How going remote can actually make Health more accessible

Introduction

Telemedicine, has become a new normal since COVID confined us to our home. It is an evolving strategy that is changing the way the world operates today. It is patient centric and concentrates on health rather than illness. It is a tool for patients to communicate with their physicians, care givers; manage their health, and enable specialists to intervene real time through quick diagnosis.

  • According to the National Center for Policy Analysis, up to 70 million patients use telehealth services as of today
  • A Forbes report mentions that shortage of doctors will rise to anywhere between 46,000 and 90,000 by 2025 in the US leading to higher dependency on virtual care
  • The global telehealth market was valued at $8 billion in 2019. The industry is expected to grow to a mammoth $25 billion by 2025.

After reading these reports, I decided to write a blog to discuss various applications and opportunities of telemedicine for both patients and providers. Also, this blog will highlight the challenges associated with implementing telemedicine and some of my recommendations to overcome these hurdles.

Let us start with the most obvious question- Why Telemedicine?

The need for Telemedicine

Healthcare costs are about 18% of the US Gross Domestic Product (GDP). With WHO guidelines to stay at home during the pandemic, telehealth applications have become the fastest and most reliable way for patients to receive care. Virtual visits to physicians have become a necessity, 90% of providers believe that telehealth is useful as it provides increased access to healthcare and faster communication. For patients, telehealth provides a way to receive quick, urgent care, and cut down on wait times at the doctor’s office.

Industry experts and studies continue to point toward telemedicine as a means to:

  • Optimize population health by making changes in patient behavior and reducing costs
  • Bridge the communication gap between patient and provider through virtual health
  • Increase Patient Engagement
  • Reduce hospital admissions
  • Reduce Insurance claims

Telemedicine is required to:

  1. Provide patients with easy and remote virtual access to care
  2. Enable patients to share documents easily during virtual meeting with the care provider /physician
  3. Improve health outcomes by monitoring patients frequently and continuously
  4. Reduce costs of healthcare delivery to sustainable levels
  5. Help alleviate the physician shortage (by increasing the physician utilization rate)

Telemedicine is not a new concept. In fact, it has its origins traced back to the early 20th century where healthcare was provided by remote Information and Communication Technology (ICT). But technological (transferring video, audio or images) and financial shortfalls then did not allow it to go into full bloom. Though a century has gone by, Telemedicine is still in its nascent stage and it seems to encounter quite a few challenges on the way:

  •  Legality, Privacy, and Security Concerns
  •  Difficulty integrating with an existing system
  •  Rising cost of healthcare
  •  Inability to be interoperable

I will talk about how you as a Healthcare provider can enhance patient care by tiding over all of these challenges in my last section. But let’s talk now about Stanley Kubrick vs Steven Spielberg! (Tch… of course the former. Just kidding, let’s talk about why Telemedicine and Telehealth, may seem, but are not the same thing.)

Telemedicine v/s Telehealth

In the healthcare industry, the terms “telehealth” and “telemedicine” are often used interchangeably. In fact, even the ATA (American Telemedicine Association) considers them to be interchangeable terms. I won’t be too surprised by this, because both Telemedicine and Telehealth have eerily similar definitions. A lot of services overlap, viz. e-health patient monitoring, medical education, video conferencing for patient consultation, health wireless applications, sending medical reports in the form of images etc.

Telemedicine is a subset of Telehealth. Telehealth as a blanket term includes all health services provided through telecommunications technology, while telemedicine sticks specifically to clinical services.

telehealth
 

telemedicine
 

To put it more simply, Telemedicine is like having the direct line to your physician or care provider so you can text, video call or chat with them about your condition and they in turn can care for you, monitor you, and send you your reports.

On a side note, the CMS (Centers for Medicare & Medicaid Services) has identified CPT (Current Procedural Terminology) codes for Telehealth and Telemedicine to ease the reimbursement process for providers. There are Incentives for Telehealth and Telemedicine under the CPC+ (Comprehensive Primary Care) program.

As a technology, telemedicine can offer a variety of enhancements in telecommunicating with a physician or a care provider. So here are some requirements for telemedicine to be successful.

 


Some more requirements to give you the whole picture:

Technology Implementation Security
Solution should cut across web,mobile and hybrid platforms Using web socket technology seamless peer-to-peer communication AES 256 encryption for file sharing and for chat as per HIPAA compliance
API’s, web services and components for fast paced development saving cost and time Cross browser or browser independent solution Best security practices to avoid data breaches and PHI protection

In my next section, I thought it would be a good idea if I grazed the current scene in telemedicine, instead of delving deep, because a chart as I will add, can say a thousand words.

Current Telemedicine Technology

Video based consultations have been on the rise. Live video conferencing using hybrid platforms, transmitting static images and videos received from diagnostic equipment to patients, and remote monitoring, these are perhaps more used now than they were a few years back.

Smartphones jumped onto the Telemedicine bandwagon much sooner than we could have ever anticipated. Research shows that about 30% of people already use mobiles to check their diagnostic information. So, mHealth apps provide real-time inspection and patients can even chat about their symptoms with their physicians.

I did briefly state this example when talking about Telehealth, but wearable devices are where the lines blur between Telehealth and Telemedicine. These have taken monitoring of patients to the next level. They monitor and capture vital parameters continuously and relay statistics to the patient’s smartphone via Bluetooth.

I remember when a friend told me about how he received timely treatment because his device alerted him of a probable heart attack, even now thinking of it makes my stomach churn in such a way that it may probably be apologizing to the other organs in there. That is perhaps the power of technology (I meant the wearable device alert, if you were lost because of what followed).

Getting back, the table below shows what kinds of technology can be used during remote treatments. A COVID 19 barometer study by Sermo, found that 63% Healthcare practices in the US used these technologies during the COVID 19 outbreak.

remote activities of tools
Conclusion

Any telemedicine solution should be able to break through the challenges I mentioned earlier in this blog. It should possess a video and audio conferencing capability having the right encryption and security in place as per HIPAA guidelines. It should be capable of sending and receiving images while complying with healthcare standards. Such a solution should easily integrate with your existing EHR or PMS system so that a provider can refer to patient’s medical record.

Technically speaking, a solution should have an AES264 encryption for security with STUN, TURN communication, and FIPS server, and it should be able to integrate with any system via API, things I have already mentioned above.

With advancement in technology and us inching towards Industry 5.0, Telemedicine has the capability to be a robust technology, taking Healthcare IT to a new level. So, Telemedicine, I think, may well be on its way to be the evolution of healthcare.

P.S: You can write to us if you would like to know about how adopting a more specific approach to Telemedicine will help you enhance patient care or if you would like to know about the services we have to offer.

About Ravi Agrawal

Senior Lead Business Analyst

  • Healthcare
  • FHIR
  • Blockchain
A self-confessed healthcare warrior, an expert in Medicare, Medicaid, ACO, and Integration projects, Ravi speaks HL7 as a language. A doctor, doubling up as a Healthcare consultant, he is always a ‘patient’ person (pun intended) with a business mind. He says that technology never ceases to amaze him, and he is a student forever.