Telehealth & Remote Patient Monitoring

Telehealth uses telecommunications technology to deliver healthcare services remotely. In community health nursing, telehealth expands access for rural populations, homebound clients, and underserved communities. Modalities include synchronous (live video visits between client and provider), asynchronous (store-and-forward — photos of wounds, dermatologic conditions, or retinal images sent for specialist review), and remote patient monitoring (RPM — client uses connected devices at home to transmit vital signs, blood glucose readings, pulse oximetry, or weight to the healthcare team for ongoing surveillance). The nurse's telehealth responsibilities include conducting focused assessments via video (observing skin color, respiratory effort, wound appearance, mobility, and environmental safety), verifying client identity and obtaining informed consent for telehealth services, ensuring the client has adequate technology and connectivity (or troubleshooting barriers), maintaining privacy and confidentiality (HIPAA compliance — the nurse ensures a private setting on both ends), documenting telehealth encounters with the same rigor as in-person visits, and knowing when telehealth is NOT sufficient and an in-person evaluation is required. Licensure considerations: nurses generally must be licensed in the state where the client is located at the time of the telehealth visit, under the Nurse Licensure Compact (NLC) or individual state licensure. Technology barriers are a significant equity issue — older adults, low-income populations, and rural communities may lack reliable internet, smartphones, or digital literacy. The nurse assesses for these barriers and provides alternatives (telephone visits, assisted visits at community sites).