Telemedicine has been around for many years but it did not come to the fore until the COVID-19 pandemic, when the need to minimize exposure to infected individuals and manage the impact of patient demand on hospitals drove doctors to shift from face-to-face check-ups to online consultations.
Telemedicine or telehealth is the remote diagnosis of patients through the use of telecommunication and information technologies, ranging from online messages to video calls. It is meant to eliminate distance barriers and improve access to medical services for rural communities that may be difficult to reach.
In the UK, before the pandemic, 80% of general practitioner appointments were carried out in person, but during the height of COVID-19, this fell to 7% to 8%. To lessen the spread of the coronavirus, in April 2020 the UK’s National Health Service advised telemedicine as a short-term measure, later formalizing into its annual operational planning guidance in April 2021.
The NHS guidance requires family general practitioners (GPs) to set up a “total triage,” in which patients needing in-person consults must have an initial discussion online or by phone. The idea is that the majority of cases can be dealt with online, but the more urgent ones may require face-to-face consultations.
As with any new process, the NHS foray into telemedicine is not without its troubles. In recent weeks, British media has reported about patients having difficulties in getting GP appointments and the NHS being accused of putting up barriers to access treatment or consultations. One case especially caught the nation’s attention—that of Joy Stokes, 69, who succumbed to cancer after being refused an appointment many times.
UK: Slowly embracing technology
The usual mode of communication in telehealth is Zoom, Facetime, or Messenger, although a number of GPs have started using more advanced video consultation technologies such as AccuRX, which has been used in almost 400,000 consultations since its launch, or roughly more than 35,000 times a day. Patients who have used AccuRX found its video quality “better than Zoom” and called it “seamless.”
Another up-and-coming platform is eConsult, an online health system that has access to patients’ health records, enabling doctors to make better healthcare recommendations. Pre-pandemic, eConsult was handling only 300 consultations a month, which has since jumped to 12,000 per day, or 360,000 per month.
US: Keeping up with telemedicine
In America, telehealth has had a “meteoric” rise, with the switch from in-person to online consultations happening practically overnight.
In addition to video conferencing and online messaging, virtual care has been made even more efficient through sophisticated medical devices and wearables that capture biometric data, such as blood pressure monitors, blood glucose meters, heart rate monitors, connected scales, prescription compliance devices, pulse oximeters, sleep trackers, thermometers, and spirometers that measure breathing. These devices are able to provide the GP a more holistic view of a patient’s health information, rather than point-in-time data that is measured during a physical visit.
A number of health institutions have moved quickly to incorporate telehealth into their practice. UC Health in Aurora, Colorado, now has a Virtual Health Center with doctors, nurses, and technicians monitoring patients 24 hours a day, seven days a week, and specialists are able to seek help from emergency physicians via video calls in specific patient emergencies such as stroke.
Ready or not, here it comes
There’s been a few success stories in telemedicine, one of them in mental healthcare.
Pre-pandemic, a psychiatric patient might spend 24 to 36 hours in an emergency room waiting for a psychiatrist, with telemedicine, telehealth consulting can be offered directly to patients in their homes or via a special room, similar to how NY-based Northwell Health has set up: “We have a special room where patients go, and a facilitator makes sure the patient is safe. We make sure the equipment is ready to go, and we can pull in our psychiatrists at any time of day to have a behavioral health intervention,” says Iris Berman, RN and vice president for Northwell.
Granted, there’s much to improve in telemedicine. Privacy and security are huge concerns, and there’s much to be done to ensure that underserved communities have access to telemedicine. But we’ve also seen some changes happening overnight. In the US, regulatory policies have loosened up a bit to allow practitioners to continue providing virtual care. HIPAA has stringent rules on the use of video conferencing apps, but the Office of Civil Rights (OCR) has stated that because of the current public health emergency, it will not use enforcement discretion against healthcare providers that use technologies such as Facetime, Zoom, or Skype, which are usually not compliant with HIPAA Security Rules.
There’s no question that telemedicine and telehealth will continue to grow in demand, even as the world slowly picks up from the pandemic. The question is, will we run with it, or will we resume with our old ways?
Looking to set up your telemedicine operations? Wingspan has solid experience in business process outsourcing and can help smooth out the process for you.
Photo by anna maria lopez lopez from FreeImages