Research Proposal Assignment on Telemedicine Technologies Paper Example

Introduction

Telemedicine technologies are essential lifelines for people suffering from substance abuse disorder in underserved areas. According to Paul and McDaniel (2016), telehealth or telemedicine, the delivery of health-related services and information through telecommunication technologies, has been utilized since the 1950s to enhance health care access and decrease health inequalities in underserved areas. Progress in telecommunication has led to the recent expansion of applications to educate, enhance, and expedite health care services to underserved populations in urban and remote regions. Based on previous studies, this proposal provides background information on substance abuse in underserved areas. It also describes why there is a need to address this problem in healthcare. Further, it outlines the PICOT clinical question that will act as the guideline for the research and then identifies the theory pertinent to substance abuse disorders in underserved areas. This proposal concludes with an insightful discussion of the key elements of the proposal.

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Background of the Problem

Internationally, alcohol abuse results in 3.3 million deaths annually (Molfenter, Brown, O'Neill, Kopetsky, & Toy, 2018). The United States continues to subsist with substance abuse among adults and adolescents, with the existent opioid epidemic a reminder of the adverse effects of drug abuse and the damage to people and society. Opioid overdoses have become the primary cause of accidental death in the United States. Today, policies focus more on the treatment of drug abuse instead of on punishment, with treatment initiatives and facilities becoming the accepted means of mitigating addiction.

Nevertheless, despite the promising advances in treatments, populations in underserved areas continue to significantly suffer from substance abuse disorders because in part of the treatment gap between optimal care and currently available services. Scholars have established that such populations, encompassing certain ethnic and racial groups, people with disabilities, limited English proficient persons, and the elderly, are affected disproportionately by challenges that decrease access to health care services (Paul & McDaniel, 2016). Disparities in drug abuse prevention and treatment may mean that such prevention for some populations is missing or that there is too little of it to benefit the population. Disparities might be gaps in access to prevention and treatment, for example, lack of transportation to attend prevention and treatment initiative sessions and activities, or lack of Internet access to telemedicine technologies. Additionally, other disparities occur when available programs are offered in ways that fail to respond to unique cultural conditions.

Similarly, unlike other forms of health care, behavioral health care includes a unique set of obstacles that affect the provision of and access to services. These hurdles may be high in underserved areas such as rural areas. One obstacle in availing behavioral health services is the misdistribution of behavioral health and specialty health providers. Numerous issues including professional isolation; low pay compared with colleagues in other areas; few social outlets and educational opportunities; and difficulties adjusting to life drive employee shortages in underserved areas (Shannon Mace, Boccanelli, & Dormond, 2018). Telemedicine can help minimize the effects of workforce misdistribution by availing a link between patients in their areas and behavioral health providers in other locations.

These issues create a great demand for innovative ways to avail care to people suffering from substance abuse disorders. Evidence supports that telemedicine can assist to overcome obstacles to accessing behavioral health services to minimize the current treatment gap (Shannon Mace et al., 2018). Moreover, they can potentially widen access to substance abuse disorders services, information, and support (Molfenter et al., 2018).

The significance of the Problem

Notably, it is well established that obstacles exist to accessing substance abuse services across underserved areas in the U.S. Addressing this problem could help close the treatment gap for people in need of the services, which can improve their lives. Telemedicine technologies can change patterns and results of substance abuse disorder service delivery.

First, telemedicine can overcome financial barriers to care since insurance and affordability issues are the top reason people who are ready to stop using drugs and seeking substance abuse disorder treatment do not receive it (Paul &McDaniel, 2016). Telemedicine can offer them access to a broad range of high-quality services and resources including alcohol and drug counseling. Second, telemedicine can ensure that care is within reach for underserved populations. It can facilitate patient access to the array of care required to manage, treat, and prevent addiction. Finally, telemedicine technologies can provide a safe place for substance abuse disorder care, without negative perceptions linked to addiction treatment (Paul &McDaniel, 2016). Moreover, many people forego required treatment because of the stigma often related to visiting substance abuse disorder treatment providers.

PICOT Clinical Question

P: Population - Individuals suffering from substance abuse disorders from underserved populations.

I: Intervention - The use of telemedicine to provide or enhance substance abuse services

C: Comparison - Non-users of telemedicine

O: Outcome -access to substance abuse services

T: Time - 6 months

PICOT Question: In individuals suffering from substance abuse disorders from underserved populations, how does the use of telemedicine compared to lack of use affect access to substance abuse services within the first six months of use?

Framework Theory

This paper proposes the use of an Interactive Systems Framework that uses key Diffusion of Innovation theory to expand telemedicine substance abuse services to an underserved area.

The Interactive Systems Framework (ISF)

The ISF is an approach originally developed by Abraham Wandersman to distribute innovations into new settings (Garney, McCord, Walsh, & Alaniz, 2016). Its aim is to distill information generated through pilot projects and study and prepare it for distribution and adoption in the field. The ISF has three primary components namely, the Delivery, Support, and Synthesis and Translation Systems. Bidirectional arrows connect the three elements, which permits feedback among the systems and concludes in innovations being expanded into diverse settings (Garney et al., 2016). The framework is intended to be employed by practitioners, researchers, and other stakeholders to translate promising innovations into new areas using a multidisciplinary perspective.

The Delivery Systems

The aim of the ISF Delivery System is to help conduct activities required to replicate and adopt innovations. One function of this system is to stimulate an environment of innovation for program staff that will promote organizational functioning. The ISF helps in developing collaboration with stakeholders relevant to the innovative project, encompassing the target population and community supporters. These collaborations inform potential program modifications and add to the potential for distribution and successful adoption (Garney et al., 2016).

Support System

This system builds the capacity to conduct program activities through supportive functions such as training and technical assistance. General capacity is essential to adopt an innovation to a new setting (Garney et al., 2016).

Synthesis and Translation System

Following the execution of an innovation, new information is generated. The information can be either internal or external. The ISF Synthesis and Translation System takes this information and prepared it for distribution. Project staff conducts synthesis and translation activities and then distribute them to stakeholders through reports, publications, presentations, and newsletters (Garney et al., 2016).

Implementation of ISF in Current Project

The researcher will collaborate with a counseling and assessment facility within one underserved area to implement telemedicine in an attempt to enhance substance abuse services within that community. Since most people in underserved areas are uninsured, services will be availed free of charge.

The identified facility will provide space for the telemedicine services. The facility's staff will act as the first point of contact for clients when they arrive. The staff will also avail administrative support for the program, mainly, interfacing with service providers as needed. After client registration, connectivity for the telemedicine services will be established using an App downloaded into each client's mobile phone. Thus, patients will access substance abuse services on their mobile phones. For instance, counseling availed through telemedicine will almost be identical to in-person counseling services. Clients will be required to sign up for weekly 1-hour sessions and access counseling services offered on the App. The technology will use a variety of theoretical orientations and interventions based on patient needs including problem-solving training, solution-focused therapy, and cognitive-behavioral therapy.

The counseling and assessment facility will assume the local-telemedicine responsibilities to ensure community involvement in the delivery of substance abuse services. Additionally, allowing the community's facility to take charge of the program will ensure the orientations and interventions provided to the clients are tailored according to the cultural considerations of that community.

Definition of Terms

The definition of key terms is important in understanding how to address the problem of inaccessibility to substance abuse services in underserved areas.

Telemedicine refers to the use of electronic information and communication technologies to avail and support healthcare. It accelerates diagnosis, upgrades referral coordination, reduces treatment delays, and avails increased access and sustainability of services. Additionally, it boosts access to specialty medical services and lowers travel costs to better patient outcomes (Molfenter et al., 2018). Telemedicine includes the use of information and communication technology, encompassing the use of electronic health records (EHRs), video conferencing, and streaming media, to exchange health information and avail health services.

Medically underserved populations refer to people that face multiple barriers to getting preventative health care or treatment for existing ailments (Paul & McDaniel, 2016). Being medically underserved can result from various aspects such as transportation, place of residence, age, ethnicity, race, language, and gender conformities. Most importantly, these hurdles can have a detrimental effect on their overall health and well-being (Paul & McDaniel, 2016).

The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders 4th edition Text Revision (DSM-IV-TR) defines substance abuse as a maladaptive pattern of substance use leading to clinically significant impairment or distress (Hasin, O'Brien, Auriacombe, Borges, Bucholz, Budney, & Schuckit, 2013). Further, substance-related disorders are divided into substance use disorders and substance-induced disorders.

Conclusion

In summary, based on the background of the problem, populations in underserved areas continue to significantly suffer from substance abuse disorders because in part of the treatment gap between optimal care and currently available services. Thus, this proposal suggests that there is a need to close the treatment gap for people in need of ser...