Nurse practitioner students at the Washington State University College of Nursing received special training this summer in seeing patients via telehealth.
The use of telehealth has skyrocketed during the pandemic. As with many pandemic-driven technology changes, it’s expected that telehealth will continue to be a larger part of clinical care in the future.
WSU was already developing telehealth education for Doctor of Nursing Practice (DNP) students under a federal grant received last year, said Anne Mason, associate dean for graduate education and director of the DNP program.
When the pandemic hit, many of the college’s clinical partners turned to telehealth to provide at least some of their patient care. That meant most of the students in WSU’s DNP program were using telehealth in their jobs or in their clinical education.
“DNP faculty wanted to make sure students were prepared for telehealth clinical placements, that they had a foundation to lean on,” Mason said.
The class held via Zoom brought together nearly 50 students in the family nurse practitioner and psychiatric-mental health nurse practitioner tracks to learn about telehealth technologies and best practices. Then students split into small groups to work with “standardized patients,” who are actors portraying patients.
Students practiced maintaining eye contact by looking into the webcam, not the computer screen, for example, said Louise Kaplan, associate professor at the WSU College of Nursing-Vancouver and the class’s lead instructor. They practiced looking at a patient’s throat via a cellphone held up to the mouth and assessing neurological symptoms by having the patient make certain motions like a finger to the nose.
“There are certain systems that telehealth works just fine with,” said Kaplan. “But I also think there are situations where people need to be seen in person. One of the principles I conveyed to students is the responsibility in a telehealth visit to decide if a telehealth visit is appropriate.”
Telehealth was used in the past, but it often involved a patient visiting a clinic and consulting with a provider remotely. In April 2019, under 1% of medical services billed to private insurers were provided by telehealth, compared with 13% in April 2020, according to the nonprofit FAIR Health.
Mason said emergency rule changes supporting telehealth reimbursement made such a dramatic increase possible. “I suspect there will be an extraordinary effort to make those rule changes permanent” post-COVID, she said.
Likewise, the WSU College of Nursing will integrate telehealth into the DNP curriculum more broadly in the future, and could also look at making telehealth education part of the Bachelor of Nursing Science program.
“I think we’ll see a really significant expansion” of telehealth education, Mason said.
Added Kaplan, “I’ve been a nurse practitioner for 40 years, and we’ve been doing health care the same way – somebody comes into my office and I ask questions. With telehealth there’s been a seismic shift in health care.”