NR 451 Week 3 Healthcare Policy

NR 451 Week 3 Healthcare Policy

        Healthcare Access - Telehealth Services & Technology
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NR 451 Week 3 Healthcare Policy
        Content
Health Care Policy Bill 
Bill Summary
Impact Of Bill On Professional Nursing Practice Standards If Passed
If Not Passed
Impact Of Bill On My Nursing Practice
Communication Strategies
Supporting The Bill
Impact Of Bill On Community

NR 451 Week 3 Healthcare Policy

This is the content of the presentation. It begins with the selected health care policy bill and its summary. We will look at the Impact Of Bill On Professional Nursing Practice Standards If Passed

And also If Not Passed.  Further, we will look at Impact Of Bill On My Nursing Practice, standards and patient outcomes. Then my approach in Communicating Concerns Of The Bill  and Supporting The Bill under different scenarios. Eventually, we will understand Impact Of Bill On the Community. 
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2        Health Care Policy Bill  
Bill Name: ACCESS Act or Support for Seniors Act
H. R. 596 – 117th Congress – 1st Session
Title 1: Supplemental appropriations
Title 2: Increased Access to Telehealth Services and Other Technologies
Title 3: Miscellaneous

NR 451 Week 3 Healthcare Policy

Bill name is Access act with section number H. R. 596, The purpose of the bill is To increase the ability of nursing facilities to access telehealth services and obtain technologies to allow virtual visits during the public health emergency relating to an outbreak of coronavirus disease 2019 (COVID-19), and for other purposes.
The bill has 3 sections or titles in it. Section 101 is Supplemental appropriations. Sec 201. is Definitions and Sec 301. is Emergency designation. 
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        Bill Summary 
Advancing connectivity during COVID-19 emergency to
Increase health care access 
Ensure Support for Seniors Act
Funding to increase access to telehealth services  & virtual
Funding is considered as emergency spending
Addresses barriers faced by skilled nurses
Funding continues for one month after emergency end
Access to telecommunications and broadband services

NR 451 Week 3 Healthcare Policy

Advancing Connectivity during the Coronavirus to Ensure Support for Seniors Act or the ACCESS Act
This bill provides funding to increase access to telehealth services and virtual visits in skilled and other nursing facilities during the COVID-19 (i.e., coronavirus disease 2019) emergency. The bill designates the funding as emergency spending, which is exempt from discretionary spending limits.

Specifically, the bill provides additional funding for FY2021, to remain available through FY2022, to the Telehealth Resource Center Program to address barriers to telehealth faced by skilled and other nursing facilities. The Office for the Advancement of Telehealth within the Federal Office of Rural Health Policy in the Health Resources and Services Administration manages this program.
In addition, the bill provides funding for FY2021, to remain available through one month after the emergency period ends, to the Department of Health and Human Services (HHS) for grants to nursing facilities to support virtual visits for residents during the COVID-19 emergency. HHS must develop relevant guidance for these grants within 15 days. HHS must also coordinate with the Federal Communications Commission to ensure grantees have access to telecommunications and broadband services.

4  Impact Of Bill On Professional Nursing Practice Standards – If Passed
Increase in emergency funds
Increase in health care access
Implementation of advanced communication technologies
Telehealth & virtual visit services at home
Grants for nursing facilities
Increased staffing and collaboration

NR 451 Week 3 Healthcare Policy

To increase the ability of nursing facilities to access telehealth services and obtain technologies to allow virtual visits during the public health emergency relating to an outbreak of coronavirus disease 2019 (COVID–19), and for other purposes.
For an additional amount for the Telehealth Resource Center of the Federal Office of Rural Health Policy of the Office for the Advancement of Telehealth, to provide assistance with respect to technical, legal, regulatory service delivery or other related barriers to the development of telehealth technologies for skilled nursing facilities and nursing facilities
Authority to award grants to nursing facilities for supporting virtual visits during the COVID–19 public health emergency
The Secretary shall award grants directly to skilled nursing facilities and nursing facilities in accordance with this section to support virtual visits by family members and other individuals for residents of such facilities during the COVID–19 public health emergency period.

Telehealth is bridging the gap between people, physicians and health systems, enabling everyone, especially symptomatic patients, to stay at home and communicate with physicians through virtual channels, helping to reduce the spread of the virus to mass populations and the medical staff on the frontlines

NR 451 Week 3 Healthcare Policy

5   Impact Of Bill On Professional Nursing Practice Standards – If Passed
Training staff to increase skills
Reduces health care cost due to reduced hospital visits
Increase patient satisfaction
Reduce burnout in nurses and HCPs
Quality improvement and early diagnosis
Reduced risk of infection
Timely care and remote health care services


NR 451 Week 3 Healthcare Policy

Telenursing — or telehealth nursing — uses technology to provide nursing services through computers and mobile devices. As mobile devices become more common and accessible, telehealth is becoming more prevalent as a healthcare option. Instead of healthcare being limited to in-person clinical settings, patients can access their physicians and primary care providers from any location. Telenursing allows patients to connect with their nurses through mobile devices, computers, mobile apps, video technology, and remote patient monitoring.
Nurses use a variety of tools when providing care through telenursing. They can send information to their patients through apps or websites. They can regularly monitor specific patient conditions through remote monitoring. Telehealth physical therapy is another option for patients who are working through the recovery process. Telehealth and telenursing are more prominent than ever as more patients are interested in direct interactions with their healthcare providers.

NPs have come to recognize that the quality of telehealth service parallels that of in-person office visits. Telehealth tools greatly increase efficiency for NPs who deliver service to clients in rural communities and sparsely populated areas.
Telenursing can reduce costs for both patients and practitioners. A 2017 study from Health Affairs found that, on average, an office visit cost patients $146 while a telehealth visit cost only $79. Savings also include reduced visitation expenses and productivity gains from decreased employee absences. Telemedicine’s overall value is expected to exceed $64.1 billion by 2025, according to Global Market Insights.
Three in four patients already feel comfortable with telemedicine, with more warming up to the idea of telenursing every day. Clients especially like the idea of freely accessing specialists that might typically remain heavily scheduled with other patients. According to a study of Massachusetts General Hospital telehealth patients, published by The American Journal of Managed Care, most patients felt virtual health visits were more convenient than in-person visits, more than 60% felt virtual visits were no different in quality from in-person visits, and more than 80% would recommend virtual visits to family and friends.
For patients, particularly those in senior living communities or in rural areas, telehealth nursing provides 24/7 access to medical care.
Ability to manage chronic conditions better Chronic illnesses such as diabetes or CPOD are managed better with regular monitoring. Remote patient monitoring can allow for contact between patient and nurse to occur more easily.
Reduced risk of infection Because patients are not put in contact with others in a doctor’s office or medical facility, the risk of contracting an illness from someone who is sick is eliminated.

Saves time Patients can get their questions answered sooner, or between in-person visits. Telehealth eliminates travel time and time spent in the waiting room, as well as wait times for an appointment.
Saves money In-person visits to doctors’ offices, urgent care centers or emergency rooms come with costs for medical claims, transportation and time. Telehealth eliminates those costs, which can be considerable.
Reduced trips to the hospital reduces burnout in nurses
Providing telehealth access in a senior living community to connect patients with a doctor, nurse or specialist in real-time can eliminate unnecessary hospital visits.  Hospital trips from these communities often take place because there isn’t always a doctor onsite. Telehealth provides that round-the-clock access to medical care. Telemedicine technology and the different care paradigm it enables help nurses minimize stress and the burnout

If implemented appropriately, telehealth can be an incredibly effective approach to ensuring patient and provider safety during this unprecedented outbreak. This unique opportunity to implement innovative and creative approaches to patient care will have long-lasting impacts for the future of telehealth.



NR 451 Week 3 Healthcare Policy


6 If Not Passed  
Prevents people including seniors to access care
Increased risk of infection
Denial of services and HCPs cannot provide services from home
Poor emergency management
Increased burden on skilled nurses and HCPs
Use of outdated or limited telecommunication and patient monitoring services

Lockdown and absence of transportation prevents health care access
Chronic conditions such as cardiovascular conditions prevent health care access
Remote monitoring will not be possible resulting in denial of services
Nurses have to use telephone and video calls, but they cannot monitor patients as there will be no patient monitoring systems such as heart rate monitor, BP monitor, and other sensor services. It increases burden on nurses.


NR 451 Week 3 Healthcare Policy

7 Impact Of Bill On My Nursing Practice 
It will safeguard me from contracting infections
Promotes cohesion and group work
Promotes real-time patient monitoring
Allows telemedicine and prescription
I can care patient from home during emergency
I can schedule the care through telehealth
Reduced work burden due to technology
Telemedicine is proving to be an increasingly valuable tool in their medical arsenal, helping to reduce the spread of infection by providing first-line defense. Much like it has done for doctors assessing and treating patients for influenza—where its use has hit an all-time high—tele-visits can help doctors combat a coronavirus outbreak, even reaching patients in remote locations who have limited access to care. Here’s a closer look at how it promotes early detection, limits exposure, and helps providers treat more patients
Online telemedicine systems are useful due to the possibility of timely and efficient healthcare services. These systems are based on advanced wireless and wearable sensor technologies. The rapid growth in technology has remarkably enhanced the scope of remote health monitoring systems. 
Naturally, this comfort increases their engagement levels; and by increasing engagement, remote patient monitoring can help improve quality of care. Not only are patients incentivized to better engage with their own health thanks to the comfort of quality care, but clinicians are also better equipped to understand and manage their patients’ health situations, with a more constant stream of data that provides a much clearer picture of the patients’ health.

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 Communication Strategies for Legislators
Communication Strategies
Establishing agenda and goals
Writing policy proposal letter with evidence-based report
Get the appointment and discuss on the issue 
Use of assertive communication to highlight concerns
Use of persuasive communication to support the bill
Presenting concerns or supports of the bill
Follow-up after the visit

Use of persuasive communication strategy for support the bill based on evidence

9  Communication Strategies for Peers
Communication Strategies
Evaluate impact of telehealth on quality, equity, access, management, and satisfaction
Discuss on telehealth and its case studies
Motivate peers to discuss solutions for health care concerns
Welcome Diverse Viewpoints
Encourage open communication
Enable knowledge-sharing

Welcome Diverse Viewpoints
One of the benefits of interacting with others, especially those with different opinions or backgrounds, is the ability to broaden perspectives as they begin to understand other viewpoints. Effective peer-to-peer interactions can benefit when employees are open-minded and take time to listen, consider and respond appropriately to opinions that are different from their own.

10 Some Concerns
Legal Risks
Policies and Procedures
Still, telehealth licensing concerns are present
Privacy and Security Risks
Cyber Security Risks
Technical Malfunction May Lead to Panic and Wrong Diagnosis 
High first-time implementation cost
 

NR 451 Week 3 Healthcare Policy

First, it is important to stress that these risks arise only in cases where physicians do not have the appropriate licenses or fail to comply with the rules and regulations of the state in question. If none of this is the case, physicians shouldn’t be worried about legal risks. However, without the correct licensing, and without following the appropriate rules, physicians open themselves up to potentially losing their malpractice insurance coverage, and receiving fines or other punishment as outlined in state and federal law.

Policies and Procedures
A new system requires new strategies. Policies and procedures should address all aspects of providing virtual care. For example, how will patient identification be handled? What constitutes a patient encounter? And, which patients and symptoms are appropriate for a telemedicine visit?
New communication protocols may be needed. For example, how will the telemedicine provider communicate with the patient’s primary care provider or follow up with the patient? Providers must also determine when and how to provide prescriptions, and how billing will be handled.

NR 451 Week 3 Healthcare Policy

All of these policies and procedures must be compliant with regulations and subject to a quality monitoring program.
 Documentation and Informed Consent
Documentation is always important in healthcare, and this is also true when delivering telemedicine services. Documentation protocol must be followed to the letter and include all pertinent details. It’s important to keep documentation of the encounter including the patient’s response to treatment, any patient instructions, who participated in the encounter and the sites that were linked, mode of service delivery or technology used, any technical difficulties, and all patient-related electronic communications such as lab/test results.
Privacy and security risks must also be considered. Using telemedicine and electronic health records can make providers vulnerable to malware and hacks. Password-protected screensavers, encryption, and other safety measures can help keep information safe, while unsecured devices and systems, such as laptops and email, can result in security weaknesses. Compliance with the HIPAA Security Rule is essential.
Informed consent is another key issue. Patients must be made aware of the risks of telemedicine, how the process works, and who will be in charge of their care. Both the patient and the provider should agree that telemedicine is appropriate and retain the ability to stop treatment at any time.

Cyber security risks
Many health care providers, even large hospital networks, likely do not have the IT resources or infrastructure to host and maintain their own telehealth platform, so they use third-party platforms, which creates additional risks.
Health care facilities are particularly vulnerable to cyberattack. “The amount of sensitive information that hospitals, labs and health care organizations have on individuals is staggering; it’s no wonder they are a prime target for hackers.” Ransomware is an attack of choice for bad actors targeting doctors’ offices. In these instances, new, unvetted tools can be a wolf in sheep’s clothing used to breach information.” Providers eager to meet their patients’ needs via telemedicine may also rush into using platforms that do not meet HIPAA requirements or lack adequate privacy protections.

Technical malfunction

Technical malfunctions such as failure in communication during assessment, patient monitoring such as heart rate monitoring might lead to panic and wrong diagnosis. 

As cost of implementation is high, and there are other risks mentioned above, some organizations prefer not to opt for the technology. 


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        Impact Of Bill On Community 
Culture-based care 
Increases cultural humility and competency
Increases trust
Improves overall health access in rural settings
Home monitoring
Telepharmacy 
Bridges gap between health care and community 



Rural health care settings are challenged to provide timely and evidence-based care, particularly for culturally diverse patients with behavioral health disorders. Telepsychiatry and telebehavioral health improve access to care and leverage scarce resources. Many organizations are attending to cultural competencies and approaches to care, but there are no specific competencies that integrate telepsychiatry or telebehavioral health with culture. Existing telepsychiatric (i.e., video, social media, mobile health) and one set telebehavioral health competencies included cultural component, including use of interpreters and language matters. Administrative adjustments are suggested to promote culturally competent care by telehealth via clinical, educational, quality improvement, program/system evaluation, and other (e.g., finance and reimbursement) interventions.
Clinicians’ increased cultural competence has been linked to increased patient satisfaction, treatment adherence and information seeking and sharing. The culture of the clinician affects the interaction, as some speak the patient’s language but have a different cultural background. These factors affect the development of trust versus fear of stigmatization. 

Telehealth can assist healthcare systems, organizations, and providers expand access to and improve the quality of rural healthcare. Using telehealth in rural areas to deliver and assist with the delivery of healthcare services can reduce or minimize challenges and burdens patients encounter, such as transportation issues related to traveling for specialty care. Telehealth can also improve monitoring, timeliness, and communications within the healthcare system.

Telehealth uses telecommunications technology and other electronic data to assist with clinical healthcare services provided at a distance, which can also include providing education, administrative functions, and peer meetings.

Home monitoring can engage patients in their homes between medical visits by helping them effectively manage their conditions

Telepharmacy extends access to pharmacy services, including medications and medication counseling, at rural healthcare facilities and community pharmacies.


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WRITE MY PAPER
AlDossary, S., Martin-Khan, M., Bradford, N., Armfield, N., & Smith, A. (2017). The development of a telemedicine planning framework based on needs assessment. Journal Of Medical Systems, 41(5). https://doi.org/10.1007/s10916-017-0709-4
GovTrack.us. (2021). H.R. 596 — 117th Congress: ACCESS Act. Retrieved from https://www.govtrack.us/congress/bills/117/hr596
Harris, K., Sithole, A., & Kibirige, J. (2017). A Needs Assessment for the adoption of next generation science standards (NGSS) in K-12 education in the United States. Journal Of Education And Training Studies, 5(9), 54. https://doi.org/10.11114/jets.v5i9.2576
Hsieh, P. (2016). An empirical investigation of patients’ acceptance and resistance toward the health cloud: The dual factor perspective. Computers In Human Behavior, 63, 959-969. https://doi.org/10.1016/j.chb.2016.06.029
Keenan, J., Rahman, R., & Hudson, J. (2021). Exploring the acceptance of telehealth within palliative care: A self-determination theory perspective. Health And Technology. https://doi.org/10.1007/s12553-021-00535-9
Mars, M. (2020). Medicolegal, ethical, and regulatory guidelines pertaining to telehealth. Fundamentals Of Telemedicine And Telehealth, 297-303. https://doi.org/10.1016/b978-0-12-814309-4.00013-6
Mason, M. (2020). Updates on current federal telehealth legislation - national health council. National Health Council. Retrieved 25 March 2021, from https://nationalhealthcouncil.org/blog/updates-on-current-federal-telehealth-legislation/.
Morrison, L. (2020). Assessing part-time nursing faculty needs: a needs assessment for a quality improvement project. Teaching And Learning In Nursing, 15(1), 42-44. https://doi.org/10.1016/j.teln.2019.08.011
Nigam, S. (2018). Telehealth and telemedicine: clinical and regulatory issues. Telehealth And Medicine Today, 1(1). https://doi.org/10.30953/tmt.v1.69
Paradis, M., Atkinson, K., Hui, C., Ponka, D., Manuel, D., & Day, P. et al. (2018). Immunization and technology among newcomers: A needs assessment survey for a vaccine-tracking app. Human Vaccines & Immunotherapeutics, 14(7), 1660-1664. https://doi.org/10.1080/21645515.2018.1445449
Tsai, J., Cheng, M., Tsai, H., Hung, S., & Chen, Y. (2019). Acceptance and resistance of telehealth: The perspective of dual-factor concepts in technology adoption. International Journal Of Information Management, 49, 34-44. https://doi.org/10.1016/j.ijinfomgt.2019.03.003



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