The literature review critically valuates the families’ experiences with video telehealth in rural communities in Northern Canada. Many electronic health care research projects have tested the video teleconferencing in Northern Canada. Diverse methods were tested for patients and families residing in the rural and remote communities. This issue will be structured, reassessed and abridged from the review of research studies conducted by Sevean, Dampier, Michelle, Strickland and Susan in 2008. What is video telehealth?
It is a free, confidential Video telephone service one can call to get health advice or general health information from a Registered Nurse. This means quick, easy access to a qualified health professional, who can assess the patients’ symptoms and help them decide the best first step. The nurse can help the patient decide whether they can take care of themselves, make an appointment with a doctor, go to a clinic, contact a community service or go to a hospital emergency room. When the patient calls, he or she is asked to describe the symptoms and answer questions to best assess the seriousness of the problem.
Based on the assessment, the Registered Nurse can either advise the best possible mode of treatment. In Ontario the telehealth service is provided in English and French, with translation support for other languages and a direct number for those with hearing and speech difficulties. It is available 24 hours, 7 days a week. For geriatric patients or for those for whom distance is an issue Video Telehealth is the best bet. Efforts have been made to monitor patients at home with telehealth equipment installed in their home.
The equipment at the patients’ house monitors vital signs such as blood pressure; temperature; weight; blood glucose; and oxygen intake. The information collected is sent via the patient’s telephone line to the computer in the health centre. If the reports are abnormal a respiratory specialist nurse will decide on the appropriate action. The video Telehealth allows the healthcare professionals to deliver high quality care tailored to individual patients in their homes. This is both comfortable as well as affordable to them as it saves on the hospital admission.
Moreover, this is good for the Physicians as they do not have to make multiple visits. It enables the doctor to manage long term conditions such as heart failure, diabetes and chronic obstructive pulmonary disease effectively at home. It can lead to early diagnosis of other health problems and empowers patients to understand their illness and take a more active role in their own care. Literature Review The literature consists of qualitative and qualitative research studies conducted between January – March, 2006 in the community. Eligible patients were given written information about the study.
The communities were scattered throughout North-western Ontario. Participant doctors included health care specialities such as; paediatrics, surgery, oncology and palliative care and patients who lived 100-600 km from tertiary centre (Dillon & Loermans 2004, Stewart et al. 2004). Three academic peer-reviewed research studies were identified and reviewed using an electronic journal article database search of the health care and health informatics academic literature. “Video telehealth” research is largely qualitative and only one quantitative study was found in the literature.
The most common research methods were semi-structure interviews which were directed to groups followed by thematic study. The goal of the literature review is to abstract the common themes found in the current “Video Telehealth” research literature. The main conclusion and methodology of the reviewed studies are presented. Each of these themes will now be discussed separately. Theme 1: Lessening the burden This theme incorporated the facet of having to travel great distances in poor weather conditions while experiencing physical limitations such as pain, fatigue and immobility.
Furthermore costs related to travel such as transportation and accommodations were of great concern. The characteristic of not having to travel to receive health care was appreciated. Theme 2: Maximizing support Patients were lauding incredible flexibility of the system to bring both providers and families together form different places. It was noteworthy that the participants valued the fact that the telehealth nurse was present during the visit to provide information to them. The patients were happy to feel the comfort of their home and communicate with the specialists. Winters & Winters 2007) Theme 3: Tailoring specific e-health systems to enhance patient and family needs Patients identified technical and organisational issues that impacted on their experiences during the telehealth visits. These included the characteristics of professional communication using a telehealth technology and the facility of both physicians and nurses to communicate in a caring manner with patients and families. Theme 4: Clinical outcomes In terms of clinical outcomes the Video Telehealth has certainly enhanced the quality of clinical care.
Improved communication with nurses and doctors were organised to maximize the patient’s experience. Critical analysis Research questionsSample/informantsMethod Data collection strategiesKey Findings Limitations Sevean et al. (2006) have provided a concise preface to the use of video telehealth as a method of health care delivery in rural/remote communities in Northern Canada. They have mentioned about its magnitude in terms of cost effectiveness, less burden to geriatric patients, clinical decision making and clinical outcomes.
Although the author has given a good background of the topic it would have been better if it was a little elaborate. Besides, there were no references to previous findings in the literature provided in the introduction of the article. There are a variety of problems with the “Video Telehealth” research. First, most of the research has investigated settings where preservative health care is being administered; however, little attention has been paid to contexts where there are deteriorative health conditions.
The “Video Telehealth” shows great promise to improve health care in the rural and remote communities, the review needs to establish the advantages and best practices for this technology in deteriorative health care. Secondly, the article has not been able to bond the application of “Video Telehealth” technology to effective cost-savings. The claim is often made that the technology will decrease the healthcare costs by reduction in travel and hospital admission fees, but research has not been able to provide clear evidence of this claim.
Thirdly, the article has poor research synchronization with a lot of replication of effort and a lack of critical evaluation of the findings. Research results are generally reported as being positive. A critical evaluation of the research shows that without great support by the doctors and nurses in the urban areas, the telehealth projects would not necessarily result in positive conclusion. Fourthly, the small and geographically focused nature of the descriptive study makes generalizations and transferability of the findings difficult, other than to the stakeholders.
The findings could have been improved by increasing the sample size, including other geographical sites conducting interviews with providers as well as patient and family members. In addition it is also acknowledged that participants were interviewed through the same video network where they received their care, although little evidence was found that it impeded their responses. To finish with the research in the rural and community settings cannot be scaled to large populations due to lack of healthcare professionals in Ontario.
The argument could be made that the current research literature cannot adequately predict the efficacy of “Video Telehealth” technology if it is scaled to hundreds of end users. The challenge with this research is that it is expensive and would require investors that are willing to trail the technology beyond the pilot research that has been conducted. Summary “Video Telehealth” technology has a number of affirmative points that are inadequately conceptualized and interpreted.
The positives of the project in the rural communities are lessening the burden to travel, maximizing support, enhancing patient needs. Additional research is required to better understand these indicators of successful outcomes. References 1)Home Telehealth: Connecting Care within the Community Richard Wootton , Susan L. Dimmick , Joseph C. Kvedar (2006) 2)E-Health, Telehealth, and Telemedicine: A Guide to Startup and Success (Jossey-Bass Health Series) [Hardcover] Marlene M. Maheu , Pamela Whitten , Ace Allen )Patients and families experiences with video telehealth in rural/remote communities in Northern Canada . Pat Sevean, Sally Dampier, Michelle Spadoni, Shane Strickland, Susan Pilatzke 4)Designing qualitative research By Catherine Marshall, Gretchen B. Rossman 5) The benefits of a qualitative approach to telemedicine research. MacFarlane A, Harrison R, Wallace P. 6)Understanding the Normalization of Telemedicine Services through Qualitative Evaluation Carl May, PhD, Robert Harrison, MSc, Tracy Finch, PhD, Anne MacFarlane, PhD, Frances Mair, MD, Paul Wallace, MD