The Evolution Of Telemedicine Health And Social Care Essay

The Evolution Of Telemedicine Health And Social Care Essay Who would have ever imagined that a doctors visit could be conducted through a phone-line, video, or the use of a computer 1000 plus miles away? Medical records can be view by another medical professional for a second opinion three counties away before you arrive. A radiologist in Singapore has diagnosis your femur fracture here in the United States. Medical diagnosis, treatment and consultations are being performed from miles away because of technology. It seems as if there is no limitation to the well being of a patient through a wide range of telemedicine services. What is telemedicine? According to the American Telemedicine Association telemedicine is the use of medical information exchanged from one site to another via electronic communications to improve patients health status. Emails, videoconferencing, transmission of still images, e-health including patient portals, remote monitoring of vital signs, continuing medical education and nursing call centers are all considered part of telemedicine.(http://www.americantelemed.org) This interactive form of medical services has provided healthcare to individuals many miles away or minutes away in the comfort of their homes, physician offices and hospitals. Ways to communicate services Store-and -forward is a means of transmission of medical information to other medical professionals and facilities that will provide the recipient pertinent medical history, vital signs, medical records, lab results and images. Store-and-forward telemedicine systems have the ability to capture and store digital still or moving images of patients, as well as audio and text data. A store-and-forward system eliminates the need for the patient and the clinician to be available at the same time and place. Store-and-forward is therefore an asynchronous, no interactive form of telemedicine. It is usually employed as a clinical consultation (as opposed to an office or hospital visit). (http://www.ahrq.gov) One of the major concerns with store and forward is whether it is as effective as face to face medical visits, does it have comparable outcomes, is it appropriate for appropriate medical management, is the patient truly satisfied with the outcome and level of services and is it cost effect ive? There are several benefits of store-and-forward technology. Patients in rural areas are able to be seen by specialty physician miles away when there is limited access to the services in the area. The store-and-forward of medical information is also being used with emergency response teams to communicate the information to the emergency room staff for an efficient transfer of vitals and medical status. The store and forward technology is said to be the least expensive way to communicate and the most accurate in real time for patients at a distance needing medical consultation. Another type of store and forward technology is videoconferencing technology. The two way television allows two doctors in two different areas to communicate to provide treatment, a diagnosis, or telesurgery. There are several healthcare areas that benefit from telemedicine Some of the common teleservices Telemedicine includes several medical disciplines that benefit from the services. Services like radiology, dermatology, nursing, pharmacy, pathology, neurology and psychiatry. The need for a second opinion in healthcare has seen a demand, and the shortage of specialty doctors in rural areas increased. The development of telemedicine has benefited the patient in many ways because of technology. Teleradiology- is the transmission of x-ray, CT, MRI, PET, and SPEC images that can be read by radiologist in another facility or country. The information is sent via the store and forward process of telemedicine. Large and small hospitals have began to use teleradiolgist to cut down on expense and having access to immediate diagnosis. Teledermatology- is the use of video conferencing and store and forward images to provide a consultation for an individual that requires a dermatologist. There have been concerns with the consistency of this tyoe of visit for patients due to unclear images of the skin and the possibility of not having that face to face visual from the dermatologist to make an adequate diagnosis. Telenurse- the use of phone, electronic email, videoconferencing, and computers to provide healthcare services or consultation to a patient. Telenusring has continued to grow in the areas of telephone triage for health insurance carriers. Telenursing has grown with interactive patient training related to changing wound dressings, insulin administering, self management of a patients health. Reimbursement Many of the healthcare providers must follow certain guidelines to receive payment for telemedicine. According to Medicare its condition for payment must include an interactive audio and video telecommunications system that is used and must permit real-time communication between the physician or practitioner at the distant site and the beneficiary at the originating site. The medical providers that are covered under this fee for payment are services rendered by a physician, nurse, physician assistant, midwife, clinical nurse specialist, or clinical psychologist. The current list of Medicare telehealth services includes: Consultations Office or other outpatient visits Individual psychotherapy Pharmacologic management Psychiatric diagnostic interview examination End-Stage Renal Disease (ESRD)-related services Neurobehavioral status examination For ESRD-related services, at least one face-to-face, hands on visit (not telehealth) must be furnished each month to examine the vascular access site by a physician, NP, PA, or CNS. (http://www.cms.hhs.gov) New Trends in telemedicine Trends observed nationally include: using telemedicine in correctional facilities and home health care settings, can significantly reduce the time and costs of patient transportation; providing additional services to rural area linking physicians together more efficiently linking hospitals and schools together to improve care and widespread The benefits With a growing population and healthcare on the rise many public and private medical providers have seen a cost reduction with the use of telemedicine and patients have benefited from the technology in telemedicine. Insurance providers are paying for less hospital in patient days because the patient can be monitored from a distance. The patients are able to communicate with a nurse or physician at home through phone, video, or Bluetooth monitoring. Telemedicine allows more freedom to the patient to feel less restricted to home visits, they have access to some providers 24 hours a day and it cuts down on their travel time to medical visits. The patients family has also displayed satisfaction from the use of telemedicine because its less strenuous on their travel time and loss of work days. Another benefit of telemedicine provides an outreach to rural areas to be included in clinical trial studies and procedures. The providers have also benefited because they are able to receive real t ime feedback from other professionals that are able to transmitted medical information quickly, decreased travel time, and continued patient education and communication. Issues that need to be addressed Education regarding telemedicine and its usage. There are concerns that many do not know that he services exist. Cost and evaluation of the services. Will the cost for reimbursement be lower because there is no face to face contact? How will the affects of technology increase cost? Liability and malpractice issues. Out of state practices of medical professionals crossing their licensed boundaries. How will they be regulated and which state laws and rules will they be governed under? Security is always a concern regarding information sent via phone and internet lines. Can medical information be protected properly and the doctors will be held liable for the misappropriation of a patients medical information. Although there are HIPPA laws regarding patients privacy according to ORTCC its much more difficult to guarantee confidentiality because several individuals outside the traditional medical team. The transmission procedure requires technical staff at both ends. In small communities, it is possible that the patient knows the nonmedical personnel socially, compounding the sense of loss of privacy. Thus, the nature of the doctor patient relationship changes dramatically with telemedicine, challenging traditional concepts of privacy and confidentiality. (http://www.ortcc.org) Conclusion With technology making waves telemedicine has been able to grow through leaps and bounds allowing those that are limited and restricted to receive the medical attention of medical professionals. Physician has gain quicker access to other professionals without sitting face to face, digital images, and audio files of heartbeats and fetal movements. The privacy, protection, reimbursement, malpractice, and governing laws are still a concern but the efficiency of communication to provide medical care is needed.

Making and receiving telephone calls Essay

The Learner will: 1.Understand how to make telephone calls. 1.2 Give reasons for identifying the purpose of a call before making it. To not waste time, so you are aware what information you need and are therefore able to ask the right questions. It is also important as you will sound professional and organised, which will reflect well upon the company you work for. It may be a good idea to have a checklist written down of all you need to know, this way you won’t forget anything and you can avoid having to call back later for forgotten information. This will prove to be a much more efficient way of working and save time. For example: If I was at work and I needed to phone a GP surgery to do with a fax that they’d sent through. I would firstly make sure I had the fax in front of me with the relevant patient information on. This way when I speak to the surgery I will have all the information to hand they may initially ask for before they are then able to assist me with my query. It is important to think through a conversation before making the call to ensure you are prepared and have the knowledge they may need. Again if I was phoning another department within the hospital trying to locate a set of patient notes I would make sure I could tell them, the patient name and medical record number, where the notes are traced to on the computer and on what day, time and by who, if they have any appointments booked soon and where and if there was any useful information on the most recent pin note, all of this would help narrow down the search to locate the patient’s notes. 1.3 Describe different ways of obtaining the names and numbers of people that need to be contacted. If you know the name of the company you need to contact then you could look up their contact details on their website on the Internet. You could also use an online phone book like the yellow pages website for most contact details. You could simply ask someone within your office/department if they have the contact details to hand as it may have been someone they have dealt with before. At Musgrove we  have the intranet, our internal website, on this you can find lots of information about the hospital, including an internal directory, where you can find out anyone’s extension number who works within the hospital by adding in their name or department. I also have a list of contacts on my pin board for numbers within our department and for the rest of the hospital. If I need to make calls to GP surgeries or surrounding hospitals I usually go on google and find them easily that way . 1.4 Describe how to use a telephone system to make contact with people inside and outside an organisation. In Musgrove we have a system that I imagine is the same with most businesses. To make an outside call you simply press 9 to gain an outside line and then type in the number you require, including the area code if needed. With internal calls you simply need to enter the 4 digit extension number for the appropriate person in the appropriate department. If you are unsure of the extension number for the call you need to make internally you can simply go on Musgrove’s intranet and use their internal directory. Here you can enter their name and/or department and it will bring up their contact information i.e email address and extension number. 1.6 Explain the purpose of summarising the outcomes of a telephone conversation before ending the call. It is important to make sure and clarify that all the information is correct and accurate so you are both aware of agreed times and goals etc, avoiding any confusion. It will avoid wires getting crossed as it is not recorded like in an email to look over after, this is also why it’s always advisable to make a note of the telephone conversation. 1.7 Describe how to identify problems and who to refer them to. If someone phones the department with a problem and it is not something I can deal with I would firstly take their name and contact details. I would ask for their phone number in case for any reason they get disconnected at any point during the call, we are then still able to call them back. Next I would find out what the problem was and what department they spoke to and then transfer them on to one of the secretaries with the obtained information. 1.8 Describe organisation structures and communication channels within an organisation At Musgrove there are certain channels we would go down depending on what the call was regarding. I often receive calls that I am unable to deal with so need to redirect to other lines in our department. Patients often contact my line querying their appointments and as I am unable to help them with this I transfer them to the Appointments office next door. To do this I would, firstly inform the caller that I was going to transfer them to the Appointments office where their query could be answered. I would then press the Recall button on the telephone and dial the four digit extension number for one of the girls in charge of arranging appointments. When they answered I would briefly explain the callers query and then hang up, thus connecting the caller to the transferred line. It is important to keep the explanation brief so you don’t keep the patient waiting any longer than is absolutely necessary. If for any reason no one was available to take the call in appointments I would then need to transfer the call back to the caller by pressing the recall button followed by *1. I would then need to explain that they were busy at present so offer them the number to call them directly. If I receive any complaints over the telephone the first action I would take would be to transfer the call through to one of the secretaries as they are better equipped to deal with such situations. Depending on the outcome of their conversation they may need to be transferred on to PALS where they can deal with the complaint more appropriately. 1.9 Describe how to follow organisational procedures when making a telephone call It’s always important to introduce yourself and state where you are calling from for example if I was making a call to a GP surgery I would start the call by saying – â€Å"Hello my name’s Nic and I’m calling from the cardiology department at Musgrove Park Hospital† I would make sure prior to making the call that I had any questions needed to ask, to hand or know what information I required from the telephone conversation. This way you ensure that the phone call is carried out efficiently, it is always good to recap the conversation where appropriate to confirm you have all the correct and accurate information needed. It is important to always remain polite and  speak clearly whilst on the telephone. You need to remember that you are representing your company so need to stay professional. Working at a Hospital you must always be aware and careful about who you are speaking to, ensuring that you only give out patient details to appropriate people such as GP surgeries, other local Hospitals or of course the patient themselves. 1.10 and 2.9 Explain how to report telephone system faults To be able to be as precise and informative as possible, concerning a telephone system fault, will usually help to resolve the issue as fast and simply as possible. If there was a fault with my telephone system at work I would firstly make sure it was not a simple error my end – for example if the telephone line had accidently been pulled out of the wall, or if the receiver was not put back on the stand correctly, meaning you were not getting any calls connected. After checking these simple things, if there was still a problem I would inform my mentor or one of the secretaries in case it was an error they were familiar with. Failing that I would contact the switchboard regarding the error or possibly the IT department. 2. Understand how to receive and transfer telephone calls 2.1 Describe how to identify callers and their needs Within the hospital many calls are made internally between offices and departments. I especially deal with calls like these when other departments are requesting patient notes that are located to the Cardiology department. The caller would state their name and department when I answered the phone as this is trust procedure. I may then ask â€Å"how can I help you† although this would not normally be necessary for this type of call as the caller would have already said â€Å"I need a set of notes that are currently traced to you†. I would next ask them for the patient’s full name and medical record number. I would also reconfirm the department they were calling from, where the notes were needed and the date the notes needed to be with them. I would also ask the caller for their extension number so I could ring them back if needed, for example if I couldn’t locate the notes or if they needed the notes as soon as possible so were coming to collect them when they were ready. All of this information would be written down in a note pad so I  always had it to hand if I needed to refer back to it at any point. 2.2 Explain the purpose of giving accurate and up to date information to callers Giving a customer accurate information over the telephone is crucial to the success and reputation of a business and could determine their future. If a caller is phoning a company regarding a price on a product they are selling and are told the wrong information, the customer will have instantly lost their trust in the company and as a result are almost certain to take their business elsewhere. It will not only make the company look inadequate but unprofessional also. At Musgrove it is very important to relay accurate and up-to-date information, whether it is directly to a patient or to a GP surgery regarding a patient. It is especially important within a hospital environment as inaccurate information could result in possible life threatening situations for patients and a lot of unnecessary worry and upset. When a patient is making a telephone call to the hospital they are often likely to be anxious and worried and will need to be put at ease and reassured. To be able to do this it’s important to answer their queries promptly and professionally with accurate information delivered in a clear and concise way as this will also help to build trust with the patient. 2.3 Explain the purpose of confidentiality and security when dealing with callers When talking to somebody over the phone there is no easy way to validate the identity of the caller, nothing to easily confirm to you that they are who they say they are. This is why often customers have to identify themselves with a password when speaking with a company over the phone regarding sensitive and personal information. Confidentiality and security procedures must be strictly followed and adhered to within the hospital under the Data Protection Act 1989. If a patient calls the office at work enquiring about an investigation or treatment they are due to have or indeed have had and are waiting for the results, the secretary taking the call must always ask for some personal details about themselves before disclosing any information. Even then there is only limited information they are permitted to tell the patient over the phone. They often have to wait until a letter arrives in the post as this is a much more secure way of conveying the  information. 2.4 Describe the types of information that could affect confidentiality and security and how to handle these The Data Protection Act was put in to place in 1998 to prevent confidential or security information from being shared or being released to the public. Peoples personal details such as their National insurance number, Pin numbers for their bank accounts or passwords for access to information are all things that must be kept confidential at all times. Everyone at Musgrove is responsible for keeping confidential information confidential and disclosing any private details would actually be breaking the law. At work we see a lot of patient’s medical records, these are also strictly confidential and we must not share this information with anyone who is not authorised to see them. At work if we come in to contact with medical records that belong to somebody we know they must immediately be passed on to another member of staff to deal with, as seeing them would compromise the confidentiality and privacy of the individual. There was recently a massive confidentiality breach within the hospital when a celebrity visited the hospital and a member of staff put a message about it on twitter. With so many social media outlets these days it makes it even more vital to keep information private, I believe the employee was dismissed from the trust and rightly so. 2.5 Describe ways of identifying the appropriate person to whom a call is transferred Often the caller won’t have a name of the person they want to speak to so it is always good to reconfirm that they have called the right department. If they are a little unsure it is important to ask briefly what the call is reference to, this would then hopefully give you enough information to know the appropriate person to deal with it. At work there’s usually only a few different locations I may need to transfer calls to. I sometimes take calls from patients that need to reschedule a future appointment or that just want some information about it. In this case I would tell the patient that I needed to transfer them through to the appointments office, where somebody could help them with their query. I also have calls form patients and GP surgeries that I sometimes are unable to deal with myself. In these circumstances I would transfer them through to  one of the secretaries, whoever was taking the phones that day. If I was still unsure on a call I would explain to the caller that I just need to put them on hold for a minute while I try to determine the most appropriate person to help them by speaking to the secretaries for advice. 2.6 Describe the information to be given when transferring calls or leaving messages After you have established who the caller is and why they are calling you then need to refer them to the correct or most appropriate person. I would explain to them that I was transferring them on so to please bear with me for a minute while I do so. Next I would push the recall button and the appropriate extension number. I would tell the member of staff I was forwarding them on to, who the caller was, where they were calling from and any information I had about what their call was regarding. When taking a message for someone at work I have actually prepared a message slip that I use to ensure I obtain all the appropriate information. On this slip I record the caller’s name, where they are calling from, what the caller’s contact number is, who the message is for, the actual message, I also record the date and time of the call so when I pass the message on they are aware of timescales. 2.7 Describe how to identify problems and who to refer them to A problem we have previously experienced at work is calls being lost when being transferred between phones. In this instance I would contact the member of staff who was transferring the call to me to see if they had the caller’s phone number or any information about them so I could call them back. Calling them back will show that you care and that you are efficient in your work. If this is a problem that continues to happen it must mean that there is a connection fault of some sort so it should be reported to the switchboard to the IT department so they can log it and hopefully sort it. 2.8 Describe how to follow organisational procedures when receiving a telephone call When receiving calls within the department we always answer with our name and the department we are in, this way the caller will instantly know if they have phoned the right location which will also save wasting anyone’s time. Another of the trust’s procedures is answering the  telephone within three rings, this is important to do as nobody likes being left waiting for someone to answer a call, especially when it could be anxious patients or patient’s relatives.

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Oedipus the King by Sophocles - 614 Words

â€Å"Oedipus the King† is a tragic Athenian play written and produced around 425 B.C. by Sophocles; a tragic dramatist, priest, and one of the three great ancient Greek writers whose excellent work has survived the centuries. The play takes place in mythical ancient Greece in a city called Thebes. It’s about a prophecy foretelling the murder of king Laius by his own son, Oedipus (protagonist), and the incestuous marriage between mother (Jocasta) and son (oedipus). The discovery of the truth brought upon Jocasta’s and Oedipus’s downfall; Jocasta killed herself and Oedipus blinded both eyes with the golden brooches attached to his mother’s gown. He blinded himself because he could not bear to witness the destruction of himself and his family; the meaning behind his choice of surgical instrument is based upon punishing himself for setting eyes on his mother’s nakedness during their marriage (the brooches are what mainly kept the gowns on) . Before discovering the truth, or even becoming king of Thebes, Oedipus ( meaning â€Å"swollen foot†) had his foot pinned together and was left to succumb in the wilderness of Mount Cithaeron in hopes of evading the prophecy. Instead, he was delivered by a shepherd to King Polybus and Queen Merope of Corinth. Once fully grown, he set out on a journey to the shrine at Delphi, only to be told he would lie with his own mother, â€Å"breed children from whom all men would turn their eyes (pg. 1226),† and that he will be his father’s murderer.Show MoreRelatedOedipus The King By Sophocles848 Words   |  4 PagesOedipus the King, written by Sophocles, follows the tragic story of a king named Oedipus who goes from an all-powerful ruler to a hopeless blind peasant. Oedipus the King was written as a play and performed in front of an audience. Sophocles shows in Oedipus the King that one cannot escape the fate of the gods. Throughout the play Oedipus struggles to f ind a solution and change all the troubles in his life. The play observes the story of Oedipus who defies the gods and through the journey experiencesRead MoreSophocles Oedipus The King884 Words   |  4 PagesKing of Thebes, owner of a family tree that identically resembles Medusa on a bad hair day, and the inspiration for a psychologically-riveting complex, Oedipus, tragic hero of Sophocles’ Oedipus the King, exposes troubling truths about the human condition and, acting as an exemplary precaution for the entirety of humanity, demonstrates how a self-destructive struggle between love, anger, and fate, conveyed through an unorthodox love affair between mother and son (Who gets custody in a divorce?),Read MoreSophocles Oedipus The King1714 Words   |  7 Pagesâ€Å"ideal tragedy† is the play â€Å"Oedipus the King† written by Sophocles. In this play, Sophocles utilizes the concept of tragedy as well the theory of the importance of scenes of recognition and reversal to create a setting, tone, and mood throughout the play. Oedipus, the mythical king of Thebes, goes through a horrendous tragedy which includes moments of recognition and reversal. These moments are key to the fame and appreciation for the play, â€Å"Oedipus the King†. Sophocles’ use of Aristotle’s conceptsRead MoreOedipus The King By Sophocles950 Words   |  4 PagesThe people throughout Oedipus’ life trues very hard to allow him to escape his fate of killing his father and then marrying his mother. In the epic poem Oedipus the King, Sophocles tells the story of the tragic downfall of Oedipus. Although many people see the role of free will that brought upon Oedipus’ doom, no matter what choices were made throughout his life, his ultimate fate would always return. The choices made at the beginning of Oedipus’ life set him up to fulfill his prophecy. His parentsRead MoreSophocles Oedipus The King992 Words   |  4 PagesThroughout tragedies in Greek literature, the hero always has one tragic flaw. In Sophocles’ Oedipus the King, Oedipus’ main flaw is his overactive hubris, which in turn clouds his overall judgment. This is evident in the Chorus’ first ode to the city of Thebes as they try to ask the Gods for the banishment of the plague. Their answer does not come from a deity, but from Oedipus himself as he enters the palace and says, â€Å"You have prayed; and you prayers shall be answered with help and release ifRead MoreOedipus the King by Sophocles1393 Words   |  6 Pages Sophocles’ play, Oedipus the King, has risen many questions concerning the main character and whether or not he acts on free will or if his future is predestined by the gods. I am going to test the theory that although Oedipus believes he is acting on his own free will, he is in fact a victim of the gods. I will analyze several different sources that discuss fate and human agency in Oedipus the King and then proceed to build my original argument on the archaic debate. There has been a great dealRead MoreOedipus The King By Sophocles904 Words   |  4 Pages In Sophocles play â€Å"Oedipus the King† a deadly plague has descended upon the kingdom of Thebes, and because of this plague a dark and iniquitous secret begins to unravel itself only to reveal a web of events connecting Oedipus and others as the culprits behind all the havoc ensued. No one is the sole source responsible for the unfortunate events that befall Thebes, as well as the royal family; In fact, those who unknowingly paved the path of destruction were themselves trying to prevent it fromRead MoreSophocles Oedipus The King Essay1960 Words   |  8 Pages This would have been excellent advice for the main character in Sophocles drama, Oedipus the King. However, the drama was written as a result of Sophocles life and the influence of the humanistic culture in which he lived. Throughout Sophocles life, he gained military knowledge as the son of a wealthy armor manufacturer and received an excellent Greek education with emphasis on Homeric poetry (textbook). Furthe rmore, Sophocles was very involved in politics and served as a treasurer, a generalRead MoreSophocles Oedipus The King871 Words   |  4 PagesThe plays written by Sophocles, â€Å"Oedipus the King â€Å"and â€Å"Antigone† are bodies of work displayed the meaning of what Aristotle defined as a tragedy. â€Å"Oedipus the King† is a story of a king trying to avoid the fate of his life that has been prophesized before his birth. In â€Å"Antigone† is story of a girl who devoted to her family, and regardless of the orders made the king Creon. In these stories the archetypes and hamartia of Antigone and Oedipus play a major role in the story. In â€Å"Antigone† the characterRead MoreOedipus The King, By Sophocles1407 Words   |  6 PagesWhen we think about a tragic play or protagonist, most people would think Shakespeare for his common theme of his plays to end with a tragedy. In Oedipus the King, written by Sophocles, tells the tale of the protagonist Oedipus. Throughout the play, Oedipus searched for his past to discover the reason why his kingdom is plagued with wilting crops and illnesses. In the end, he becomes a tragic protagonist after discovering his past was related to the previous king’s death. While the search progressed