Borchers, L., and Kee, C. (1999) An experience in telenursing. Clinical Nurse Specialist 13 (3): 115-118.
Two nurses write on using a home telemedicine video system to complete a home assessment of a patient’s home, and having the family and patient provide the information. Having a more detailed, visual record that is provided by the televideo approach is worth noting. The authors suggest that this approach is particularly advantageous to someone with an extended recovery period or for someone who has repeated admissions for unknown reasons. Specifically, the teleapproach can “offer a mechanism for assessing the ways in which home situations impact on patient recovery.”

However, disadvantages of using a teleassessment could impact on safety issues. This system, which provided only a snapshot record could note if problems of getting in and out of bed to get to a piece of machinery, for instance, but particulars needed for addressing the problems would not be known from this off-site approach. A second disadvantage is allowing the patient and/or family to control what is captured on video and select what should be recorded—such choice might overlook safety issues needing to be addressed.

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Kinsella, A. (2002) Home telehealthcare: an idea whose time has come—but with safety concens. Medical Malpractice Law & Strategy XIX (7): 5-8.
Among the safety issues identified in home telehealthcare use today is not the presence of new technology but the less-than-uniform capabilities of a diverse, aging, and increasingly frail (as they live longer) population who may be using it. Actual use by patients (and sometimes unknowing misuse or nonuse) of the devices may be cause for safety concerns. Home telehealth devices are not inherently unsafe—however, how they are used and the setting in which they are used must be tracked routinely to avoid potential risks to patients.

Note: Not only the elderly are subject for imperfect capabilities for use of new technologies. See an overview of Microsoft’s recently commissioned report on the wide-ranging physical needs of 18-64 year-old computer users to meet varying visual, dexterity, audio, and cognitive needs, at: http://www.microsoft.com/enable/research/default.aspx

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Kinsella, A. (2003) A step-by-step guide to home telehealth program planning. Caring Magazine, Aug.: 16-20.
Practicing safe home telehealth requires nurses to determine the appropriateness of patients’ homes for delivering and receiving home telehealth. Safety is among the many important issues involved in this determination—that means assessment ought to go well beyond just “eyeballing” a room. Installing a telehealth system may necessitate providing new wiring and rearranging the patient’s familiar landmarks. For an elderly patient who is used to a specific pathway from lamp to telephone to armchair, any changes have to be particularly non-intrusive. Safety of operation and consistency of delivery are the keys to this planning.

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