The use of telehealth can eliminate healthcare disparities in areas and in populations that would otherwise experience healthcare inaccessibility. During the Covid 19 surge, the use of telehealth grew as patients could not go to the doctors' offices either due to lack of appointments or due to closure. Telehealth has continued to be used in patients who were treated for severe cases of Covid who have been discharged home to monitor symptoms and ensure proper vital signs monitoring. (Bryant et, al 2020). Telehealth helps keep patients at home especially patients in rural areas who may lack transportation to healthcare facilities. In my facility, telehealth has been beneficial, especially for consulting physicians, especially neurologists, and psychiatrists who may not be available to evaluate patients. Telehealth is also used to monitor critically ill patients in the ICU setting at night where the doctor is constantly monitoring vital signs or any other hemodynamic changes.

Some of the barriers that must be removed to achieve well-being are affordability of healthcare, healthcare literacy, technology literacy, gender, race, religion, and age. To reduce these barriers, healthcare should be made affordable to all. Patients needing support in healthcare or technology education should be assessed, and education should be provided. Patients should also have accessibility to devices - computers, phones, and the internet to use these phones. In communities that may not have these resources, there should be community centers where these resources are available. (Verma et al, 2019). Also, when designing programs for telehealth, there should be consideration of the end-user - the patient who may be elderly and may need a simple device that they may use to transmit information. (Samuels et al, 2021),

Both patients would benefit from telehealth services as long as they are proficient with technology. Mr. Kasich would benefit from a safety standpoint if he had a means of contacting someone if he fell, or if he had a device that would monitor him for falls. His falling may be attributed to his hypoglycemic event therefore having telehealth monitor his blood glucose and remind him to eat, and what to eat would help keep his blood glucose levels balanced. He also has CHF therefore monitor his fluid intake, meal intake, weight, vital signs including pulse oximetry would help alleviate an exacerbation of CHF. Telemonitoring would also remind him to exercise and ask him of any pain due to his history of cancer. All these measures would be beneficial to help him from hospitalization which in his case is 40 miles away, which may create a burden on his wife who may also be elderly, and may not have the means to visit him while in the hospital. Similarly, Mr. Lane is a truck driver who primarily lives in his truck needs the same reminders as Mr. Kasich. Due to his prolonged stay in the truck, he may benefit from reminders to exercise as prolonged sitting periods with CHF may lead to serious problems example pulmonary embolism. The goal for both patients is to optimize their care at home.

From a nursing and an ethical standpoint, both patients should be provided with equal care despite their payor source, their age, or their living conditions.

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