NURS-FPX6214 Assessment 1 Instructions

Executive Summary: Technology Needs Assessment and Telehealth Capella University

Health Care Informatics and Technology Technology Needs Assessment

Executive Summary: Assessment of technology requirements and telehealth Remote patient care can now be provided through the developing technology known as telemedicine, or telehealth as it is more widely known. Telehealth is a method by which telecommunications technology improve the delivery and support of health education as well as healthcare. It allows patient self-management and long-distance healthcare (Center for Connected Health Policy [CCHP], 2020). A healthcare organization’s adoption of telemedicine will undoubtedly improve patient outcomes. This executive summary serves to make a recommendation for the adoption of a particular telehealth technology at Denver Fertility (DF), with the goal of enhancing patient outcomes and quality of care. The suggestion is supported by data from a technology needs assessment – whilst concurrently discussing policy considerations and its potential impact for stakeholders. NURS-FPX6214 Assessment 1 Instructions

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Relevance and Importance of a Needs Assessment

With the ever changing market of healthcare, there are many new technologies a healthcare organization may choose to implement within their practice. In order to determine which telehealth technology is best suited to their individual practice and will ultimately improve patient outcomes, a needs assessment must be performed.

A needs assessment serves to define the specific needs of populations and telehealth programs, whilst identifying possible assumptions about the value, purpose and intent of instituting new technology amenities (DeGaetano & Shore, 2015). Identification of population needs, and subsequent creation of services to fill these needs, is fundamental to telehealth implementation. With the ever increasing costs of healthcare, identifying a specific solution to fill an explicit need is essential to successful telehealth establishment (DeGaetano & Shore, 2015). Furthermore, a needs assessment is an evidence-based planning for healthcare organizations that ensures appropriate allocation of resources and allows for tailored health services (Aldossary et al., 2017). This assuming, that a given organization is limited by cost and amount of resources. In this instance, conducting a needs assessment at DF in order to determine a specific technology to implement is critical.

Telehealth Technology and Patient Outcomes

Evaluation of a performance gap analysis and technology needs assessment performed at DF informed that the application of mobile health, or mHealth, is the most befitting option for a new telehealth technology implementation. CCHP (2020) defines mHealth as health care, practice, and education that is supported by any mobile communication devices. mHealth supports healthcare through provision of services and personal data via numerous applications (apps), such as targeted text messages, diabetes monitoring, and fitness tracking to name a few (CCHP, 2020).

There are several key issues in nursing care occurring at DF to be addressed (a) patient lack of access to services; (b) deficiency in communication amongst providers and patients; (c) patient knowledge deficit. Nursing care is assisted by mHealth in several ways, and ultimately affords improvements to multiple areas and patient outcomes. Ford et al. (2020) report that patients experienced increased knowledge and awareness of their health and diagnoses after the use of mHealth. In addition, a literature review of 19 studies regarding mHealth found that along with increased access to services, patients experienced improved self-efficacy and self- awareness, and enhanced communication between patients and providers occurred (Radbron et al., 2019). Application of mHealth at DF would assist in all aspects of gaps in performance.

Safety Requirements and Regulatory Considerations

When implementing new telehealth technology, it is important to consider safety requirements and regulatory considerations. These exist not only on a national level, but state-to- state as well. It is imperative that healthcare providers be aware of, and adhere to, these requirements and regulations to avoid penalty. In 2012, the Federal Communications Commission (FCC), the Food and Drug Administration (FDA), and the Office of the National Coordinator for Health Information Technology (ONC) were tasked with the regulation of current technology as well as developing advances in mHealth. These organizations cooperate to protect patient safety and promote innovation, but additionally, the Federal Trade Commission (FTC) defends patients and consumers of mHealth from misleading claims and data breaches (Marcoux & Vogenberg, 2016).

One such regulation is that providers of telehealth must be licensed in the state they practice as well as the state in which the patient resides. The can be a logistical nightmare for some providers, but it is important to consider nonetheless when implementing telehealth technology (Marcoux & Vogenberg, 2016). Another aspect to contemplate is reimbursement regulations for private insurance and federal programs, such as Medicare and Medicaid, alike. It often comes down to specific wording in laws that determine whether or not an organization may be reimbursed for services rendered via mHealth (Adler-Milstein et al., 2014). Additionally, in order to uphold patient safety, some states have specific requirements surrounding online prescribing, such as in person consultations or physical examinations prior to writing prescriptions (CCHP, 2020).

In order to maintain federal and individual state regulations, there is much research and education for healthcare organizations to do before establishing a new telehealth technology. The time, effort, and resources required for this endeavor is something to consider.

Patient Confidentiality and Privacy Protections

In addition to safety requirements and regulatory considerations, patient confidentiality and privacy protections must be considered. The Health Insurance Portability and Accountability Act of 1996 (HIPAA) protects personal health information (PHI). With the addition of telehealth to a covered healthcare organization, obligations to patient confidentiality and privacy do not change (CCHP, 2020). Healthcare organizations must uphold standards, even with new potential risks for a breach in patient data. For example, telehealth upkeep may require consultation with an information technology (IT) team, which involves members that are not a part of the patient care team. This exposure to patient data can be remedied by entering into a business associate agreement that requires the IT organization to uphold the same standards to HIPAA as the healthcare organization (AAAAI, 2018; CCHP, 2020). Encryption and password protection are additional ways to assist with HIPAA compliance, but are not infallible (CCHP, 2020).

Interestingly enough, the current COVID-19 pandemic has caused regulatory bodies to waive imposed penalties for HIPAA noncompliance for healthcare providers utilizing telehealth during this national emergency (Relias Media, 2020). It is uncertain how long this allowance will last for healthcare providers utilizing telehealth. This could allow for a smoother transition period until complete compliance is ascertained by the healthcare organization.

Potential Impact for Stakeholders

Acquisition of new telehealth technology has vast implications for stakeholders and end users. First and foremost, there is potential for a profusely positive impact on quality of care and patient outcomes if DF were to implement mHealth within their organization. Increased access to services, enhanced knowledge and self-efficacy, and improved communication are all potential positive impacts for patients and family members (Ford et al., 2020; Radbron et al., 2019) NURS-FPX6214 Assessment 1 Instructions.

For healthcare providers, mHealth eases the workload and improves efficiency. As Ford et al. (2020) found, mHealth aids in patient education. This alleviates time spent in this area for nurses and providers, allowing them to focus their efforts in additional areas of patient care.

Additionally, information stored in an app, instead of on paper reduced time spent collecting and collating data (Radbron et al., 2019). As stated previously, mHealth also improves communication between patients and members of the healthcare team.

A final consideration is the cost, time, effort, and resources stakeholders will have to put into implementation in order to reap these rewards. While these aspects are important to reflect upon, the benefits of new telehealth technology seemingly outweigh this.

Conclusion

With the ever changing face of healthcare and push for improved patient outcomes, telehealth is a valuable asset for organizations to consider implementing. While the challenges of numerous regulations and time and resources spent are of note, the potential benefits of increased patient knowledge, access to care, and self-efficacy, and provider and patient communication are difficult to ignore. Advancements are continually being made in healthcare, and it is likely that telehealth is here to stay.

References

Adler-Milstein, J., Kvedar, J., W. Bates., D. (2014). Telehealth among US hospitals: Several factors, including state reimbursement and licensure policies, influence adoption. Health Affairs, 33(2), 2-7-215 https://doi.org/10.1377/hlthaff.2013.1054 NURS-FPX6214 Assessment 1 Instructions

Aldossary, S., Martin-khan, M., 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), 1-9. doi:http://dx.doi.org.library.capella.edu/10.1007/s10916-

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American Academy of Allergy Asthma and Immunology [AAAAI]. (2018). Security and HIPAA. Retrieved from https://www.aaaai.org/practice-resources/running-your-practice/practice- management-resources/Telemedicine/HIPAA

Center for Connected Health Policy [CCHP]. (2020). About telehealth. https://www.cchpca.org/about/about-telehealth

DeGaetano, N., Shore, J. (2015) Conducting a Telehealth Needs Assessment. In: Tuerk P., Shore

(eds) Clinical Videoconferencing in Telehealth. Behavioral Telehealth. Springer, Cham. https://doi.org/10.1007/978-3-319-08765-8_2

Ford, E. A., Roman, S. D., McLaughlin, E. A., Beckett, E. L., & Sutherland, J. M. (2020). The association between reproductive health smartphone applications and fertility knowledge of Australian women. BMC Women’s Health, 20(1), 1–10. https://doi-org.library.capella.edu/10.1186/s12905-020-00912-y

Marcoux, R. M., & Vogenberg, F. R. (2016). Telehealth: Applications from a legal and regulatory perspective. P & T: A Peer-Reviewed Journal for Formulary Management, 41(9), 567– 570.

Radbron, E., Wilson, V., McCance, T., & Middleton, R. (2019). The use of data collected from mHealth apps to inform evidence‐based quality improvement: An integrative review. Worldviews on Evidence-Based Nursing, 16(1), 70–77. https://doi- org.library.capella.edu/10.1111/wvn.12343

Relias Media. (2020). Shift to telehealth could remain trend after COVID-19: Reproductive health remains priority. Contraceptive Technology Update, 41(6), 1–4.