Develop a 750- to 1500-word paper (3 to 5 pages), following proper APA format, answering the questions below, and including a synopsis of the case study at the beginning of the assignment. You should also provide a minimum of three in-text citations and associated references when answering the questions, being mindful of the standards of care and scope of practice for nursing informatics, HIPAA, the Joint Commission, and other regulatory agencies.

1. Discuss the possible outcomes for this patient had she not been on a home telemonitoring system.
2. Imagine that you are in the position of justifying home telemonitoring to an insurance provider. Using this case scenario, identify potential costs and costs savings for home telemonitoring.
3. As telehealth and telenursing continue to be integrated into healthcare, what are the advantages and disadvantages from a patient’s perspective?
4. As telehealth and telenursing continue to be integrated into healthcare, what are the advantages and disadvantages from a nurse’s perspective?

The patient is a 71-year-old male who has stage 4 cardiomyopathy/pulmonary hypertension,

atrial fibrillation, COPD, and type 2 diabetes mellitus. He has been an active patient with a home

healthcare agency for several years, with an admitting diagnosis of CHF.

Initially, the patient was seen three times a week by an RN for CHF assessment and management.

The patient’s history included frequent hospitalizations for exacerbation of CHF and uncontrolled

atrial fibrillation. He experienced a total of four hospitalizations in the year before placement of a

telemonitoring system in his home, after about 6 months of receiving conventional home care.

Ever since the patient was placed on a telemonitoring system for daily tracking more than 8 months

ago, he has not been rehospitalized. The telemonitoring interactions with his nurse have made him very

conscious of the role that his medications, diet, and fluid restrictions play in his overall health status.

In addition, the telemonitor has proved its benefits to local physicians. The patient’s family physician,

cardiologist, and pulmonologist all were able to provide better care for the patient by examining the

tabular and graphical trends that were elicited from the daily vital signs monitor. This information aided

in the titration and addition of the various medications needed to control the patient’s CHF and atrial

fibrillation. The physicians were able to ascertain the response to the medication adjustments and other

treatment modalities, such as oxygen titration. At the start of care, the patient’s weight was 196 pounds; it

is now at a stable 187 pounds, with the symptoms more controlled than they have ever been.

The patient’s nurses, meanwhile, have peace of mind knowing they can keep an eye on their patient

daily while making additional visits as needed, with the documentation being provided by the system to

justify the additional nursing visit. This tool can also be incorporated into the nurses’ care plan, enabling

a higher standard of care to the patient. At present, the patient is being case managed by

nursing staff visits that occur once per month. He now enjoys a newfound peace of mind and security

and an improved state of health, something this patient has not experienced in more than a year.