Telehealth-Enabled Holistic Care- A Population-Specific Approach to Health Promotion and Disease Prevention

Telehealth-Enabled Holistic Care- A Population-Specific Approach to Health Promotion and Disease Prevention

The delivery of healthcare services is becoming complicated as the demand for healthcare services grows against a shrinking healthcare workforce. In other cases, certain health situations hinder the ability of patients to receive healthcare services within hospital facilities or in-person care. The use of technology in healthcare delivery has improved the accessibility of care as well as health promotion. This article presents a case study and care plan involving a 67-year-old African American woman living in a rural U.S. The application of telehealth in the management of geriatric populations for health promotion, wellness preservation, and maintenance of function across the health-illness continuum is highlighted.

Population of Focus

Rural communities in the United States have limited access to quality care with majorly worse health outcomes (Cromer et al., 2019). They are often less diverse, with notable racial and ethnic disparities in socioeconomic status, health access, and outcomes. The health disparities are more pronounced among elderly minorities, especially elderly African Americans in rural areas. A majority of elderly African Americans in rural areas live mostly in low socioeconomic households. Older adults, especially African-American women, live alone or lack social support from relatives and friends. Elderly African-American women are also prone to multiple chronic health conditions, including diabetes and hypertension. They are also limited in their ability to move around, and access required healthcare services as well as self-care.

Case Study

Mrs. D.K., a 67-year-old African American woman, lives in a small town in rural U.S. She has been living with type 2 diabetes since she was diagnosed two years ago. She was also recently diagnosed with high blood pressure. Her mobility is also becoming limited as she ages and has joint pain. Mrs. D.K. lives with her 21-year-old granddaughter, four years since her only daughter passed. The granddaughter attends a nearby college and works at a coffee house in the town. She now has to balance her school and job and care for her sick and aged grandmother. Due to her low socioeconomic status and rural residence, Mrs. D.K. has limited access to regular medical care and support to help her manage her diabetes and high blood pressure. Her granddaughter also has limited skills regarding caring for her grandmother with her comorbid situation, including administering the prescribed medications correctly.

There are only five qualified specialists working at the local health community center. Mrs. D.K.’s granddaughter has been going to the health center for the last three months to collect medications and information on how to manage her grandmother’s diabetes and blood pressure. Notably, the rates of diabetes, heart disease, hypertension, and stroke are higher in rural areas as compared to urban regions (Aggarwal et al., 2021). This is the case in Mrs. D.K.’s clinic. There are a number of patients competing for the same services. In some instances, Mrs. D.K. missed appointments as the physician was unable to travel to her home, there were many bookings, and the physicians could not manage to see her on time.

Care Plan

The first step in Mrs. D.K.’s care plan is to assess her situation with a focus on her physical capability and needs, including mobility capacity and needs, as well as other limitations related to diabetes, functional abilities and capacities such as her ability to bath and dress, and psychosocial needs. The assessment will also include her granddaughter’s mental well-being and ability to manage her education, work, and her grandmother’s health. The situation is affecting the mental health of Mrs. D.K. and her granddaughter, and both need readily available assistance with medication, health maintenance, and mental health support.

The interventions for Mrs. D.K. and her granddaughter’s situation will include implementing a telehealth service and the use of a smartwatch with the capability to monitor blood pressure connected to a mobile health application. The telehealth services will include consultations, blood sugar and pressure monitoring, guidance on medications and medication assistance, and other educational support to help with diabetes and blood pressure management over the phone and video calls. The implementation of telehealth services will provide a more convenient way for Mrs. D.K. to regularly check in with the specialists and honor all appointments without leaving her house or visiting her physically. The use of telehealth will also overcome the need for regular traveling and transportation limitations due to her socioeconomic status and age. The application of telehealth in rural and remote care delivery has proved to improve the effectiveness of clinical care as well as the care processes, leading to the delivery of fast patient-specific care (Tsou et al., 2021). The elimination of the need to travel reduces the costs of care associated with patient or physician transportation (Hilty et al., 2023). The use of telehealth services is also expected to improve Mrs. D.K.’s utilization of care services, as she will be able to access care specialists as needed. Additionally, the use of a smartwatch linked to a smartphone will allow Mrs. D.K., her granddaughter, and the physicians to continuously assess her health, including blood pressure and heartbeat rates. Overall, the use of telehealth services, a smartwatch, and a linked app will reduce the time needed to monitor Mrs. D.K.  physically. Subsequently, this frees up the physicians and the granddaughter to take care of her other daily activities.

Mrs. D.K. will also be introduced to yoga and guided meditation to help manage her emotional and mental health. Yoga and meditation have a significant effect on managing stress and anxiety and improving mobility. The telehealth services will support the delivery of virtual yoga and meditation tutoring at a time convenient for both Mrs. D.K., her granddaughter, and the yoga specialist. In addition, Mrs. D.K. and her granddaughter will also be provided with resources for mental health support to improve access to healthcare and other support services.

Conclusion

Populations living in rural areas, especially the elderly, face multiple barriers to accessing needed healthcare services. Cases such as the one involving Mrs. D.K. presented above show how other factors such as race, health status, and socioeconomic status notably limit how elderly rural populations access, experience, and receive healthcare services. Consistently, the use of telehealth and mobile health apps, as shown by evidence from various applications, will make it convenient for Mrs. D.K. to access healthcare services and monitoring required to manage her diagnosed diabetes and hypertension. It will also ensure that she receives regular virtual check-ins and that she and her granddaughter have access to specialists at all times, regardless of their location.

 References

Aggarwal, R., Chiu, N., Loccoh, E. C., Kazi, D. S., Yeh, R. W., & Wadhera, R. K. (2021). Rural-urban disparities: Diabetes, hypertension, heart disease, and stroke mortality among black and white adults, 1999-2018. Journal of the American College of Cardiology, 77(11), 1480–1481. https://doi.org/10.1016/J.JACC.2021.01.032

Cromer, K. J., Wofford, L., & Wyant, D. K. (2019). Barriers to healthcare access facing American Indian and Alaska natives in rural America. Journal of Community Health Nursing, 36(4), 165–187. https://doi.org/10.1080/07370016.2019.1665320

Hilty, D. M., Serhal, E., & Crawford, A. (2023). A telehealth and telepsychiatry economic cost analysis framework: A scoping review. In Telemedicine journal and e-health: The Official Journal of the American Telemedicine Association (Vol. 29, Issue 1). https://doi.org/10.1089/tmj.2022.0016

Tsou, C., Robinson, S., Boyd, J., Jamieson, A., Blakeman, R., Yeung, J., McDonnell, J., Waters, S., Bosich, K., & Hendrie, D. (2021). Effectiveness of telehealth in rural and remote emergency departments: Systematic review. Journal of Medical Internet Research, 23(11), e30632. https://doi.org/10.2196/30632

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Assignment Prompt
Apply what you have learned about Health Promotion and Disease Prevention, and demonstrate the ability to develop a holistic plan of care, incorporating Telehealth and defining assessment and intervention of specific population incorporating unique attributes of populations for health promotion, wellness preservation, and maintenance of function across the health-illness continuum.

Develop a case study and a plan of care, incorporating current mobile App technology:
1. Select a population. Define your population by gender, age, ethnicity, socioeconomic status, spiritual need, and healthcare need. Apply concepts learned in the course to identify healthcare needs specific to the population and access to care (Utilize your textbook Chapters 1-25 and identified Websites). Also, use at least two references within the last five years.
2. Develop a case study for a patient in your chosen population.
3. Define a provider level of care that includes telehealth, alternative therapies, and mobile App technology discussed in this class. Describe how telehealth could impact the care delivery of this patient.
Hint: Concise, condensed information, with specifics and details about population and unique needs with a plan for meeting these needs should be considered. Incorporate the content you have learned in this course.

Expectations
• Due: Monday, 11:59 pm PT
• Length: 3 pages not including the title page and references page
• Format: APA, 7th edition format is to be observed (12 pt., 1” margins, Times New Roman)
• Research: Two references within the last five years