Is Telemedicine the Future of 21st Century Medicine?

Healthcare technology has a direct impact on both the length and overall quality of human life, which is why so many are focused on predicting and developing the prevailing trends, technologies and practices of tomorrow. Telemedicine, which Medical Daily defines as “the union between technology and health, is believed by many to be the future of healthcare in the United States and the world.” If you aren’t familiar with telemedicine, as it is a relatively new concept, a healthcare provider offers the following definition:

Telemedicine is the use of medical information exchanged from one site to another via electronic communications to improve, maintain, or assist patient’s health status. Closely associated with telemedicine is the term “telehealth,” videoconferencing, transmission of still images, e-health including patient portals, remote monitoring of vital signs, continuing medical education and nursing call centers are all considered part of telehealth and telemedicine.

 

The Evolution of Absentia Care

Physicians have provided care at a distance long before the technology that makes telemedicine possible even existed. Hundreds of years ago, African villagers used smoke signals to warn outsiders to stay away from the village due to widespread disease. In the early 1990s, people living in rural Australian areas used two-way radios, powered by a dynamo driven by a set of bicycle pedals, to communicate with the Royal Flying Doctor service of Australia, according to an ICU Care article. From these somewhat primitive and early examples of absentia healthcare, telemedicine has evolved into a potentially industry changing technology.

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The Four Types of Telemedicine.

Telemedicine practices typically fall into one of four categories: “Synchronous”, “Store-and-Forward”, “Remote Patient Monitoring” and “Mobile Health”.  Synchronous telemedicine could be as simple as a telephone conference or as complex as remotely controlled robotic surgery. What is required is the presence of both the patient and care provider at the same time, with a communication link between the two that allows for a real-time interaction to take place, according to ICU Care.

• Live Video (Synchronous)
• Store-and-Forward Telemedicine
• Remote Patient Monitoring (RPM)
• Mobile Health (mHealth)

  Live Video (Synchronous): The most common form of synchronous telemedicine is video conferencing, however, there are also “peripheral devices which can be attached to computers or the video-conferencing equipment to aid in an interactive examination.” This type of service, which is also commonly referred to as “real-time”, may serve as a substitute for an in-person encounter when it isn’t available and can be used for consultative, diagnostic and treatment services. For example, with a tele-stethoscope, a remote physician can hear a patient’s heartbeat, or with a tele-otoscope, a remote physician can see inside a patient’s ear. With the ability to treat patients remotely, physicians can leverage telemedicine technologies to treat more patients faster and from anywhere at any time. In the future, physicians may have the widespread ability for physicians to remotely treat patients in real-time has the potential to fundamentally change the dynamic of the industry. Synchronous medicine is conducive to a variety of medical specialties, including psychiatry, family practice, internal medicine, rehabilitation and more.   Store-and-Forward Telemedicine: Store-and-Forward telemedicine differs from real time in that it does not require the simultaneous participation of both parties. Store-and-forward telemedicine involves “acquiring medical data (like medical images, bio signals etc.) and then transmitting this data to a doctor or medical specialist at a convenient time for assessment offline.” Medical specialties conducive to this type of telemedicine include dermatology, radiology and pathology. For store-and-forward to function effectively, a properly structured and built out Medical Record, preferably in electronic form, is critical. In a store and forward scenario, information is typically transmitted through secure or encrypted email. This information can include X-rays, MRIs, photos, patient data and even video-exam clips. Primarily, the goal of store and forward telemedicine is to aid in diagnoses and medical consultations when live video or face-to-face contact is not necessary. One of the biggest benefits is that the need for coordinating schedules is eliminated, as the primary care provider and the patient do not need to be available simultaneously, as in a real-time telemedicine scenario.   Remote Patient Monitoring (RPM): Personal health and medical data can be collected from an individual in a one location via electronic communications technologies and then be transmitted to a provider (oftentimes via an outsourced data processing services) in a different location. With remote patient monitoring, healthcare providers can “continue to track healthcare data for a patient once released to home or a care facility, reducing readmission rates.” Remote patient monitoring can also healthy individuals stay healthy in their homes and communities, without being required to travel to a provider’s office. This is especially beneficial for patients who have physical disabilities or trouble moving around.   Mobile Health (mHealth): Another facet of telemedicine is mobile health. Mobile devices are becoming an integral tool for many 21st century businesses. In healthcare, organizations can create apps or use targeted text messages to promote healthy behavior or distribute large-scale alerts about disease outbreaks or other public health hazards.  

Challenges Facing Telemedicine

While telemedicine holds a lot of promise for primary care providers and patients alike, it isn’t without potential drawbacks and hurdles that will need to be addressed. Specifically, it poses some technical and practical challenges for healthcare providers.  

Technical Training and Equipment

Implementing telemedicine software and processes requires restructuring IT staff and responsibilities, along with purchasing expensive equipment. Both tasks require time and cost a considerable amount. In order to build an effective system, training is critical. Physicians, IT staff, practice managers and other medical staff need to be adequately trained on the new systems to ensure a satisfactory ROI, according to eVisit.  

Reduced In-Person Consultations

You can make a great argument for the merits of telemedicine, however, technology can be limiting. Many doctors and healthcare professionals are concerned about technical problems associated with telemedicine, according to eVisit, and could lead to “possible patient mismanagement.” With an in-person consultation, patient’s feel the tangible “personal touch” that simply can’t be achieved through a digital consultation. While telehealth is a great alternative to an in-person consultation, it cannot replace it completely…yet.  

A Step in the Right Direction

While we’re not quite at the point, in terms of technological advancement, of being able to have 24/7 access to medical help at the touch of our fingertips, telemedicine and the tools associated with it are a step in the right direction. Telemedicine is a highly convenient service with a lot of potential to improve quality of care and overall access to healthcare. Today, with biometric technology on mobile devices, patients can literally access their health records at the touch of a fingertip. The trial for healthcare professionals and patients will be determining how to best use these tools and figure out how they fit into the care process. However, regardless of any challenges, it’s clear that telemedicine isn’t going anywhere. The next time you need to go in for a checkup, consider logging onto your computer instead.

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