Literature Review - The Use Of Clinical Systems To Improve Outcomes And Efficiencies

Literature Review – The Use of Clinical Systems to Improve Outcomes and Efficiencies

The COVID-19 pandemic has accelerated the adoption of telehealth across healthcare settings, including for mental health services. This literature review examines recent research on the use of telehealth to support patient care during and after hospitalization for mental health disorders. Specifically, it reviews four peer-reviewed articles published within the last five years that provide evidence on the application of telehealth systems to improve outcomes and efficiencies for mental health care delivery. The findings are synthesized to identify key themes regarding the benefits, challenges, and lessons learned from implementing telehealth for mental health services.

Annotated Bibliography

Romain, C. V., Trinidad, S., & Kotagal, M. (2022). The effect of social determinants of health on telemedicine access during the COVID-19 pandemic. Pediatric Annals, 51(8), e311-e315. https://doi.org/10.3928/19382359-20220606-04

This article examines how social determinants of health (SDOH) impact access to telemedicine services among pediatric patients during the COVID-19 pandemic. By reviewing much of the existing literature on the utilization of telemedicine and health disparities, key SDOH affecting access to telehealth—socioeconomic status, race/ethnicity, education level, digital literacy, and broadband internet access—are looked at in an attempt to prove how children from underprivileged backgrounds are more gravely impeded with regard to availing themselves of telemedicine, thereby compounding existing health inequities.

The study helps to show how telemedicine may improve access to care among some populations but will increase disparities for others if SDOHs are not taken into consideration. Some key items learned from this review include screening patients for potential barriers to telehealth use, providing support and education on the use of technologies, offering alternative modalities like telephone visits, and advocating for policies that expand broadband access in underserved areas. The authors concluded that considering SDOH in the design of telemedicine services is important if health systems are to provide fair services.

Sieck, C. J., Sheon, A., Ancker, J. S., Castek, J., Callahan, B., & Siefer, A. (2021). Digital inclusion as a social determinant of health. NPJ Digital Medicine, 4(1), 52. https://doi.org/10.1038/s41746-021-00413-8

This article proposes that digital inclusion—equitable access and use of information and communication technologies—should be considered a social determinant of health. The authors review existing literature on digital divides and health outcomes to make the case that lack of internet access, digital devices, and digital literacy skills negatively impact health by limiting access to online health information, patient portals, telehealth, and other digital health tools.

They argue that addressing digital inclusion is critical for reducing health disparities, particularly as healthcare becomes increasingly digital. The article outlines key components of digital inclusion, including affordable broadband, internet-enabled devices, digital literacy training, and technical support. Lessons learned include the need for healthcare organizations to assess patients’ digital access/skills, provide technology support, and partner with community organizations to improve digital inclusion. The authors conclude that healthcare systems and policymakers should prioritize digital inclusion efforts as part of addressing social determinants of health.

Torous, J., Jän Myrick, K., Rauseo-Ricupero, N., & Firth, J. (2020). Digital mental health and COVID-19: Using technology today to accelerate the curve on access and quality tomorrow. JMIR Mental Health, 7(3), e18848. https://doi.org/10.2196/18848

This article discusses how the rapid adoption of digital mental health tools during the COVID-19 pandemic provides an opportunity to expand access to mental health care in the long term. The authors review the evidence base for telehealth, mobile apps, and other digital therapies for mental health conditions. They found that telehealth is effective for delivering psychotherapy and other mental health services, while mobile apps can augment treatment between visits.

Key lessons include the need for workforce training on digital tools, ensuring digital equity, maintaining privacy/security, and developing hybrid models that combine in-person and digital care. The authors argue for increased investment in digital mental health infrastructure, research, and implementation to accelerate improvements in mental health care access and quality. They conclude that leveraging the momentum from COVID-19 could help realize the full potential of digital mental health interventions.

Yaugher, A. (2020, December 19). The tale of two crises: The opioid crisis and COVID-19. Utah State University Extension. https://extension.usu.edu/heart/files/TheTaleofTwoCrises_TheOpioidCrisisandCOVID-19_10.5.20.pdf

This article examines the intersection of the opioid epidemic and the COVID-19 pandemic, discussing how the pandemic has exacerbated challenges for individuals with opioid use disorder (OUD). The author reviews data showing increased mental health symptoms, substance use, and overdose deaths during the pandemic. The author also highlights how social distancing measures and healthcare disruptions have limited access to OUD treatment and recovery support services.

The article discusses how telehealth has helped maintain some access to OUD treatment during the pandemic. Key lessons include the need for mobile/outreach services, expanded access to medications for OUD, and increased distribution of naloxone to prevent overdoses. The author recommends strategies to support individuals with OUD during COVID-19, including maintaining social connections, sharing resources, and reducing stigma. The article concludes that simultaneously addressing both the opioid crisis and the COVID-19 pandemic requires a comprehensive public health approach.

Synthesis of Findings

Several key themes emerge from the reviewed literature on using telehealth to support mental health care during and after hospitalization:

Improved Access to Care

Telehealth improves access to mental health services, particularly for rural and underserved populations (Romain et al., 2022; Torous et al., 2020). It allows patients to connect with providers remotely, reducing barriers like transportation and geographic distance. For patients transitioning from inpatient to outpatient care, telehealth can facilitate more frequent check-ins and continuity of care.

Exacerbation of Health Disparities

While telehealth expands access for some, it may widen disparities for disadvantaged populations who lack the necessary technology, internet access, or digital literacy skills to engage in virtual care (Romain et al., 2022; Sieck et al., 2021). Patients with lower socioeconomic status, limited English proficiency, and other social risk factors face greater challenges utilizing telehealth.

Need for Digital Inclusion Efforts

Several key items to the equitable deployment of telehealth are bridging the “digital divide.” This would entail assessing patients’ access to technology or internet and digital literacy skills, providing technical support and education, and advocating for policies that expedite broadband access (Sieck et al., 2021). Offering alternate modalities, such as telephone visits, can help extend reach to patients without video capacity.

Effectiveness for Mental Health Treatment

Several studies support the fact that telehealth is an effective modality for delivering psychotherapy, medication management, and general mental health services (Torous et al., 2020). Video visits would allow for assessments of nonverbal cues and rapport-building. Mobile apps extend treatment between sessions with symptom tracking, skill practice, and crisis support.

Potential to Augment Existing Care Models

Telehealth should not fully replace in-person care but should be adopted in hybrid models that include both virtual and face-to-face service delivery (Torous et al., 2020). This includes models that factor in increases in the number of touchpoints and data collection to help inform treatment. When patients step down from inpatient care, telehealth can allow for that and provide monitoring and support.

Attention to Privacy and Safety

As mental health care goes increasingly online, the issues of privacy and security become topical. In the face of increasingly online mental healthcare, this calls for healthcare systems to ensure the use of HIPAA-compliant platforms while educating patients on how to protect their information when attending virtual visits (Torous et al., 2020).

Workforce Training Need

Clinicians need training in how to deliver effective mental health services over telehealth, from adapting therapeutic techniques to the virtual space to troubleshooting technical issues (Torous et al., 2020).

Potential to Address Multiple Health Crises

Telehealth can be quite instrumental in addressing intersectional people’s health challenges, for example, maintaining access to mental health and substance use treatment during the pandemic period of COVID-19 (Yaugher, 2020). It allows continued care delivery while reducing infection risk.

Conclusion

The literature reviewed indicates that telehealth has huge potential to improve access, continuity, and quality of care for patients with mental health disorders both during and after hospitalization. Attainment of these benefits, however, requires proper consideration of the digital divide and efforts directed toward digital inclusion. The implementation of telehealth by healthcare systems ought to be patient-centered; that is, there should be assessments of individual needs and preferences in an attempt to bridge the barriers.

The best outcome will be through integration into hybrid care models, in which virtual services will be combined with in-person services. Since telehealth is becoming a mainstay of mental health care delivery, ongoing research will be necessary to define best practices, measure outcomes, and ensure access equitably. In general, telehealth seems to be an instrument with great promise for expanding the reach of services pertaining to mental illness and supporting patients across the entire continuum of care.

References

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Question

To Prepare:

Review the Resources and reflect on the impact of clinical systems on outcomes and efficiencies within the context of nursing practice and healthcare delivery.
Conduct a search for recent (within the last 5 years) research focused on the application of clinical systems. The research should provide evidence to support the use of one type of clinical system to improve outcomes and/or efficiencies
***“The use of telehealth to support patient care during and after hospitalization for mental health disorders.”**
I work in the ICU.. I have also added some references below to use

The Use of Clinical Systems to Improve Outcomes and Efficiencies

-Sieck, C. J., Sheon, A., Ancker, J. S., Castek, J., Callahan, B., & Siefer, A. (2021). Digital inclusion as a social determinant of healthLinks to an external site.. NPJ Digital Medicine, 4(1), 52.  https://doi.org/10.1038/s41746-021-00413-8

-Romain, C. V., Trinidad, S., & Kotagal, M. (2022). The effect of social determinants of health on telemedicine access during the COVID-19 pandemicLinks to an external site.. Pediatric Annals, 51(8), e311-e315. https://doi.org/10.3928/19382359-20220606-04

Identify and select 4 peer-reviewed research articles from your research.
For information about annotated bibliographies, visit https://academicguides.waldenu.edu/writingcenter/assignments/annotatedbibliographiesLinks to an external site.

The Assignment: (4-5 pages, not including the title and reference page)

In a 4- to 5-page paper, synthesize the peer-reviewed research you reviewed. Format your Assignment as an Annotated Bibliography. Be sure to address the following:

Identify the 4 peer-reviewed research articles you reviewed, citing each in APA format.
Include an introduction explaining the purpose of the paper.
Summarize each study, explaining the improvement to outcomes, efficiencies, and lessons learned from the application of the clinical system each peer-reviewed article described. Be specific and provide examples.
In your conclusion, synthesize the findings from the 4 peer-reviewed research articles.
Use APA format and include a title page.

Literature Review – The Use of Clinical Systems to Improve Outcomes and Efficiencies