The 1990s
100 Years of Texas Nursing Magazine
Telehealth: The Wave of the Future
Texas Nursing, November/December 1996
In this article, Texas Nursing presents data on access to healthcare advice over the phone and examines the many pros and cons of telehealth as a service.
A 24-HOUR TELEPHONE SERVICE, which used nurses to evaluate caller health problems and make recommendations for treatment, proved popular among consumers and employers, according to a survey by Blue Cross and Blue Shield of Minnesota (BCBSM).
The result of the survey: Many Blue Cross and Blue Shield organizations across the country are implementing nurse lines. Early reports indicate these nurse lines are successful in providing good information and guiding consumers to appropriate use of health resources.
Twenty-first century nursing will provide nurses with numerous options for communication with patients; telephones and telehealth are expected to become integral parts of hands-on care. Components such as advocacy, prevention and, ultimately, consumer empowerment will naturally follow this constellation of services.
The traditional role of the nurse in the community will come full circle with technology, allowing nurses to be in closer contact with the public than ever before.
Consumers are more accepting of health information including advice about treatment received through a telephone or on-line service, even if it means giving up a face-to-face visit with a care provider, according to the survey.
Nurses must be ready, willing and able to make the necessary changes.
These are among the findings of a statewide survey sponsored by Blue Cross and Blue Shield of Minnesota (BCBSM). The survey was conducted during October 1995 among benefit decision makers in companies with 100 or more employees and among Minnesota residents who receive health care coverage from an employer with 100 or more workers.
"The survey is the clearest evidence to date of how dramatically access to health care is being redefined by both employers and employees,” said Jim Woodburn, MD, medical director of National Accounts for Blue Plus, the HMO affiliate of BCBSM. “How people get information—and in some cases even treatment—is less important than the quality and convenience of the information.”
Twenty-first century nursing will provide nurses with numerous options for communication with patients; telephones and telehealth are expected to become integral parts of hands-on care.
Woodburn said that personal contact with care providers remains important for many health-related issues, but giving up some face-to-face contact might be an acceptable trade-off for health information over the telephone or computer.
The survey asked consumers and employers to evaluate three different electronic services. The most highly regarded by both groups is a 24-hour telephone service in which a nurse diagnoses a health problem and provides the caller with recommendations for self-treatment. About eight out of 10 health care consumers surveyed—77 percent—said they would use such a service and 81 percent of employers in companies of more than 100 employees would be likely to offer the service were it available.
A telephone or on-line service that provides information on health care topics of general interest would be used by 63 percent of the consumers and offered by 61 percent of employers, according to the survey.
The third option posed in the survey—telephone or on-line directories that list health providers and specific information on quality of care, patient satisfaction measures and fees—would likely be used by 60 percent of consumers and offered by 61 percent of employers.
Both employers and their insured workers and families place a high value on the quality of electronic information services. However, convenience (cited by 44 percent) ranks nearly as high as quality (46 percent) among the factors that would influence consumers’ decisions to use telephone or on-line services. The services cost is cited as an influential factor by only 38 percent of consumers.
Cost, however, is paramount to employers, cited by 67 percent as an influential factor. Quality—cited by 55 percent of employers—ranks second among issues that would shape an employer's decision to offer electronic services as part of a company health plan.
“What makes the findings especially striking is the high acceptance of electronic information services even though both employees and employers believe they would depersonalize health care,” said Woodburn.
While majorities of both consumers (61 percent) and employers (52 percent) said that electronic services could depersonalize health care, the survey found that for 44 percent of consumers, electronic information might be a satisfactory replacement for face-to-face contact with a health provider.
“What makes the findings especially striking is the high acceptance of electronic information services even though both employees and employers believe they would depersonalize health care,” said Woodburn.
HEALTH CARE IN THE YEAR 2000
Both employers and employees are convinced that electronic health information services will dramatically increase access to health care in the year 2000, but they are less certain about the impact on quality and cost.
The two groups were asked to assume that in the year 2000, 25 percent of all information about treatment options was provided through electronic services. Based on that scenario, 83 percent of employers and 77 percent of consumers said health care would be more accessible. However, only 68 percent of employers and 57 percent of employees said care would be more affordable five years from now. Sixty percent of employers said the quality of health care would improve, but a minority—49 percent—of employees agreed that quality would be higher at the turn of the century.
ABOUT THE SURVEY
The survey was conducted by Rockwood Research. Interviews of both employers and persons covered by employer-provided health plan were conducted by telephone between Oct. 19 and 26, 1995. The maximum margin of error at the 95 percent confidence level is plus or minus 6 percentage points for the employer sample and plus or minus 5 percentage points for the insured sample. TN
RN LOBBY DAY AT THE CAPITOL
More than 400 nurses and nursing students descended on the Texas Capitol Tuesday, March 4, to let legislators know that Texas RNs do, indeed, make the difference.
RN Lobby Day at the Capitol '97 began with a legislative breakfast in the Capitol Extension Cafeteria. Legislators and their health care staffers were invited to come and visit with nurses representing a wide variety of practice and geographic areas.
Following the breakfast, TNA President Pat Yoder Wise and former state Rep. Nancy McDonald, RN, along with TNA Governmental Affairs Co-Chairs Joyce Adams and Fran Martin, welcomed an overflow crowd in the Capitol Extension Auditorium. Rep. Glen Maxey secured the auditorium for professional nursing to use for an hour-long orientation—before nurses and nursing students set off for their visits to senators' and representatives' offices.
Each legislator's office received a packet of information about the nursing legislative agenda and information about legislation supported by nursing.
At the end of the day, participants reconvened to discuss how their meetings went and share information.
Sharon Brigner, current president of the National Student Nurses Association, was a participant in RN Lobby Day at the Capitol from Texas Woman's University in Houston.
"These legislators are interested in hearing what we have to say; they are all real down-to-earth," she said, "and we spoke to them in just that way. It wasn't threatening at all. Everyone was real friendly. I learned a lot." TN
(Editor's note: Much of the above information is borrowed from NurseWatch at the Legislature, March 12 edition.)
RN Lobby Day at the Capitol '97 began with a legislative breakfast in the Capitol Extension Cafeteria. Legislators and their health care staffers were invited to come and visit with nurses representing a wide variety of practice and geographic areas.
Nursing Professional Ring Unveiled
THE OFFICIAL, PATENTED NURSES RING was unveiled at the ANA 1996 Centennial in Washington, DC and will be internationally unveiled at the upcoming 1997 International Council of Nurses Congress in Vancouver, Canada.
For the first time in history, the USA has issued a legal government patent for a professional designation ring for nurses (RN's only).
The Texas Nurses Association represents the Professional Nurses Ring for all Texas nurses and nursing students. Proceeds from all Texas ring sales will be shared with the TNA and Nurses House, the national TNA nurses charity.
The ring was developed by over 2,500 volunteer nurses globally over a five-year period in liaison with the ANA, ICN, and other international associations. In order to manage and fund the Nurses Ring program, and to hold the patents, the volunteer organizers formed White Sun Inc.
The 'Stylized N' symbolizes the five points of caring—Compassion, Competence, Conscience, Confidence and Commitment.
Meticulously crafted in high polish fine gold—the symbol of worth, the Nurses Ring offers fluidity without sharp edges so it can be worn comfortably and safely. It is a unisex design intended for "pinkie finger" wear, the professional designation finger by etiquette.
As research shows over 95% of nurses do not carry a business card, the ring is meant to identify a Registered Nurse to all publics. From 100's of nurses to date wearing the ring, it has proven to be not only an RN identifier, but a public relations tool and a family heirloom commemorating the caregiver.
Texas' Registered Nurses can wear their Nurses Ring with pride. TN
THE VALUE OF A MEMBER
TEN little members standing in a line,
One disliked the President, and then there were nine.
NINE ambitious members offered to work late,
One forgot his promise, and then there were eight.
EIGHTcreative members had ideas as good as heaven.
One lost enthusiasm, and then there were seven.
SEVEN loyal members got into a fix,
They [quarreled] over programs, and then there were six.
SIX members remained with spirit and drive,
One moved away, and then there were five.
FIVE steadfast members wished there were more,
One became indifferent, and then there were four.
FOUR cheerful members who never disagreed,
Till one complained of meetings, and then there were three.
THREE eager members! What do they do!
One got discouraged, and then there were two.
TWO hard-working members, our rhyme is nearly done,
One joined a health club, and then there was one.
ONE faithful member was feeling rather blue,
Met with a colleague, and then there were two.
TWO earnest members, each enrolled one more,
Doubling their number, and then there were four.
FOUR determined members just could not wait,
Till each won another, and then there were eight.
EIGHT excited members signed up sixteen more.
In another six verses, there will be a thousand twenty four!
—Author Unknown
1998 Nursing Education Summit
