What is Telehealth?

Telehealth is a growing topic in modern medicine, but it is still a new subject for many people. Today we'll look at what telehealth is, how it is used now, and how it could be used in the future.

What is Telehealth?

Telehealth refers to the use of telecommunications and virtual technology to provide healthcare to people who are not able to see a practitioner in person. It could involve everything from a patient having a phone call with a doctor to discuss their symptoms, to using technology like a step tracker to monitor patient health as they recover from an operation at home, to performing a surgery using a robotic interface. Typically, when people say telehealth, they are referring to video conferencing between patient and doctor via the internet, or to the remote monitoring by doctors of patient indicators such as blood pressure or heart rate.

A growing area of telehealth is virtual home healthcare, typically offered to older people or patients with chronic conditions. In these situations, the clients need some amount of monitoring and support but either do not need or do not want full-time care such as being in a hospital. With telehealth, the patient can have regular video meetings with a doctor – around once per week, for example – which can be a consultation, a check-in, or a status report. Such a virtual meeting would not be appropriate for an in-depth diagnosis, but once a diagnosis is known and the patient only needs to be monitored, they can stay comfortably at home and their doctor can care for them remotely.

The Benefits of Telehealth

One of the biggest benefits of a telehealth system is that it gives patients fast access to healthcare professionals without the patient having to leave their home. For patients with limited mobility, this is key as it improves both their safety and their comfort, not to mention reducing stress and the difficulty of coordinating travel and doctor's appointments. For patients who are frail or anxious and require assistance to leave their home, getting to a doctor's appointment can be a major hurdle so an in-home service is preferable.

It also helps to save patients money on travel or accommodation for when they must stay nearby to a hospital or doctor's office. And importantly, because the patient can stay at home rather than having to stay overnight in a hospital, it is easier for friends and family to visit them. This is important as social support is both of huge practical value – in terms of a family member who goes grocery shopping and cooks’ meals for an older patient, for example – and of significant psychological value – in terms of the patient feeling socially valued and integrated within a community.

The Challenges of Telehealth

Some of the challenges with telehealth are regarding the technology, and some are regarding the patient-clinician relationship. In terms of technology, many telehealth services require a broadband internet connection. Video calling requires a fast and reliable internet connection which not all patients have access to. Complicating this further is that patients will usually want to have privacy and quiet for their telehealth consolations, so it is not practical for the patient to use public internet at a cafe or library. The patient must have fast internet at home to benefit from many telehealth services.

In terms of relationship with the healthcare provider, telehealth can require some adjustments of expectations. A significant part of the healthcare process is providing an environment where the patient feels understood, listened to, and cared for. Just the presence and attention of a healthcare professional can help patients feel better. But this human connection is more difficult to achieve over a video call or through text messages. For this reason, where possible telehealth is better as a supporting feature of in-person healthcare rather than a replacement for it.

How Telehealth is used now

Currently, telehealth is most often used in rural areas where physicians need to be able to communicate with patients who may be many miles away and have limited transport options. These rural communities are often underserved by traditional healthcare options, especially if there is a large percentage of older people in the community.

Another common use of telehealth is monitoring patients who are recovering from an illness or injury. For example, patients with congestive heart issues may first see a doctor in person for diagnosis, treatment, and prescriptions, then have telehealth equipment to monitor them while they recover at home. Monitoring devices can be used to measure key indicators like blood pressure, which is combined with other information such as weight so doctors can monitor patients' progress from afar.

A growing use of telehealth is for consolations. When a patient visits a GP, they can be examined but the knowledge of a specialist may be required to assess specific issues. Traditionally, the patient would then be referred by the GP to the specialist and must make another visit. But telehealth offers an alternative: Consultants can receive information like written assessments, photos, or other imaging electronically from the GP and then make an assessment without the patient having to come to see them personally.

How Telehealth could be used in the future

In the future, we can expect for telehealth to become more commonly used and more widely accepted. A sub-category of telehealth that is particularly likely to grow is mHealth, or mobile health, in which care is given to patients via their smartphones. The promise of mHealth is especially important in countries where few people have fast internet access through a computer, but more people have a smartphone, such as is the case in many developing countries.

Another factor that will impact how telehealth affects healthcare in the US is how the services are charged by insurance companies. Currently, telehealth services are treated as reimbursable, meaning that people pay for the service and then claim back money from their insurance. But in future, telehealth services could be better integrated into healthcare systems as an overhead, meaning the patient would not have to pay up front.

Finally, telehealth offers an opportunity for international collaborations between healthcare professionals, who will be able to advise and consult with each other regardless of the physical distance between them.

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