Imagine, one day baring your back to your computer screen with your dermatologist looking on to show her the strange-feeling mole on your shoulder. Your dermatologist then makes a diagnosis of a growth that warrants a closer look, so you are transferred to the office receptionist to make an appointment.
Telemedicine is Here and Now
That day is today, and the practice is called “telemedicine” or “e-care.” It is the exchange of medical information from one site to another to improve patient health, at its most basic definition. To expand upon this definition, e-care relies on two-way video, smartphones, e-mail, wireless tools and other forms of telecommunication applications to achieve its goal.
There is also remote patient monitoring that uses devices at the patient’s locale to collect and send data to the appropriate agency or lab for interpretation. This service supplements home health care nurses and can be used to send specific information relating to blood pressure, blood sugar or heart activity.
Typically, using live, interactive video or transmission of diagnostic imaging, vital signs and other video clips of patient data, a primary care physician or a specialist can make a diagnosis based on transmitted medical information. This could make the difference between a patient seeing a specialist or choosing not to pursue the diagnosis further because of problems getting to the doctor’s office.
Also, studies have shown a significant decrease in the cost of treating health conditions such as hypertension, diabetes or conditions that benefit from near-constant monitoring.
Lastly, the use of the Internet for research of specialized medical problems and the ability to participate in group discussions online, such as support groups is another reason to have e-care.
Why now?
With such technological advances as the replacement of analog forms of communication with digital forms, combined with falling costs of these technologies, interest has been sparked in its use in formulating new and innovative ways of delivering health care. The Internet has permeated telemedicine through email, teleconsultations, teleconferencing, video and digital imagery. This is great groundwork for what is coming in the future. Biometric devices that measure anything from blood pressure, blood glucose, and heart-rate monitors are being increasingly used in e-care because of the constant feeding of information to health care centers. Here are a few examples of the usefulness of telemedicine in the real world:
- Takes health care to the patient and allows hospitals and doctors to expand their reach beyond the walls of the institution. Because of primary provider shortages in both rural and urban areas, this improves patient access to this type of health care in these areas. There is the potential to treat millions of new patients, especially important in the wake of the Affordable Health Care Act, which added millions to health care rolls.
- Improved quality. Studies have shown that telemedicine was as good as an in-person consult. But with mental health and Intensive Care Units, telemedicine delivered a superior product with better outcomes and higher patient satisfaction.
- Patient demand. E-care reduces patient travel time with its accompanying stress. The past 15 years of studies have confirmed patient support for telemedicine services.
- Cost efficiencies. It has been found that e-care lowers the cost of health care and increases efficiency through technology and better control of chronic diseases, reduces or eliminates travel time.
- Constant monitoring. Physicians and therapists can monitor discharged patients and track recovery using communication devices.
- Research has shown that telemedicine may have many important positive outcomes. There are fewer and shorter hospital stays, fewer readmissions, better following of aftercare treatments at home, and faster recovery periods as compared to patients without remote monitoring.
- Other types of communication afforded between respective staffs. This way, expert information is shared in real time when it counts most, as in an emergency.
Other Examples of E-care
Specific examples include prompt diagnosis and treatment of stroke victims. If the victim receives a very specific stroke medicine within three to five hours, the effects of the stroke are severely curtailed. Another useful application of telemedicine is to use it with two-way video and real-time information feeds for the patient, especially in the intensive care unit where physicians may be overtaxed. Another pair of eyes looks at the patient’s condition, vital signs and monitored signals to assure that the harried doctor did not miss anything pertaining to the patient.
Studies have found that there is a lowering of the risk of heart disease with the use of telemedicine principles. Cardiovascular disease is the leading cause of death, globally. A Philadelphia study found that twice as many patients were willing to participate in cardiovascular management programs if they could send and receive health information online, meaning over the telephone or computer.
In the U.S., diabetes costs 100 billion dollars a year in lost work time, hospitalizations, emergency room visits. Studies suggest that telemedicine can help diabetics, especially older adults. Where it helps is in self-belief that the long-term lifestyle changes will be effective for the patient, or self-efficacy.
And, a Galveston, Texas, study uncovered during a six-year investigation into children with mental illnesses that of both patients and guardians, 70 percent said the counseling sessions helped the kids perform better in school.
Futurists vs. Realists
Futurists look to health care and see a doctor in every living room. That means the decentralization of health care delivery systems away from hospitals and clinics to homes and perhaps satellite clinics. It’s not going to happen anytime soon, says those who would call themselves realists. There are road bumps on this health-care superhighway.
Believe it or not, there are millions of people in American with no or very limited access to computers and the Internet. There are also those who do not want access to the Internet or to bother with an electronic paperweight in their house. There are people who would rather see their doctor in person, regardless of travel distance or time. There are also linguistic differences where the technology vocabulary could obscure critical medical information, to the patient’s detriment. There’s also a world of cultural and legal issues that have to be untangled before widespread use of telemedicine can be fully deployed. But at least part of the future is here now.
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