Perspectives on Telehealth Use with the Neonatal Population: Policy, Practice, and Implementation Considerations.

Telehealth has proven to be a valuable approach to providing care to the neonatal population, including supporting families during the transition to home, facilitating remote monitoring of fragile neonates, and connecting neonatal experts with infants and caregivers in underserved or remote communities. Clinicians engaging in telehealth need to be aware of policies and regulations that govern practice as well as the potential health equity issues that may present themselves.

Telehealth Policy and the Advanced Practice Nurse.

Telehealth is an efficient and effective method of care delivery used by advance practice registered nurses (APRNs) nationally, especially in the wake of the coronavirus disease 2019 pandemic. With the ever-changing rules and regulations governing telehealth practice, the APRN may struggle to keep abreast. Telehealth is governed by legislation and regulation in addition to telehealth-specific laws. APRNs delivering care through telehealth must be informed about the crucial aspects of telehealth policy and how their practice is affected. Telehealth-related policy is complex and evolving and varies by state. This article provides APRNs with essential knowledge about telehealth-related policy to support legal and regulatory compliance.

Identifying Congenital Heart Block in Primary Care.

Congenital heart block is a rare disease characterized by electrical conduction abnormalities of the heart in patients with both structural and without structural abnormalities. The most common cause of congenital heart block is autoimmune related, but other potential causes exist. Treatment for congenital heart block is determined by the severity of the disease and presenting symptoms. Primary care providers are in the optimal position to support patients and families. Although common causes and treatments of congenital heart block are known, much research is still to be done on the cause, optimal treatments, and potential long-term side effects.

Telehealth Education: Impact on Provider Experience and Adoption.

BACKGROUND: COVID-19 propelled telehealth to the forefront of health care, forcing many advanced practice registered nurses (APRNs) to incorporate telehealth into their practice without sufficient education. Lack of training has been cited as a barrier to telehealth adoption. PURPOSE: This study evaluated provider adoption of telehealth based on the type of telehealth education received. METHODS: A quantitative survey of telehealth providers (n = 224) was distributed through the listservs of 4 national organizations to determine whether there was a significant difference in provider levels of perceived usefulness, self-efficacy, perceived knowledge, satisfaction, and use of telehealth based on the type of telehealth education received. RESULTS: Telehealth adoption was significantly associated with the type of telehealth education received (vendor, online, written instructions only, and on the spot). CONCLUSION: With telehealth utilization expected to endure postpandemic, faculty should incorporate the most effective telehealth education methods into APRN curricula, ensuring successful adoption by the future workforce.

Telehealth Educational Resources for Graduate Nurse Faculty.

BACKGROUND: The rapid acceleration of virtual health care delivery, telehealth, has underlined the pressing need for graduate nursing students to gain skills and competencies that will ensure effective and efficient delivery of telehealth care in future generations. PROBLEM: There is a need for graduate nursing students to be prepared to use telehealth, but few nursing programs offer this training. Barriers to this implementation may be due to lack of faculty knowledge, telehealth resources, or telehealth opportunities. SOLUTION: Graduate nursing faculty should use resources and the wisdom of early adopters of telehealth to ensure adequate telehealth preparation is integrated into all graduate nursing programs. CONCLUSION: This article describes emerging core competencies for telehealth education and offers guidance, resources, and activities for nurse educators who seek to prepare emerging advanced practice RNs to plan, deliver, and implement effective telehealth practices.

Pediatrician Attitudes Toward and Experiences With Telehealth Use: Results From a National Survey.

BACKGROUND: The American Academy of Pediatrics 2015 policy statement on telehealth proposed that telehealth could increase access to high-quality pediatric care and that pediatricians should work to reduce barriers to telehealth for their patients. However, little is known about pediatricians' experiences with and attitudes toward telehealth. METHODS: Data from a nationally representative survey of American Academy of Pediatrics postresidency US member pediatricians in 2016, restricted to respondents providing direct patient care (n = 744; response rate = 48.7%). Survey collected information on experience with telehealth in the previous 12 months, perceived barriers to telehealth incorporation, and conditions under which nonusers would consider using telehealth. In addition to descriptive statistics, we used multivariable logistic regression to examine characteristics associated with any telehealth experience in the past 12 months. RESULTS: Fifteen percent of pediatricians reported any telehealth use in the 12 months prior to the survey. The most commonly reported barriers to telehealth adoption were insufficient payment and billing issues. Multivariable regression models indicated that pediatricians in rural areas, the West, and subspecialists were most likely to report telehealth use, and identifying barriers was negatively associated with telehealth use. Among nonusers, over half indicated they would consider adopting telehealth if they were paid for the visits. CONCLUSION: Telehealth is considered an important health care delivery mechanism, but only 15% of pediatricians in 2016 reported having used telehealth. Reducing barriers will be instrumental in promoting future telehealth adoption. Many barriers have been reduced during the response to COVID-19, and the impact of these policy changes will need further study.

Implementing school based telehealth for children with medical complexity.

PURPOSE: This quality improvement project aimed to improve parental experiences with healthcare delivery and collaborative health care offered at a school serving children with medical complexity (CMC) by implementing telehealth services. METHODS: Parents of students at an urban public charter school for CMC were surveyed before and after telehealth was implemented at the school for two months, and again one year later, using the Measure of Processes of Care (MPOC-20). RESULTS: Parental scores on the MPOC-20 were generally high both before and after the implementation of telehealth. There were no significant differences in the scores. Anecdotally, parent satisfaction with telehealth services was high. A review of the utilization of school-based telehealth during the 2015-2016 school year among 13 schools, including this unique school for CMC, revealed that the odds of having a telehealth visit at the school for CMC vs the other 12 schools was 23.8 (p value < 0.001; CL:11.2 to 50.6). CONCLUSION: Parental experiences with healthcare delivery were high both before and after the implementation of telehealth at an urban public charter school for CMC. Utilization of telehealth at the school for CMC was significantly higher than that of children enrolled in the program at 12 other schools. Further research is needed to evaluate parental experiences with school-based telehealth services.