Telehealth and telemedicine are considered synonymous. In both situations it’s about the physical distance between the patient and the health care provider. Both uses information and communication technologies to deliver and exchange medical information (or any kind of data related to health) in order to achieve diagnosis, treatment plan and prevention of disease and injuries. Telemedicine includes also research and evaluation and continuing education of health care providers. However, a refined definition regards telemedicine as a service delivered by physicians only, while telehealth can be provided by “health professionals in general, including nurses, pharmacists, and others.” (1)
The way patients see telemedicine or telehealth showed improvements since the beginning of this century
In an early study from 2000, telemedicine was used to deliver specialist oncology/haematology care. Patients were satisfied with their teleconsultations, but also expressed concerns regarding the limitations of such a service. (2)
Another study, published in 2004, has shown a better perception of telemedicine. According to the authors: “Despite concerns regarding its confidentiality and its ability to approximate the social stimulation of in-person nursing visits, patients in these pilot trials seemed satisfied with home telecare and appeared ready to accept its widespread use. “ (3)
Also, a study released in 2011 concluded that “[…] brief use of a Web-based telemedicine service has a significant positive effect on patients’ perceptions of this service. Therefore, as patients do not have prior experience with innovative telemedicine services, offering patients a risk-free way to explore and experiment with the service can increase the development of accurate perceptions and user needs.” (4)
A recent study, published in 2018, used telehealth for type 2 diabetes management. The patients were pleased by telehealth improved access to care. Lots of them said they would prefer telehealth care rather than their regular appointments at the doctor’s office. However, “they would not want it to fully replace their contacts with their doctor, especially when it comes to discussing more serious health issues.” (5)
A short history of telemedicine
It can be said that telemedicine started in the early 20th century when electrocardiograph data were transmitted over telephone wires. Then, in the 1960s telemedicine was used for military and space technology sectors.
Also, consultations between specialists of a psychiatric institute and general practitioners of a state mental hospital were made through television.
It is interesting to mention that in 1925, Hugo Gernsback, a radio pioneer, published an article about a device called the “teledactyl” (tele, far; dactyl finger, from the Greek). That device would permit doctors to see their patients through a viewscreen, and to touch them from miles away with robot arms. That article predicted telemedicine, we can say. (6)
Nowadays telehealth has multiple uses
Although the reimbursement method is not very clear, the telehealth is reaching more patients, some of them being willing to pay a fee for the teleconsultation.
However, 38 states plus District of Columbia require private insurance companies to pay for telehealth. (7)
Intended to be used in disadvantaged areas, like poor or developing countries, with lack of medical care, telehealth has begun to spread over the world, as the access to the internet and to the specialized gadgets and devices becomes more affordable. The patient is able to measure their blood sugar level, or their blood pressure and the data are transmitted to the health care provider. Also, the video conferences allow the patient to speak directly to the physician or to the counselor.
We already mentioned diabetes type 2 home surveillance. There are also post-surgical follow-ups and post-hospital discharges where telehealth is used to keep in touch with the patients. Also, telehealth addresses chronic condition, especially in seniors, for whom might be difficult to leave the home. Telemedicine can also be used for a prescription renewal, or for treatment management.
People may use telehealth for other reasons, like they do not have to pay for the transportation to the doctor’s office, or they do not have time to wait. Teleconsultations are scheduled and the patient gets a reminder to ensure he or she will be online for the appointment.
Telehealth can be useful for behavioral health, or mental health, because the patient feels in a secure environment talking to the counselor from his own home. Be careful, though, if you are in a crisis, or someone is in a crisis, or it’s an emergency, do not use telehealth. Seek for immediate help by calling 911 in the U.S. or 112 in Europe. Every telehealth provider should have a list of numbers to call when there is an emergency.
(1) https://www.who.int/goe/publications/goe_telemedicine_2010.pdf
(2) https://journals.sagepub.com/doi/abs/10.1258/1357633001933925
(3) https://www.liebertpub.com/doi/abs/10.1089/15305620050503889
(4) https://www.liebertpub.com/doi/abs/10.1089/tmj.2010.0208
(5) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6045870/
(6) https://www.smithsonianmag.com/history/telemedicine-predicted-in-1925-124140942/?no-ist
