Free Telemedicine And Telesurgery Essay Example

Type of paper: Essay

Topic: Nursing, Health, Business, Services, Internet, Technology, Information, Virtual Reality

Pages: 10

Words: 2750

Published: 2021/01/28

Telenursing refers to the provision of nursing services via telecommunications and information technology where there is large separation distance between the patients and the nurses (American Telemedicine Association, 2011). Telenursing has enhanced the interaction between nurses and patients or nurses and health care applications. The increasing medical cost, expansion of health care to distant areas and increase in a number of patients have contributed to rapid growth of telenursing in the recent past. Telenursing services are essential for improving efficiency, accessibility of healthcare and for delivering nursing care remotely. According to Benhuri (2010), effective provision of telehealth services requires collaboration of international nurses in order to decide on how they can utilize ehealth technologies to satisfy needs of the patients across the globe irrespective of their time, staffing, geographical boundaries and discipline. The use of telenursing has improved the efficiency of delivery of nursing services and has expanded the number of patients without destroying the nurse-patient relationship. This document shall focus on pros and cons of telenursing in the United States.

Background of Telenursing

Nurses have engaged in providing services to patients through telephone calls regardless of time. The use of modern technology especially in communication has contributed to the advancement of telenursing because nurses are able to offer nearly all services they provide to patients in their hospital through telecommunication and telephone calls. Nurses are required to register with organizations providing those services as a full-time or part-time telehealth nurses before they get permission to serve as telenurses. In a survey conducted on 36 countries in 2005 across the world, USA had the highest number of telenurses with 68% while Canada and Australia had 10% and 5% respectively. American telemedicine Association (ATA), International Council of Nursing Telenursing Network, Canadian Telehealth Forum and International Society for Telemedicine and eHealth Telenursing working Group are some of the organization offering telehealth services (American Telemedicine Association, 2011).
According to American Telemedicine Association (2011), telenurses offer services through applications such as remote monitoring, Telephone triage and home care. The telenursing services are practiced in healthcare clinics, prisons, doctor’s offices, mobile units and telehealth nursing call centers. Telenurse links with clients through telephone or online video services to examine and solve the patients issues such as monitoring the blood pressure, advice the patients on how to take insulin injection, how to change the dressing, conduct physical assessment among other services.
Telenursing services involve telemonitoring through gathering and transmitting of clinical data of the patients electronically. The patient is provided with portable monitoring gadgets that are set at home and the patient is taught on how to use the gadgets (Yogesan, et. al, 2009). According to Hebda and Czar (2012), the patient’s clinical data is “transmitted via standard telephone line” to the healthcare provider A trained telenurse interprets the patient’s data to determine the progress and intervene when appropriate to do so. Telenurses have autonomy to make decisions based on individual knowledge and professional ethics They exercise professional ethics by ensuring the protection of patients’ information, making the right decision to save client’s lives and to accept their responsibilities in regard to decisions they make.

Advantages of Telenusing

According to Hebda and Czar (2012), telenursing reduces cost of healthcare by promoting home care services as opposed to hospitalization. The cost of providing nursing services to patients suffering from chronic illnesses and aging patients has become unbearable to most of the patients in the United States among other countries. However, chronic illnesses such as cardiac arrest, hypertension, emphysema, chronic wounds, asthma and diabetes are easy to manage at a low cost through telehealth services. Telenurses can easily monitor patients’ health, recommend drugs, provide consultation services and supervisory procedure via telecommunication technology without face-to-face interaction with the patients thus reducing travel cost and time the patients take to get those essential services (Nelson, et. al, 2012).
According to Nelson, et. al, 2012), telenursing has extended the nursing services to more patients who could have missed such services if there were no teleconferencing. Some nursing services are only available specific locations where some patients may not be aware of such places may find it hard to reach such places to access the services. For example, the number of nurses who have specialized in chronic wounds care in the United States is very few and available in specific places. However, with telenursing services the patients with chronic wounds are able to access the services of wound care experts without the hustle of visiting such places (Yogesan, et. al, 2009). Patients are able to get details on how to manage their wounds remotely that they would not otherwise get. Furthermore, the increasing ratio of patients to nurses has been addressed partly through telenursing.
It has shortened the distance and time covered by patients to seek healthcare services. Telenursing is a home-based healthcare service and is accessible within a short time around the clock (Yogesan, et. al, 2009). Therefore, patients can easily access the healthcare services anytime without having to travel to the hospitals to meet with the nurses.

Disadvantages of Telenursing

Some patients are not confident with telenursing for fear of lack of privacy of patient’s information. Patients’ information requires confidentiality and some patients require a lot of conviction that the information they share with healthcare providers will not be disclosed to another person otherwise they cannot share such information if they risk disclosure to unintended persons (Nelson, et. al, 2012). Therefore, most clients have not developed trust with telehealth due to lack of conviction that their clinical data will be handled confidentially. That could result to inadequate knowledge on how to use the telenursing services by some clients.
The services are not available in all parts of the United States due to inadequate reimbursement model to determine a clear mode of payment for the telehealth services. The Medicare provides for partial reimbursement while Medicaid has no uniform procedure of operation (Hebda & Czar, 2012). Therefore, the services of telehealth providers are being limited by lack of efficient reimbursement policies in the United States thus hindering the accessibility of telenursing services to many patients.
The efficiency of telenursing services is dependent on the communication efficiency between patients and nurses since there is no physical contact between them (Hebda & Czar, 2012). The telenurses rely on the information they get from patients via telephone call or electronic data to make a decision regarding patients’ conditions and the essential intervention to assist the clients. In the case of communications breakdown, the telenrse might not understand the problems of the patients thus the patients cannot get solution to his or her problems. Ethical dilemma might arise if the person calling the telenurse in not the patient but a close relative thus it makes it had for the nurses to make a decision based on information given by another person instead of patients themselves (Starren, Nesbitt, and Chiang 82).
The internet has transformed the world in terms of communication and information dissemination. It is currently considered as a convenient tool used for information and communication exchange among individuals found in any geographical location. In terms of health, the internet possesses to have both advantages and disadvantages effects on humans. This paper is a discussion of internet effects on health with examples and evidences in every effects highlighted. The paper is written in four paragraphs and the first one discusses the relationship between the internet and health. The second is about the negative effect network has on people’s health. The third paragraph is about the negative effects of the internet on health and the last paragraph is on the positive effects of the internet on health.

Internet and Health

The internet evolution has impactedon healthcare services. It has improved the access to health information by the patients, health professionals and general public. Internet has brought e- health which is defined as internet supported health care services and communication processes. There are several electronic engines example MEDLARS which are revolutionizing healthcare field as they enable health professionals to have an easy and up to date access to any medical case via the internet. Everyone is able to access health information via the internet because of the existence of many health publications online. There is also online education for doctors/nurses through applications such as Telemedicine used to improve healthcare knowledge and skills.
Internet brings about information on health that can be inaccurate or unreliable. Currently, the internet is easily accessible therefore it has attracted many people especially patients who go online to retrieve health related information that they use. However, most of the information published online on health websites is usually not updated frequently and lack content sources. A research was carried out by US Department of Health and Human Services supervision in 2011. It showed that only 4% of one of the most frequently visited health web site issued their content source and 2% of health websites showed how their content was updated. This finding raises concerns because studies carried out by Tan, and Nai Lai (82, states that many individuals currently obtain health information from the internet and are likely to prescribe drugs and nutrition supplements online. There is a lot of fake health websites found online. This is evident from an investigation which was directed by Federal Trade Commission in 2011 about websites that promotes fake health products. Federal Trade Commission found the existence of a fake websites which promote Acai supplements that helps people to lose weight. The websites sets up phony news sites which uses the authentic logos of news organizations.
Internet overuse can also have a negative effect on a person physical status. Social media and other online activities can make one to have a lonely inactive life. This lifestyle subsequently results to weight gain and other related health problems because of lack of physical exercises. Also, the internet and other media have been identified to be related to Higher Body Mass Index (Struber, 2004). Too much internet use also affects the health negatively because it can lead to eye problems, headache, backaches and mental disorders. According to Chu et al (2011), one can develop Computer Vision Syndrome(CVS). The CVS is a complex of eye and vision problems resulting from long computer use and idividuals who use internet regularly are at risk. It affects almost 90% of the people who use computer frequently.
The internet does not only impact negatively on health but also positively. According to Hjelm (2005), one of the most positive impacts of network on health issues is the improved communication between health professionals. Internet has enabled patient information to be transferred easily and faster between general practitioners and hospitals. Patient records which are saved in various health regions and hospitals are able to be accessed easily therefore reducing delays when it comes to major issues example discharging letters.

Telenursing and virtual reality

This definition, however, limits AR to some specific technologies. the definition which can be taken which has no limits combines three features which include the ideas of real and virtual, interactive when it is in real time, and the fact that when it is in 3-D it is registered. This approach in definition is more accepted as opposed to the first definition as it includes other technologies like 2-D overlays. There are some application areas where the use of both 2-D and 3-D has been seen. One example is in the film “Jurassic Park” where the objects are photorealistic and mixed with real environment in 3-D but it is surprising because it is not interactive (Caudell, & Mizell 543).
A major decision that will be required when building AR system is whether one will use video or optics to combine virtual and reality. Each of the options has their own advantages and disadvantages. The device that is used to combine the real and virtual is called see-through HMD. In normal standards, closed-view HMDs will not allow the view of the real world directly. This is not the case with see-through HMDs where it is possible to have a view at the world directly. When this is the case, the virtual objects are superimposed by either optical or video technologies.

The diagrams below show how the combination is done by the two technologies, optical and video technologies.

History of AR
Augmented reality started with a scientist called Morton Helig in the 1957. His work started with creating a machine that was called Sensorama. This machine had a design that was to model that of a cinematic experience such that it was to take in all the senses. This machine was able to blow wind at someone, was able to cause vibrations on the seat that someone sat on, and also was able to play sounds right before the eyes of people staring at them! Although it was expected that the construction would sell commercially, this was not so. This was because it was still not easy for the cameraman who was to have three cameras stripped around him/her all the time.
In 2008, Augmented Reality found their way to smart phones where people can enjoy the experience of getting close to somewhere even though they are far from that place using the smart phones.

Why we need AR

There are many applications that have come with augmented reality. It has found its application in the medical field where doctors and nurses use this technology in surgery. With AR, doctors are now able to collect datasets for patients while they are in real time. The datasets that are collected can then be combined in real time with a view of the real patient. What this will mean is that the doctor will have a vision of the X-ray inside a patient using this technology. They will then avoid any hazardous happenings that might happen in the real time. The AR technology is also useful for general application in the surgical room. With this technology, surgeons are able to some features using the naked eye; this is not possible in MRI or CT scans and vice versa. The technology is in a position to give access to both data to the surgeons simultaneously (Andrew, Collmann, and Borda 82).
Another application of AR technology is in manufacture and repair of complex machines. It has helped to get the visualizations of the insides of the complex machines that are constructed everyday. It has helped to understand complex machines rather than relying on theory alone. With this technology, engineers are now able to get 3-D images on the work they are working on.
The technology is also used in aircraft engineering where helicopters use Head-Up Displays (HUDs) and Helmet-Mounted Sights (HMS). This has been simplified with the use of this technology.
The technology is also very useful in the entertainment world where the many exhibitors show virtual sets that will me used to merge real actors with backgrounds which are not real and also which are in 3-D. what will happen is that the actors will stand in front of a screen which is blue in color while a camera which is controlled by a computer will be used to record the scene.

Previous version of AR

Initially, AR was used in stationary systems. They were performed in closed rooms. Today, things are changing real fast as the applications are found on the fly. With wearable computing, the applications of AR are varied. With the developments that are seen currently, engineers are seen to be keen on coming up with mobile applications. The previous applications dealt with applications of AR in the stationary nature. The machines and cameras were stationary as they were associated with stationary desktop computers. This is no longer the case as new emerging trends advocate for applying the AR technology in the field and not confined in one place alone.

Comparison with similar technology

One similar technology of Augmented Reality is Virtual Environments (VE). Comparing with the VE, one major problem with VE is rendering. This is no longer a problem in AR. In VE, there is a need for realistic images given the fact that they replace the real world completely with the CE. This is not the cases with the AR where the images are only used to supplement the real world. In AR, therefore, fewer virtual objects need to be drawn and what is more, they don’t have to be realistic in order to be used in the said application. In AR, the display devices have fewer requirements as compared to virtual environments. Tracking and sensing are two areas where the requirements of AR are stricter than in virtual environments. This restriction is attributed to the problem of registration in AR.


Nurses like Manuel should understand that telenursing enhances the nursing care and not a replacement of nurse. Furthermore, it strengthens the relationship between patients and nurses since it extends the presence of nurses around the clock thus increasing patients’ satisfaction. Patients must be willing to use telenursing services and give consent and willing to use such gadgets before they start getting such services. Furthermore, telenurses have competence for handling ethical dilemmas in their practices and exercise high sense responsibility in their practices. Telenursing is a reality and the way to go due to in order to solve the issue of increasing shortage of nurses and high cost of nursing services.


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