Telemedicine at COVID-19: Advantages, Downsides, Challenges, and Adaptability

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Telemedicine is a fast expanding service that aims to enhance access to high-quality, efficient, and cost-effective healthcare, particularly amid the present COVID-19 epidemic.

Telemedicine is making a big contribution to healthcare throughout the pandemic and is used in various ways. However, when it comes to treating patients during a pandemic, telehealth technologies have several limits. Furthermore, if not handled properly, telemedicine may contribute to hospital overcrowding. During a pandemic, though, hospitals are learning to adapt to telemedicine.

Telemedicine, as specified by the Centers for Medicare and Medicaid Services (CMS), is “a service that aims to improve a patient’s health by providing two-way, real-time interactive interaction between the patient and a physician at a distant site.”

Telemedicine may become a fundamental necessity for the general public, health care providers, and COVID-19 patients, particularly while individuals are quarantined, allowing patients to seek real-time guidance on their health concerns through interaction with healthcare providers.

Telemedicine History

Radio transformed communication in the early 1900s. Inspired by radio’s growing importance in every sector, from entertainment to national security, it wasn’t long before entrepreneurs started thinking about how doctors could attend to patients via the radio. Under the heading “The Radio Doctor-Maybe!” a 1924 issue of Radio News Magazine displays a graphic of a doctor attending to a patient through video call. “At the time, this was only an editor’s vision of future technology, but 90 years later, these aspirations would come true.”

So, when did telehealth begin? In 1940s Pennsylvania, radiography pictures were conveyed 24 miles by telephone line between two townships in the world’s first example of electronic medical record transmission. In the 1950s, a Canadian doctor expanded on this technique by building a tele radiology system that was utilized in and around Montreal. Motion films grew increasingly popular as these procedures expanded, and with the introduction of contemporary film, technology came serious ideas for video medicine. Clinicians from the University of Nebraska were the first to employ video communication for medical purposes. The institution created a two-way television system in 1959 to send material to medical students across campus, and five years later joined with a public hospital to execute procedures.

Today, telehealth technology helps many rural populations that lack access to local physicians, and this was the motivation for the University of Nebraska’s research. Telemedicine first developed in metropolitan settings in the early 1960s, making an appearance in emergency medicine. In 1967, the University Of Miami School Of Medicine collaborated with the local fire department to broadcast electrocardiographic rhythms to Jackson Memorial Hospital through radio in rescue circumstances. Remote medicine has officially made its debut.

Telemedicine’s Evolution

Telemedicine grew in popularity in rural regions, where people with limited access to healthcare could now reach professionals from afar. The Public Health Service, NASA, the Department of Defense, and the United States Health and Human Services Departments all contributed time and money to telemedicine research in the 1960s and 1970s.The collaboration between the Indian Health Services and NASA was one of the most successful of these government undertakings.

The initiative, dubbed Space Technology Applied to Rural Papago Advanced Health Care (STARPAHC), offered medical care to Native Americans on the Papago Reservation in Arizona and astronauts in space. Microwave technology was used to send and receive X-ray pictures, electrocardiographs, and other medical data to and from the Public Health Service hospital.

COVID-19 and Telemedicine

With the national health crisis in full swing, it is time for policymakers to take the matter seriously. To combat the epidemic, we must employ all available means. States with advanced telemedicine policies do far better in the face of the issue. Even though serious patients require hospitalization and acute treatment, telehealth providers can assist with remote patient monitoring, respiratory management, and triage. Patients suffering from various conditions can get medical attention without being exposed to the virus. Medical personnel can safeguard themselves by avoiding interaction with large groups of patients in waiting rooms and offices. Telehealth platforms around the country are collaborating with hospitals and other medical organizations to provide emergency support. Safe and efficient testing locations with full software support may be built in less than 24 hours.

When is Telemedicine Helpful?

Telemedicine benefits any condition that does not require laboratory tests or a physical examination. Telemedicine can even provide continuous treatment, such as psychotherapy. When there are barriers to treatment, such as the COVID-19 outbreak, a patient who lives far away from a medical care center, or a patient who is unable to transport himself, physicians may expand the list of disorders they are prepared to treat. A doctor, for example, may utilize telemedicine to prescribe drugs for a potential sickness.

Telemedicine: Remote Care Advantages

To see how telemedicine might significantly improve healthcare, consider a recent doctor’s appointment that lasted several hours, frequently disturbing work or school. Traveling to a doctor’s appointment can take several hours, with just a tiny portion of that time spent communicating with a doctor. Some office visits are progressively being supplemented or replaced by telemedicine apps. The care provided through this platform has several advantages, including:

  • Travel time has been cut.
  • Secure connection with physicians via email or video chat. Secure websites where patients may communicate with doctors.
  • Immediate aid with emergency problems involving mental health, substance misuse, and dermatology, among other things.
  • Provides care to those living in remote areas that require specialized treatment.

Telemedicine is becoming increasingly popular, with healthcare practitioners and patients adopting it worldwide. Telehealth has various advantages, and it is no surprise that many medical professionals, from tiny offices to big institutions, incorporate it into their existing systems. Remote care is not a novel concept. For decades, telemedicine has existed in some form or another. The ability to communicate rapidly and readily with practitioners and specialists in distant regions just recently became available. Telehealth rose to prominence as the Internet and other digital technology evolved.

Telemedicine benefits providers, patients, and the overall healthcare system. Although telehealth will not be able to replace traditional medicine anytime soon, it is a helpful and practical approach that may assist improve the scope and quality of patient treatment. It is critical to remember that telehealth is not a substitute for traditional medicine but rather a distinct style of practice that strives to deliver the same services as traditional healthcare. The use of technology is merely another tool for improving diagnosis and therapy.

Telemedicine has grown in popularity among patients. According to certain surveys, many patients are eager to test telehealth and have been happy to continue using it. The primary causes are as follows:

  • Access to general and specialist care should be made as simple as possible.
  • Cost-cutting measures
  • Safety

Accessibility and Comfort

People who live in distant places often have difficulty receiving sufficient medical treatment. Location may sometimes be the difference between life and death. Telemedicine has democratized healthcare by allowing patients from all over the world to get excellent treatment. All they require now is a consistent internet connection.

However, the growth of telehealth has rendered not just geography unimportant. The patient’s age and mobility might make it difficult to approach appropriate medical providers and receive appropriate care. Patients can use telemedicine to do the following:

  •  Have continuity of care with the doctor they trust.
  • Consult with the greatest professionals, regardless of where you live.
  • Receive real-time information on their condition.
  • Have a more pleasant treatment experience.

Cost Cutting

One of the most often mentioned advantages of telemedicine among patients is financial savings. While the therapy costs are the same whether delivered in person or via telemedicine, the secondary expenses are much lower in distant care. There are several factors to consider when scheduling a doctor’s visit, especially for patients who live in remote or rural areas.

With telehealth, a patient may save time and money on travel to a physician’s office or clinic, schedule a virtual visit during a work break, and save the expenditures of hiring a babysitter or asking a friend to care for their children.

Safety

Long wait times at clinics and hospitals have long been an issue. With the coronavirus epidemic, it became obvious how not just dull but also harmful spending too much time in packed waiting rooms can be. Infectious illness exposure is especially dangerous for older individuals and those with compromised immune systems. Telemedicine has the potential to eliminate unneeded risks. Patients can communicate with their doctors remotely and make in-person visits only when necessary.

Downsides to Telemedicine

Telemedicine is a handy and cost-effective option to see your doctor without leaving your house, but it has a few drawbacks. Every sort of visit cannot be performed remotely. You must still visit the office for imaging testing, blood work, and diagnoses requiring a more hands-on approach. Concerns have been raised about the security of personal health data sent electronically. During the COVID-19 epidemic, insurance companies gradually pay the cost of telehealth consultations; nevertheless, some services may not be completely covered, resulting in out-of-pocket payments.

However, telemedicine may not be appropriate for every individual or scenario. When compared to traditional medical approaches, there are several possible drawbacks to employing telemedicine. The following sections examine some of the downsides for patients and healthcare practitioners. Protecting medical data, hackers and other criminals may obtain a patient’s medical data, particularly if the patient connects to telemedicine over a public network or an unencrypted route.  When a person requires emergency care, using telemedicine initially may cause a delay in treatment, especially when a doctor cannot offer life-saving care or laboratory testing online.

Healthcare professionals may also encounter various telemedicine-related difficulties, such as licensing issues. Because state laws differ, clinicians may not be permitted to practice medicine across state boundaries, depending on the state in which they hold their license and where the patient lives. Concerns about technology: Choosing the best digital platform to utilize might be difficult. A poor connection might also make providing quality treatment challenging. Clinicians must also verify that their telemedicine program is secure and complies with privacy regulations.

The incapacity to examine patients: Providers must rely on patient self-reports during telemedicine sessions. This may require professionals to ask extra questions to obtain a full health history. When a patient fails to report an essential symptom that may have been detected during in-person care, it can jeopardize therapy.

Taking on Telemedicine Challenges

Telemedicine now faces several obstacles for both doctors and patients. Among these difficulties are:

The Price is Prohibitively Expensive

The first problem that telemedicine faces cost since many believe using the technology is too expensive. Various items on the market today can cost hundreds of thousands of dollars to install in a healthcare center that provides telemedicine. Other goods are available for less than $100 a month with a possible minor implementation cost. Because they are still being developed, the less expensive goods may be more difficult to use. The solution to this problem is to create user-friendly software that is both simple and economical for doctors and patients.

Misapplication of Technology

Another significant problem in telemedicine is the development of new technologies, apps, and training modules that accurately portray how a physician works. Many programs are designed by software designers who have no idea what it is like to be a doctor. This results in software that is difficult for doctors and patients to utilize. To produce technology that is simple to use for both sides, software engineers must collaborate closely with physicians to create programs and applications that are simple to use and provide the greatest possible healthcare.

Doctors’ Compensation

Another issue that telemedicine faces are adequate physician pay. Many doctors nowadays give treatment to patients even after hours. Many of these doctors are not reimbursed for their care after being called in. Most states now allow telemedicine payment to solve this issue, and legislation approved every few months tends to favor reimbursing doctors for their services.

Electronic Medical Records Integration (EMR)

Another problem that telemedicine encounters nowadays is integration with EMR. While many telemedicine services are currently being created for EMR integration, the majority are still unable to provide them. The practice of obtaining and preserving all patient information through virtual visits is known as EMR integration. To overcome this issue, doctors and software developers must collaborate to create software that can be integrated with EMR. This will offer clinicians real-time access to the most recent patient medical records, allowing them to provide the finest treatment possible.

COVID-19 and Telemedicine

The COVID-19 pandemic underlined the need and utility of telemedicine in connecting patients and health providers when an in-person session is not feasible. Teleconsultations are a safe and effective technique to examine suspected COVID-19 cases and assist the patient’s diagnosis and treatment, reducing the risk of disease transmission. Telemedicine also allows many critical healthcare services to continue operating routinely and without interruption during a public health emergency. Telemedicine legislation differs by country, but every health institution interested in providing telemedicine services must first analyze its maturity level.

Uses Of Telemedicine During COVID-19 Pandemic

COVID-19 Triage And Screening

Telehealth can also be used to monitor patients for COVID-19 symptoms and to determine their risk of infection. Phone screening, online screening tools, mobile applications, or virtual telemedicine visits can be used to assess patients’ COVID-19 symptoms, determine their severity, and determine whether the patient needs to be seen for assessment and admitted to the hospital or if the patient can be managed at home. Screening algorithms can aid telehealth communication.

Telehealth can also screen patients for non-COVID-19 care before they attend a healthcare establishment. If COVID-19 symptoms are reported during the telehealth interview, patients may be encouraged to postpone non-emergent care and instead seek COVID-19 testing.

Contact Tracing

Telehealth, particularly phone-based telehealth, can be used to interview COVID-19 patients to determine who they were in contact with while potentially infectious and to follow up with those contacts to inform them of the need for quarantine, assess whether they have any symptoms, and advise them on what to do if symptoms develop.

Observing COVID-19 Symptoms

To reduce congestion in healthcare institutions and spare hospital beds for more severe cases, patients with mild or moderate COVID-19 symptoms can isolate in a community isolation center or be monitored at home. Healthcare practitioners can check in with patients often using telemedicine technology (e.g., phones or apps) to monitor their status, advise, and decide whether the patient’s condition is deteriorating and if they need to be evaluated for in-person care, such as hospitalization.

COVID-19 Hospitalized Patients Receive Specific Treatment

Patients hospitalized with COVID-19 may require the services of a multidisciplinary team (e.g., nurses, respiratory therapists, physicians). One team member can visit the patient’s room and use telehealth technology (tablets, phones) to check the patient’s status, alter treatments or treatment plans, and handle problems. Furthermore, health care institutions can employ telemedicine to consult doctors with particular training or knowledge in respiratory illnesses such as COVID-19.

Tele-radiology can also be utilized to consult with radiologists located in faraway areas. Telehealth may also educate medical professionals and healthcare workers with online COVID-19 training.

Providing Non-COVID-19 Patients With Access To Necessary Healthcare

To the greatest degree, telehealth can be employed to preserve the continuity of care and minimize negative effects from preventive, chronic, or regular treatment that could otherwise be delayed owing to COVID-19 issues. Telehealth visits can assist in determining when it is appropriate to postpone an in-person visit or service. To decrease the frequency of in-person visits and overcrowding in outpatient settings, follow-up visits can be made by phone or internet. To decrease the necessity for in-person contacts, providers can employ internet-based medicine prescription and multi-month medication dispensing.

When an in-person visit is not practicable or viable owing to COVID-19 considerations, remote access to other Telehealth modalities can also assist ensure healthcare access. To reduce stress during COVID-19, mental and behavioral health treatments can be made available to the public via hotlines or virtual provider-patient interactions.

Monitoring COVID-19 Patients In Recovery

Following the release of COVID-19 patients from the hospital, healthcare practitioners can utilize telehealth technology to follow up with individuals who may need to remain isolated at home or be monitored for any abrupt deterioration or long-term health problems caused by COVID-19.

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