Telemedicine is a concept gaining popularity in healthcare.  Not only is it a way for doctors and patients to get better health outcomes, but it is also a way to achieve greater cost savings.  As awareness of telemedicine increases, patients are more comfortable communicating via technology with doctors.  Let’s take a closer look at what telemedicine really is.

Telemedicine uses digital information and communication technologies to provide healthcare remotely.  It allows physicians to evaluate, diagnose and treat patients using technology so that they don’t need to visit in person.  This results in reduced travel time, healthcare costs and increased access to patient care.  Telemedicine enables doctors to evaluate patients using technology such as smartphones.  Patients can be evaluated from the convenience of their own home.  Telemedicine usually suits non-emergency cases and typically a clinician handles it.  Telemedicine falls into three broad categories.  They are as follows:

Categories of Telemedicine

  1. Remote Patient Monitoring: Tele-monitoring is a technology that allows patients to be examined from within their own homes.  This service allows remote patients to be monitored at home using mobile medical devices.  Statistics such as blood pressure can be monitored.
  2. Store and Forward: This is known as Asynchronous Telemedicine.  It enables a healthcare provider to share patient records with another healthcare provider.
  3. Interactive Telemedicine: This enables clinicians to communicate with patients in real time.  The patient may be at home or in a nearby clinic.  It can be conducted on the phone or via video conferencing.

How Telemedicine Works

Telemedicine connects patients with their physician.  A patient may dial a telemedicine number provided by a primary care physician, an employer or a web search.  The symptoms and medical history of the patient are noted.  Then the patient gets a call from a clinician or a nurse but not the doctor.  The physician may either tell you to visit the hospital or prescribe medication or schedule an appointment.

The video conferencing software used for telemedicine must be HIPAA compliant.  The software features a waiting room, EHR and a payment function.  For larger hospitals, there is a customized telehealth solution.

Telemedicine is conducted in several ways:

Basic Telemedicine consists of a simple video call which is HIPAA compliant.

Portable Telemedicine consists of a computer and mobile devices such as ECGs and digital cameras.

Robust Telemedicine software permits physicians to use many innovative telemedicine equipments to meet the needs of patients.

Coverage

The telemedicine fee can be paid for by an insurance plan, Government reimbursement schedules, a patient’s employer or independently for a fee.

Telemedicine and Telehealth

Although telemedicine and telehealth are words often interchangeably used, there is a difference.  Telemedicine consists of remote clinical services and non-clinical elements.  It is exclusively medical information exchanged to improve a patient’s health.  E-communication enables a patient clinical services from his own home.  Digital images and video conferencing are used in telemedicine and in telehealth too.

Telehealth, on the other hand, usually refers to a broader spectrum of remote health care services but does not include clinicial services.  It includes non-clinical services such as medical education, provider training and management meetings.  These technologies support healthcare services.

Advances in Telemedicine Technology

As the role of Artificial Intelligence (AI) grows in healthcare, telemedicine benefits.  One unique invention are the Smart Speakers.  A patient at home communicates his problem into the speaker and the speaker then searches for the appropriate telemedicine services.  Healthcare providers are excited about these developments.  AI software can go through data faster than humans can therefore enabling a quicker diagnosis before a disease becomes uncontrollable.  Another AI advancement was IBM’s Watson for Oncology.  It is expected to diagnose 12 types of cancer which make up 80% of cases all over the world.

Advantages of Telemedicine 

Here are the benefits to both the patients and providers of telemedicine.

To Patients:
  1. Convenient: Patients don’t have to take time out for an appointment and therefore no travel expense is incurred.
  2. Increased Access: Patients from rural areas can access specialized doctors who may not be situated in those areas.  Such services may include post-surgery care.  Telemedicine offers better healthcare to those patients in areas where there is a shortage of health professionals.
  3. Diseases spread less: This is so because contagious diseases which would otherwise spread in the waiting room, now won’t.
  4. No missing work: Patients can arrange for a consultation during break hour with telemedicine.
To Providers:
  1. Reduction in the cancellation of appointments.
  2. Encourages a healthy lifestyle. Telemedicine allows healthcare providers to encourage patients to adopt healthy life styles.  Ie- to quit smoking
  3. Better diagnosis and treatment
  4. Increased revenue
  5. More patients with the same amount of staff and space

Disadvantages of Telemedicine:

Although telemedicine has its benefits, there are some drawbacks worth noting.

  1. Cyber security: Even though the Patient Protection & Affordable Care Act (2010) regulates telemedicine, the system may be susceptible to hackers and data breaches.  Medical data is a big target for online criminals.
  2. Cannot prescribe medicines: There are states which do not allow medicines to be prescribed through telemedicine unless if there is an established relationship between the patient and physician.  Medicines cannot be prescribed without a physical examination.
  3. Technical training is required: Clinicians need to be trained on how to use the equipment.  Initial set up costs are high and may not even be a possibility in rural areas.
  4. Unclear Policies: If patients belong to different states, some states may require clinicians practicing telemedicine to have a licence in the state where the patient resides.  Uncertainty in matters when it comes to reimbursement policies, private protection and healthcare laws.  Reimbursement rates still vary and so do billing processes.
  5. Technological Limitations: Older people can’t adopt to telemedicine.  System outages do occur.  Technology cannot always detect what a doctor can in person.

History of Telemedicine

Telemedicine is not a new concept.  Actually, it originated in the 19th century.  Let’s examine the inception of telemedicine.

19th century:  The earliest adoption of telemedicine took place.  The telegraph, telephone and radio were used during the civil war to report casualties.

20th century: 

1948– Radiologic images were sent through the telephone between two medical staff at two different centers in Pennsylvania.

1959- Neurological findings were sent across campus at the University of Nebraska using two way interactive TV.

5 years later- Psychiatric consultation was provided 112 miles away at Norfolk State Hospital.

Today:  Rural patients and patients from developing countries can connect with urban physicians more easily.  It is easier to monitor patients at home using mobile medical devices.  Physicians can now gather vital information and make a diagnosis without that patient’s visit to the office.

Therefore, clinics and hospitals will have to adopt telemedicine practices to remain competitive in the market.  Despite its technical challenges, telemedicine reduces healthcare costs, increases access to care, results in a more productive workforce and leads to a finer patient experience.

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