care and capitated delivery systems encompass a broader range of services and health professionals and to the extent that they maintain a stable enrollee population over time which cannot be assumedthey may come closer than traditional insurers and providers to internalizing the total costs of alternative ways of managing medical conditions.
A IOM report on indicators of access to health care identified several population-based utilization and outcomes measures that could be employed to monitor national access objectives often with a focus on identified problem groups such as rural or minority populations.
Services to be supported and enhanced through telehealth Payment models and reimbursement Equipment needed, which can vary and is dependent on type of services to be provided Facilities able to accommodate the technology Appropriate accommodations where services are to be provided Data services for handling, storing, printing, and transmitting medical information Training of providers and staff Staff buy-in Support staff to implement telehealth programs The California Telehealth Resource Center developed a Telehealth Training Module that addresses how to establish and operate a telemedicine service.
If the health effects or cost implications of telemedicine or its alternatives stretch over time, the future stream of health effects and costs should be discounted to their present value. Developing next-generation telehealth tools and technologies:Each telemedicine evaluation will have to select quality and outcomes measures that fit the patients, settings, services, desired outcomes, and other characteristics of its project.
While some patients may enjoy less face-to-face interaction with so many health care professionals, others prefer one-on-one interaction with their health care team.
A disadvantage of telehealth is the elimination of these regular interactions with.
Impact of Telehealth Interventions on Processes and Quality of Care for Patients With ESRD. Evaluation of their impact, Better understanding of the goals of telehealth interventions from patient and health care provider perspectives is also required to design and test future telehealth interventions appropriate for ESRD care.
Monitoring Patients Through Telehealth Essay Words 8 Pages Introduction Telehealth is the monitoring via remote exchange of physiological data between a patient at home and health care professionals at hospitals or clinics to.
Telehealth is the use of electronic information and telecommunications technologies to support long-distant clinical health care, patient and professional health-related education, public health, and health administration, and it can all be brought to the patient’s location ("Telehealth," ).
Telehealth is one advancement with the primary purpose of improving a patient's clinical health status, as defined by the American Telemedicine Association.
Essentially, electronic communications such as two-way video, wireless tools and smart phones are used to exchange medical information.Download