Telehealth uses the latest technology available to make people better. In an age of innovative new advancements, every day holds new possibilities for the burgeoning telemedicine industry, many with huge potential for patients and providers.

But it’s often hard to keep up with the research – on what’s new, what works, and what doesn’t. It’s why, in this article, we’ll go through the basics of telehealth services, present the most commonly used telehealth systems, and take a look at the future from this perspective.

First, let’s go through a brief history of telemedicine as a field, and how we got where we are now.

The History of Telehealth

Telemedicine was introduced as soon as the first means of telecommunications were set to connect people, as early as the first telephone-transmitted radiological images sent in 1948.[1]

In the 1960s, telemedicine was regularly used by psychiatrists at the Nebraska Psychiatry Institute to broadcast live in other rooms of the institute so that patients wouldn’t have to be escorted to other areas of the building.[2]

This increased the effectiveness of their program and was a real success. Telepsychiatry is still one of the most successful applications of telehealth.

At the Final Frontier

The first medical monitoring systems were first used in a U.S. Space program which used sensors to monitor animals that were sent into space. This was happening in 1961 and was one of the most advanced medical technologies available at the time.

Undoubtedly, telemedicine’s biggest breakthrough came with the invention of the Internet. A revolutionary new way of connecting people worldwide – often in real-time – it was a landmark leap forward, allowing doctors across the world to communicate with each other and their patients from anywhere.

The application of telemedicine to this new channel of communication was so rapid, that in 1993 the American Telemedicine Association emerged, just years after the Internet was born.

Where Are We Now?

Starting with 2009, the laws surrounding this industry became clearer than in the previous hears and the niche started to see some detailed regulations and guidelines. It’s important that all providers use the same protocols and telehealth systems for the highest efficiency in transmitting and handling information.

In 2016, telehealth services were founded, with the goal of bringing access to telehealth services to people in rural areas.

This recent step is meant to give access to telehealth even to the most remote areas in the country, where it is most needed.

What Is Telehealth?

Terms like telemedicine, telehealth, and similar have been circulating for a while, but many people are still unsure what each defines exactly.

Let’s go through each of them.

Telehealth vs. Telemedicine

Telehealth and telemedicine are often used to define the same thing:

The application of electronic technology like telecommunications to facilitate the distribution of health and health-related services.

The only difference between the two terms would be the fact that telehealth can be used in a broader sense and include adjacent services like wellness or telepsychology.

Telehealth also includes a crucial function: monitoring and treatment administration, for patients who use wearable devices like heart monitors, blood sugar level monitors, etc. These devices provide real-time data about the patient’s health, which allows the doctor to react in a timely manner and prescribe the best treatment.

With the help of today’s technology, telehealth can be used in almost any field of medicine, from surgery and imagery to psychiatry or nutrition. Each subdomain gets the prefix “tele-” to indicate that it is based on remote communication and the doctor and patient don’t need to be in the same room or area to communicate.

We will go through some of the most important applications of telehealth below.

Telehealth Applications

As mentioned before, almost every subdomain of medicine can use telehealth for transmitting, gathering, and analyzing medical information remotely.

We can split the application of telehealth into four main categories:

  • Asynchronous Data Transmission
  • Live Video
  • Remote Monitoring, and
  • mHealth.

Asynchronous Data Transmission

This methodology involves the transmission of medical data at a pre-established moment so that the medical specialist can analyze it offline and offer feedback based on it.[3]

As its name suggests, the doctor and the patient are not in touch permanently but schedule the communication on a more frequent basis.

Live Video

The best way of remotely connecting doctors and patients for consultations it through a live stream video. Broadcasting in real-time allows the doctor and patient to communicate easily and save time by eliminating transportation.

As long as the quality of the video is good, live video consultations are just as efficient as in-person consultations.

Still, third party video chat providers like Skype or Facetime are not reliable for such services, because they don’t comply with many medical privacy regulations, such as the HIPAA act and other protective laws.[4]

Remote Monitoring

RPM, short for Remote Patient Monitoring, is usually applied to chronic patients, like those with heart conditions, asthma, diabetes, infertility, etc. [5]

To measure certain parameters and they manage their health by keeping their doctor up to date, they use peripheral devices such as:

  • Blood sugar monitors
  • Heart monitors
  • Thermometers
  • Blood pressure cuffs, and
  • Other devices such as fitness trackers.

This requires a certain degree of motivation from the patient, and sometimes the efficiency is compromised by this.

mHealth

The term mHealth refers to the use of mobile devices like smartphones for medical monitoring and consultations.

In other words, and according to the World Health Organization:[6]

Medical and public health practice supported by mobile devices, such as mobile phones, patient monitoring devices, personal digital assistants, and other wireless devices.

Fit for industrialized nations, this telehealth sector is very promising because of how easy it is for the patients, which motivates them to stay connected to their medical provider and watch their health more closely.

Telehealth Services

Depending on the medical needs of the patients, different telehealth services were developed and keep on appearing.

With more and more patients and providers being on board with telemedicine, the services keep on expanding and going towards a normalization of remote medicine, which can only help facilitate the healthcare industry.

Examples of Telehealth Services

In this table, a few great examples of telehealth services that are changing the face of healthcare.

Application

Details

Telepsychiatry

Because psychiatry is based mainly on consultations and not on imagery or in-surgery tech, telepsychiatry can often be done through live video.[7] 

Here, psychiatrists talk to patients in real-time while they are at home or a local clinic, where they can receive help from on-site staff. 

This service can be especially useful for people who need psychiatric help but avoid getting it because of the stigma associated with mental health conditions.

Telenursing

Another important telehealth application is telenursing, which allows patients to receive nurse services remotely – often using cutting-edge e-clinic software

These services include remote triage, home care, and patient monitoring.

Telemonitoring

Telemedicine works great for monitoring chronic disease, post-operatory patients, and other cases that need long-term monitoring. 

Like many e-health services, it can be real-time – with live updates – or asynchronous – time-delayed.[8]

Telemedicine

This concept refers mainly to the direct communication between doctor and patient through an electronic channel: telephone, Internet, text messages, etc. 

This is what patients usually think about when they hear about telehealth, and many doctors allow patients to call or text them for advice.

Benefits of Telehealth Services

To understand why telehealth should penetrate more the medical industry, we need to understand what its benefits are.

Here’s a list of some of the many benefits that telehealth offers – both to patients and to providers.

Advantage

Details

Location-Independent Healthcare

The most obvious benefit brought by telehealth is that it eliminates the distance between patients and providers, which can make a huge difference for many patients. 

A lot of people can’t get to a specialist because they can’t afford the costs of getting there (transportation, arranging babysitting, losing working hours, etc.) or they can’t move around because of their condition.

Greater Patient Reach

Other times, the doctors in rural or remote areas have to cover a large area and don’t have the possibility of reaching all the patients in a timely manner. 

Telehealth gives these doctors an opportunity to reach their patients without leaving their clinic, which makes their job more effective.[9]

Improving Engagement

Another benefit brought by telehealth is that it can increase patient engagement; among other things, by making medical services more accessible and more comfortable by removing the need for in-person visits.

Encourages Customer-Orientation

Medical providers can think of their medical business in more flexible terms, and be more customer-oriented. 

Extending medical services to more flexible working hours and environments is a breeding ground for new ideas and ways of getting health care to all patients.

Enhancing Patient Satisfaction

One of the clear benefits of telehealth, which has a big impact on its future, is that it has been linked with high patient satisfaction.[10] 

Reducing waiting times, long travel distances, inconvenient transportation, and other logistic aspects can play a big role in patient satisfaction, ensuring they reach a doctor much faster and save money while doing so.

Medicare

Ultimately, for today’s modern consumer, it all comes down to what we can get right here, right now.

So, many patients are asking themselves this very moment: Can I get telehealth services myself, and how?

One of the downsides of telehealth at the moment is that such services are not available everywhere. We are still looking at a relatively young industry that is still growing and adapting, and the truth is that not everyone can access telehealth services for a variety of reasons.

What is Medicare?

Medicare is a health system that supports telehealth and its progress, but it has certain requirements before patients and providers can receive reimbursement for telehealth.

The good news is that the system and its coverage are expanding more and more. If only a few telehealth services and providers were covered some years ago, today many more are becoming eligible for Medicare reimbursements.

Am I Covered?

To be covered by Medicare, a patient often must be receiving telehealth services in a special medical facility, such as a Skilled Nursing Facility, Renal Dialysis Center, Mental Health Center, or similar.

In many instances, this clinic must be located in an area with a shortage of doctors and specialists for the patient’s particular condition. In other words, Medicare will frequently only reimburse telehealth services if the patient has no other choice besides telehealth.[11]

Another limitation of telehealth under the Medicare system is that not all providers are eligible to offer their services under Medicare. Some specialties aren’t covered by Medicare at all, while others do, but offer limited providers for the patient.

This situation is to be expected but does limit the list of options quite a lot.

It’s important to know that only HCPCS and CPT codes are covered by Medicare and that they are updated periodically.

To check the updated list, here is the official CMS website where you can see the providers covered by Medicare.

Cyber Security

An important issue to discuss when it comes to telehealth is the security of medical data.

Medical patient information is one of the most valuable forms of data out there, and consequently, often the target of cyberattacks.

So what are telehealth providers doing to address this risk?

Protecting Patient Information

Medical providers who decide to offer telehealth services must choose channels and technologies that are able to protect the patient’s information and store it securely.

This is why offering consultations through Skype or other video chat parties that are not designed for telehealth is dangerous and can compromise the privacy of the patient.

Telehealth software must be compliant with HIPAA and other regulations regarding data security, they must encrypt information and store it securely.[4]

Besides using protection systems integrated into software solutions, healthcare providers must offer full staff training regarding security, as human error often is often the cause of security breaches.

Patients also should receive training regarding the protection of their data and regularly check their devices for viruses, spy software, and other cyber attacks.

The Future of Telehealth

From patient monitoring to emergency care, establishing treatment plans, and scheduling at-home consultations, telehealth offers a lot of opportunities for improvement.

We are living in exciting times for telehealth and medicine in general, and witnessing a rapid expansion of this industry.

Many of the disadvantages currently linked with telehealth stem from this, mainly the facts that it’s not yet regulated everywhere or that provider and patients are still skeptical about it.

As telehealth and its applications are expanding, there is research supporting its use and exploring areas where it needs improvement. At the same time, telecommunications and remote technologies are progressing and seeing more and more innovations.

Priorities for Telehealth – Where To From Here?

The latest medical software includes virtual reality (VR) and artificial intelligence (AI), two astonishing fields that will drastically change the way we live, and the way we treat our health problems.[12]

We predict that a lot of future medicine will be based on preventive methods and more focused on the patient experience and comfort. Many telehealth services aim to become part of the patient’s routine and be seen as pleasant activities instead of dreaded obligations.

More practical and short-term expectations are related to how the government sees the importance of telehealth services, and the fact that funding is put into this sector shows a healthy interest towards faster and easier healthcare.

With telemedicine, it might take a while before the public acknowledges the true extent of its benefits. From patient monitoring to emergency care, establishing treatment plans, and scheduling at-home consultations, telehealth offers a lot of opportunities for improvement.

Final Thoughts

Understanding what telehealth is about and exploring future possibilities makes us believe in a world where patients and medical providers are more connected than ever before.

Being aware of what the telehealth system offers, and the potential applications of telehealth tech, are important steps towards its progress. The public should be informed of its benefits, as well as about the weaker points that need extra attention, like cybersecurity and state regulations.

Above all, the future of telehealth looks brighter than ever, and we believe it’s just a matter of time before it becomes a part of our daily lives.

References

  1. ^ Field, M. J. (Ed.). (1996). Telemedicine: A Guide to Assessing Telecommunications for Health Care. Washington, D.C.: National Academies Press.
  2. ^ Ferrer-Roca, O., & Sosa-Iudicissa, M. C. (Eds.). (1998). Handbook of Telemedicine. (Vol. 54). Amsterdam: IOS Press.
  3. ^ Langarizadeh, M., Tabatabaei, M. S., Tavakol, K., Naghipour, M., Rostami, A., & Moghbeli, F. (2017). Telemental health care, an effective alternative to conventional mental care: A systematic review. Acta Informatica Medica, 25(4), 240.
  4. ^ United States. (2004). The Health Insurance Portability and Accountability Act (HIPAA). Washington, D.C.: U.S. Dept. of Labor, Employee Benefits Security Administration.
  5. ^ Vegesna, A., Tran, M., Angelaccio, M., & Arcona, S. (2017). Remote patient monitoring via non-invasive digital technologies: a systematic review. Telemedicine and e-Health, 23(1), 3.
  6. ^ WHO. (2011). New Horizons for Health through Mobile Technologies. Global Observatory for eHealth. World Health Organization: Geneva, Switzerland. Retrieved from https://www.who.int/goe/publications/goe_mhealth_web.pdf?
  7. ^ Chakrabarti, S. (2015). Usefulness of telepsychiatry: A critical evaluation of videoconferencing-based approaches. World Journal of Psychiatry, 5(3), 286.
  8. ^ Wilson, L. S., & Maeder, A. J. (2015). Recent directions in telemedicine: Review of trends in research and practice. Healthcare Informatics Research, 21(4), 213.
  9. ^ Goodridge, D., & Marciniuk, D. (2016). Rural and remote care: overcoming the challenges of distance. Chronic Respiratory Disease, 13(2), 192.
  10. ^ Polinski, J. M., Barker, T., Gagliano, N., Sussman, A., Brennan, T. A., & Shrank, W. H. (2016). Patients’ satisfaction with and preference for telehealth visits. Journal of General Internal Medicine, 31(3), 269.
  11. ^ Medicare.gov. (2020). Is my test, item, or service covered?. Retrieved from https://www.medicare.gov/coverage/telehealth
  12. ^ Baker, M. (2017). How VR is Revolutionizing the Way Future Doctors are Learning About Our Bodies. Retrieved from https://www.ucsf.edu/news/2017/09/408301/how-vr-revolutionizing-way-future-doctors-are-learning-about-our-bodies

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