Telemedicine - essence, history, challenges
Telemedicine is a remote provision of healthcare, such as health assessment or medical consultation on the use of telecommunications infrastructure. It allows healthcare professionals to evaluate, diagnose, and prescribe treatment to patients through widely available technology, such as: video-conferencing via laptop or smartphone without the need for a patient visit to the doctor's office.
Telemedicine is constantly becoming an increasingly important part of medical practice, given the drive to reduce the cost of medical care. It saves time for a patient who has the opportunity to discuss their health when it comes to a mild and non-emergency situation, instead of visiting a primary care specialist or emergency room. In recent years, there have already been legislative initiatives in many US states that facilitate the implementation of telemedicine and seek ways to reimburse this type of care in the same way as conventional care.
Types of telemedicine
Telemedicine can be classified into 3 core categories: remote patient monitoring, data recording and transmission, and interactive telemedicine.
Remote patient monitoring, also known as telemonitoring, enables the monitoring of the health status of patients with chronic illnesses in their homes with mobile medical devices that collect data on various vital signs, such as: blood sugar, blood pressure, heart rate, oxygen saturation, and others. These data can be monitored by the healthcare professionals employed in real time and specific action can be taken to the benefit of the patient as needed.
When recording and sending data, also known as asynchronous telemedicine, healthcare professionals can share information about patients such as, for example, telemedicine. laboratory results with a physician located in another location.
Interactive telemedicine enables real-time communication between doctor and doctor. Such telemedicine sessions may be conducted at the patient's home or at a nearby health care facility and include telephone consultation or the use of video conferencing software.
Examples of the use of telemedicine
For a patient in the home, typical telemedicine consultation includes the following:
1. The patient dials a special telephone number for telemedicine, which is usually served by:
- primary care physician
From a medical establishment with which the patient 's employer has a telemedicine contract, or
- from a telemedicine portal that can be found by searching the internet
- When making a call, depending on the particular situation and the evaluation of the consulting physician, the patient directly receives guidance about his condition from the on-call physician who serves the telemedicine line, is referred to a specialist, or is advised to visit a health care facility.
Payment for telemedicine services
There are different options for paying for telemedicine services. Some hospitals include the cost of this service in the fee for the administrative care of their patients or as part of subscription packages. In other cases, this price is borne by the employer. There are countries where this price is included in medical care, which is reimbursed by the state or health insurance funds. Some people choose to pay for the telemedicine consultation themselves.
Telemedicine and e-health
Telemedicine is a subdivision of eHealth, which includes both remote clinical healthcare and non-clinical healthcare elements. In practice, the two terms are often used interchangeably.
E-health includes a wider range of remote healthcare than telemedicine, and is not limited to clinical healthcare. It also includes: postgraduate qualifications of medical professionals, training of healthcare providers and conducting administrative meetings.
Unlike eHealth, telemedicine specifically refers to the exchange and use of medical information for the purpose of improving patient health. The definition of telemedicine also includes the use of electronic communication to provide clinical health care without the need for the patient to be in a doctor's office or hospital.
Technologies such as video conferencing and digital image sharing are perceived as both telemedicine and eHealth.
Innovations such as the use of artificial intelligence, blockchain technologies and smart talking devices (such as Alexa) are expected to increase the benefits and applications of telemedicine.
Advantages of telemedicine
Some of the benefits of telemedicine for patients are:
- Convenience. Patients do not need to be absent from work to be examined. There are no accompanying costs, such as: costs of gasoline or babysitting.
- Accessibility. Patients from small settlements may receive highly specialized care, such as: psychotherapeutic counseling or post-operative follow-up, which may not be available in their place of residence. Similarly, patients living in hard-to-reach places have access to primary care, dental and psychiatric counseling.
The benefits for medical professionals are
- Less unresponsive patients: Because they are more patient-friendly, telemedicine consultations reduce the number of hours canceled and patients who did not appear. In addition, the physician may contact the patient immediately prior to the consultation or at the appointment, in case the patient has forgotten.
- Motivating patients to lead healthier lifestyles: Telemedicine is especially effective in combating addictions, such as smoking, alcoholism, etc.
Disadvantages of telemedicine
Some of the challenges facing telemedicine include:
- Cybersecurity: Like any other technology that uses electronic data transmission, telemedicine is potentially at risk of hacking and security breaches.
- Prescribing Issues: Many states do not allow prescription drugs remotely without first having a live exam between the doctor and the patient.
- Technical training and equipment: Telemedicine service providers should be trained in how to use telemedicine equipment. The initial cost of telemedicine equipment can be a barrier, especially in rural areas.
History of telemedicine
The development of modern telemedicine begins with the invention of telecommunications infrastructure, such as telephone and telegraph. Initially, telemedicine was used for military purposes during the Civil War in the United States to order copper. supplies and for consulting a doctor.
The first transmission of an electronic health record was in 1948 d in Pennsylvania, when X-rays were sent at a distance of 40 km between two cities by telephone. A few years later, Canadian radiologists further developed this early technology and created a tele-radio system that caters to Montreal and its environs. During 1959, doctors at the University of Nebraska broadcast neurological examinations to students on campus using a two-way interactive television connection.
In the early years of telemedicine, doctors used technology to access patients living in hard-to-reach rural areas. However, technology is quickly beginning to reach urban areas, especially those with a shortage of specialists. During 1967, doctors at the University of Miami Medical School and the city's Fire Department transferred data from an ECG unit through the fire department's radio frequencies to Jackson Memorial Hospital.