MSN-FP6214 Technology Needs Assessment Paper
Technology Needs Assessment for the Implementation of Telestroke Within the Inpatient Urban and Rural Emergency Departments.
Telehealth, also known as telemedicine, has many uses to improve patient outcomes in rural and urban healthcare settings. Telemedicine can be defined as the use of information communication technology to deliver medical services from a distance (AlDossary, Martin- Khan, Bradford, Armfield & Smith, 2017). Through the use of a needs assessment healthcare systems can determine areas for improvement. An area of weakness in the inpatient setting is ensuring that patients get evaluated by a neurologist to retrieve accurate stroke symptom evaluation and treatment. This assessment will take a closer look at the considerations needed to implement telestroke within a network of hospitals that extends from the urban setting to the rural hospitals.
Importance of a Needs Assessment
Prior to implementing a new policy or procedure in the healthcare setting a needs assessment needs to occur. There are many parts of this assessment including expressed needs through communicating with providers, accessibility, affordability and examining quantitative and qualitative data. A good frame work is essential to the success and sustainability of practice changes, such as the implementation of telehealth.
Every community and healthcare setting have specific needs and areas of improvement that need to be met. The interventions determined form the needs assessment allow patients to be treated with a higher level of care which benefits not only patient outcomes but impacts the healthcare staff and stakeholders. Needs assessments are important within healthcare because it is a way to use evidence-based practice to keep systems and policies updated (AlDossary, Martin-Khan, Bradford, Armfield & Smith, 2017).
Key Issues Addressed
Upgrading telehealth technology is important for hospitals to be able to increase the quality of care and patient outcomes while utilizing the advances in technology that have been made over the years. Medicine has advanced exponentially and patients can receive better and more effective treatment, but one of the barriers is the availability and timeliness of this treatment. Strokes are the fifth leading cause of death and the leading preventable cause of disability in the United States (Flanders, 2019). If identified in the first couple hours, patients may be eligible to receive tissue plasminogen activator (TPA), this medicine is a clot buster and the patient may see a full resolution of their symptoms within 24 hours of receiving the medicine.
The American Stroke Association’s door-to-needle time goal is less than 60 minutes. This means that the patient is examined by a qualified physician and medication is being administered, if applicable, to the patient within 60 minutes. Columbus, Ohio has many large hospital systems that have varying levels of neurology services available. Implementing the use of video consultations in the emergency department 24/7 will allow expert recommendations in the quickest time possible.
Safety Requirements and Regulatory Considerations
Real-time telestroke will be a new addition to the emergency departments through the hospital system. Due to this new technology there will be a change in policies and practices that will need to be solidified and regulated throughout each hospital. Providing education to the care providers involved will be essential in making sure that each patient receives the same care. This education will include who initially contacts the neurologist and who is responsible for setting up the video-audio device as well as how follow-up conversations will be had between the care providers. Currently, there is a strict stroke protocol that is in place which will need updated accordingly.
Although a stroke assessment can be done through communication devices, it is possible that it will not always be as accurate as an examination with an in-person physician. It is because of this that the attending physician needs to take primary responsibility for the patient and communication any discrepancies that they find form the neurologist’s assessment and their own. Other regulatory considerations include insurance participation in the reimbursement of the cost of telehealth. These barriers should be minimized in this setting due to the physician being located in the same state as the patient as well as affiliation between the physician and hospital system (Marcoux & Vogenbery, 2016 MSN-FP6214 Technology Needs Assessment Paper).
Patient Confidentiality and Privacy Protections
The Health Insurance Portability and Accountability Act (HIPPA) of 1996 provides data privacy and security safeguards for medical information. This means that no one outside the patient’s care team will have access to their medical information. The same confidentiality that is used in hospitals applies to the use of telehealth, electronic health records and other methods of storing patient information. Technology has increased communication between the disciplines, this is seen through physicians accessing patient information from remote locations and the use of text messaging between physicians and nurses (Storck, 2017).
Telestroke is achieved through the use of video-audio conferencing on a tablet or computer. From the patient’s perspective it is the same privacy as talking to a physician that is physically present in the room. Due to the neurologist being located at another facility or in a nonmedical setting it is important for the physician to be aware of their surroundings and use a password protected, facility approved device.
Potential Impact on Stakeholders
Regulatory agencies such as the Joint Commission in conjunction with the American heart Association developed stroke core measures. Following these measures allows a hospital to receive The Joint Commission’s Gold Seal of Approval. This lets the community and healthcare workers know that the organization is committed to providing the best care and always seeking the highest quality services. The Acute Stroke Ready Hospital Certification has a variety of standards including telemedicine that is available within 20 minutes of it being deemed necessary (The Joint Commission, 2018). Having all hospitals within a hospital system meet these standards of care will bring the best physician and care team, as well as attract patients and funding.
Conclusion
Updating technology throughout the health system is an important way to utilize the best recourses possible and provide the highest level of care. Telehealth has been around for many years but is not being used in many urban and rural hospitals. Successful implementation starts with a needs assessment that examines that specific needs of the community as well as the resources and funding available. Implementing telestroke within a hospital system is a good way to start with a specific ailment and examine the success or areas of improvement.
References for MSN-FP6214 Technology Needs Assessment Paper
AlDossary, S., Martin-Khan, M. G., Bradford, N. K., Armfield, N. R., & Smith, A. C. (2017). The development of a telemedicine planning framework based on needs assessment. Journal of Medical Systems, 41(5).
Flanders, S. (2019). Advancing telestroke interventions in an urban ED: Nursing, 49(6), 18–20.
Marcoux, R. M., & Vogenberg, F. R. (2016). Telehealth: Applications from a legal and regulatory perspective. P&T: A peer-reviewed journal for managed care & formulary management, 41(9), 567-570.
Storck, L. (2017). Policy statement: Texting in health care. On-Line Journal of Nursing Informatics, 21(1), 5. MSN-FP6214 Technology Needs Assessment Paper
The Joint Commission. (2018). Facts about Joint Commission stroke certification. Retrieved from https://www.jointcommission.org/factsaboutjointcommissionstrokecertification/