Written by: Dr. Shama Nosheen Edited by: Dr. Christopher Cirino
Information Technology has brought the world at the distance of the tips of your fingers. It’s mindboggling to imagine that, three decades since its invention, 84% of the world’s population now owns a smartphone. We have been searching for our symptoms on Google since it existed, and everyone knows that the Internet is not the ideal way to get your diagnosis, but today, advanced technology has made it possible through telemedicine.
What is Telemedicine?
Telemedicine or e-medicine is the remote delivery of clinical and healthcare services through information and communication technologies, bridging the physical gap between doctors and patients. Telemedicine communicates someone to a physician through technology like video calls, messages, phone calls, and emails.
Virtual appointments have replaced one-seventh (14%) of the outpatient visits to the doctor. Inpatient care even utilizes telemedicine, where it is 13 to 17% prevalent. It is currently 1/4th of the trillion-dollar industry and still expanding. Advanced research shows that, in 2019, the market value of telemedicine was 50 billion dollars, and it is forecast to hit 450 billion dollars by 2023.
The COVID-19 pandemic was a catalyst for the growth and acceptance of telemedicine. While cases surged, so did telemedicine utilization, with a 20-fold increase since the outset of the pandemic compared to the prior year. On the other hand, there was a drop in office-based encounters by 50% during the same period (Cantor, 2021). While clinics were closed for social distancing measures, access to medical care continued through telehealth.
Telemedicine Advantages and Disadvantages
|Convenient and Sustainable||Malpractice Concerns|
|Location Independent||Misdiagnosis, Under/OverPrescribing|
|Cost-Effective||Loss of Examination and Touch|
|Promotes Patient-Centered Care||Accessibility Gap|
The Advantages of Telemedicine
Convenient and Sustainable
Health has always been about convenience. A smartphone and a good internet connection can ensure accessibility to a doctor from any area of the world. Telemedicine has also eradicated the inconvenience of waste of time and anxiety in going to a doctor, waiting for your appointment, and in the end, possibly getting referred to a specialist to repeat the process.
These virtual visits make your physician accessible whenever and wherever needed. It’s also convenient for doctors to follow up and monitor patients from time to time, a mutual benefit for both the health care provider and the patient. It also helps improve the quality of care because patients can easily reach out at an earlier stage of disease by reporting symptoms as early as possible.
In this fast-paced world, telemedicine is a quick and reliable fix, not only for urban communities but also for the rural and remote communities where general, as well as special care, is inaccessible, leading to delays in treatment. Telemedicine is a proven life savior in such cases.
Health-equity gaps exist within the United States and in rural areas around the world. People living in more rural or impoverished communities often do not have access to the same quality of care as those living in more affluent areas. Ignoring communities residing in remote areas can create serious health issues and emergencies like rising index of chronic diseases, neonatal and maternal deaths, and the spread of infectious diseases.
Remote care and diagnosis via telemedicine benefit both the patient and healthcare by reducing the distance, expenses, time, and stress. It helps mitigate the overall burden on the health care system and morbidity and mortality rates of a country. In one study, a virtual urgent care program improved healthcare access in a rural underserved population in North Carolina.
In the era of globalization, digitalizing health care helps us transcend the physical barrier to well-deserved care and opens the opportunity for practitioners to offer their expertise across borders, lands, and oceans. Telemedicine may be a game-changer for developing countries as well. Health professionals from those countries can provide their services across the world and earn another stream of income.
Closely linked with the cost of telemedicine is its cost-effectiveness. It reduces the long-term costs of treating disease before it worsens into a serious health issue. Consequently, it decreases the burden on the healthcare system by decreasing hospital and emergency room administration and deaths. It is also clinically effective in most situations and helps isolate the sick from the healthy to decrease risk of infections.
There are always technical aspects of establishing a telehealth practice. The cost is high, and it requires technical support and resources. Lack of these resources is a considerable barrier. Some practitioners also lack the technological literacy to use it effectively. There are always cultural and social differences between the patients and health care practitioners, which are also considered drawbacks of telemedicine.
Telemedicine has received significant patient satisfaction in surveys. It is patient-centered care by actively engaging patients and accessing their environment for potential cues into their diagnosis. Iwhich is completely lacking in in-person visits. During face-to-face communication through electronic media, a doctor can focus on a single patient, without any interruption caused by other patients as commonly seen in clinics.
Drawbacks of Telemedicine
Loss of Physical Examination Opportunity
Although, in hectic schedules and demanding lifestyles, Telemedicine is our savior, one of the barriers in the growth of this industry is its unconventional approach. One may prefer the old and traditional method of seeing a doctor because it has been effective for them for so long. Telemedicine lacks the human touch and the human connection due to its virtual nature. It’s hard for patients sometimes to communicate their emotions and concerns through a touch screen and internet connection.
Since there has been a global expansion of Telemedicine, rules, and regulations must apply to protect the system and the patient. The confidentiality and security of patient data must be implemented, unlike the social enterprises like Facebook and WhatsApp, accessing data of users.
This remote health care solemnly relies on self-assessment and self-evaluation of patients. So, the doctors need to put an extra effort in obtaining a thorough history to reduce errors in diagnosis and missing out on something that would have been quite evident in an in-person visit. So, there is a chance of malpractice both due to human and technological error.
Within the United States, one of the greatest claims for malpractice relate to a physician practicing across state lines and overreaching their licensing and prescribing. The lack of a physical exam limits a sufficient diagnosis in some cases, particularly when it involves medications.
Risk of Missed or Failed diagnosis, Underprescribing, or Overprescribing
Certain clinical methods are necessary to make a diagnosis, which can’t be performed through a screen. This drawback can lead to misdiagnosis. A doctor cannot perform a physical examination and may not perceive the physical status of a patient accurately. For example, they cannot listen to a patients lungs or heart sounds. These limitations lead to ineffective prescribing, underprescribing, or overprescribing.
Limited Technology Still a Gap
Telemedicine is not equally accessible to all. Instead of a location issue or transportation limitation, people may have limited access to adequate technology or not be tech-savvy. Patients over 65 were less likely to choose telemedicine compared to a younger population (18-44); those with better access to technology were more likely to use video visits than patients with less access.
There were also technology glitches reported during the visits, occurring in one-third of patients in one study, most commonly audio issues (26%).
Expansion and Future of Telemedicine
Although Telemedicine isn’t a cure-all and a lot of health care has this intangible aspect of physically being there, there has been an ongoing increase in the scope of telemedicine since the pandemic hit us with social distances measure. The hidden potential of these virtual services has now been realized in many fields like ICUs, the management of chronic diseases and psychiatriccare, and speech, cognitive and physical therapies. Now, preventative and post-surgery care can be effectively administered via telemedicine.
Clearly, a line needs to be drawn between the the benefits of telemedicine and the risk of losing the advantages of direct, face-to-face care for certain visits. Telemedicine has proved to be a jaw-dropping solution to the world in desperate times of the global pandemic. The future holds the possibility of telemedine becoming the standard of care or even usurping traditional clinical healthcare methods, e.g. specialty services, in some areas.
Telemedicine offers an alternative to conventional methods, bridging the barrier between doctor and patient. Surprising results of telemedicine have increased its market value. Meanwhile, some problems and limitations of telemedicine need to be identified and resolved to make it more effective and beneficial. But if you look at its current efficiency and goals, it still delivers good results.
The mission of Tomorrowsdoc.com is to highlight the future of healthcare. If you found this informative, please share it with your friends and colleagues. Subscribe to the site. The writing centers on themes that are covered in an upcoming book publication: Becoming Tomorrow’s Doctor: A Guidebook on the Practice and Future of Medicine. Thanks for reading.
Cantor J, McBain R, et al. Who is (and isn’t) Receiving Telemedicine Care During the COVID-19 Pandemic. Am Journ Prev Med. 2021. doi: 10.1016/j/amepre.2021.01.030.
Gajarawal S, Pelkowski J. Telehealth Benefits ad Barriers. J Nurs Pract. 2021. 17(2): 218-221. doi: 10.1016/j.nurpra.2020.09.013.