Telehealth for Family Nurse Practitioners: Virtual Healthcare
This year the United States healthcare system is undergoing unprecedented change. Historically, the complexities of the American healthcare system have slowed organizational change, but the global pandemic has forced Americans to adapt quickly. The healthcare system that emerges on the other side of COVID-19 will be different than ever before.
What does this mean for nurse practitioners? Telehealth nurse practitioner jobs and nurse practitioner degrees are in high demand and will contribute to the transition from traditional in-person care to virtual care. The well-being of millions of Americans and the state of their economy relies on the success of the healthcare system. Americans will rely on telehealth to increase access to care during the pandemic and long afterward.
Learn more about the changes in telehealth, the role of a nurse practitioner and the future of the United States’ healthcare system throughout COVID-19 and beyond.
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Everything You Need to Know About Telehealth
Healthcare providers have been slowly introducing telehealth technology to their practice for several years, but the COVID-19 pandemic has accelerated the adoption of telehealth. Telehealth claim lines increased 4,347% nationally, from 0.17% of medical claim lines in March 2019 to 7.52% in March 2020.
COVID-19 has changed Americans’ perception of telehealth. According to a recent survey by Sykes, approximately three-quarters of respondents said they would consider using telehealth to be remotely screened for COVID-19, and two-thirds said the pandemic has increased their willingness to try virtual care. Telehealth is changing, and healthcare providers must stay up to date.
What Is Telehealth?
Telehealth is the use of virtual communications and digital technologies to provide and access healthcare services remotely. Telehealth uses numerous methods to assess, treat and manage the healthcare of users, including:
- A telephone or mobile device
- Video conferencing
- Online patient portals
- Email communications
- Instant messaging
- Store and forward information sharing
- Automated scheduling and booking
- Personal health applications
Telehealth is not only used to administer clinical services, but it’s also used by a nurse practitioner interacting with patients via telehealth visits or a healthcare provider to improve efficiency and streamline administrative tasks using non-clinical services. Telehealth improves efficiency by enabling practices to:
- Store exam notes, history, test results, X-rays or other files
- Streamline patient booking
- Set payment processing on autopilot
- Provide built-in consent forms
- Track key metrics for the practice
- Expand healthcare operations
The Evolution of Telehealth
The history of telehealth extends as far back as 1906 when the inventor of the electrocardiogram published a medical paper on the telecardiogram. In the 1920s, healthcare providers started using radios to provide remote medical advice to people on ships.
The earliest account of hospital-based telemedicine took place in the late 1950s when a closed-circuit television link was connected between the Nebraska Psychiatric Institute and Norfolk State Hospital for psychiatric consultations.
Nowadays, when Americans think of telehealth they probably imagine LED screens, smartphones and video conferencing. In 2020, technology has allowed consumers to use telemedicine technology in their residence. Text therapy and other instant messaging platforms enable patients to text counselors and other healthcare providers in seconds.
The introduction of artificial intelligence and machine learning may quickly alter the future of telehealth. A nurse practitioner should be aware of the evolution of telehealth since it has an inherent impact on healthcare service delivery.
How Is Telehealth Changing?
On March 6, 2020, the “Coronavirus Aid, Relief and Economic Security” Act (CARES) was introduced as a new law. This law ushered in telehealth changes by providing healthcare agencies with more funding to address the COVID-19 outbreak and relaxing existing telehealth restrictions to enhance patient access to healthcare services.
The presence of COVID-19 is changing telehealth regulations in the following ways:
- CARES will invest $29 million per year for the next four years for the expansion of the telehealth infrastructure
- Practitioners can use everyday communication platforms like FaceTime or Skype and personal phones and tablets during the COVID-19 public health emergency without breaking HIPAA rules
- New patients can receive telehealth services
- Users of telehealth can access healthcare services without geographical site restrictions
Stricter regulations may be introduced after COVID-19, but at present, telehealth remains accessible to help professionals such as nurse practitioners and other HCPs deliver remote care with ease.
Telehealth vs Telemedicine: What’s the Difference?
If telehealth is the use of virtual communications and digital technologies to provide access to clinical and non-clinical healthcare services remotely, then what is telemedicine?
Telemedicine refers specifically to the remote clinical services used by patients.
One study asked individuals working in telehealth, such as nurse practitioner and physician roles, about the top 10 uses of telemedicine today and found that patients used telemedicine for the following:
- Concierge services for fee-paying patients: 91%
- Medication management/prescription renewal: 86%
- Minor urgent care (i.e. pink eye, fevers): 85%
- Birth control counseling: 83%
- Home health care: 82%
- Chronic condition management: 80%
- Pediatric after-hours needs: 79%
- Behavioral health: 77%
- Post-hospital discharge: 73%
- Post-surgical follow-up: 59%
Virtual Appointments vs In-person Appointments
Despite the increasing willingness to try virtual appointments, some Americans are still unsure about what a virtual appointment entails. In-person appointments require “bedside manner”, a term that refers to “a doctor's approach or attitude toward a patient.” However, a new term coined, “webside manner” is a health care provider’s approach or attitude toward a patient in a virtual setting.
A telehealth nurse practitioner must learn how to conduct oneself in a virtual appointment to maintain the quality of care a patient receives. Professionals in telehealth nurse practitioner roles should engage in the following to exhibit positive webside manner:
- Establish a “telepresence”: Periodically make eye contact with the camera or screen
- Over-communicate: Guide patients through the assessment and explain what they should expect and why
- Respect privacy: Deliver virtual care from a quiet, private space
- Be professional: Ensure the setting is clean and you are dressed professionally
- Prepare: Review the patient’s medical history (if it’s available) before the assessment and have a plan of action to increase efficiency
- Answer questions and schedule a follow-up: Allow time at the end of the assessment for the patient to ask questions and schedule a follow-up appointment before exiting the call
Patients who are new to telehealth may require additional guidance from a telehealth nurse practitioner during their appointment. Healthcare providers should communicate with clarity and answer any questions their patients may have about the virtual appointment process.
Nurse Practitioners Who Work Using Telehealth Technology
A nurse practitioner sees patients in a virtual setting by working remotely using telehealth technology. Telehealth plays an important role in the solution to the nursing shortage in the United States.
According to a recent study, “It has been reported that agencies using telehealth have an average patient-to-nurse ratio of 15:1, as compared with non-telehealth agencies having a ratio of 11:1.” This means that a nurse practitioner can use telehealth to see more patients and provide timely care.
A nurse practitioner who administers care via telehealth can monitor, educate, follow-up, collect data and manage care remotely. Family nurse practitioners can also provide family support and help patients manage chronic illnesses from a distance. A nurse practitioner practicing in a telehealth role is responsible for the following:
- Perform comprehensive health assessments over a telemedicine platform
- Use evidence-based practice to formulate diagnoses and establish care plans
- Build positive, therapeutic relationships with clients
- Provide education, resources and counseling about acute and chronic conditions
- Use telehealth to streamline administrative tasks
- Collaborate with other team members
The demand for nurse practitioners in the United States has inflated salary opportunities for working nurses. According to Ziprecruiter, as of Aug 21, 2020, the average annual pay for a nurse practitioner working in telehealth in the United States is $113,883. They also report salaries as high as $242,500 a year for nurses working in high-paying cities with more work experience.
The job outlook for a telehealth nurse practitioner roles in the United States is very positive. According to the U.S. Bureau of Labor Statistics (BLS), jobs as nurse anesthetists, nurse midwives and nurse practitioners are projected to grow 26% from 2018 to 2028. This growth rate is categorized as “much faster than average” when compared to other job outlooks in the United States today. The impressive job outlook is due in part to the aging baby boomer population, the mass retirement of licensed nurses and the subsequent nursing shortage confronting the nation, according to BLS.
A family nurse practitioner is a highly educated professional with many years of academic and hands-on experience. A typical FNP in the United States must earn at least a master’s degree in one of the advanced practice registered nurse (APRN) roles, have a minimum of two years of clinical experience, have a state license and pass the national certification exam.
Many FNPs earn their doctor in nursing practice (DNP) while continuing to work as full-time nurses. Working nurses often opt for flexible nursing programs that allow them to complete their advanced education while remaining employed. Online degree programs allow nurses to complete courses according to their schedules and sometimes provide clinical placements.
Benefits of Telehealth
Telehealth is beneficial to FNPs and patients when used effectively. The widespread adoption of telehealth could help remedy several healthcare challenges that are affecting the United States. Telehealth displays the following potential uses for healthcare personnel:
- Screen patients for COVID-19
- Provide low-risk urgent care remotely
- Increase access to mental health therapy and addiction counseling
- Monitor patients with chronic health conditions
- Connect with patients in rural areas
- Follow-up with patients after hospitalization
- Create hybrid online and in-person programs for physical therapy
- Support internal healthcare personnel education and training
- Improve practice efficiency
The potential uses of telehealth have led to the resulting benefits:
- Reduce expenses: In one study, the use of telemedicine resulted in cost savings from $300 to $1,500 per visit for the hospital and $19 to $120 per visit for patients.
- Increase revenue: A recent survey found that 84% of U.S. patients are more likely to select a provider who offers telemedicine over one who doesn’t.
- Mitigate exposure: Healthcare providers who treat patients remotely reduce their exposure to illnesses, such as COVID-19.
- Improve patient satisfaction: 77% of consumers who have tried virtual visits report a high level of satisfaction.
- Help with staffing shortages: Studies show that the use of telemedicine can increase the capacity of healthcare personnel, which may help them to reach more patients.
The Limitations of Telehealth
Despite the many potential uses and benefits provided by telehealth, disrupting the traditional healthcare model also comes with challenges. Telehealth is still relatively new to the healthcare landscape and comes with its own limitations. The following areas reflect some of these limitations for people working in telehealth nurse practitioner roles:
- Insurance coverage: Not all insurance companies cover telemedicine services, which could be a deterrent for patients.
- Privacy: Medical data may be susceptible to security breaches and hacking online. Privacy risks could be a concern and deterrent for many patients.
- Licensing: A nurse practitioner working in a telehealth role must be aware of state laws and may not be able to treat patients who live in different states.
- Technical difficulties: Not all telehealth platforms are easy-to-use. A nurse practitioner should be trained in the proper use of telehealth technology.
- Inability to examine patients: Not all appointments can be administered online; telehealth is not always suitable for first-time visits.
The Future of Telehealth
What will the future of telehealth look like and how can a nurse practitioner prepare for upcoming changes? “There are two main areas of adaptation for telemedicine at this time: Hospitals are expanding their telehealth services and also finding ways to train staff on a shortened timeline,” said Lisa Hedges of Software Advice in Healthcare IT News.
Staff training will be essential during the healthcare industry’s large-scale transformation. Hospitals, clinics and other healthcare service providers are seeking educated family nurse practitioners, ideally with previous experience working in a telehealth nurse practitioner role.
The American Hospital Association (AHA) is currently advocating for several changes in telehealth, such as:
- The resolution of legal and regulatory challenges in virtual care
- Expansion of insurance coverage with adequate reimbursement
- Further federal research on the cost-benefits of telehealth
- Improved access to technology in rural areas
If the demands listed by the AHA come to fruition, it will be easier than ever for a nurse practitioner to deliver high-quality virtual care to more patients. This results in financial savings, increased efficiency and higher patient satisfaction in the United States’ healthcare system.
Become a Nurse Practitioner With an Online DNP-FNP
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Are you interested in becoming a nurse practitioner while continuing to work full-time? Marymount University provides students with the following resources and outcomes:
- Guaranteed clinical placement services
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Take your nursing career to the next level with an online DNP-FNP degree from Marymount University.
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