Respiratory nurse calls for patient engagement in telehealth

Reserach by Shropshire community nurse, Jenny Tarver, reveals need for more robust patient-centred research to support widespread deployment of telehealth

Telehealth technologies should not be used to replace existing care pathways and more robust patient-centred research is needed to support widespread deployment, according to a specialist respiratory nurse from Shropshire.

Jenny Tarver, a community specialist nurse at Shropshire Community Health NHS Trust, has recently completed a research scholarship on telehealth with the Florence Nightingale Foundation, sponsored by NHS Professionals.

My research ultimately revealed that there was a significant lack of patient involvement in telehealth research processes, with most of the studies only exploring patient specific outcomes as a secondary consideration

And her findings show that telehealth could have a significant role to play in future health services, but she warns that more research needs to be done to decide the most effective way of deploying the technologies at scale.

She said: “Because of the escalation of chronic disease among an increasingly ageing population, there has been a worldwide effort to determine innovative approaches to deal with the problem, and telehealth has been used as one possible solution.

“Locally in Shropshire, commissioners had developed a growing interest in telehealth, as it is very useful in our rural county. Telehealth has proven to be a good way of prioritising which patient can be seen before someone else.”

The aim of her research was to determine specific patient benefits and improved outcomes that come from telehealth interventions and to explore the most cost-effective way of integrating systems into existing care pathways.

She said: “My research ultimately revealed that there was a significant lack of patient involvement in telehealth research processes, with most of the studies only exploring patient specific outcomes as a secondary consideration. It also allowed me to identify some of the positive and negative impacts of telehealth.”

One of the key positives, she found, was that telehealth strengthens a person’s capacity to self manage their condition, which is a central part of the Government’s attempts to control the demand for healthcare.

Some nurses are afraid of technology, but I think they shouldn’t be afraid of embracing telehealth and instead they need to take this opportunity to engage with their patients in a new way

She said: “My research allowed me to make a number of recommendations, but the underlying theme was that more research should be done with a patient focus. Telehealth has lots of benefits, which could be extended if the professionals use more patient involvement in all elements of the telehealth implementation. I would also recommend that the telehealth intervention needs to be used as a tool to assist and enhance future practice, rather than replace it.

“If telehealth is to be a success, there will need to be a comprehensive assessment of potential patients prior to the use of the technology to prevent potential unwanted effects such as stress and anxiety. Nonetheless, this potential could be maximised further with more robust research which includes significant patient engagement.”

Nurses, in particular, could benefit from the widespread deployment of telehealth. Tarver concludes: “There is a lot of potential for nurses to utilise telehealth, but there are very mixed perceptions of it. As I work in a respiratory team of nurses, we can see the benefits first hand, and we definitely see it as a positive. Telehealth has definitely enhanced my role as a respiratory nurse, and I am now the lead resource in telehealth.”

Addressing previous concerns about whether nurses and clinicians are ready to embrace the technology, she added: “Some nurses are afraid of technology as it is a completely different way of working. They are used to diagnosing patients face to face, but by using telehealth they have to speak to them over the phone, and have to know what questions to ask. However, I think nurses shouldn’t be afraid of embracing telehealth, and instead they need to take this opportunity to engage with their patients in a new way.”

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