Telemedicine is a term widely used in the healthcare industry which simply refers to the diagnosis and treatment of a patient via telecommunication technology. With the advent of technology, telecommunication, and high-speed internet, telemedicine, or telehealth services, has quickly grown to become a convenient and more than viable option for getting the help that you need wherever you are. However, telehealth still remains a relatively new tool in health, and that unfamiliarity may have physicians and prospective patients unsure about this technology and what it is capable of. What is telemedicine, what are telemedicine services, and how do medical practices use them? Read on to learn more.
The Early History of Telemedicine
To put it most simply, this emerging technology refers to the diagnosis and treatment of patients’ health related issues from various specialists via technology such as telemedicine software or telemedicine platform. While you may immediately think of smartphones and tablets, “virtual” care has roots that go back centuries when it comes to patient care. Articles as early as 1879 described doctors using telephones to reduce unnecessary doctor visits. Since the 1920s, doctors have used radios to send medical advice and guidance to patients and clinics on ships.1
However, the form of hospital-based telehealth that most people think of now was used as early as the late 1950s. The Nebraska Psychiatric Institute and Norfolk State Hospital set up a closed-circuit television link that allowed for psychiatric consultations between the two practices.1
The evolution of phones and the internet has only led to further advancements in telehealth. Today, telemedicine is a subset of the larger telehealth umbrella, which includes other forms of medical care that use technology. Alternately referred to as video conferencing visits, doctors on demand, or online doctor visits, telehealth today is usually implemented via computer, smartphone, or tablet.
Types of Telemedicine
Telemedicine generally comprises three different types: real-time, remote patient monitoring, and store-and-forward.
Real-time services, also known as synchronous telemedicine, occur via the phone, computer, or other device that has a camera and is capable of helping you gather patient data. Synchronous telemedicine essentially allows for most of the same services and care that a patient could expect from a face-to-face appointment such as in behavioral health visits. It creates a real-time interaction where the doctor can discuss a patient’s medical history, provide consultation, and assess any immediate issues that the patient might be facing. From there, the doctor may schedule a follow-up appointment or direct you to more specialized care.2
Alternately, this same type of visit may be in a physician’s office. This allows for more direct and robust long-term care. This usually involves the help of an assistant, known as a telepresenter. As the appointment progresses, the telepresenter can provide more hands-on service, from taking a patient’s blood pressure to performing a general physical exam, as instructed by the telecommunicating physician.3
While online-only forms of synchronous telemedicine are certainly around, many hospitals and health professionals are integrating real-time service with their regular in-person practices. This allows telemedicine or telehealth to supplement face-to-face appointments, resulting in more comprehensive care.3
Also referred to as self-testing or self-monitoring, remote monitoring allows physicians to monitor a patient’s health and vital signs through various technologies. While remote monitoring can be used for many chronic conditions, it is most extensively used in managing chronic diseases, including diabetes, cardiovascular disease, and asthma. 2
Remote monitoring is highly cost effective and convenient, but it does require some responsibility on the patient’s part. There is also the risk that a patient may perform test improperly, leading to inaccurate results.2
Store-and-forward, sometimes known as asynchronous telemedicine, functions more like emails wherein responses come after sending a message as opposed to an immediate, real-time interaction. Patients and physicians can share text and general information, along with diagnostic images, videos, lab tests, medical records, and other specialized data about a patient’s care. This type is most often used in dermatology, pathology, and radiology.3
This is generally more useful for patients or clinicians who may be too busy, and with the proper care and responsibility, asynchronous telemedicine can potentially save time and allow for greater efficiency. However, without access to a physical examination, store-and-forward more heavily relies on the patient’s history reports, documentation, and images, which may not always be accurate or otherwise result in a misdiagnosis.2
What Are Telemedicine Services?
All three of the above types of this new technology, Real-Time Service, Remote Monitoring, and Store-And-Forward, can be used in conjunction to ensure that a patient receives the best care. A patient may start with real-time appointments, and once the doctor has reached a diagnosis, they can monitor the effects of treatment through a combination of asynchronous telemedicine and remote monitoring. The physician can also send prescriptions to the patient’s pharmacy of choice, which would then arrange a convenient delivery or pickup time for the patient.
Telemedicine services range from practice to practice, but it can generally be applied to nearly any medical field. Pediatrics, psychiatry, and radiology were some of the early adopters of telehealth. General practitioners, internists, and neurologists also commonly use telecare. It can be a tool for many doctors. For example, while a surgeon may not be able to perform surgery via telecommunication, they can provide pre- and postoperative consultations through telecare.3
The Benefits of Telemedicine
Telemedicine offers a wide range of benefits to patients and physicians alike.
Accessibility to Care
Perhaps the greatest advantage of virtual care as a whole is that it provides accessibility to care that a patient may not otherwise have. This is particularly beneficial in small, rural areas and other underserved communities where patients may otherwise have to travel long distances even though they aren’t in a rural area in order to receive more specialized care. This also benefits those with physical or mental health disabilities or chronic disease that may prevent them from leaving the house for frequent doctor visits.4
Not only is connected health effective for those who live in rural communities, but telemedicine also offers greater accessibility to those who may not always have time during the day to go to their doctors’ offices. At the same time, doctors can set more flexible hours for increased patient satisfaction. They can see patients from home or while traveling.
Related to accessibility, American telemedicine is cost-effective and affordable for both patients and doctors as it often has the same insurance reimbursement rate as an in person visit. Patients do not have to pay for the travel involved or take time off from work. Doctors, similarly, do not have to travel to the patient’s location, which may be costly for subspecialists, who often have to travel to multiple sites that may be remote or inaccessible to provide their services.3
The larger potential savings of a widescale online healthcare movement still require further study and trials, and current telehealth costs vary based on the services offered. However, in the long term, telemedicine could dramatically shift the health care landscape, particularly in terms of redistributing hospital resources to primary care and ultimately into patients’ homes. That could potentially result in a dramatic drop in healthcare costs.4
Safer and Healthier
As of this writing, the COVID-19 pandemic is still underway. With urgent care, emergency rooms, and hospitals already at capacity, telemedicine can provide a safe and convenient alternative or supplement to in-person care that allows patients to practice safe social distancing. Even outside of a global pandemic, using telemedicine ensures that a patient does not accidentally get doctors or hospital patrons sick while also ensuring that the patient does not pick up a secondary illness from the waiting room.
Greater Quality of Service
Telemedicine solutions are all about communication, and the more avenues of convenient communication that physicians and patients have access to, the greater the quality of service. Virtual care allows for easier follow-up care to ensure the patient’s wellbeing and improve care outside of in-person visits.3
Telemedicine also helps doctors reinforce treatment adherence. While no patient needs to be babied, frequent check-ins allow doctors to provide management for medication, lifestyle coaching, and any potential adjustments based on treatment results.3
Telemedicine is evolving and becoming an important tool for many physicians and health care providers. From emergencies to follow-ups, this emerging care option is highly flexible and convenient, and it may be adapted to suit practices within almost any medical field.