From buying homes to shopping for vacations, consumers can do almost anything online or virtually these days. Almost any product or service is accessible with a click of a button. So, this may leave you wondering, why can’t healthcare be delivered virtually, too? Some think it can. Recently, with the advent of digital medicine, or telehealth, this is becoming more of a reality for patients everywhere, which is a concept worth exploring.

Telehealth has the potential to offer benefits to all parties involved in healthcare, including the patient, providers, and healthcare organizations. With the potential to reduce costs, increase access, and increase quality for patients, it’s practically the holy grail of healthcare! Thus, expanding telehealth services is a critical policy issue in healthcare. Ultimately, to understand telehealth better, it is important to explore it in-depth by discussing the relevant research in the area and identifying the barriers to its implementation.

In addition to telehealth, there is also a concept known as telemedicine, which is arguably a bit different. Telemedicine and the scope of the services it covers can be difficult to define. Principally, according to the Mayo Clinic, it is the offering of any health service at a distance using communication assistive technologies. Surprisingly, telemedicine is not the same concept as telehealth. Telehealth encompasses telemedicine and includes public health surveillance methods, non-clinical healthcare operation functions, and healthcare staff training. Telehealth, therefore, is more of an organizational parameter, and telemedicine is more of a patient-focused parameter.

To many, however, the differences between telehealth and telemedicine are negligible. What is more important is the impact they have on organizations and patient care.

Federal Medicaid and Medicare dollars remain the most prominent players in healthcare. Therefore, incorporating telehealth into Medicaid and Medicare systems is a necessary step to make telehealth a more available option for patients everywhere. Many states already have Medicaid Reimbursement policies set up for telehealth services, and, according to the World Health Organization, they have the opportunity to cover these services for patients.

State Medicaid programs can determine the variety of telehealth services covered, the reimbursement rate, and even what areas of the state can receive these services. According to the Center for Connected Health Policy, all states, except Massachusetts, have a reimbursement policy for telehealth services within their Medicaid programs and are currently expanding the use of such services. To gain a better grasp of what telehealth encompasses, it might help to evaluate its services, which include remote patient marketing, virtual appointments, and mobile health.  

Remote Patient Monitoring

Remote patient minoring is the most widespread use of telehealth services. According to NEJM Catalyst, it allows for healthcare organizations to collect data from outside of a clinic or hospital, which is often in a patient’s home. This enables providers to get the most accurate picture of a patient’s health and allows them to be in the best possible position to prevent chronic diseases, which represent a substantial financial burden for our healthcare system.

It also allows patients to receive care from home without having to go to a clinic as frequently. This gives patients more autonomy in their care. There are a variety of remote patient monitoring applications. These range from suffocated apparatuses, such as patient sensors, to mobile health applications and emergency assistance devices.

Virtual Appointments

Doctors utilizing Skype or Webex to connect with patients is becoming increasingly common, especially for initial consultations. This gives providers more flexibility in their hectic schedules and saves commuting time for patients. Healthcare organizations are also able to contract out providers more if they utilize virtual appointments for their patient loads.

Mobile health

According to the National Center for Biotechnology Information (NCBI), one of the most significant applications of telehealth is mobile health, which is commonly called mHealth, and the use of cellular devices to access healthcare. With mobile healthcare applications, patients can upload and access their healthcare records whenever they want. Moreover, they can use these applications to monitor their diet and exercise. Mobile health puts the patients at the center of their healthcare.

In the United States, NCBI reports, two-thirds of adults own a smartphone, and over 90 percent have a reliable cell phone. Wearable devices and mobile phones provide a means for healthcare organizations to collect real-time data on patients; this is a far superior way of getting patient health data and for providers to connect to patients than from traditional cross-sectional lab results during an office visit.

The ability for mHealth applications to deliver real-time data to providers and healthcare organizations is a critical aspect of an increase in the quality of care for patients. This makes telehealth very effective at preventing diseases so that trips to the hospitals or clinics are not necessary. It also makes telehealth the pivotal connection between personalized medicine and prevention. Undoubtedly, mHealth applications are critical for this connection.

Increasing Healthcare Quality

Delivering more healthcare quality requires delivering more value to patients, which is not an easy task. Some sources suggest, however, that through telehealth, patient care can be even more individualized by using enhanced communicative technologies that remove restrictions on when and where patients can receive treatment or diagnosis. Patients can even be monitored remotely, and they do not have to miss work to go to an appointment; they can even be treated while at work!

The flexibility of telehealth has many implications for healthcare organizations. Some studies have shown that this will greatly increase the likelihood that patients utilize health services, potentially providing more revenue for healthcare organizations that employ telehealth to treat patients. It also means less of an opportunity cost for consumers, potentially meaning they would be willing to allocate more of their budget for healthcare.

The patient’s time is valuable, and in many cases, it is worth more than money to them. Moreover, with a lower barrier to receiving health services, more prevention screenings will likely be done, leading to fewer incidences of more costly diseases like cancer or Alzheimer’s disease. However, this could mean a reduction in revenue for companies that specialize in delivering or discovering these treatments.

Increasing Access

The most direct application of telehealth is its use to provide healthcare in areas where patients have difficulty accessing healthcare. This was initially the drive to incorporate telehealth into many health systems and to help underserved populations and was what led to telehealth being incorporated into Medicaid systems in most states.

Often, states that have the largest rural population have huge Medicaid program as well and have a great need for telehealth. These rural areas are often the ones that are most in need of health services; however, less than 10 percent of physicians practice in these areas of the country, and even fewer specialists work in these areas.

That said, telehealth health enables better coordination of patient records between organizations and providers. This can ultimately lead to better access to rural communities. According to a paper published by C. Patricoski, Alaska has demonstrated success in this regard because, in the rural state, the incorporation of telehealth services has become a must for patients.

Reducing Cost

Telehealth has already shown the ability to reduce costs for healthcare organizations and healthcare costs for patients.  Patients utilizing telehealth services will have more choice of providers and services leading to more competitive and efficient healthcare markets. Patients can see the best provider anywhere and at a time that is most convenient to them. This can be done while minimizing commuting time and time in a hospital. Healthcare organizations, in turn, have less of a need for the extensive facility and full-time employees.

These facts have led many experts to view telemedicine as a cost-effective alternative to the more traditional face-to-face manner of providing medical care that states can choose to cover under Medicaid. In healthcare, communication is key to the patient-physician relationship and to delivering value to patients. Without this communication, patients cannot get proper treatment, nor can physicians make a proper diagnosis.

Moreover, the Physicians treatment regiment and diagnosis has to be communicated clearly to the healthcare staff and patients.  Telemedicine and other communication assistive technologies in the future can be integral parts of reducing healthcare spending and increasing access to patients.

Current Status

Implementing more telehealth services to make it more mainstream in healthcare requires overcoming many barriers. The primary concern for most organizations has been regulatory issues associated with implementing more telehealth services. However, security remains the primary concern for mobile health applications and personal computers use in healthcare as these applications are so sensitive to hackers, and health data is extremely sensitive.

Currently, many experts believe that there are not enough protections to enable the widespread use of telehealth or mHealth and that the widespread use of telehealth services is not realistic. Many organizations are still in the early use and development of telehealth for widespread utilization of patient care.

Patient Trust

Patient trust is key in healthcare. A neglected aspect of telehealth is how well patients trust the use of technology in healthcare and will utilize virtual health services. Some studies have shown that patient engagement requires, from a mobile health app standpoint, that APPs help patients manage and care for multiple conditions.

Not all patients are tech savvy or trust technology enough to use it with their healthcare. However, certain patient populations may be more receptive to telehealth services, particularly younger patients or patients with severe conditions that have no other choice. For these populations, expanding the use of telehealth services may be an advantage to help with clinical care. More research is needed to help better understand which patient populations will best respond to telehealthcare services. This is an area where many organizations will have to experiment to figure out what works best.

Provider Trust

Critical to the effective use of Healthcare IT, telehealth, and other healthcare technology applications is that providers buy into the effectiveness and want patients to utilize them. While telehealth applications can potentially get providers more patients, they may feel that a virtual examination of patients is ineffective and that patients respond better to clinical decisions when they are face-to-face.

Additionally, providers and organizations that utilize telehealth will have to understand and follow the rules and regulations for their respective states to get reimbursed. Some organizations may not embrace the use of remote patient monitoring and other telehealth application for accurately capturing what is going on with a patient’s health. Physicians may believe that there are more effective healthcare applications than telehealth for managing patient care. Making telehealth applications easy to use and enjoyable for clinicians is crucial to their lasting success.

Despite the obstacles, expanding the use of telehealth in healthcare appears to be worth it. To quote  Dr. David Blumenthal, president of the commonwealth fund, “These emerging models produce virtual communities of learning and practice that embrace all members of the healthcare team. They are the latest point on the telemedicine continuum that began with the point-to-point connection achieved by Einthoven’s pioneering electrocardiogram. Building out the connection established under telemedicine into an ever-expanding knowledge-sharing network can create new potential to improve health and save lives.”

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