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Many features of call centers’ services are comparable to conventional hands-on care in the home. For instance, call centers are typically staffed by RNs who actas case managers or perform patient triage. These professionals can provide infor-mation and counseling to patients as part of a disease management program andas a means to educate them on their disease process. In effect, their goal is to offerappropriate access to care (from nurses at the call centers) and help patients toprevent avoidable emergency room visits and rehospitalizations. An example ofthis assistance includes a nurse calling (i.e., not waiting for a patient to contact thecall center) a recently discharged diabetic patient on a regularly scheduled basis toevaluate progress at home, activity tolerance, medication compliance, foot care,and diet management. This empowering of patients towards self-management isa very significant and needed part of telenursing.Home care telenursing can also involve other activities, such as providing cus-tomized patient education in dietary or exercise needs, nursing teleconsultations,review of results of medical tests and examinations, and assistance to physiciansin the implementation of medical treatment protocols. The work can be wideranging; for example, there are some home-based telecardiology programs thatinvolve the patient, the family, the physician, and a specialized cardiac monitoringcenter. A multidisciplinary approach is used along with best practice–defined pro-tocols to manage the patient; improve the patient’s quality of life; and reducehealthcare costs, most particularly reduced hospitalization costs. Nurses play a keyrole in this network of care.By reviewing all of these examples of telenursing practice, one can see thatnurses using telenursing can broaden their involvement in the targeted care of
Telehealth Patient Populations|329each of their patients. It is predicted that home care will soon become a hub of allpatient activity; the home will be where care that is begun in hospitals and othersettings will be managed over the very long term and in the most cost-effectivehealthcare setting. Home care telenurses can well expect to play a vital and dy-namic role in the changing delivery systems that are likely to be in place in thecoming decades.TELEHEALTH PATIENT POPULATIONS (FROM PRIAL AND HOSS, 2009)Any patient who has a condition that must be monitored is a candidate for hometelemonitoring. Patients with chronic illnesses have particularly benefited fromongoing monitoring to prevent acute episodes. Patients who are homebound orwho have limited access to transportation are also appropriate for monitoring.Chronic Disease PatientsGiven demographics and advances in medical practice, there has been unprece-dented growth in patients with chronic diseases. Those patients are at significantrisk of having an acute episode when subtle but significant changes in their med-ical condition occur. The ability to identify these changes in a timely fashion al-