Receiving specialised care frequently poses a common issue particularly in rural or remote areas. People with ongoing diseases like diabetes or high blood pressure have had to rely on visiting a GP or hospital to be tested on a regular basis. With the advancement of telehealth and the many technological advances it provides, patients can now in certain instances avoid lengthy commutes and monitor their ongoing diseases themselves.
This article looks in depth at what telehealth is, as well as the potential benefits and negatives that come with telehealth. Telehealth is expansive, but this article seeks to better explain how all patients can more effectively use it.
What is Telehealth?
Simply, telehealth is digital communication and devices that allows healthcare professionals to access health care services remotely to better manage one’s overall health care. Telehealth offers convenient health care access to people, as well as providing better access to health specialists, no matter where a patient is located.
It also offers support that allows a patient to monitor his or her care, whilst under the supervision of a doctor. From videoconferencing to providing biodata information, telehealth offers a wide range of services to better treat individuals.
The WHO refers to telehealth as, “delivery of health care services, where patients and providers are separated by distance. Telehealth uses technology for the exchange of information for the diagnosis and treatment of diseases and injuries, research and evaluation, and for the continuing education of health professionals.
Telehealth can contribute to achieving universal health coverage by improving access for patients to quality, cost-effective, health services wherever they may be. It is particularly valuable for those in remote areas, vulnerable groups and ageing populations. ” Telehealth also includes distance learning, healthcare system management, health data management, and patient movement among other things.
Telehealth has been growing in worldwide popularity since 2013, and in the USA, the market for telehealth was valued at $29.6 billion in 2017. Since then, it has only increased. But, telehealth isn’t just for countries with a highly privatised healthcare system. In 2019, it was estimated that telehealth could save England £7.5 billion yearly.
It would include a £2.2 billion savings to patients who would be referred to a non-GP consultant as an estimated 27% of patients do not need to see a GP. In developing countries, particularly in Africa, telehealth offers the opportunity to better patient care in rural areas, yet it is often hampered by poor internet and electricity.
Telehealth doesn’t refer simply to seeing a GP or practitioner either. The same article estimated that 41% of patients would better adhere to their medication schedule if telehealth technology applied to them.
Telehealth equipment allows patients to better care for themselves, whilst under the overall care of doctors. Equipment that automatically sends information to doctors can benefit patients who suffer from asthma, diabetes, or those with high blood pressure.
Each of those diseases requires equipment to test and monitor these conditions, for instance, those with high blood pressure can use a telehealth monitor to take their blood pressure and have the results sent to their GP. Of course, not every individual is able to benefit from telehealth, but asking your GP or nurse about suitability for telehealth can give you more information.
Differences between Telehealth, Telemedicine, and Telecare
Telehealth, telemedicine, and telecare are all under the umbrella of e-medicine, which serves to better care and educate individuals through the internet and telecommunications. There are many other specific telehealth categories, such as telenutrition, telenursing, teleaudiology, and more, but those are generally specific to a certain branch of medicine.
Telehealth is far broader than telemedicine, as it refers not just to medical visits, but also education and administrative meetings. Most telehealth equipment allows people to better monitor ongoing chronic conditions via equipment that automatically sends the readings to doctors.
Telemedicine is a subset of telehealth that specifically covers education and health care services from a distance. Most often used for follow-up visits or management of chronic conditions, telemedicine generally uses secure video calls and audio calls to better care for patients.
Telecare refers specifically to equipment that is used for telehealth that determines if there is an issue and sends an alert to a call centre. It is under the umbrella of telehealth and generally benefits elderly patients who more frequently require devices in case of a fall or such emergency.
Therefore, telehealth, telemedicine, and telecare are all under the umbrella of e-health. All telemedicine and telecare are telehealth, but not all telehealth is telemedicine or telecare.
Benefits of Telehealth
There are many benefits of telehealth. In the case of COVID-19 pandemic, telehealth became even more important. The House of Commons noted on 11 March, 2020 that, “We have moved to a principle of “digital first” in primary care and with out-patients: unless there are clinical or practical reasons, all consultations should be done by telemedicine.”
This jump to near-constant telehealth throughout all of the United Kingdom swiftly introduces the benefits of telehealth to many, whilst also raising questions about usefulness and security. Up until now, telehealth has been predominantly used in countries like America that has a vastly privatised and rural network. There is a place for telehealth within the UK NHS, as there are many benefits to be reaped with a strong telehealth network.
Wider Patient Reach
One of the biggest benefits of telehealth is that it expands care to better reach all individuals in need of care. Even with doctors being busier than ever due to a pandemic, telehealth allows for patients to be cared for in rural areas, as well as patients with chronic issues to be seen and cared for with the very best of care in a non-traditional way.
Telehealth Improves Patients Experience
The Nursing Times noted in a recent article on reconciling telehealth alongside nursing concerns, that patients have seen an improvement in their overall care and comfort. One patient from Yorkshire noted, “I was struggling to cope with my health before telehealth was fitted, either waking up or going to sleep feeling uneasy or ill.
Telehealth gives me a sense of reassurance to know somebody is keeping a check on me every day. It feels like a godsend. I feel much more at ease with the different aspects of coping with my illness. If I don’t feel quite right, I can take measurements at any time in the day and the majority of the time everything is OK.”
Telehealth Benefits Rural Communities
In a rural area, telehealth increases healthcare quality, especially because it allows the patient to be seen by a GP without driving long distances. It also better allows a patient to have more specialised care that before now, would not be possible unless the patient lived closer to a larger city or the required specialists.
Telehealth Benefits Patients with Limited Mobility
For patients with limited mobility, especially the elderly or those without reliable means of transportation, telehealth can make a big difference in their overall care. Telehealth allows patients, especially older ones who may need more appointments to be seen promptly and as frequently as they need, without having to even leave the house.
Telecare equipment also benefits those with limited mobility as many of them automatically send the necessary information about the patient to the clinic for review by a GP.
Telehealth Increases Efficiency of Medical Personnel
Additionally, telehealth increases efficiency of GPs and medical personnel, allowing more patients to be seen on a daily basis. Because telehealth allows for prioritising and better triaging patients, it limits wait and travel time for patients, allowing for better decision making on both the patient and GP levels.
Telehealth Improves Patients Promptness
A persistent problem for the NHS has always been missed GP appointments, which accumulate and cost the NHS millions over the years. With telehealth, there is no longer a concern about traffic or confusing times at the surgery. Patients are more likely to show up.
In fact, a Nebraska study that looked at no-show rates at the Omaha Children’s Hospital noted that once they switched to telehealth for many appointments, they had a 50% drop in no-shows overall.
Telehealth Supports Independence
For elderly patients who may struggle with getting a ride to doctor’s visits, telehealth offers them more independence from families and institutions. MHealth intelligence notes, “From innovative connected care platforms to the Internet of Things, telehealth is showing today’s seniors (and tomorrow’s soon-to-be seniors) how they can live out their golden years in their own homes.”
The report quoted, references AARP statistics, and states that “… 87% of seniors age 65 and older, and 71% of those between 50 and 64 want to age in place, and will require home-based technology to make that a reality.”
Telehealth has Satisfied Patients
Patient satisfaction is often a consistent reason many practices worldwide switch to telehealth. The American chemist chain CVS states that they have a 99% satisfaction rate with their telehealth line.
Telehealth Offers Extensive Technology Options
From apps to patient portals, testing supplies to reminders, telehealth relies on technology to remind patients of medications and procedures, whilst still offering the kind of care previously only seen in hospitals or GP clinics. This extensive technology allows for more independence and freedom for patients, especially elderly patients, and can relieve the minds of caregivers and family members.
Limitations of Telehealth.
Of course, there are some limitations with telehealth. While the pros generally outweigh the cons, it is imperative to see both sides of the argument for telehealth.
Telehealth limits physical contact and examination
While telehealth offers the ability to video call and contact patients with doctors, the technology just isn’t there for a physical examination. In some cases, physical examinations aren’t necessary, but other cases, a patient needs to be examined by a doctor to be best treated. Another limitation of telehealth is that in some cases, a doctor could prescribe a necessary treatment right away and have it issued to the patient.
With telehealth, a doctor may prescribe a treatment and then the patient will have to wait until they can be seen in person for the treatment to be prescribed and taken. For instance, a patient with a bacterial infection seen in person would be started on a dose of antibiotics as well as given an injection. A patient seen via telehealth would be diagnosed, and then told they need to come in for treatment and observation.
Telehealth is Limited by Technology
Perhaps a patient isn’t comfortable using a phone or computer to discuss confidential information with a doctor. Or maybe a patient isn’t confident with technology or doesn’t own a computer that can be used. There are limitations in the technology that means telehealth cannot be used by every patient, and those patients should still be respected and treated in person.
There also may be issues with technology like a power outage or internet provider being down. Telehealth is strongly reliant on several working parts to work appropriately, and if one of those parts fail, then both the patient and the doctor have wasted their valuable time.
Telehealth and Medical Staff
Another limitation of telehealth is simply doctors and nurses who are not trained in telehealth or don’t feel comfortable using it. Training and educating staff takes time and effort away from their treating of patients. While most of the world is clearly ready and many people are already using telehealth, in some countries and areas, not enough staff feel comfortable with telehealth and thus it limits its overall effectiveness.
Ethical issues of telehealth
One of the larger issues that will arise as telehealth becomes more and more common are ethical issues relating to technology and telehealth. Giving informed consent for a video call as well as backing up information to the cloud or whatever required source should be explained to the individual, particularly in person.
Additionally, there needs to be specific knowledge of who views one’s information and as well as strict regulations for keeping information private. Of course, one of the biggest concerns about telehealth would be privacy and how one can confirm that their personal information shared in video and audio calls is private and safe.
Not every appointment can be a telehealth appointment. Vaccinations still need to be given in person, and many emergency visits have to be under the physical attention and guidance of a doctor. Yet for those struggling with a chronic or recurring condition or the elderly, a change to telehealth allows for consistent care with the high standards patients are looking for.
There are many benefits to telehealth, but the cons should be considered as well. Overall, telehealth is an excellent option for many and deserves its place in every office.