In recent years, telemedicine has emerged as a force in healthcare that’s promising to change the ways medical services are delivered and accessed nowadays. Innovations in telemedicine can impact the healthcare field to shift in a different direction that’ll follow the technological developments and promote health equity in all populations.
How telemedicine works
Telemedicine generally includes three types of applications, including live interactive video calls; store-and-forward transmission of medical images and/or information such as patient’s treatment history, diagrams of treatment dynamics, and previous prescriptions; and remote patient monitoring (Marcin et al. 2015). By using telemedicine, we are allowed to use remote monitoring devices to track patients’ vital signs such as heart rate, blood pressure, and blood sugar level. A famous example of telemedicine occurred in 1999 when Jerri Nielson, who was a physician at the time, found a lump in her breast, the diagnosis and treatment of her breast cancer was done over distance by satellite connection and the video equipment and chemotherapy dropped by US Air Force pilots (Waller and Stotler 2018). When distance becomes a problem, telemedicine is the most efficient way to get the patient's help immediately.
Fig 1. Treatment procedure through telemedicine culture. Haleem et al. 2021
So how is the treatment workflow process being used in telemedicine care? The workflow of telemedicine is shown in Figure 1. Telehealth support will start with the patient’s entry or detailed information, further followed by the telehealth supportive care unit; this step is then followed by the setting up of the doctoral assistant to the patient and then after the diagnosis and appropriate treatment offered to the person under utmost care (Haleem et al. 2021). The process of telemedicine can be confusing but it’s important to know in order to deliver efficient and effective healthcare remotely. The process starts with scheduling an appointment and registering by providing medical history, insurance details, and other relevant information. Then, on the day of the appointment, patients log into the telemedicine platform and wait for the arrival of the healthcare providers to start the consultation. The consultation usually happens via video conferencing, audio calls, or messaging platforms, and this is when the healthcare providers will discuss the symptoms, medical history, and current health concerns. Healthcare providers will then discuss potential diagnoses, treatment options, medications, and lifestyle recommendations. If needed, healthcare providers will send prescriptions electronically to the patient’s pharmacy and make referrals to specialists. Lastly, after the consultation, the healthcare provider will update all the records and notes and instructions for follow-up care, to make sure the patient understands it.
The advantages and disadvantages of telemedicine
The adoption of telemedicine has gained a lot of attention and interest from the general public over its efficacy compared to traditional in-person care. A major argument is that compared to traditional in-person care, how can we trust the adoption of telemedicine to work without the personal touch and physical examination that are provided in face-to-face visits? It is important to recognize that critical diagnostic information may not be fully captured through a video call, and there are potential misdiagnoses from being unable to perform hands-on assessment. However, it is possible that telemedicine consultations can achieve comparable clinical outcomes to traditional care. Studies have concluded that telemedicine works and has positive effects in multiple areas including online psychological intervention programs for chronic heart failure that include remote monitoring; home telemonitoring of respiratory conditions; wed and computer-based smoking tracking programming; telehealth approaches to prevent coronary heart disease; telepsychiatry; internet and computer-based cognitive behavioral therapy for anxiety; and home telehealth for diabetes, heart disease and chronic pulmonary disease (Ekeland et al. 2010). Despite the inabilities of personal touch and physical examination that are provided in face-to-face visits, telemedicine is trustworthy and it proves to be effective in multiple medical fields.
The future of medical care is concerned with improving the organization and providing health services to health professionals, including medical ability to increase public access to medical professionals, reduce patient expectations, increase the quality of the referral system, and improve communication between service providers and patients (Hadian et al. 2024). This can be accomplished with the innovations of telemedicine. First, telemedicine represents a solution that delivers healthcare services and medical care; second, telemedicine is related to the aim of bridging the “distance between enabling technologies; and third, telemedicine produces some benefits mainly concerning the possibility of bringing medical care to patients when it is not possible for the patients to access medical providers directly (Cannavacciuolo et al. 2022). Moreover, there are several specific benefits of telemedicine such as it reduces hospitalization stay and rehospitalization rates, prevents patients and healthcare professionals from unnecessary travels, provides faster and better-oriented care, improves access to healthcare services for people living in rural and underserved areas, and it enhances medical follow-up (Khodadad-Saryazdi 2021).
However, even though the innovations in telemedicine will benefit the population in many ways, it’s still not part of the healthcare system due to a few challenges. Disparities in internet access are a major barrier to adopting telemedicine, especially in rural and socioeconomically disadvantaged communities. On top of that, even though telemedicine is considered to be cost-friendly, if telemedicine is not a good substitute for in-person care and telemedicine visits do not eliminate the need for in-person visits, then healthcare spending may increase with telemedicine use (Liu et al. 2021). Another problem is that telemedicine is not well-known among the population. It has 6 items that measure knowledge related to telemedicine in Figure 2, and according to the statistics, there was no statistically significant association seen with age, gender, designation, and specialty, 48% had ‘good’, 16% ‘fair’, and 35% ‘poor’ knowledge regarding telemedicine, that comes to about 60% of study population are aware of telemedicine (Adnan et al. 2021).
Fig 2. Knowledge regarding telemedicine and its relationship with sociodemographic characteristics. Adnan et al. 2021.
How to improve telemedicine
Innovations in telemedicine are facing many obstacles, but there are few strategies developed that can improve the situation. In some cases, when telemedicine visits do not eliminate the need for in-person visits, the price typically will be higher. However, in general, telemedicine saves patients from the inconvenience and personal cost of travel and time away from home. There are also many telemedicine services that provide free medical advice to doctors such as the Swinfen Charitable Trust (SCT) program. The SCT provides a digital camera for X-rays and clinical photographs and then sends it to an appropriate specialist. This not only saves the patients’ time from searching for a reliable specialist but also benefits the clinicians with educational and training gains (Smith 2007). In terms of internet access, researchers concluded that access to broadband internet was associated with utilization of telemedicine especially in rural and underserved areas (Quinton et al. 2021). Residents living in rural and underserved areas are experiencing disparities due to access to the internet. It's important for policymakers to help build networks and encourage the residents to get access to the internet as it’ll be more financially friendly. Moreover, it’s critical to spread awareness of telemedicine in order to help more people get access to cost-friendly healthcare services, and increasing knowledge of telemedicine will enable patients to use it wisely and safely (Hawa et al. 2023).
Conclusion
In conclusion, there’s still a long way to go to fully integrate telemedicine into the healthcare field, but it’s important to spread awareness as telemedicine can enhance healthcare delivery, reduce costs, and improve patient outcomes, especially for underserved populations. By acknowledging innovations in telemedicine and addressing the challenges it's facing, it’s possible to build a more inclusive and effective healthcare system that meets the needs of individuals and communities worldwide. And telemedicine will be the future of the health system to achieve health equity among all.
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