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telemedicine

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In recent years, telemedicine has become a useful alternative to seeing a doctor in person or addressing chronic health conditions. All it requires is an internet connection and some kind of teleconferencing application/service to take advantage of these services. They can also treat many different conditions as well as supply therapy or prescription services. Finding a telemedicine service that takes your insurance and provides access to an array of options is crucial to getting treated for non-emergency conditions. Remember that even telemedicine has its limits and there may be some conditions or treatments that are better provided in person. Despite this, however, there are plenty of conditions an online doctor can treat. Here is a quick look at five, covering both urgent care/quick care and chronic conditions:

Cold & Flu

Have you ever had a bad case of the sniffles, a terrible sore throat, itchy/burning eyes, or any combination of terrible flu symptoms that just make your day horrible? Of course you have! And you probably didn’t think about seeing a doctor or going to urgent care to address the situation. While over-the-counter cold and flu medications might help reduce the symptoms a bit, sometimes you need that little extra step of getting a doctor’s assistance. That’s where Urgent Care by way of telemedicine comes in. Instead of needing to go to an actual urgent care facility, you can get treatment for a cold or flu via a virtual doctor. The doctor will chat with you about your medical history, your current symptoms, and help you determine if what you’re experiencing is a cold or flu. Following the discussion/appointment, they can prescribe medication for treatment appropriate to helping you recover. Treated in this manner can allow you to recover a little bit easier because you don’t even have to leave your house, and can stay in bed resting while getting the treatment unit.

Pink Eye

Pink eye, or conjunctivitis, is a highly contagious inflammation of one’s eyes (specifically the conjunctiva). It might be because of a virus, bacteria, allergies, or a reaction to eye drops. The problem is that pinkeye spreads easily, but the good news is that it can be easily diagnosed. If you are doing your virtual doctor’s visit via a video call, the doctor will be able to actually see your eye and note what type of pink eye infection you have. If it’s just a phone call, they can still help you determine if you have pinkeye from your description of the symptoms. They can then prescribe treatment from there. Common treatments for pink eye include warm compresses, eye drops, or allergy medications.

Urinary Tract Infections

At some point in our lives, everyone will probably be afflicted with the dreaded urinary tract infection. A UTI has a number of symptoms and is caused by bacteria getting into the urethra. Burning sensation, a strong need to urinate, pain, and frequent urination can all be indications of an infection. During your telemedicine visit, the doctor will discuss your symptoms, history, age, potential risks, and other concerns. The questions will be laser-focused and highly specific to the individual. If the symptoms are indicative of a UTI, they’ll most likely prescribe an antibiotic to help clear up the infection and schedule a follow-up to ensure the infection is healed.

Asthma

Asthma is a chronic condition and can be debilitating when an asthma attack strikes. Treating asthma usually involves inhalers and steroids, along with coaching from an asthma coach or allergy specialist. Asthma coaches help patients learn proper inhaler usage/technique, keeping the condition under control, and discussing ways to deal with the various asthma triggers in your environment. Treating your asthma with an online doctor or specialist mitigates cost, increases time efficiency, and helps the doctor help you ensure you’re following the treatment plan properly.

Depression

Depression can manifest itself in a few ways. Persistent depressive disorder is a long-lasting mood that is characterized by periods of major depression interspersed with less severe periods. Psychosis can also cause depression based on delusions of fear, guilt, poverty, illness, and many others. One of the most likely forms of depression is seasonal affective disorder, which rears its ugly head during the winter months. Signs of depression include:

  • A persistent feeling of being sad
  • Anxiety
  • Hopelessness
  • Irritability
  • Appetite loss
  • Trouble sleeping
  • Concentration and memory issues
  • Minor aches and pains
  • Restlessness
  • Guilt
  • Feeling worthless
  • Fatigue

Teletherapy (a subset of telemedicine that covers mental health and wellness) can help treat this condition. Treatment for this issue can come through psychotherapy, specialized treatments, and medication. An online doctor can talk to you about the causes and treatments for your depression, in addition to diagnosing it. More importantly, they can prescribe antidepressants to help treat the issue. Going the online route can increase your comfort level and ultimately treat depression more effectively. 

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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

(7) http://www.securetelehealth.com/private-insurance.html