Telemedicine: Impact on Healthcare Industry
Introduction
The key issues faced currently by healthcare industry are quality, equity, access, and cost-effectiveness. These are the issues that both developed and developing countries are facing. Modern Information and Communication Technologies (ICTs) such as cell phones, the Internet, and computers can address the health problems that are prevalent on a global level as people can communicate with each other exchanging and seeking the relevant information. The use of ICTs for the delivery of the health services is referred to as telemedicine. It provides clinical health care to remote areas through the use of information technology and telecommunication.
In telemedicine, distance is a determinant whereby healthcare professionals can provide healthcare services to remote areas through the utilization of ICTs. This technology allows them to exchange all valid information for treatment, diagnosis, prevention, evaluation, and research. It is also used to educate health care providers. In addition, it aims at improving the health of individuals and communities.
This paper discusses the various ways through which the healthcare industry has been transformed through telemedicine, its impact on safety, quality, and management of health care. Furthermore, it also encompasses numerous methods concerning the continuation of medical education through telemedicine. Also, it also talks about the availability and accessibility of its services in developed and developing countries as well as the barriers to its diffusion.
Telemedicine in Developed and Developing Countries
In the developing countries, one of the major concerns is the access to the basic health care. Telemedicine provides great opportunities in increasing access to the health care. Distant healthcare providers can diagnose, evaluate, treat, and even provide follow-up care to the patients in the developing countries that are not sound economically. The underserved areas can get efficient tertiary care advice through telemedicine. In situations where local healthcare professionals have access to expert help, It enables people to obtain opinions from the specialists; unavailable to them otherwise. This aids in providing reassurance to both patients and doctors.
There has been a decrease, both directly and indirectly, in the number of referrals to facilities located off-site due to its programs. This has also led to the reduction of the need to transfer patients. Telemedicine in developing countries is successfully enabling the remote care and diagnosis beneficial for both health care systems and patients wherein the distance traveled to receive special care as well as the related stress, time, and expenses are reduced. Another benefit offered by the telemedicine programs is that they improve practitioners’ practice in rural areas as they receive the support for professional growth and development through this medium.
Secondary benefits such as connecting remote sites through telecommunication technologies help in overcoming geographical barriers as health care providers around the world can connect to remote and rural sites easily. Thus, it is easy to overcome issues such as flight of human capital or the ‘brain-drain’ problem. The remote training of healthcare professionals fosters their academic growth as they can contact the specialists around the world easily at any time. Thus, the services and skills offered locally are improved significantly. These factors are also proved by the telemedicine program in Mongolia that supports maternal and neonatal health.
As far as Mongolia is concerned, the maternal and infant mortality rate in the country is quite high. In order to overcome this issue, telemedicine support is being provided in the remote provinces of the country for the promotion of maternal and infant health. The services supported by telemedicine in Aimags provinces include fetal monitoring, high-risk pregnancy consultations, use of colposcopy for screening of cervical abnormalities, and prenatal ultrasound diagnostics. Women in remote areas who cannot afford paying for expert opinions can be particularly benefitted through the usage of telemedicine program.
In developed countries, such as the United States of America, it has been incorporated into healthcare services. Although different states face different issues pertaining to the incorporation (like reimbursement and other legality concerns), it is highly recommended to help the underdeveloped countries. In particular, countries that lack adequate healthcare facilities need to incorporate telemedicine through the volunteer efforts of healthcare professionals.
How Telemedicine is Transforming Health Care
There has been a considerable interest internationally in improving the healthcare industry’s safety, quality, cost-effectiveness, and cleanliness. McLean conducted a study to investigate and analyze the impact of telemedicine on the quality and safety of the healthcare. The study found that the quality, standard, and safety of the healthcare were improved. For some of the patients, the improvement in the quality of life was observed. On the other hand, it was not the case for other patients. For example, improvements were observed in patients of asthma and chronic heart failure while no improvements could be seen in diabetic patients. For a total of 15 studies conducted on heart failure patients, 9 reported improvement in the quality of life. Some were so satisfied with the telemedicine services that no considerable difference between normal counseling and tele-counseling could be detected. Furthermore, significant improvement in the quality of life was observed in COPD.
Telemedicine counseling
Telemedicine counseling also helped in reducing the maternal fatigue affecting mothers who had infants with difficult behaviors. Parents that had infants with extremely low birth weight rates were also provided with emotional support and education. All in all, resulted in patient satisfaction whereby it reduced cost and travel time along with increased convenience. Furthermore, it also helped a majority of patients in follow-up for various diseases. In a Canadian review of various telemedicine programs, the rural areas had higher patient satisfaction as compared to the urban areas. In comparison to waiting for longer personal counseling, 76% of people preferred telemedicine counseling as it was easy and convenient.
Breen and Matusitz Study
Breen and Matusitz conducted a study and described the way through which a telemedicine system can be executed in a variety of medical settings, to strengthen and assist the communication such as the interchange, dialogue, and correspondence between the patient and healthcare provider. It provides training, research, public health, and patient care for diagnosis, receiving, and sending of information about health and administrating care. Analysis of X-rays and educating health professionals may also be done through telemedicine.
Telemedicine Applications
Telemedicine has been segmented into various applications such as cardiological, neurological, dermatological, and respiratory diseases and these are used extensively in the management of various pathologies, conditions, and diseases. It has also been discovered recently that people in their final stages of AIDS/HIV are benefiting from telemedicine as their human contact is decreased and the patients are accepted and treated.
Telemedicine Electronic Devices
The technological forms of the telemedicine are classified into numerous electronic devices such as e-mail services, camera light boxes, telephones, fax machines, remote monitoring systems, interactive television units, video conferencing, and multimedia. In military combat solutions, rapid communication services are provided to medics who could then treat various casualties in firefights. Serious wounds acquired by the military can easily be managed and treated through telemedicine.
Telemedicine Brings Ease
Breen and Matusitz also report that telemedicine has given patient satisfaction through a decrease in travel time, waiting time, and reduction in hassles to get an appointment from the doctor and follow-up. It has turned out to be an extremely remarkable alternative to traditional methods of counseling especially for remote, terminal, and debilitated populations.
Telemedicine and CME
Wang asserts that telemedicine can provide sustainable improvements to health and help in continuing medical education. Telemedicine systems are also an effective way to online continuing medical education (CME) for physicians. It also offers three principal advantages: the delivery of personal health services to remote areas, patient health education, and continuing medical education. Wang also studied the experiences of telemedicine in Taiwan over the period of 1995-2004. The estimated results of the panel data regression showed that an increase in CME lectures provided online led to an increase in per capita national health expenditure and conventional health services. There is a nonlinear nexus between CME and health indicating an improvement in the health of individuals with greater online CME provision. After reaching an optimum, however, decreasing population health is associated with greater CME lectures.
Telemedicine and Communication
Beck mentions in her report that after years of big promises, it is finally living up to its full potential. The delivery of health care has become more rapid through the Internet connections, changing standards of insurance, the presence of smart phones, and jobs being done by more health providers who use electronic communications. Phones, webcam, and emails are linking the patients to the doctors around the world. The better care of health has been provided by telemedicine at locations where medical expertise cannot reach.
Remote Medical Care
In the new virtual care center, Mercy Health System (a hospital without a bed), nurses and doctors keep working around the clock. This care center provides remote support to 38 smaller hospitals situated in states from Oklahoma to North Carolina (for emergency rooms, intensive-care units and various other programs). Most of these 38 hospitals do not have any on-site physician 24/7. The president of the Mercy Virtual reported a 30% decrease in the number of deaths than anticipated and a 35% decrease in the average length stay of the patients have been observed as monitoring of ICUs took place by Mercy specialists. This indicates that nearly1000 people were saved from dying due to the special assistance provided to the patients. According to a trade group, the American Telemedicine Association, remote medical care has been provided to more than 15 million Americans in 2015. In fact, this number grew by 30% in 2016.
Critics in Telemedicine
Even though telemedicine is spreading widely, there are some critics concerned about the quality of care received . Various barriers hinder the growth of telemedicine in some regions including developing countries as the infrastructure is not sufficient for the proper utilization of the modern Internet technologies. Also, the instability of the electric power supplies, unreliable connectivity of the internet, computer viruses, and limited availability of bandwidth hinder the adoption of telemedicine.
The financial cost is also one of the most important barriers to the adoption and application of telemedicine. Training cost, equipment, maintenance, and transport cost can be difficult to deal with for countries with low income. The application of telemedicine is also limited by knowledge, resources, and local skills.
Conclusion
Based on the studies included in this review, it can be concluded that information and communication technologies like cell phones, the Internet, and computers can address the health problems on a global level. It can be done through the deliverance of healthcare services. The health of the individuals and their communities is significantly improved by telemedicine as the health care services are provided to remote areas by health care professionals using ICTs for an exchange of all valid information for treatment, diagnosis, prevention, evaluation, research and for providing education to health care providers. The healthcare’s safety, quality, cost-effectiveness, and cleanliness have significantly improved internationally . Though there are various hindrances to the spread of telemedicine in developing countries, a focused approach towards its implementation may work wonders for nations as the health of the local people is improved.
References
Beck, Melinda. “How Telemedicine Is Transforming Health Care.” The Wall Street Journal, 2016.
Breen, Gerald-Mark, and Jonathan Matusitz. “An Evolutionary Examination of Telemedicine: A Health and Computer-Mediated Communication Perspective.” Soc Work Public Health, 2010: 59-71.
Mclean, Susannah, Aziz Sheikh, Kathrin Cresswell, Mome Mukherjee, Claudia Pagliari, and Akiko Hemmi. “The Impact of Telehealthcare on the Quality and Safety of Care: A Systematic Overview.” PLoS One, 2013.
Rao, Babar, and Adriana Lomabardi. “Telemedicine: current status in developed and developing countries.” Journal of drugs in dermatology, 2009: 371-375.
Wang, Fuhmei. “Continuing Medical Education via Telemedicine and Sustainable Improvements to Health.” International Journal of Telemedicine and Applications, 2016: 1-6.
WHO. TELEMEDICINE Opportunities and developments in Member States. Global survey on eHealth, Geneva: WHO Press, 2010.
[i] WHO. TELEMEDICINE Opportunities and developments in Member States. Global survey on eHealth, Geneva: WHO Press, 2010, 8.
[ii] WHO. TELEMEDICINE Opportunities and developments in Member States. Global survey on eHealth, Geneva: WHO Press, 2010, 13.
[iii] WHO, 14.
[iv] WHO. TELEMEDICINE Opportunities and developments in Member States. Global survey on eHealth, Geneva: WHO Press, 2010, 15.
[v] WHO, 16.
[vi] Rao, Babar, and Adriana Lomabardi. “Telemedicine: current status in developed and developing countries.” Journal of drugs in dermatology, 2009: 371-375, 372
[vii] Mclean, Susannah, Aziz Sheikh, Kathrin Cresswell, Mome Mukherjee, Claudia Pagliari, and Akiko Hemmi. “The Impact of Telehealthcare on the Quality and Safety of Care: A Systematic Overview.” PLoS One, 2013.
[viii] Mclean, et al. 2013.
[ix] Ibid.
[x] Ibid.
[xi] Breen, Gerald-Mark, and Jonathan Matusitz. “An Evolutionary Examination of Telemedicine: A Health and Computer-Mediated Communication Perspective.” Soc Work Public Health, 2010: 59-71, 63.
[xii] Breen and Matusitz 2010, 64.
[xiii] Ibid.
[xiv] Breen, Gerald-Mark, and Jonathan Matusitz. “An Evolutionary Examination of Telemedicine: A Health and Computer-Mediated Communication Perspective.” Soc Work Public Health, 2010: 59-71, 64.
[xv] Ibid
[xvi] Wang, Fuhmei. “Continuing Medical Education via Telemedicine and Sustainable Improvements to Health.” International Journal of Telemedicine and Applications, 2016: 1-6, 2.
[xvii] Ibid.
[xviii] Beck, Melinda. “How Telemedicine Is Transforming Health Care.” The Wall Street Journal, 2016.
[xix] Ibid.
[xx] Ibid.
[xxi] WHO. TELEMEDICINE Opportunities and developments in Member States. Global survey on eHealth, Geneva: WHO Press, 2010, 19.
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