Name
Chamberlain University
NR-706: Healthcare Informatics & Information Systems
Prof. Name
Datea
Mr. Kasich, a 77-year-old man, presented to the emergency department following a fall while getting out of bed. His blood glucose was critically low at 35 mg/dL, resulting in a diagnosis of uncontrolled type 2 diabetes mellitus with hypoglycemia, despite having a prior history of stable glucose control. His medical profile is further complicated by advanced congestive heart failure and lung cancer. He has Medicare Parts A and B coverage and lives with his wife in a rural location approximately 40 miles from the nearest healthcare provider. Notably, he is proficient in operating his home computer, which could facilitate digital health solutions.
In comparison, Mr. Lane is a 42-year-old long-haul truck driver who was hospitalized for worsening heart failure. He also has type 2 diabetes mellitus, but unlike Mr. Kasich, he has private insurance coverage. Mr. Lane is single, resides primarily in his truck, and lives a highly mobile lifestyle, which poses unique healthcare challenges.
Both patients are being discharged with access to telehealth services. These services involve remote monitoring tools that track critical parameters such as weight, blood pressure, blood glucose, and oxygen saturation. The collected data are transmitted directly to a telehealth nurse for continuous review. Although telehealth lacks face-to-face physical interaction, its goal is to reduce hospital readmissions, improve patient satisfaction, promote positive health outcomes, and empower patients in managing their own health. This aligns with the principles of patient-centered nursing practice.
Telehealth has emerged as a powerful solution to enhance equitable distribution of healthcare resources by bridging gaps in accessibility. For patients in underserved or geographically isolated regions, such as Mr. Kasich, telehealth reduces the burden of frequent travel while ensuring timely monitoring and interventions. Similarly, for highly mobile individuals like Mr. Lane, telehealth allows continuous access to healthcare despite their nontraditional living arrangements.
However, for telehealth to truly achieve equity, systemic barriers must be addressed. These include insufficient broadband infrastructure, limited access to technology, digital illiteracy, and financial constraints. Without interventions in these areas, disparities may persist, particularly among rural, low-income, or minority populations. Addressing such barriers promotes fairness, optimizes healthcare resource utilization, and ensures all patients receive quality care irrespective of their location or socioeconomic standing (Edirippulige & Armfield, 2017).
Despite its promise, several challenges impede the equitable use of telehealth:
Equity in Access: Rural areas often lack reliable internet connectivity, which directly limits telehealth adoption.
Respect and Self-Determination: Patients may feel depersonalized when interactions occur primarily through digital platforms, reducing their sense of autonomy.
Health Literacy: Limited understanding of health information or lack of digital competency can restrict effective engagement with telehealth tools.
Cyclic Disadvantage: Vulnerable groups may face compounded challenges from poverty, chronic illness, and systemic inequities, perpetuating poor health outcomes.
Healthcare Disparities: Minorities and low-income patients are disproportionately affected by barriers, leading to unequal care delivery (Nouri et al., 2020).
| Aspect | Mr. Kasich (77 years old) | Mr. Lane (42 years old) |
|---|---|---|
| Health Conditions | Type 2 diabetes with hypoglycemia, congestive heart failure, lung cancer | Type 2 diabetes, heart failure |
| Insurance Coverage | Medicare Parts A and B | Private insurance |
| Living Situation | Lives with wife in rural setting, 40 miles from healthcare facility | Primarily resides in his truck, single, mobile lifestyle |
| Technology Proficiency | Skilled in using a personal computer | Likely limited due to occupational demands and mobility |
| Telehealth Benefit | Reduces travel burden, continuous health monitoring | Enables consistent care despite constant travel |
| Challenges | Internet reliability in rural area; multiple chronic illnesses | Maintaining access while on the road; irregular living pattern |
| Ethical Considerations | Avoiding age-related bias, supporting informed decision-making | Protecting privacy in nontraditional living environment |
From a nursing perspective, implementing telehealth requires adherence to ethical principles. Respecting autonomy means ensuring patients understand how to use telehealth tools and are active participants in their care. Nurses should provide clear education to both Mr. Kasich and Mr. Lane to support informed choices.
Equity remains essential, as nurses must advocate for fair access regardless of the patients’ geographic or occupational challenges. Confidentiality is another major concern, particularly for Mr. Lane, whose health data may be transmitted from unsecured public networks. Nurses have an ethical duty to safeguard patient information through proper data protection measures.
Moreover, cultural sensitivity and respect should guide interactions, as patients may have differing expectations regarding healthcare delivery. Maintaining trust, fostering patient engagement, and ensuring telehealth tools enhance rather than replace therapeutic relationships are central to ethical nursing care (Beauchamp & Childress, 2019).
Telehealth offers an innovative pathway to expand healthcare access, enhance patient empowerment, and reduce preventable hospitalizations. Both Mr. Kasich and Mr. Lane illustrate how telehealth can be adapted to diverse patient needs—ranging from rural living to highly mobile lifestyles. Nonetheless, the success of telehealth hinges on addressing barriers such as internet access, digital literacy, and ethical concerns related to autonomy and confidentiality.
By proactively addressing these challenges, nurses can ensure patient-centered telehealth delivery that respects autonomy, promotes fairness, and contributes to reducing disparities. Ultimately, telehealth represents not only a technological advancement but also a vital tool in building a more equitable healthcare system.
Beauchamp, T. L., & Childress, J. F. (2019). Principles of biomedical ethics (8th ed.). Oxford University Press.
Edirippulige, S., & Armfield, N. R. (2017). Education and training to support the use of clinical telehealth: A review of the literature. Journal of Telemedicine and Telecare, 23(2), 273–282. https://doi.org/10.1177/1357633X16632968
Nouri, S., Khoong, E. C., Lyles, C. R., & Karliner, L. (2020). Addressing equity in telemedicine for chronic disease management during the COVID-19 pandemic. NEJM Catalyst Innovations in Care Delivery, 1(3). https://doi.org/10.1056/CAT.20.0123
