October 20, 2003 -- Can a computer provide quality health care? Can a sick patient get all she or he needs over a telephone line? Of course not, but "telehealth" services might improve access to care that would not be available otherwise, and will certainly aid in the delivery of preventative health care—long the realm of nurses.

The ANA definition of telehealth is the delivery of health care with time and distance barriers removed. This is accomplished with the use of technologies such as telephones, computers, or interactive videos. The implementation and use of telehealth remains in its infancy. However, as the number of households with internet access increases each year, interest in telehealth has grown.

Advanced practice nurses, the primary providers of preventative care, see the potential in any avenue to improve access to health care services. In fact, nurses have been practicing telemedicine for years in various forms. Telephone triage is just one example. The advent and growth of telehealth has a huge impact on the nursing profession--in patient care and in nursing education.

Students today, who come from high schools loaded with technology, expect their college education to be similarly high-tech.

"We want to be at the forefront of the emerging applications of technology in health care," says Sarah Farrell, associate professor of nursing and director of technology for the Rural Health Nursing Center. "It can benefit our work, our teaching, and our care of patients, as many of the existing faculty projects prove."

Examples of the use of technology at the School of Nursing include the use of personal digital assistants (PDAs) in clinical care, videoconferencing, the creation of CD-ROMs, and Web-based learning, among many others.

Associate Professor Ann Hamric has developed a Web-based ethics course for Research Nurse Coordinators and non-nurse coordinators, those who organize the day-to-day operations of human-subject research. Four of the six modules are available via the Web, enabling participants to access the course from their home sites. Dr. Shelley Huffstutler and Dr. Courtney Lyder are also utilizing the Web to offer geriatric curriculum to advanced practice nurses.

Faculty pioneers in the use of PDAs in education (the brand name Palm Pilot™ is one example of a PDA), Suzanne Burns, Arlene Keeling, Shelley Huffstutler, and Audrey Snyder continue their work to improve its application in the clinical setting. Equipped with PDAs, students can check on medications, treatment protocols, and even get a consult of sorts within five minutes. Burns is perfecting a version of her computerized weaning program for PDAs, enabling nurses to help patients wean off a ventilator sooner and safer.

Clinical practice laboratories have long been central to nursing education, increasingly more so as baccalaureate programs flourished and nursing students no longer "staffed" hospitals. Now, nursing schools are investigating just how far simulated learning can evolve. Reba Moyer Childress, director of the Laboratories for Clinical Learning, is project coordinator for a National League of Nursing grant studying the use of simulation in learning (see page __ for more).

Childress also uses video technology to help students evaluate the way they deliver care. "I try to get them to think on their feet. That’s why the lab is so important," she says. "By the time they go into the hospital, they immediately use the skills they’ve used in the lab. They go to their clinical rotation well-prepared."

A $750,000 training grant will enable project director Doris Glick and many other faculty members to put the curriculum on-line for a master’s program in Community or Public Health, or Health Systems Management.

Farrell herself, who has investigated various applications of technology over the years, is currently testing the use of polycams (a videoconferencing tool) to observe students in her psychiatric/mental health clinical rotation from a location two hours away. "This could result in a big savings in limited resources, while ensuring patients are getting quality care and students are fully supervised."

"We could re-write the story on technology every year, and there would be new information to share," Farrell observed. "So much is happening and technology is advancing every minute."