Primary-care registered nurse telehealth policy implications

Abstract

Coronavirus disease 2019 (COVID-19) has drastically changed health-care delivery models within primary-care settings. Primary-care providers are limiting routine care face-to-face office visits while triaging COVID-19 symptomatic patients to hospital emergency rooms. Primary-care providers are rapidly adopting telehealth modalities for care provisions during this unprecedented pandemic to allow practices to continue delivering primary care while preventing community spread of COVID-19. Federal legislation has responded to emergent public-health needs by removing barriers that have impeded widespread adoption of telehealth modalities. This legislation has omitted professional registered nurses (RNs) from delivering reimbursable telehealth services, which is problematic for primary-care practice. RNs historically have led telehealth service delivery and should therefore be included in new legislation as eligible health professionals permitted to provide reimbursable telehealth services. RNs improve quality outcomes in primary care within innovative team-based care models and are essential clinicians capable of providing ongoing care coordination and disease management for patients needing to stay on track with their usual care needs.

Experiences of Australian primary healthcare nurses in using telehealth during COVID-19: a qualitative study

“…During the period from March to April 2020, when telehealth was funded for GPs and allied health but not for GPNs, 25 the role of the nurse was significantly constrained. A similar story was reported by Watkins and Neubrander, 26 who describe how American nurses were prohibited from providing reimbursable telehealth services. The impact of funding models limiting GPN roles in Australia is not new 27 ; however, the impact seen during COVID-19 highlights the need for funding to support rather than inhibit health professionals to work to the full extent of their scope of practice to optimise service delivery during crises.…”

Front‐Line innovation: Rapid implementation of a nurse‐driven protocol for care of outpatients with COVID‐19

“…Nurses have been described as the linchpin of healthcare systems and have played a central role in the COVID‐19 (Watkins & Neubrander, 2020). The value of telehealth nursing practice has been increasingly recognised in the United States, and a clear evidence base suggests that it may be as effective as face‐to‐face visits (Speyer et al, 2018).…”

“…Currently, virtual transitional care and chronic disease management visits by RNs are reimbursable by the Centers for Medicare and Medicaid Services. However, the recent legislation that has expanded healthcare reimbursement for telehealth during the pandemic neglected to include RNs as eligible providers (Watkins & Neubrander, 2020). Our programme provides further evidence that experienced RNs can work assume more responsibility than is currently promoted by reimbursement practices while remaining within their scope.…”

Telenursing as a New Nursing Paradigm in the 21 Century: A Literature Review

“…Telenursing findings will be fruitful in improving nursing services in particular and or health services in general. Telehealth nursing practice utilized technology-based communication to provide remote patient nursing services such as assessment, providing educational interventions, monitoring and evaluating patient care (23). Another study showed that nurses were satisfied with facilitating patient data on a primary PC or personal tablet to be able to monitor intravenous fluids as well as some drugs that could be monitored from outside the patient's room (24).…”