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In the scenario we’ve been asked to review, a 2-year-old patient named Caitlynn who was admitted to the ER the previous night was later diagnosed with Cystic Fibrosis. The challenge in this case is that young Caitlynn lives in a small remote town where services are lacking, and the parents have schedules that make it difficult to make the commute to the larger hospital consistently. Therefore, the need to receive medical service through remote collaboration becomes an important method for her care and one that might benefit from looking at the latest research to find ways to improve. Collaborating remotely has inherent challenges, not limited just to communication, but also the limitations of not being physically in the same room. However, with careful planning and execution remote collaboration can be successful. In order to propose improvements to the remote care plan for Caitlynn, it is important to first examine the existing models for researching evidence-based care solutions.

Several different evidence based care models exist for researchers to examine for his or her appropriate situation. The model selected for this scenario is the Iowa model. According to an article published in 2008, Gawlinski and Rutledge defined the Iowa method as one that places an emphasis on quality care while remaining fairly intuitive for nurses to utilize. This model centers around three decision points: 1) is there an institutional reason to focus on this problem, 2) Is there a sufficient research base? And 3) Is the change appropriate for adoption in practice?

In the Vila Health scenario, the situation surrounding the inability of the patient’s family to travel consistently to receive the necessary care fulfills the criterion for the first question of the model. Performing a cursory academic journal search for “telemedicine in rural communities” provides several research articles to analyze and apply and can then satisfy the second criterion. By applying these first two criteria, we can then research and develop the necessary tools to complete the final criterion of successful adoption in practice.

Much research exists that demonstrate the benefits of using telemedicine. Potter and all noted this in their 2016 study, reporting the benefits to rural patients but also the degree of quality patient-centered healthcare achievable using this technology. Nelson’s 2017 study also reiterated these benefits as well as the time and cost savings associated with not having to travel for those who live in remote areas. Both of these studies are relevant here but perhaps the most compelling evidence from this scenario that demonstrates a need to propose an improvement was the medical team and the local doctor were relegated to using Skype because there was not a telemedicine connection available between the two facilities.

While Skype is a great tool for connecting socially, it is not designed for use in medical treatment due to inherent security flaws, lack of important tools, and most importantly, HIPAA compliance. By not using HIPAA compliant technologies, the providers run the risk of any patient interactions being rejected by insurance carriers as well as opening up a whole host of privacy concerns which can jeopardize the medical team and the institutions they serve.

For this reason, it is imperative to get Caitlynn’s local doctor, Dr. Benjamin, connected via telemedicine technology with Dr. Copeland’s facility so that any potential HIPAA risks are eliminated and the full power of today’s telemedicine capabilities can be utilized.

Once this communication is established, the advantages of using telemedicine as part of a plan of care for Caitlynn can augment what she will also receive from in-person treatments with Dr. Benjamin. It is also worth noting that implementing telemedicine also provides a sense of peace toward the patient’s family knowing that they need not upend their lives just to travel to get the care needed for young Caitlynn.