What are the four areas where telemedicine telehealth are used currently quizlet?

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Ambulatory care settings. Clients are connected with automated systems to monitor medication adverse events and medication nonadherence. Clinicians have real-time information on a patient's experience with medications.
• Cardiology. ECG strips can be transmitted for interpretation by experts at a regional referral center, and pacemakers can be reset from a remote location.
• Counselling. Clients may be seen at home or in outpatient settings by a counselor at another site.
• Data mining. Research may be conducted on large databases for educational, diagnostic, cost/benefit analysis, and evidence-based practice.
• Dermatology. Primary physicians may ask specialists to see a client without the client waiting for an appointment with the specialist and travelling to a distant site.
• Diabetes management. Clients may report blood glucose readings by using the touch-tone telephone.
• Mobile unit post-disaster care. Emergency medical technicians (EMTs) and nurses at the site of a disaster can consult with physicians about the health needs of victims.
• Education. Healthcare professionals in geographically remote areas can attend seminars to update their knowledge without extensive travel, expense, or time away from home.
• Emergency care. Community hospitals can share information with trauma centers so that the centers can better care for clients and prepare them for transport.
• Fetal monitoring. Some high-risk antepartum clients can be monitored from home with greater comfort and decreased expense.
• Geriatrics. Videoconference equipment in the home permits home monitoring of medication administration for a client who has memory deficits but who is otherwise able to stay at home.
• Hypertension management. Clients receive automated reminders and education feedback regarding hypertension treatment guidelines.
• Home care. Once equipment is in the client's home, nurses and physicians may evaluate the client at home without leaving their offices.
Hospice. Palliative and end-of-life services via technology can increase access to services in remote areas or supplement traditional care.
• Military. Physicians at remote sites can evaluate injured soldiers in the field via the medic's equipment.
• Pharmacy. Data can be accessed at a centralized location.
• Pathology. The transmission of slide and tissue samples to other sites makes it easier to obtain a second opinion on biopsy findings.
• Psychiatry. Specialists at major medical centers can evaluate clients in outlying emergency departments, hospitals, and clinics via teleconferences.
• Radiology. Radiologists can take calls from home and receive images from the hospital on equipment they have in place. Rural hospitals do not need to have a radiologist onsite.
• School clinics. School nurses, particularly in remote areas, can quickly consult with other professionals about problems observed.
• Social work. Social workers can augment services with telehealth home visits.
• Speech-language pathology. More efficient use can be made of scarce speech/language pathologists.
• Virtual intensive care units. Remote monitoring capabilities and teleconferencing allow experts at medical centers to monitor patients in distant, rural hospitals, particularly when weather conditions or other factors do not allow transport.
• Extended emergency services. Remote monitoring and teleconferencing support allow emergency care physicians to view and monitor ambulance patients, supervise EMTs, and initiate treatments early and redirect patients to the most appropriate facilities, such as burn centers or trauma units, without being seen first in the emergency department.

Lack of standards. The lack of plug-and-play interoperability among telehealth devices and point-of-care and other clinical information systems is cited as a major obstacle (Brantley et al. 2004; Charters 2009). There is a need for a standard interface specification that allows telehealth data to be merged easily with information from other clinical information systems. Work is in process on the development of these standards using HL7 messages constructed with Extensible Markup Language.
• National Health Information Infrastructure (NHII). In succinct terms, the NHII is all about the secure exchange of healthcare information between a requestor and a provider. While work is in progress the NHII remains a vision at this time. It requires an identity management system, one trusted on a national scale, that will give information providers a means to validate the electronic identity of a requestor. Similar work is presently under way with the U.S. government. Rules are still needed to create electronic IDs for the NHII. The Department of Health and Human Services, the American Telemedicine Association, and the Rand Corporation, among other entities, have been discussing the NHII.
• Homeland security. The homeland security community has not given significant consideration to telehealth technology when assessing its needs, strategies, and desired outcomes (Brantley et al. 2004). It can make use of various surveillance systems to analyze symptoms on a large scale for possible biological and chemical attacks.
• Mainstream acceptance. Despite its advocates, many healthcare professionals have been slow to accept telehealth applications (Thede 2001; Williams 2007). Their reasons include the perception that telehealth applications are not "real" nursing, that telehealth offers few benefits to them, concerns over privacy and legalities, and fears that telehealth applications will reduce the number of healthcare professionals needed.
Accreditation and regulatory requirements. The Joint Commission on Accreditation of Healthcare Organizations first identified medical staff standards for credentialing and privileging for the practice of telemedicine in 2001 and approved revisions in 2003. Practitioners are required to be credentialed and have privileges at the site where the client is located. Credentialing information from the distant site may be used by the originating site to establish privileges if the distant site is accredited by the Joint Commission. However, this issue for telehealth practitioners remains unresolved as the Joint Commission continues to work on this issue of acceptance of credentialing and privileging decisions by another Joint Commission accredited facility (Ctel 2010b). The Food and Drug Administration has several guidelines for the use of telehealth-related devices.
• Patient safety. The majority of discussions that address patient safety emphasize the potential of telehealth to enhance patient safety through applications such as e-prescribing. Some literature makes mention of threats to patient safety when telehealth applications fail to render the same level of care as hands-on care or when problems occur with the use of electrical devices.
• Limitations. Despite its many benefits telehealth suffers some limits as well. One is that the quality of transmitted skin tones is dependent upon room lighting. Another is that the distant provider cannot palpate and is dependent upon the skill of the presenter. A third is the lack of smell. Speed and accessibility to information at any time from any place are essential to quality of service (Babulak 2006). Slowdowns or outages in service are not acceptable.
• Inadequate funding for technology support. Descriptions of some telehealth applications describe a lack of monies to establish and maintain the technical infrastructure needed (Bond 2006). In some cases, nurses are responsible for the set-up and basic support of telehealth devices. While the wisdom of this approach may be questioned in light of the limited availability of nurses it can be used as an opportunity to establish rapport and comfort with the technology (Starren et al. 2005).
Quality of services rendered. There are two major issues surrounding the quality of telehealth services. One is that services must be at least of the same level of quality as traditional services, particularly for reimbursement services. The second issue is the paradox that geographically isolated populations that stand to derive the largest benefits from telehealth because they have limited access to traditional healthcare services often have the poorest infrastructure, resources, and capability to support telehealth (Liaw and Humphreys 2006).

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