N108: Transition to the Registered Professional Nurse Role Study Guide Telehealth Telehealth is the use of electronic information and telecommunication technologies to support long- distance clinical healthcare, patient and professional health–related education, public health, and health administration. Telehealth has the potential for supporting effective care of rural populations that have difficulty accessing certain types of healthcare. Through online technology, nurses and physicians may be available to patients who reside far from the provider. Cameras can be used to facilitate long-distance assessment and specific laboratory and physical assessment information can be communicated to the provider through the internet. One area of practice for nurses in Telehealth is in telephone triage. Patients and families call the telephone help line, and the nurses use evidence-based protocols to assess and direct patients in self- care or in accessing medical care as needed. Telephone help lines are often supported by health plans to decrease the use of expensive emergency room care for less serious problems that could be managed in other ways. Telehealth may also be used to facilitate improved screening and detection of illness, to improve patient self-management of chronic conditions for short and long-term symptom monitoring, and for the delivery of appropriate health interventions. 2.14 Health Care Organizations Nursing care is affected by how patient care is organized and administered. Generally, agencies providing care are classified according to length of stay, ownership, or type of service. Understanding these categories is useful because they are used to plan for services, to describe institutions, and to allocate funding and reimbursement. It is helpful for nurses to have an understanding to assist in guiding clients and families through what sometimes seems a maze of confusion in the healthcare system. Classification According to Length of Stay One way of classifying inpatient agencies is according to the average length of stay, or how long patients remain in the facility. Ambulatory care, short stay, traditional acute care, and long-term care are terms that reflect the average length of stay in a facility. • In-and-out care: Contact with the client is measured in minutes vs. hours. Typical examples are office visits, emergency department visits, and therapy sessions. • Short stay : This provides care to patients who suffer from acute conditions or require treatments that require less than 24 hours of care and monitoring. Diagnostic tests or minimally invasive surgery are examples. • Acute care: This traditionally occurs in hospitals where patients stay greater than 24 hours but less than 30 days. Stays are shortened since the advent of managed care and DRGs. • Long-term care: This provides care to residents for the remainder of their lives; care also includes services to patients with limited recovery needs, functional losses, chronic diseases, mental illness, or major rehabilitation, which may range from 30 to 90 days.