In Sickness and In Health: Telehealth is the next medical revolution
Incidents involving trampolines don’t often end well for me, and this time was no exception. I found myself with an alarmingly crooked nose that was quickly doubling in size. Normally, this would’ve ended with a trip to the ER, but 15 minutes later I was on a video call with an ENT (Ear, Nose, Throat specialist) doctor at the local hospital with a prescription for anti-swelling tablets and an ice pack pressed to my face. I was ordered to wait for the swelling to go down before visiting him in person and getting a CT scan. I’d saved myself an unnecessary trip to the hospital and consequently time, fuel and effort.
Online appointments with primary care physicians are not a foreign concept to most of us. When making an appointment with the Engemann Student Health Center, students are always offered the option of a phone appointment. Something about sitting in my dorm room and getting treated instead of making myself presentable and dragging myself to the health center while sick has always appealed to me.
Telehealth, which encompasses telemedicine, telecare and telecommunications, is the use of technology and electronic information to distribute and provide long-distance health services. Telemedicine is any remote patient-clinician interaction and diagnosis through telecommunication technologies. It can be traced back to the 1960s, where the development of novel technologies was driven primarily by the space and military divisions of numerous countries.
In the past couple of years, while we’ve seen a significant increase in the number of telehealth services, their utilization remained low. However, since the onset of the pandemic, there has been a shift in these trends. In the first quarter of 2020, telehealth visits increased by 50% compared to the first quarter of 2019. Most of these were not coronavirus-related. But the question remains whether the telemedicine revolution is real and sustainable. Should remote care become the standard of care? Do we need to rethink how we approach the practice of medicine?
For vulnerable populations like the elderly and socio-economically disadvantaged classes, efficient virtual patient care would mean that they could overcome the issues that are associated with in-person care. There is no need to worry about the disruption of a workday, unnecessary travel and its associated costs, or the discrimination that marginalized communities often experience in clinics.
For those who are geographically disadvantaged, such as residents in rural or provider shortage areas, telemedicine provides basic access to primary, dental and mental health care. Considering that 83 million people in the United States live in primary care health professional shortage areas and 122million people live in mental health professional shortage areas, an established protocol for telehealth could effectively address the longest standing issue in medicine: accessibility.
Since healthcare is a privatized industry in the United States, this increase in accessibility represents an enormous untapped market that corporations, such as Amwell, Amazon and Google, are pursuing. Furthermore, in 2020 an emergency provision through Medicare was made to reimburse all telehealth services. Now, bipartisan congressional support for making this provision permanent is on the rise. Given the convenience of telemedicine, combined with the investment of industry leaders in this market and the surge in necessity due to the coronavirus, telehealth seems like it’s here to stay.
On the other hand, there are numerous barriers to the implementation of telehealth. Firstly, accessibility depends entirely on patients’ access to stable internet and electronic equipment.
Additionally, most insurance packages do not cover or reimburse telehealth consultations forcing patients to seek it in person. There are also challenges due to the training of health professionals to use these tools, the cost of the equipment and a breakdown of doctor-patient relationships.
The biggest concern is the protection of patient information and vulnerability to hacking. Doctor-patient confidentiality is the foundation of standard medical practice as we know it, but now we have to consider the responsibility of the middle-man in this relationship. In a time when data security concerns are at the forefront of the news and our minds, software providers and health platforms need to be strictly regulated and overseen to prevent breaches of our fundamental rights.
Whether you prefer telemedicine or not, it has great potential to correct disparities in our health system and integrate healthcare into the fast-paced, technology-driven world we live in. But before this potential can be realized, there need to be meaningful steps made to overcome mistrust in technological dependency while legally defining and enforcing rules and restrictions to the evolving world of medicine. Perhaps one day, you’ll be able to go to the doctor in the comfort of your own dorm room.
Yagna Sreeramaneni is a sophomore writing about the current issues in health. Her column, “In Sickness and in Health,” runs every other Friday.