A case study of the use of telemedicine by advanced practice nurses in rural Missouri.
BACKGROUND
Telemedicine aims to increase access to health care through the use of technology, but its impact on rural health care has had limited study. The purpose of this study was to evaluate the impact of newly implemented telemedicine systems on rural practice and patient care in the Missouri Telemedicine Network.


METHODS
Telemedicine equipment and hook-ups were provided to satellite clinics and nonaffiliated clinics, nursing homes, hospitals, and health departments in three rural counties. Qualitative research methods were used to elicit data and develop a case study report of the experience of the rural nurse practitioner's use of telemedicine technology. Results were then compared with those of three other counties without telemedicine technology.


RESULTS
Advanced practice nurses reported professional development and connectedness with telemedicine capability. Those with telemedicine access reported both current and potential applications of technology to practice. Both formal and informal learning opportunities were cited. Those without telemedicine access viewed telemedicine as potentially supportive of enhanced patient care and professional satisfaction.


CONCLUSIONS
This preliminary study provides support for the role of telemedicine in augmenting the role of the advanced practice nurse in a variety of rural settings.
D000328:Adult; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D008923:Missouri; D009722:Nurse Practitioners / Q000193:education*; D019982:Organizational Case Studies; D012423:Rural Health; D012424:Rural Population; D017216:Telemedicine / Q000706:statistics & numerical data*