What is telehealth?
Telehealth and telemedicine are used interchangeably but encompass healthcare professionals from medical doctors to nurses to rehab professionals like physical therapists and occupational therapists. Online consulting in healthcare has been on a steady incline for years, and now, with the global pandemic, telehealth is building momentum and becoming a daily reality.
Originally developed to improve experiences in both receiving and providing care, as well as reducing costs, telehealth is meant to bridge the gaps - to prevent readmission, educate patients and caregivers, ease processes like refilling prescriptions, and to provide or receive care without having to worry about in-person social distancing, to name a few advantages.
Of course, no field has grown without its challenges - telehealth requires a complete remodel of current healthcare systems to make it routine as opposed to infrequent, and many systems have not been equipped to make such a change until more recently. Reimbursement has been difficult in this area, as well - patients who could benefit from this type of care, like those dealing with chronic illness or elder adults, are often on a Medicare plan, which has been slow to reorganize reimbursement. However, in April 2020, Medicare took some significant steps to allow for more Medicare patients to benefit from telehealth during COVID. This may change or it may stay, but right now, more patients have access to telehealth than ever before.
Who uses telehealth?
As the saying goes, "it takes two to tango." Clinicians and patients both need to be engaged in the process in order for telehealth to work. Clinicians, on the whole, have been somewhat apprehensive about telehealth, since many of them need to be hands-on for evaluation of vitals readings, lung and heart sounds, palpation, etc. Luckily, as telehealth has grown and continues to grow, there are courses clinicians can take to prepare themselves and learn alternative methods of testing that can be used to collect relevant information.
Patient engagement can be difficult in this setting as well. However, with social distancing of the utmost importance, it appears that patient engagement and clinician involvement is trending upwards, particularly as more people learn about what telehealth is and how it can benefit them.
In many cases, patients can expect positive outcomes as they might in an in-person setting. While research is not as comprehensive as in other aspects of healthcare, there are some positive outcomes being shown in recent studies. One study demonstrated a positive effect of telehealth across patient populations.
How to get involved
Healthcare professionals and patients, alike, need education on use-cases for telehealth and how it can be beneficial for everyone involved. Many patients, particularly those in areas with reduced access to care, are unaware that telehealth is an option for them, and they may shy away from engagement if they do not fully understand it.
For clinicians, there are a few programs available that provide telehealth accreditation; for rehab professionals, that is still underway. Regardless, a course in telehealth can give a clinician the confidence to understand the rules, regulations, and policies they must abide by in order to provide appropriate care. If you are a clinician, be sure to learn your state's regulations and ensure that you hold an active license in the state in which you intend to practice before beginning work.
Telehealth was slowly but steadily rising before and, now, seems like it is here to stay. Especially in the days of social distancing and stressed hospital systems, it is a solid option for providing or receiving optimal care safely. As with any new venture, it is imperative to find the appropriate education to prepare for work in a new field; online courses and accreditations continue to grow, and reimbursement measures are currently underway to optimize use of telehealth. If you are looking to start work in a fluid, growing field, this just may be the right fit for you.
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2) Smith AC, Thomas E, Snoswell CL, Haydon H, Mehrotra A, Clemensen J, Caffery LJ. Telehealth for global emergencies: Implications for coronavirus disease 2019 (COVID-19). J Telemed Telecare. 2020 Jun;26(5):309-313. doi: 10.1177/1357633X20916567. Epub 2020 Mar 20. PMID: 32196391; PMCID: PMC7140977.
3) Tuckson RV, Edmunds M, Hodgkins ML. Telehealth. N Engl J Med. 2017 Oct 19;377(16):1585-1592. doi: 10.1056/NEJMsr1503323. PMID: 29045204.
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