Nurses Advancing Telehealth Services in the Era of Healthcare Reform

Joelle T. Fathi, DNP, MN, BSN, RN, ANP-BC; Hannah E. Modin, MHA, B.A; John D. Scott, MD, MSc, FIDSA


Online J Issues Nurs. 2017;22(2) 

In This Article

Abstract and Introduction


The current era of healthcare reform is driving a shift in priorities and pressures for delivery of high quality healthcare. With a surge in the need to efficiently meet patient care demands, and to accommodate the ever-evolving sophistication and modernization of information and communication technologies (ICT), it is an opportune time for innovative care delivery by telehealth. This article reviews the emergence of telehealth in America,describes modalities of telehealth services, and considers such factors as quality, means, and cost of delivery and need for telehealth services. Telehealth can increase access to primary and specialty care, and ensure high quality care at lower cost. The authors also discuss policy considerations related to telehealth, including the roles and contribution of nurses and future consideration for this state-of-the-art care model.


Limited health resources and providers in some American communities exacerbates health disparities (Williams, 2007). Progressive development and sophistication of communication and technology, coupled with demand for novel approaches to care, positions nurses to collaborate and address health disparities in these communities through deployment of telehealth technology. Telemedicine, meaning "healing at a distance" (Strehle & Shabde, 2006, p. 956), is increasingly viewed as a mechanism to deliver more efficient and patient-centered healthcare services to individuals who face barriers to access care.

Delivery of healthcare by means of Information and Communication Technology (ICT) sources is varied, and references to this are commonly used interchangeably. Terms used to describe these services, such as telemedicine, e-health, telehealth, and even mobile health, can be confusing until the construct and meaning of telemedicine is more clearly understood.

The Institute of Medicine (IOM) simply describes telemedicine as "…the use of electronic information and communications technologies to provide and support health care when distance separates the participants" (IOM, 1996, p. 1). Telehealth offers the opportunity to deliver care to a diverse array of underserved populations, including those in rural (National Conference of State Legislatures, 2016), urban, and suburban communities. Modalities and sophistication of telehealth technology have evolved over time, and uses of telehealth in the United States will likely continue to change with the demographics and healthcare needs of the country.