Digital health tools have not always been warmly welcomed by healthcare professionals.  For instance, electronic medical records have been opposed by doctors due to the extra work they often require.  New research from the University of Missouri’s Sinclair School of Nursing suggests nurses may have similar concerns about telehealth.

The researchers found that while telehealth does have considerable benefits in terms of its convenience for patients, it also adds considerably to the workload of nurses who can scarcely afford any extra stress.

The study saw the activities of nurses monitored as they analyzed and documented blood pressure and glucose levels from diabetic patients both in-home and via telehealth platforms.  The analysis revealed that performing the activities via telehealth almost doubled the workload of the nurses compared to in-person appointments.

“Telehealth can be an effective and convenient service for patients managing chronic diseases such as diabetes or hypertension, but what often gets overlooked is all the work being done by the nurses on the back end to assist patients,” the researchers say.

“They are entering the data they receive into medical records, identifying instances when patients have abnormal blood glucose levels, reminding patients to self-monitor and submit their data, requesting input from primary care providers, and making referrals to other providers for more specialized care.”

Extra work

The research reveals that while in-person appointments were typically followed up with once every few months, when the patients were seen via telehealth, they would submit their blood readings multiple times per week.

This increased communication meant that the patients tended to receive more support during the telehealth consultations and were therefore better able to adjust their lifestyle and medication, which in turn led to better health outcomes.

“As a nurse, I am always thinking of new and innovative ways to use technology to help people manage their chronic conditions and live a more healthy, active lifestyle,” the researcher says. “As telehealth continues to become more popular, it can be used to get health behavior intervention tools to the people who need them most, but we also need to keep in mind the strain it puts on nurses that are going above and beyond to make this possible.”

Improving care

The researcher is especially keen to utilize telehealth to improve access to care in areas such as chronic disease management for people who may live in rural areas with minimal resources available locally.

The paper highlights how telehealth can certainly help to achieve this, but it also runs the very real risk of considerably increasing the workload of healthcare staff at the same time as improving the care for patients.

“We can’t expect nurses to use these tools successfully without better understanding the impact it will have on their workload,” the author concludes. “Going forward, this research can provide the framework for quantifying how much time nurses spend on these telehealth tasks, especially with the current nationwide nursing shortage.

“If the nurses are completing twice as many tasks via telehealth, should they be responsible for half as many patients?”