Telemedicine: The evolution of telemedicine in healthcare accessibility

Concept and history of telemedicine

The emergence of telemedicine has revolutionized the way of delivering medical care to patients. This refers to the remote delivery of healthcare services through the usage of telecommunications technology. It emphasizes the variety of practices and technologies, which includes virtual consultations, mobile health applications and remote patient monitoring. This offers a more accessible, effective and flexible alternative to conventional healthcare delivery as it helps healthcare professionals to analyze, diagnose and provide medical services to patients without the requirement for an in-person visit. 

Though it became crucial and gained immense popularity in the landscape of healthcare during the time of the COVID-19 pandemic, the concept of telemedicine emerged in the early 20th century when there was the usage of radio to give medical advice to ships at sea. The reach and capabilities of telemedicine have considerably expanded with the advancement of technologies, including the telephone and further internet, over the decades. In the 1960s, telemedicine was used by NASA for monitoring the health of the astronauts in space, contributing to its further development. In the late 20th century, the emergence of video conferencing technology has further accelerated the growth of telemedicine, which makes it possible to enable real-time, face-to-face consultation.

In 2024, the number of users of online doctor consultations across the world has increased to 116 million in comparison to 57 million in 2019. The user numbers accessing virtual care are forecasted to further steadily rise in the coming years. Currently, around 76 per cent of the hospitals in the United States are found to be connecting with people at a distance by means of video conferencing or other technologies.

Various telemedicine programs

Synchronous programs

This refers to the live two-way interaction between the healthcare provider and patient, which is performed in real-time. In this procedure, online appointments are conducted through the usage of a patient’s mobile phone, computer or tablet with a camera. Patients are found to be downloading applications in their smartphone or table for connecting with a healthcare provider.

Asynchronous programs

This includes the store and forward applications, which do not take place in real-time. In this process, patients send videos, images or other clinical information to the healthcare provider, who evaluates and responds at a later time. Medical devices and health applications may be used by patients for monitoring and tracking personal health information that is forwarded to healthcare providers.

Advantages of telemedicine

The advantages of telemedicine are as following –

Convenience and comfort

With virtual healthcare, people get the accessibility to healthcare services from their homes, which leads to the offering of comfort and privacy. This minimizes the requirement for travelling a long distance, leaving important work or arranging for childcare. This reduces the waiting time and supports the individuals in the arrangement of their consultations with the doctors around their busy schedules.

Cost-effective

Virtual consultations are regarded as more affordable and cost-effective in comparison to in-person doctor visits or physical appointments with healthcare specialists. As per the findings of a 2020 review, around 56 per cent of health costs and 94 per cent of travel costs are reduced when doctors offer virtual healthcare services in the settings of paediatrics, intensive care unit (ICU) rooms, dermatology and radiology.

On the other side, physicians can offer virtual consultations where and when they want, which leads to the avoidance of the expenses of office rent and commuting. Additionally, with convenient scheduling and 24/7 online booking, physicians are able to enhance patient volumes by attracting more patients to get their medical services and decrease no-shows, which provides the opportunity to earn higher revenue.

Increased accessibility to care

Due to telehealth facilities, obtaining healthcare services has become more accessible and flexible, especially for people who live in rural areas. This assists the people to address the transport challenges which is one of the key reasons for the inaccessibility of effective healthcare in rural areas.

Prevents chronic diseases 

In accordance with a 2021 review, it has been found that telemedicine ensures the timely delivery of preventive care to patients suffering from cardiovascular diseases. This assists in the prevention of critical conditions and development of these diseases. 

Prevents the transmission of illness

With the usage of telehealth appointments and prescreening the patients virtually, the spread of infectious diseases like flu, COVID-19 and others can be controlled and prevented. Reduction in the in-person patient visits in the hospitals leads to less viral exposure for patients and less engagement of the medical staff with the patients which ultimately prevents the spread of germs and diseases.

Contextualized evaluation  

Virtual appointments allow healthcare experts like physical therapists and other occupational to observe the patients in their natural environment. This helps them to thoroughly assess the abilities of the persons through interacting with their real environment.

Potential issues associated with telemedicine

Maintaining data security and confidentiality of the patients is one of the critical ethical concerns in the offering of healthcare services through telecommunication technologies. Transmission and storage of personal and sensitive information of patients is involved in the offering of telehealth services, reflecting the requirement of robust security measures. In this regard, healthcare providers must ensure that they are using secure and HIPAA-compliant platforms for the protection of patient data from incidents of data breaches due to unauthorized access. Additionally, two factor authentication, encryption and regular audit of security protocols are important for safeguarding the valuable information of the patients.

Moreover, lack of technological infrastructure like high speed internet high quality cameras often restricts the obtaining of efficient telehealth services. Individuals must ensure that they have a stable internet connection before proceeding towards virtual appointments in order to avoid technological glitches.

 Additionally, regulatory complexities often become a major concern in providing telehealth services. The regulatory landscape for virtual health services differs considerably across various regions. For example, in the United States, telehealth is found to be governed at both the state and federal levels. While the guidelines for telehealth services are provided by the Centers for Medicare & Medicaid Services (CMS), the licensure and practice standards are supervised by the state medical boards. In India, the guidelines for telehealth services are regulated by the Ministry of Health and Family Welfare to ensure the standardization of care. Therefore, practitioners need to be more concerned and aware of the state’s regulations where they practise to avoid any kind of legal challenges.

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