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A perspective: Can nurse practitioners have their own business?

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    Posted in Telemedicine

    Last Updated | November 12, 2021

    What is Telehealth Nursing or Remote Telemedicine Nursing?

    COVID-19 has accelerated the adoption of Telehealth or telemedicine nursing, with more and more people willing to try virtual care. In essence, Telehealth nursing is the use of telemedicine and technology to support clinical healthcare, health education, and healthcare administration in remote locations.

    Telehealth nurses rely on various modes of communication and the most cutting-edge technology to assess, treat and manage the healthcare of users. Registered nurses leverage telecommunication technology such as video conferencing tools, telephone, email communication, web cameras, online patient portals, VOIPs, personal health applications, instant messaging, and store and forward information sharing to deliver high-quality care to patients over long distances. This can be the difference between life and death for those who need highly specialized care but do not have access to specialists.

    Nurses can conduct Telehealth sessions from their homes, trauma centers, crisis hotlines, outpatient care facilities, physician clinics, healthcare facilities, poison control centers, or anywhere where proper technology is present.  In emergencies, nurses from all over the globe can collaborate through telephone triage set-ups. Telehealth nurses can get a patient’s blood pressure and glucose readings, check the patient’s oxygen levels, heart rate, and respiration, or even instruct patients on how best to treat a burn or dress a wound.

    A Telehealth nurse practitioner is responsible for monitoring low-risk urgent care patients, following up with patients post-hospitalization, collecting data, and managing care remotely. A remote nurse can perform comprehensive health assessments, schedule appointments and refer patients to specialists,  leverage evidence-based practice to establish care plans and reach an effective diagnosis, offer Pre-surgical and post-surgical care, streamline administrative tasks and reduce patient loads, coordinate with remote physicians, and even offer information and counseling to patients regarding the management of chronic and acute conditions.

    Indubitably, Telehealth nursing is a valuable tool in managing chronic illnesses, enhancing patient care and satisfaction, enabling more efficient nurse utilization throughout hospital departments, and decreasing emergency department visits and hospital admissions.

    Where Can Nurse Practitioners Practice Independently Using Telehealth?

    Even though states like California do not allow nurse practitioners to practice without physician supervision, others let nurse practitioners practice independently. States where you can start your Telehealth nursing business include Alaska, Arizona, Hawaii, Idaho, Iowa, Montana, New Hampshire, New Mexico, North Dakota, Oregon, Rhode Island, Utah, Washington, and Wyoming. Other states such as Colorado, Connecticut, Illinois, Delaware, Maryland, Kentucky, Maine, Minnesota, Nebraska, Nevada, South Dakota, Vermont, Virginia and West Virginia grant you full practice authority only after you have practiced under physician oversight for a set number of hours, varying from state to state.

    The Role Of A Nurse Entrepreneur In Telehealth Nursing Business

    Pre and Post-Surgical patient care: Telehealth nursing practices are fast replacing traditional follow-up clinic visits. Nurses can remotely monitor patients’ vitals with the help of connected medical devices, and guide through pre-surgical preparation on video communication platforms. Similarly, as a part of post-surgical care, e-visits aid recuperation and help nurses root out exacerbations using images and visuals shared by a patient. Telehealth nurses are usually involved in routine monitoring of specific objective clinical data post-surgery including ileostomy output, heart rate, glucose levels, blood pressure and medication adherence, analyze medical tests’ results in real-time, and even provide care instructions.

    Manage Chronic Diseases: Telehealth nursing replaces frequent in-person visits for patients dealing with chronic conditions, such as Diabetes or COPD. Always-accessible Telehealth nurse practitioners enhance adherence to devised care plans, help patients manage symptoms on their own, keep tabs on patients’ health parameters via connected devices (biosensors, glucometers, stethoscopes, etc.), and provide symptom alleviation instructions remotely. According to a survey, participants in a behavioral health intervention Telehealth program saw 31% less hospital admissions.

    Offer care Instructions: Patients can share images and videos to Telehealth nurse practitioners via Folio3 telemedicine solution, of wounds, infections, and burns so that they can check the healing status, monitor any side effects of medication, or even instruct patients remotely on how to change a bandage, perform an exercise, or dress an incision.

    Pregnancy monitoring and newborn care: Nurses can offer new mothers and expectant women professional advice about pregnancy, monitor health to ensure a healthy pregnancy, conduct childbirth preparation courses, and monitor both mothers’ and babies’ vitals, or even assist in birth remotely.

    Provide Home Care: Elderly patients and patients with special needs find it difficult to make frequent in-person visits. However, a telenursing platform enables nurses to receive real-time information about patients’ health state, vitals, and condition, coordinate home care, and ensure timely intervention to improve the quality of life.

    Coordinate with specialty Physicians:  Telehealth Nurse Practitioners can collaborate with other specialty physicians to provide a wider base of care to patient needs. Telehealth nurses can assess a patient’s condition to determine whether they need remote emergency care or need an in-person appointment with a physician. Telehealth nurses lessen administrative load by providing medical advice for patients with minor health issues, streamlining billing, and scheduling appointments and referring patients to specialists.

    What You Should Know Before Starting a Telehealth Business?

    Before a nurse practitioner can practice telemedicine, there are few factors to keep in mind:

    Know the licensure requirements for different states: Navigating Telehealth requirements for licensing, scope of practice and reimbursement is important to avoid state board disciplinary actions and malpractice lawsuits. Different states have different laws for Telehealth nursing. Nurses looking to offer Telehealth services should get a registered nurse license that complies with federal as well as state regulations.

    Garner a Robust Telehealth software for consultations: To set up a Telehealth nursing business, you need a platform that allows providers to have online consultations in a HIPAA-compliant way. For instance, you need to ensure that your telemedicine platform only allows authorized users to access electronic health records (EHR) and other sensitive patient information. Additionally, your Telehealth platform should allow secure two-way conversation among healthcare providers and between providers and patients, in order to prevent the occurrence of data breaches. Folio3 Custom medical software development company designs Cloud-based platforms, integrated with more modern, human-centered experience standards, allowing seamless integration with EHR and other systems.

    You May Need a Collaborative Physician

    In some states, Tele nurse practitioners cannot operate independently without the supervision of a physician. However, there are 22 states mentioned above, that let you practice without a collaborative physician. Not to mention, there are 13 other states where you just need an agreement with one of the supervising physician, as long as they are located within a 30 mile radius of your practice, to start Telehealth services.

    Meet Competency Standards

    All Telehealth nurses are required by law to meet standards of care set by the American Academy of Ambulatory Care Nurses and the American Nurses Association. They must practice within the ANA standards for safety and quality as well as competency. International telenursing competencies are also available via the International Council of Nursing.

    Learn about Reimbursement Rules in your state

    State laws and payer policies about telemedicine reimbursement vary from state to state. Most states are embracing the advancement of technology to evolve and extend healthcare for patients. As of yet, 26 states have passed “parity” laws, requiring reimbursement for remote video visits. Unfortunately, however, you cannot still bill for emails, instant messaging, and other constant modes of communication. It is best to familiarize yourself with the reimbursement policies for Telemedicine practices within your states before starting a Telehealth nursing business. Also contact your payers to determine what telemedicine services will be reimbursed.

    To summarize, these are the formal steps that you need to follow. However, when you are creating a plan to start a telehealth business, it’s best to practice on medical device UI UX. This is because the user experience and user interface will directly influence the functionality and efficiency of the telehealth solution.

    How much does it cost to start telemedicine?

    If you are looking to start a Telehealth Nursing business, you need to invest in specific medical devices for a start. The type of medical devices you need varies depending on the Telehealth specialties you are looking to offer. If you don’t have much capital right away, you can always purchase the basics that you need to start right away and scale up as needed. To offer primary care services to patients, you can expect to invest anywhere from $5,000-$10,000 on medical equipment, including a digital stethoscope and an examination camera. Not to mention, you have to garner the pertinent telemedicine platform license for the state you are operating from, which can set you back another $1500.

    Next, you need a robust HIPAA Compliant telemedicine portal with multiple features, such as patient consultation hosting, a patient portal, video conferencing tools, and integration with EMR, which can cost you anywhere between $7,000 and $10,000. Ideally, you need a platform that integrates with EHR, offers tech support for your patients, ensures safety of patient data, and supports your network speed. You also need to invest in the hardware components, such as cases, wall mounts, and carts for your telemedicine center, which can cost you another $20,000. If you want to design a telemedicine app that lets your users garner telemedicine services right from their phones, it costs around $25,000 for the basic apps and $50,000 to hundreds of thousands of dollars for more complex telemedicine solutions. Folio3 Medical app Development Company designs all-in-one Telehealth solutions that let you start your Telehealth business without any worry.

     How do I start a Telehealth nursing agency?

    Get Certified

    While there doesn’t exist any specific certification for Telehealth nursing; but since most remote nurses are responsible for offering nursing care to patients who are in ambulatory care settings, they are required by law to possess the pertinent skills and know-how to provide care to these patients. This is why, you need to garner an Ambulatory Care Nursing Certification (RN-BC) before you can start your Telehealth nursing business. You are eligible to apply for a RN-BC certificate if you have practiced for a full two years as a registered nurse, or possess at least 2,000 hours of clinical practice in ambulatory care and/or Telehealth nursing within the last 3 years or have completed a minimum of 30 hours of continuing education in ambulatory care.

    Find the Right Technology Partner

    You need the right telemedicine technologies to be able to offer remote care to your patients.  When choosing a Telehealth solution, make sure it is HIPPA-compliant, secure, easy to use, seamlessly integrates with your EHR solution so that you get every patient’s updated medical records at your fingertips, and equipped with a method of verifying patient eligibility for reimbursement. To prevent missed Telehealth appointments, make sure your telemedicine visits appear on the practice’s schedule. Telemedicine solutions integrate with EHR systems to automate appointment scheduling and sending reminders to both patients and your staff.

    Select the Type of TeleHealth Service to Offer

    You need to choose the type of Telehealth services you are looking to implement; Synchronous Telehealth solutions support a two-way audiovisual connection between a patient and a healthcare provider. They leverage video conferencing tools to simulate an in-person visit. On the other hand, asynchronous Telehealth solutions transmit recorded medical data to a health practitioner, who can check them out later. For instance, Patients can upload their data such as images, videos, and reports to the platform, enabling nursing practitioners to follow the treatment progress, eliminating the need for direct communication.

    Similarly, you have to decide on the scope of your Telehealth services. Most nurse practitioners aim to deliver as many of their regular services as possible to ensure continuity of care. However, you may also limit the scope of your services to only serve the needs of critical patients during a crisis. Remember that you don’t have to start a full-fledged Telehealth practice all at once. You can start with a few services and scale as needed. For instance, you can choose to see only low-risk, short check-in appointments before providing full-time care to new patients.

    Create a Telehealth examination room

    Ideally, you need a private space that incorporates video technology into the natural flow of the patient encounter. You need to be aware of the best practices for conducting these sessions. First things first, these nurse-patient encounters need to be held in private to ensure patient data confidentiality.  Having clinical staff or other people walking behind you during the video calls may not be the best setting for instilling trust in patients.

    Can HL7 EMR Integration Help With Telehealth & Nursing?

    Yes. HL7 is designed to improve the health standards with the implementation of standardized communication and tech standards. It does that by sharing health information and improving interoperability. It can address the communication errors by enhancing the clinical data content and delivering essential structure. Moreover, medical information collection, exchange, and interpretation will be error-free and efficient.

    How Can nurses make 6 figures as an NP Telehealth?

    Yes, Telemedicine nurses can make anywhere from $63k-$229k an year, depending on the scope of services they provide.

    What are the Best Nurse practitioner business ideas in Telehealth?

    Telehealth Nurses with an entrepreneurial spirit have tons of opportunities ripe for the taking. If you are into Telehealth business, there are a variety of hustles that may align with your skills, interests and schedule, such as:

    Legal Nurse Consultant

    You can expand your Telehealth business to delve into legal nurse consultancy. A Legal nurse consultant advice on legal cases online. An attorney might consult with a legal nurse consultant to better understand the facts of their case or ask them to scrutinize testimony in a legal case to look for any loopholes or errors.

    Specialized Care Provider

    Nurses can apply the specialized set of skills acquired throughout their careers to expand their own Telehealth businesses. There are a lot of things you can do online as a specialized care provider, such as providing childbirth training, fertility consulting, lactation consulting, elderly care, mindfulness and stress reduction training, or educate patients on managing chronic diseases.

    Fitness Coaching

    Telehealth nurses can acquire certifications for nutrition and personal training and expand into the fitness arena if they have the right skills for it. This business idea requires you to work hand in hand with clients online to create a personalized health plan that encompasses physiotherapy, diet, exercise, and lifestyle changes. This area of Telehealth focuses on disease prevention and management rather than treatment.

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