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

Emergence of Telehealth in America

Beginning with the invention of telephonic capability, the concepts and benefit of telemedicine were conceived in 1905 by a Dutch physiologist who utilized the telephone for transmission and monitoring of cardiac sounds and rhythms (Bashshur, Shannon, Krupinski, & Grigsby, 2013; Strehle & Shabde, 2006). The theoretical use of the television for delivery of bi-directional medical care first surfaced in 1924 on the cover of Radio News (IOM, 1996). This was represented in a novel depiction of a doctor, on the screen of a radio, assessing the health of a listener child, through the screen.

The 1940s brought transmission of radiography over telephone circuits between cities in Pennsylvania separated by 20 miles (Gershon-Cohen & Cooley, 1950). Given the potential need for healthcare delivery at a distance, as Americans began traveling to outer space, it was not surprising that the National Aeronautics and Space Administration (NASA) utilized some of the first closed circuit televisions for telemedicine (LeRouge & Garfield, 2013). Soon thereafter, Lockheed Missiles and Space Company and the Kaiser Foundation International partnered to pioneer a remote monitoring system (Gruessner, 2015), known as Space Technology Applied to Rural Papago Advanced Health Care, to provide care for the Papago Indian Reservation in Arizona (Cushing, 2015), a medically underserved rural area. While these first approaches were experimental, and not solely tested in the traditional medical setting, current advancements in technology now drive new opportunities for nurses to deploy telehealth technology in the future (Fong et al., 2011).

Today, patients may be a ferry or car ride away, or many miles from the nearest major medical center, critical access hospital, or primary care provider. All scenarios can result in healthcare delivery service gaps and barriers to access urgent or non-urgent healthcare; contributing to risk for disease and death. Video conferencing and other telehealth methods promote the opportunity to ensure timely care that is efficient, safe, and patient-centered. These outcomes cannot be accomplished without a cadre of nurses and other healthcare professionals.

Providers are increasingly looking to telehealth as a viable care delivery model for the future, and the adoption of certain telehealth technology and delivery of services is on the rise (HimSS Analytics, 2016). Concurrently, growth in technology and changes in consumer behavior are generating younger, technologically savvy patients, who represent diverse populations (Powell, Chen, & Thammachart, 2017). These patients demand efficient ambulatory care at the tap of a finger, driving advances in mobile health technology to provide health education and services via mobile devices (National Conference of State Legislatures, 2016). As one of the most widespread professionals with high level skills, nurses across America are called to action to determine how to leverage informatics and technology in the transformation of care delivery to improve the nation's health with high quality, cost efficient, and convenient care (Sensmeier, 2011)