Does the position statement demonstrate adequately the links to the National Competency Standards for Registered Nurse?.
Advances in Health informatics and telemedicine are providing greater access to healthcare resources
Demonstrate the ability to critically review a prepared position statement, analysing its content from both a theoretical and clinical perspective.
Using the following framework will help in providing a structured critique of the position statement
Framework (guide only)
1. Is the position statement structured? Does it have an introduction and a conclusion
that clearly states the position?
2. Does the position statement relate to the topic?
3. Does the position statement demonstrate adequately the links to the National Competency Standards for Registered Nurse?
4. Are the references used to support the position statement current and credible (i.e. evidence), why or why not?
5. Do you think the author eliminated any important information (i.e. evidence) in
stating their position? If so, please refer to these evidence sources in your critique.
6. Remember when giving feedback it must be constructive regardless of whether it is
positive or negative feedback.
Remember that the critique will be assessed against the criterion referenced rubric:
Interpretation: Extensively critiques the content and Insightfully analyses the position taken. Identifies inconsistences (if any) in the position statement
Analysis & Evaluation: Thoroughly analyses assumptions in relation to NMBA competencies for clinical practice, discriminates rationally using reasonable judgment, provides extensive information in support of position or offers alternative view
Evidence: Provides extensive evidence in support of the position statement or provides clarifying evidence if required in support of alternative views. All evidence is from credible sources
Referencing: Accurate use of APA referencing style in all instances. A range of in-text citations has been used
Position Statement: “Advances in Health informatics and telemedicine are providing greater access to healthcare resources”.
The Australian Institute of Health and Welfare [AIHW] (2013) stated that residents in rural areas have shorter lives and higher levels of illness and disease risk factors than those in major cities. Some areas in Australia are disadvantaged in accessing goods and services, educational and employment opportunities and have lower incomes (AIHW, 2013). The number of medical practitioners in remote/rural regions is less than the number of employed medical practitioners in the major cities. In rural areas, there is around 148 fulltime equivalent medical practitioners per 100,000 in population compared to 335 full time equivalent medical practitioners per 100,000 in population in major cities (AIHW, 2008). The major cities have a better ratio of medical practitioner available to them than fellow rural residents. The New South Wales rural doctors network [RDN] (2012) outlined that the Australian government was introducing an approach in improving health services to rural area which involved a trial of advances in health informatics and telemedicine funded by The Australian Department of Health and Ageing from 1rst July 2010 to 30th June 2011. It can be argued that advances in Health informatics and telemedicine are providing greater access to healthcare resources. This will be shown by defining Health informatics and telemedicine, the benefit for the stakeholders particularly those who live in rural areas, as well as looking at the possible disadvantages.
Health Informatics also can be defined as multi-disciplinary teams that manage the information including collection, storage, retrieval, communication and optimal use of health related data (Graham, as cited in Hovenga, Kidd, Garde & Cossio, 2010). Further more, health informatics involves Information Technology 2 [IT] in problem solving and decision-making assuring the highest quality health care in all basic and applied areas of biomedical sciences (Graham, as cited in Hovenga, Kidd, Garde & Cossio, 2010). The Australasian College of Health Informatics [ACHI] (2014), an Australasian health informatics professional body, defines it as the use of health information tools and techniques, not only computer skills, but to support clinical care, health service administration, education and research. It can be said that health informatics process allows information to be collected and entered to the system and stored in a place where it is accessible to the users. The information management in health informatics allows the users to have access to download or retrieve the information from the system (Department of Health, 2012).
An electronic record of the patients information is kept allowing nurses and other health care team members to follow the care of the patients regardless where they are (Olesen, 2012). Sustainable health information helps the patients get continuity and best possible quality of care (Olesen, 2012). The electronic record allows other health care team members to access current records and promotes collaborative support for therapeutic intervention. This activity NMBA (2013) domain 3, provision and coordination of care, of national competency standards for the registered nurse point 6.4 states “collaborative supports the therapeutic interventions of other health team members”. The use of advanced health informatics supports the collaborative therapeutic interventions.
However, According to the Australian Law Reform commission (n.d.), there is privacy regulation in handling health information in Australia, the Privacy Act 1988. The Australian College of Rural and Remote Medicine (2012) outlined that written or verbal consent must be obtained prior to use of the telehealth system for patients. It can be an issue when outsiders have access to the health informatics system without 3 authorization or hackers can breach privacy laws. As health information is entered into the system, the users, such as nurses, medical practitioners, allied health and other professional members with access authority are able to use the data to support clinical care. Therefore, the design of the health informatics model has to consider and maintain the patients privacy. The nurses using health informatics should maintain patients privacy and confidentiality as mentioned in the Nursing and Midwifery Board Australia [NMBA] competency standard in collaborative and therapeutic care point 10.2, which is maintaining confidentiality in discussion about an individual/groups need and progress and point 10.4 “ demonstrate awareness of changes to policy and guidelines“ (NMBA, 2013). Maintaining patients privacy is part of the legal obligation for the nurses and other health care team members to comply with the policy and guidelines.
World Health Organization [WHO] (2010) described telemedicine as a method of providing health care services for people who live away from the centre of health care support providers by using information and communication technology for clinical care practice. Telemedicine is greatly beneficial when the patients and the care providers are separated by distance (WHO, 2010). People who live in remote areas or who live in an area with a lack of health care providers can gain advantages from this type of care. The Australian Government provided resources for the resident to be involved the system and provided funding for telehealth (Department of Health, 2012). The Department of Health (2012) stated the purpose of telehealth program is to support telemedicine, medical education and health education in Australia. Telemedicine enables the transmission of voice, data, images and information to reduce the need to travel across long distances for the patients and the health care professionals.
Evidence shows how informatics management can benefit the health sector. The trial held by RDN conducted in 2011 and 2012 showed an increase in the number services to aboriginal patients by 143% or 14,727 services provided within 12 months (RDN, 2012). The management of data can be done electronically within real time. An Internet networks allow the users to access the information thus removing the distance barrier. The stakeholders in the rural areas have access effectively to information from major cities. For example nurses can update the patient information through the health informatics system and the other healthcare team members can update patients current health status. In the traditional system information has to be presented as a hard copy and delivered to the user manually or face to face. Informatics Technology [IT] can solve a lot of the distance barrier issues to delivery of information in rural areas.
In addition, telemedicine gives significant advantages in storing and forwarding health information allowing remote health monitoring and the ability to conduct real time interactive activities (RDN, 2012). The ability to store and forward the information in telemedicine allowing pathology and imaging result from rural area to be transferred electronically to a radiologist or other medical experts in major cities. Another benefit of telemedicine is allowing real time interaction such as teleconsultation or education and case conferencing. During the telemedicine trial, RDN (2012) claimed that they conducted Holter/ambulatory electrocardiogram monitoring for patients in rural areas. This technique saves the journey to the major cities to attend cardiac monitoring.
RDN (2012) outlined some issues in implementing telemedicine using health informatics, such as technology set-up, platform and cost limitation, Medicare funding, resistance by staff and patients. Telemedicine requires specific setting to 5 allow data transmitting between both sides. RDN (2012) claimed that to set up telemedicine required IT support offices for both end and this can be a human resource issue in rural areas. The cost to run the telemedicine is relatively high. RDN (2012) stated that the cost to run telemedicine is $117.00 per hour. The high cost to run might affect overall healthcare fees. RDN (2012) stated that private specialists were less likely to use telemedicine incorporating health informatics, as they have limited access to get a rebate on the telemedicine fee from the Medicare rebate system.
The nurses role in telemedicine is significant to support in the provision of health care for the Australian government telehealth project (Bryce, 2013). In addition Lorentz (2008) stated that from the commencement of telemedicine, the nurses efficiently and effectively delivered care for patients in rural area. However, the growing technology requires the nurses and other health care team members involved in telemedicine to update their skills and be competent in using required technologies (Lorenz, 2008). This activity reflects NMBA standard 4.2 “participates in professional development to enhance nursing practice”. The nurses should update the knowledge in conjunction with current health care development.
The patients in rural areas gain great benefit from telemedicine. One example, Jonsson & willman (2008), conducted a study in implementing telenursing home healthcare, suggested that the patients felt positive toward the virtual communication to complement their health care. In addition Jonsson & Willman (2008) stated that the nurses claimed that they utilized their time better in providing health care for patients in rural area. Therefore, the implementation of health informatics and telemedicine should be supported in the health care system in Australia. The residents in rural areas are able to reduce distance travel requirements to attend medical appointments in 6 major cities.