Telehealth is an innovative tool in health care that allows delivering virtual medical service as well as educational interventions. Telehealth comprises a variety of services, such as remote patient monitoring, mobile health applications, etc. It frequently implies consulting physicians by means of video conferencing thus providing an opportunity to receive high-quality care for individuals who have poor access to healthcare facilities or those who continue treatment at home after discharge. In addition to better patient outcomes and proven cost-effectiveness, telehealth also suggests interventions to support family caregivers who are usually responsible for the home-care organization. Thus, telehealth technologies such as video, web-based, telephone-based and telemetry or remote monitoring are expected to have a positive impact on the caregiver’s outcomes. This paper studies a systematic review of telehealth tools and interventions and provides a mind map of telehealth technologies and categories that can improve caregiver’s outcomes.
Précis
Chi and Demiris (2015) provide a systematic review of studies that involve a telehealth-based intervention or use of this technology at any stage of the process of care. They are relevant to the outcomes of family caregivers disregarding the setting or clinical condition of the patient under care. The need for formal and informal caregivers is growing due to the fact that the volume of aging patients and those with chronic diseases is increasing. These categories of patients demand regular care to provide them with the necessary quality of life and control treatment adherence. Thus, the researchers investigated articles dedicated to technologies that “can support caregivers and facilitate better coping” (Chi & Demiris, 2015, p. 37). On the whole, the selected research articles studied technology that can increase the efficiency of caregiving, make it less stressful and safer for caregivers as well as for patients.
The focus of the scholarly article under consideration is the use of telehealth-based interventions and tools aimed at the improvement of caregivers’ outcomes. These interventions can be a part of any stage of the process of care, design, implementation, or evaluation (Chi & Demiris, 2015). The study was conducted with the use of specialized databases such as Embase, CINHAL, Cochrane, and PubMed. Data from the selected studies were extracted with the help of a standardized form. The final sample consisted of 65 articles, which included both telehealth interventions and a focus on caregiver outcomes (Chi & Demiris, 2015). The journals where the articles were published included such fields as medicine, nursing, medical informatics, psychiatry, pediatrics, behavioral health, and dementia care. The majority of them were issued in the United States.
The study identified the following information. The majority of interventions in the cases under analysis were provided in home setting (85%), 12% were conducted in clinical settings or hospitals, and only 3% described the experiences of senior-living communities (Chi & Demiris, 2015). Moreover, almost one-quarter of articles (23%) investigated the application of telehealth by rural caregivers (Chi & Demiris, 2015). The correlation of caregivers for adult and pediatric patients was almost equal, 51% and 49% correspondently. Telehealth technologies revealed in the articles included video (by means of videophone or videoconferencing), telephone-based (using phone calls or text messages), web-based information, and telemetry or remote monitoring.
The study showed that video was applied more often than other technologies. The mentioned technologies were used to provide six major types of interventions. Almost equal use was recorded for education (37%), consultation (37%), and psychological or cognitive behavioral therapy (35%). Three other categories of interventions were less popular. They include social support (23% of interventions found in the articles), data collection and monitoring (20%), and clinical care delivery (11%) (Chi & Demiris, 2015). The majority of articles stated in their findings that caregivers admitted substantial improvements in their outcomes. Thus, they reported a decrease in anxiety, stress, depressive feelings, burden, irritation, and isolation. Also, they mentioned an increase in satisfaction, higher confidence and comfort while applying telehealth. Finally, caregivers felt more social support, better social function, improvement in caregiving skills and knowledge as well as better patient management, higher quality of life, and improvements in problem-solving and decision-making skills (Chi & Demiris, 2015). Only 5% of the studies under analysis reported no significant improvements for caregivers.
The information summarized in the article is important for healthcare providers interested in the use of technology on the whole and telehealth in particular. It is particularly significant because the majority of studies focus on patient outcomes and pay little attention to caregivers, both formal and informal, who are responsible for the process of care and are under the impact of different factors. The study by Chi and Demiris (2015) proves that telehealth can be beneficial not only for patients but also for caregivers. Therefore, it can be used for diverse interventions and become a powerful tool for improving patient outcomes through empowering caregivers.
Mind Map Discussion
A mind map was developed to summarize and logically present the major issues of the article under analysis (See Appendix). Thus, it lists the opportunities for technology utilization, providing a choice for caregivers. Also, the mind map includes interventions collected by researchers, such as education, consultation, social support, and others. The mind map implies that telehealth technology can be utilized through some interventions. In fact, any type of technology can be used for any intervention, and their choice depends on opportunities of healthcare facilities that organize assistance, technical equipment of caregivers, and the setting where care is provided. The mentioned interventions lead to certain outcomes reported by caregivers. The mind map logically presents these outcomes and makes evident the benefits of healthcare technology application for caregivers.
A caregiver can use the findings of the research summarized in the map to consult healthcare providers about the possibilities of applying telehealth interventions for the patient. The bottom part of the mind map presents evidence-based outcomes reported by caregivers using telehealth in the process of care. This block is informative and allows caregivers to study the benefits of telehealth application. Still, the choice of intervention is partially the responsibility of caregivers and partially the issue of healthcare facilities.
The opportunities and benefits of telehealth for increasing the efficiency of healthcare delivery have been the issue of research for decades. For example, Weinstein et al. (2014) discuss the existing barriers and possibilities provided by telemedicine, telehealth, and mobile health applications. These tools have a powerful potential to change the ways of delivering medical care and empower both healthcare providers and caregivers thus contributing to better patient outcomes. Kvedar, Coye, and Everett (2014) review technologies and strategies related to telemedicine and telehealth that can improve the process of patient care. The researchers agree that telehealth, that implies the use of technologies providing opportunities for managing patient’s condition outside healthcare facilities, creates a new way of care delivery. Also, remote access to health professionals makes home-care more effective.
Conclusion
On the whole, the issue of telehealth as a technology empowering the delivery of care is not new. Nevertheless, the majority of studies focus on patient outcomes and benefits or cost-efficiency of such interventions for healthcare providers thus leaving aside caregivers. Still, caregivers are significant individuals in delivering care to patients after they are discharged from a healthcare facility. Moreover, they frequently face problems similar to those faced by professional nurses such as burnout, fatigue, stress, and depression. Consequently, their condition can have a negative impact on the quality of care they provide. However, telehealth is a technology that is beneficial for caregivers in many ways. First of all, the feeling of support improves their psychological health, makes them more satisfied and confident, improves their caregiving knowledge and skills, and provides them with better coping and problem-solving skills. After all, a well-informed and supported caregiver can deliver better care to the patient thus improving patient outcomes and empowering rehabilitation. Therefore, telehealth can be recommended as a technology to be used by caregivers to improve their outcomes and increase the general quality of care.
References
Chi, N., & Demiris, G. (2014). A systematic review of telehealth tools and interventions to support family caregivers. Journal of Telemedicine and Telecare, 21(1), 37-44. Web.
Kvedar, J., Coye, M., & Everett, W. (2014). Connected health: A review of technologies and strategies to improve patient care with telemedicine and telehealth. Health Affairs, 33(2), 194-199. Web.
Weinstein, R., Lopez, A., Joseph, B., Erps, K., Holcomb, M., Barker, G., & Krupinski, E. (2014). Telemedicine, telehealth, and mobile health applications that work: Opportunities and barriers. The American Journal of Medicine, 127(3), 183-187. Web.