Friday, July 24, 2020

The History, State, and Future of Telemedicine

Vadim Dolt
Technology / Innovation

The field of telemedicine has changed drastically from its inception 50 years ago. It began with sci-fi magazines and a few hospitals trying to reach patients in remote locations. The development of telecommunication and medical technologies provided the foundation for rapid growth in the area of telemedicine in recent years, and finally the COVID-19 pandemic has created an unprecedented demand for that service.

 

In the February 1925 issue of Science and Invention, Hugo Gernsback published an article that would combine his fascination with the future of radio communications and predict a device for the year 1975 that we still don’t see in any practical household form today.

 

Gernsback’s device was called the “teledactyl” and would allow doctors to not only see their patients through a view screen but also touch them from miles away with spindly robot arms. He is considered one of the earliest predictors of telemedicine, even though his actual device never materialized.

old image of telemedicine

Telemedicine is a subset of a larger field called Telehealth. Telemedicine is focused on serving patients remotely using technology. Telehealth includes that, but also adds services for the doctors such as training, collaboration, remote access, and others.

What Is Telemedicine Today?

What many of us (including myself) got to experience during the COVID-19 pandemic as telemedicine was primarily Interactive Medicine. This is a type of service where patients and physicians communicate in real-time. It is most often done via video conferencing and must comply with HIPAA. During these sessions, doctors can assess medical symptoms, look at patient history, perform psychiatric evaluations, and more using interactive medicine.

 

The second type of telemedicine is ongoing remote Patient Monitoring. That service is applicable to patients with chronic conditions. Those conditions could be either physical or psychological. Patient monitoring has been gaining adaption with older patients and fueled by the development of medical devices that can take vital signals and send results electronically to doctors.

 

Digital stethoscope, Dermatoscope, EKG, Oximeter, Ultrasound, Blood pressure devices are all now available with data transmission capabilities and can be utilized within the framework of telemedicine. In addition to traditional, standalone devices, some vendors are now offering a fully integrated remote diagnostics center that collects a multitude of parameters and shares them with your doctor. Those require very minimal training to use and while possibly too expensive for an individual to purchase, can be installed at rural locations that do not have permanent medical facilities.

How Does Telemedicine Benefit Our Society?

In today’s healthcare world, convenience is key. Patients living in remote and under-served areas can utilize telemedicine and can have access to a wide variety of specialists conveniently at home. Elderly patients that may lack transportation services and special needs patients all will have access to necessary care with the technology of telemedicine. And as COVID-19 has demonstrated, in the times of the seasonal flu or coronavirus, telemedicine allows individuals to be in the safety of their home and prevent the spread of diseases. 

Challenges That Stand in the Way of More Widespread Adaption

The policies governing telemedicine are very unclear and vary widely from state to state. Since it developed so quickly (especially during the pandemic), legislative and insurance policymakers did not keep up with adaption. As a result, many providers do not get sufficient reimbursement for telemedicine practices to make it a financially viable investment for them.

 

During the height of the pandemic, these rules were temporarily changed, and doctors were allowed to practice telemedicine and treat those visits as regular in-person sessions. That gave many individuals, including myself, an opportunity to experience efficiency and other benefits of telemedicine.

Roles Agencies Can Play in Helping Drive Adaption

To implement telemedicine at scale will require significant investments on the part of service providers. So far, they have been hesitant to do so due to the lack of clear policy on reimbursements and other parts of the framework that will govern telehealth in general. But the market demand to put pressure on legislative policy-making bodies to address those issues is in the near future.

 

Once providers have a clear legal foundation in place, they will open purse strings to enable telemedicine services. The benefits of telemedicine outlined are too compelling to ignore. Agencies with the focus on healthcare will undoubtedly play an important role in that revolution. They will be able to apply their efforts in the following areas.

Building Out Communication Infrastructure

Secure communication is required for HIPPA compliance. Fast and reliable communication will be required for patient satisfaction.

Implementing Telemedicine Solutions

A large part of that work might be done by providers themselves, but there is also an opportunity around integrations with Electronic Records systems, billing systems, etc.

Change Management

This will be one of the more important areas around the telemedicine rollout. Many processes and procedures that providers have in place today will have to be updated to account for telemedicine. Employees would have to undergo a substantial amount of training, not only on the use of the system, but also on the right way to prepare the patient for a remote session.

Patient Support

Existing materials, both digital and print, will have to be updated to support and educate patients. Patients that will begin utilizing telemedicine will start expecting other services and information to become digital. Those service providers that don’t have online appointment scheduling or patient portals will be expected to provide that capability.

 

It has been a difficult year for healthcare service providers due to COVID-19. But like any other major upheavals in the society, the current pandemic is accelerating significant change in human behavior. Telemedicine based visits with your provider will be commonplace in a not too distant future. To enable those services correctly, you will need a partner to help you navigate technological and training complexities.

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