Telemedicine: The Whats, Whys, & Hows of Remote Health

What Is Telemedicine?

The COVID-19 pandemic has hit the pause button on many nonessential aspects of life, including vacation travel, dining out, and retail shopping, but one thing that cannot be paused is the need for medical care—especially now. Thus, the world has had to quickly adapt to seeking and administering medical care while maintaining as much social distance as possible. This has led to swift advances in telemedicine—a method of remote diagnosis and treatment of patients via electronic information and telecommunication technologies between doctors and their patients. Telemedicine is an innovative solution for alleviating stress on the medical system at a time when a heavy influx of sick patients in hospitals and clinics can potentially overtax healthcare systems.1

While the concept of telemedicine has been in the works since the late 1990s and has been accelerating in use along with the rapid expansion of the internet, this method of healthcare delivery abruptly and exponentially increased in use following the arrival of COVID-19 in the United States.1 The original objective of telemedicine, however, has not changed much in the last 30 years—to provide access to clinician care, intervention, and advice to a greater number of people without increasing risk of exposing the clinician, staff, and other patients (i.e., in a doctor’s office or hospital waiting room) to infectious disease.2,5  The telemedicine approach includes clinical services provided via telecommunications technology, such as videoconferencing, talking over the phone, streaming media online, and store-and-forward imaging. The term telemedicine should not be confused with the term telehealth, which encompasses a broader scope of remote healthcare services.6 

Types of Telemedicine Consultations

To participate in telemedicine, patients should first reach out to their healthcare provider to make an appointment. Some doctors’ offices have appointment scheduling options on their online patient portal. This could be as simple as filling out an online form, making a phone call, or sending an email. If you do not have a primary care physician, telemedicine apps, such as Lemonaid™ and Doctor on Demand™, are available options to help patients connect with an appropriate telemedicine service.

Store-and-forward collects relevant medical information and sends it electronically to another site for evaluation. This information may include medical history, lab results, images or videos, and electronic medical records. Store-and-forward telemedicine typically is used by providers who need to outsource diagnoses to specialists (e.g., teleradiology allows healthcare professionals at smaller hospitals to share patient x-rays for diagnosis by a specialist at another location).7

Remote patient monitoring provides healthcare clinicians with the ability to remotely monitor a patient’s vital signs and other health data,  allowing them to identify signs of distress and quickly intervene. This approach is commonly used to monitor people with chronic illnesses or those recovering from surgery (e.g., a patient with diabetes can use a glucose tracker to measure his or her glucose levels at regular intervals and transmit them to the doctor).7 This form of telemedicine has become more mainstream with the advent of Apple iWatches® and Fitbits®. 

Real-time telemedicine pertains to live consultations, using audio and video technologies, between a healthcare clinician and a patient.4 This approach is one of the most common forms of telemedicine and offers a virtual alternative to in-person visits to a doctor’s office or healthcare facility (e.g., a mental health session between patient and therapist via videoconference). 

Pros and Cons of Telemedicine

Pros

Cons

Telemedicine is convenient and more easily accessible for some healthcare providers and their patients8

Remote analysis, monitoring services, and electronic data storage significantly reduce healthcare service costs.7

Streamlined avenues for patients to reach out to clinicians encourage better patient engagement.

Telemedicine increases patient access to healthcare through on-demand clinicians providing real-time urgent care consultations.

Telemedicine requires the purchase of special equipment and specific technical training.7

Patients that repeatedly connect with a random on-call healthcare provider can reduce care continuity.

Poor broadband connections and system hiccups could lead to mismanagement of patients and decrease the personal touch of in-person visits. 4

Healthcare laws, policies, and privacy protection rules could struggle to keep up with this fast-growing industry. 7

Conclusion

While the telemedicine approach to healthcare delivery improves patient access to critical healthcare services in a variety of specialty areas and across diverse patient populations, especially during the COVID-19 pandemic,9  there are still significant administrative barriers that need to be addressed in telehealth as a whole. Telemedicine restrictions vary by state, each of which have specific licensing requirements by medical boards, and there still are ambiguous reimbursement policies that affect how healthcare providers are paid.7 However, alongside rapid advances in technology and increased patient need, it’s likely that telemedicine will only become easier to utilize, more cohesive, and more widely accepted by physicians and patients alike in the coming years.

Sources

  1. American Telemedicine Association website. Quick-Start Guide to Telehealth During A Health Crisis. https://cdn2.hubspot.net/hubfs/5096139/Files/Resources/ATA_QuickStart_Guide_to_Telehealth_4-10-20. Accessed May 20, 2020.  
  2. The New York Times. Is Telehealth the Future of Health Care? New York Times website. https://www.nytimes.com/paidpost/philips/is-telehealth-the-future-of-health-care.html . Accessed May 20, 2020.
  3. Rosenthal M. The New Language of Telehealth. https://www.nytimes.com/2020/05/05/well/live/doctors-patients-mother-baby-pediatrics-telemedicine-computers.html?searchResultPosition=2. Updated May 5, 2020. Accessed May 20, 2020.
  4. Telehealth and Telemedicine: The Use of Telehealth and Telemedicine in Public Health. Centers for Disease Control and Prevention website. https://www.cdc.gov/phlp/publications/topic/telehealth.html. Updated August 19, 2016. Accessed May 20, 2020.
  5. Telehealth: Delivering Care Safely During COVID-19. The U.S. Department of Health & Human Services website. https://www.hhs.gov/coronavirus/telehealth/index.html. Updated May 7, 2020. Accessed May 20, 2020.
  6. What is telehealth? How is telehealth different from telemedicine? The U.S. Department of Health & Human Services website. https://www.healthit.gov/faq/what-telehealth-how-telehealth-different-telemedicine. Updated October 17, 2019. Accessed May 21, 2020.
  7. The Ultimate Telemedicine Guide | What Is Telemedicine?  eVisit Telemedicine Solution website. https://evisit.com/resources/what-is-telemedicine/#5. Updated May 25, 2018. Accessed May 21, 2020.
  8. Managing Satisfaction: What Patients Think of Telemedicine in 2019. Wheel website. https://www.wheel.com/blog/telemedicine-patient-satisfaction-studies-2019/. Updated January 30, 2019. Accessed May 21, 2020.
  9. The Promise of Telehealth For Hospitals, Health Systems and Their Communities. The American Hospital Association. https://www.aha.org/system/files/research/reports/tw/15jan-tw-telehealth.pdf. Updated January 2015. Accessed May 21, 2020.  

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