Mr. Kasich is a 77-year old who was recently taken to the emergency room after he fell when trying to get out of bed. There, he was found to have a blood glucose level of 35 milligrams per deciliter and was diagnosed with uncontrolled type 2 diabetes mellitus and hypoglycemia despite many years of well-maintained blood glucose levels. After further assessment, Mr. Kasich was transferred to a medical room in the hospital. His background includes diagnosed with type two diabetes mellitus, advanced congestive heart failure, and lung cancer. Has Medicare parts A and B. Lives with wife in a remote area 40 miles from the closest healthcare provider. He is proficient in using his home computer. Mr. Lane is a 42-year old who was admitted for exacerbation of heart failure. His background includes diabetes mellitus type two. He is a long-haul truck driver with a large trucking company. Is privately insured. He is single and primarily lives in his truck. Both Mr. Kasich and Mr. Lane are going home with telehealth consisting of a telemonitoring device that transmits weight, blood pressure, blood glucose levels, and pulse oximetry to a remote telehealth nurse. Even though telehealth does not often include hands-on interaction, the goal of keeping patients out of a hospital is consistent with quality nursing practice. Telehealth applications are designed to enhance the patient experience and improve clinical outcomes while providing care for patients in their home environment rather than in an institutional setting. Telehealth supports self-care by empowering patients, which is a central tenet of nursing practice.
Review the case scenario above and address the following.
• Discuss how telehealth can assist in addressing equality of health care resource distribution. What barriers must be removed to achieve well-being, sufficiency, and health care access for all?
• In your discussion, consider concepts such as equity, respect, self-determinism, health literacy, cyclic disadvantage, and health care disparities among marginalized populations or groups.
• Compare and contrast how each patient may benefit from telehealth services and the ethical considerations from the viewpoint of the nurse.
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