Imagine this scenario: you have a stroke while camping in the middle of nowhere. You are taken by paramedics to the nearest ER, where you are told that there are no stroke neurologists around. But luckily, the ER has videoconferencing equipment connecting it to stroke neurologists based in larger hospitals in other cities. These stroke neurologists are then able to assess your neurological functioning and provide acute stroke treatments, all from a distance. In this way, telecommunication technology in healthcare or “telemedicine” could play a key role in saving the life of someone who needs immediate specialist care, but is too far away from specialist services to physically reach this critical care.

Telemedicine is playing a vital role in delivering long-term care to the global population. The advent of new forms of technology, such as computers, broadband internet, and videoconferencing equipment, has enabled physicians to provide care for their patients without needing to be in the same physical location. This new form of delivering healthcare has numerous benefits for many demographics of the global population.

Telemedicine results in the electronic transmission of information between a patient and healthcare provider. Examples of telemedicine include video consultations between the patient and their provider, monitoring patient data (e.g. heart rate, blood pressure, etc.) remotely, as well as providing information to the patient regarding management of their conditions.

Using telecommunication equipment to provide long-term care to patients has benefits for the patient as well as their healthcare provider.

Benefits to the patient:

• People living in rural areas, or other areas without access to specialist care services, are able to consult with their healthcare provider without needing to travel a long distance
• People living with chronic conditions, who need regular monitoring of their vital statistics (e.g. checking heart rate and blood pressure on a weekly basis) are able to send the information to their physician without needing to physically visit their physician
• Individuals who are homebound (e.g. confined to a bed or wheelchair) will not need to travel to see their physician, instead, they can have a caregiver monitor their condition and send updates to the physician on a timely basis. This is especially benefial for people recovering from the effects of stroke, a heart attack or serious car crash.
• Having access to laboratory test results online will reduce the need for patients to visit their physician to have access to their test results
• The increased level of collaboration leads to patient-empowerment, which results in more patient-centric care provision.

The benefits of telemedicine on an individual’s health have been documented in numerous studies. For example, Hui and colleagues found that telemedicine could be used to deliver care to 99% of geriatric cases. Furthermore, the study also found that follow-up care using teleconferencing is cheaper than face-to-face consultations in clinics and fewer admissions to acute admission wards for the patient involved. Hui also found that the majority of patients also accepted the use of telemedicine as an accepted method of continuity of care. The ability to receive chronic care from home also resulted in patients reporting an improved quality of life, as a result of reduced travel time and expenses.

Benefits to the healthcare provider:

• Shorter waiting times in a clinic due to fewer patients having to physically visit the site, leading to improved capacity to serve more patients
• Greater collaboration between healthcare providers can lead to cost-savings (for example, a hospital can rely on the services of specialists from different hospitals using telemedicine, without having to employ specialists at each of the hospital sites)
• Increased ability to regularly monitor a patient’s condition, enabling physicians to provide better quality care, tailored to the patient’s needs
• Patients can be release from hospital earlier, freeing up beds for other patients

Most of the research on the benefits of telemedicine has been centered on the patient. Further research is needed from the provider’s point of view (e.g. cost-benefit analysis for the provider) in order to encourage more of them to adapt to telemedicine strategies.

Although telemedicine provides opportunities to improve accessibility and quality of care for the general population, there are certain disadvantages. For example, some of the population may not be proficient at using computers and other forms of telecommunication equipment needed. In order to overcome this limitation, all patients who are expected to use teleconferencing equipment should be adequately educated on their functionality. Sarhan and colleagues found that using teleconferencing equipment instead of face-to-face consultations may be detrimental to the patient-physician relationship. This “de-personalization” of the consultation experience may result from poor interpersonal skills, language differences, and inability to appropriately explain jargon. It is important for physicians to remember that videoconferencing does not overrule the need for relationship-building with their patients, and they should take adequate steps to ensure this continues.

Furthermore, technical errors (e.g. the consultation breaking off midway due to internet disconnection) may also result in the inability to complete a consultation. Healthcare providers must ensure that they cater for these scenarios, and take appropriate steps to ensure that the consultation with the patient is completed to their satisfaction.

Telemedicine provides numerous opportunities to enhance healthcare delivery for the population. It gives patient’s greater access to healthcare provision, especially those living with chronic conditions, or in rural areas. It also offers a healthcare provider the capacity to deal with more patients, as a result of reduced waiting times in their clinics. However, both the patient and healthcare providers must take due care to overcome potential limitations which result from telemedicine. This includes education the general public on using teleconferencing equipment, ensuring relationship-building conversations between the physician and patient are kept in place, and technical errors as a result of hardware/software issues are dealt with appropriately. In attaining a situation where these limitations are minimised, telemedicine can help to improve accessibility and quality of care provided, thus improving overall population health.

References

Elford R, White H, Bowering R, Ghandi A, Maddiggan B, St John K, House M, Harnett J, West R, & Battcock A (2000). A randomized, controlled trial of child psychiatric assessments conducted using videoconferencing. Journal of telemedicine and telecare, 6 (2), 73-82 PMID: 10824374

Hui, E., Woo, J., Hjelm, M., Zhang, Y., & Tsui, H. (2001). Telemedicine: A Pilot Study in Nursing Home Residents Gerontology, 47 (2), 82-87 DOI: 10.1159/000052778

Image via megainarmy / Shutterstock.