Telehealth — innovative care delivery services that connect patients to health professionals using videoconferencing, texting, streaming, and other wireless communication — was born of the need for accessible, affordable health care.
Recently, telehealth saw a surge during the global pandemic. Providers and patients searched for innovative ways to deliver and access health services while minimizing exposure to COVID-19.
Today, telehealth is bigger than ever. Health professionals and patients may want to explore what the post-pandemic future of telehealth looks like. Although some service providers and patients are eager to return to in-person visits, others predict that telehealth, with its flexibility and convenience, is here to stay.
While telemedicine refers to a narrower range of clinical services, telehealth refers to a broad scope of remote healthcare services. These include:
- Remote primary care
- Mental health services
- Nonclinical services (e.g., provider training and continuing medical education)
More specifically, the Health Resources Services Administration defines telehealth as “the use of electronic information and telecommunications technologies to support long-distance clinical health care, patient and professional health-related education, public health and health administration.”
Telehealth encompasses a wide range of services on many different telehealth platforms. Patients may seek mental health support via app-hosted secure text messages with a counselor, videoconference with a primary care physician about emerging physical symptoms, or attend a Zoom meeting about local public health initiatives.
Telehealth offers patients many ways to connect with health professionals.
Synchronous communication allows patients and providers to communicate in real time via telephone or live audio and video. Synchronous communication can take place over a computer, smartphone, or tablet.
In some cases, an in-person healthcare provider may take vital signs from a patient or perform tests (e.g., ultrasounds). The provider then uses telehealth technologies to communicate such information synchronously to a remote member of a healthcare team (e.g., a doctor, nurse, or medical assistant).
Asynchronous communication involves “store and forward” technology that enables patients and providers to collect data (e.g., notes, images, and metrics) now, as well as respond to and interpret it in the future. Many patient portals and apps ease asynchronous communication through encrypted, secure messages.
Remote patient monitoring enables healthcare providers to monitor a patient’s clinical measurements (e.g., insulin levels for diabetes monitoring) from a distance. It can be synchronous (live) or asynchronous.
Telehealth technologies are transforming how patients seek and receive treatment and care. Today, patients can talk with care providers in real time, get answers to their questions, receive prescriptions, send photos and messages through encrypted chat portals, and keep track of medical records wirelessly through cloud sharing programs — all without ever entering a brick-and-mortar health facility.
During a pandemic, telehealth services foster public health by allowing patients to receive care while following social distancing guidelines. These services present a safer option for primary care providers because they may be effective at minimizing potential exposure to COVID-19.
Additionally, telehealth can alleviate the burden of patient demand on healthcare facilities. This reduces the need for healthcare workers to use personal protective equipment (PPE). In this way, telehealth has helped healthcare systems deliver care while minimizing risk.
Beyond the context of a pandemic, telehealth offers many potential uses that are here to stay. Telehealth can:
- Help maintain continuity of care by providing access to preventive and routine care
- Increase access for patients with mobility challenges (e.g., elderly patients) and patients who may live far away from traditional service sites (e.g., rural patients)
- Connect patients with service providers faster, in many cases, than traditional services
- Offer coaching and support for patients managing chronic conditions, including nutrition counseling and weight management
- Allow healthcare providers to follow up with patients (e.g., recently hospitalized patients)
- Allow care teams (including the patient and their team of healthcare providers) to monitor clinical measurements (e.g., blood pressure or blood glucose levels)
- Deliver ongoing training for healthcare providers through peer-to-peer professional consultations
Moreover, patients may find that keeping track of their own medical records and measurements is easier through the use of telehealth services. For example, a person with a family history of heart disease may use wearable technologies (e.g., a smartwatch with a built-in pedometer and heart rate monitor) to track their daily exercise and blood pressure, saving their data in a health monitoring app to share with their doctor.
In many ways, telehealth promotes patients’ autonomy and access to vital healthcare resources. Similarly, telehealth technologies help providers reach vulnerable communities, including patients in rural areas.
The future of telehealth is vast. With so many apps and software programs to choose from, patients and providers have more ways to connect than ever before.
Telehealth platforms run the gamut, from full telehealth software suites to modest apps. The following three examples are among the many telehealth possibilities likely to expand in the coming years:
These software suites integrate multiple technologies simultaneously to connect patients with providers. For example, Mend sends SMS appointment reminders (via texts), offers online forms, facilitates patient scheduling, and enables voice and video calling.
These apps run on an internet browser (e.g., Chrome or Firefox) and enable HIPAA compliant communication between patients and providers. As an example, Doxy.me allows for free, secure, and unlimited messaging and video communication, in addition to offering paid services with additional security and encryption. People use it for telehealth mental health counseling sessions, among other secure communications.
This type of software coordinates data from FDA-approved medical devices. Through this technology, providers can remotely operate wireless scales, blood pressure monitors, pulse oximeters, glucometer adapters, and other Bluetooth-enabled devices. AMC health, for example, uses tracking and Bluetooth connectivity to enable remote devices to send biometric data, which patients and providers can then read and analyze.
Although telehealth is here to stay, telehealth programs need to address the potential limitations of telehealth to deliver the best health outcomes for patients.
Presently, telehealth programs need to consider the following challenges:
- The level of comfort with technology varies among patients and healthcare providers. Some people will always prefer in-person consultations.
- Limited access to technological devices required for telehealth communications may prevent some patients and providers from connecting. For example, patients with internet connectivity issues may not be able to routinely access mental health teleconferencing calls. The technological divide among vulnerable populations, including lower-income and homeless or displaced patients, may also prevent some from accessing telehealth care.
- Confidentiality is crucial for any communication between a patient and a healthcare provider. Some patients may have concerns for privacy and worries about addressing sensitive topics over telecommunication.
- The regulation of telehealth services varies by state. This poses a logistical and financial challenge for telehealth apps and software programs seeking interstate licensure.
Telehealth has limits: Some medical situations require in-person visits, especially if the need is urgent. Surgeries clearly cannot take place over telehealth platforms (at least not yet).
Telehealth’s future, then, requires providers and health professionals to keep pushing for technologies that ensure confidential, HIPAA-protected communication. In addition, activists and proponents of telehealth may need to advocate for funding and policies that allow vulnerable groups to access telehealth services (e.g., expanding internet networks in rural areas).
Telehealth is here to stay. Healthcare professionals, including administrators, continue to explore how to adopt new technologies in ways that improve access and equity.
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