What is ‘Telemedicine’?
Telemedicine is healthcare that is provided remotely. It is often delivered in three forms: live telemedicine, remote monitoring, and the “store-and-forward” method. Live telemedicine enables patients and healthcare professionals to communicate with patients via phone or video-conferencing in real-time. Remote monitoring allows physicians to keep track of patients’ vital signs through mobile medical equipment. Last, the “store-and-forward” method allows medical documents such as test results to be transmitted via a secure portal.
The use of telemedicine has recently become increasingly common due to the strains that the COVID-19 pandemic has put on healthcare systems around the world. In an attempt to minimize the spread of infections in waiting rooms, health care professionals started to utilize the internet more in order to provide quality care for patients remotely. In the months following the onset of the pandemic, it was reported that as many as 47% of Canadians used virtual means to receive medical care, as opposed to 4% prior to the announcement of the outbreak made by the World Health Organization. Prior to the pandemic, physician-patient communications via the Internet were mainly conducted in the form of emails, aimed to discuss test results. However, social distancing guidelines and mechanisms that were set up to control the spread of the outbreak pushed the healthcare sector to adopt innovative ways to provide virtual care for patients without compromising quality. Several private companies, such as Maple and Babylon Health, have also seized the opportunity to provide virtual assessments and prescription refills for those who wish to stay away from doctors’ offices and pharmacies.
Although the healthcare sector has long been reluctant to adopt virtual care as a means to provide medical assistance remotely, there is no question that telemedicine has helped alleviate some of the difficulties that hospitals and clinics faced in accommodating patients during this pandemic.
Benefits of Telemedicine
Aside from minimizing the spread of COVID-19 in emergency rooms and clinic waiting areas, virtual care has proven to have numerous other benefits. It has helped hospitals immensely in clearing existing backlogs in operations by freeing up space and preserving personal protective equipment (PPE). In doing so, it has maximized efficiency in the use of hospital resources. Moreover, initial assessments that are done virtually have the potential to help health professionals to pre-sort and triage patients more efficiently and save costs for hospitals and reduce length of stay for patients. Virtual primary care visits have offered critical insight into the living conditions of patients as well as other environmental factors that often aid physicians in determining an accurate diagnosis. Finally, telemedicine has reduced the time of visits by an average of 20% in addition to eliminating travel time for patients altogether. Therefore, virtual visits appear to be a great alternative for those who are not in need of urgent medical care or struggle to find the time to see a physician in person due to work or home responsibilities.
Consequences of Telemedicine
Although telemedicine has been a valuable asset to hospitals and clinics as a way to augment or replace in-person visits during the pandemic, it certainly has its shortcomings. Namely, lack of access to high-speed internet in rural areas in addition to the heavy reliance of telemedicine on expensive electronic devices poses a serious barrier to patients that could benefit most from virtual care but lack the resources to access it. Telemedicine also does not appear to be highly effective for individuals who face complex medical needs that require attention from health professionals across disciplines or for those who require extensive testing in the forms of x-rays, biopsies, etc. Overall, despite all of the positive potentials that telemedicine has for transforming healthcare, it still appears to be better suited for younger, healthier populations of higher socio-economic status.
The Future of Telemedicine
The utilization of telemedicine to deliver health care remotely during the COVID-19 pandemic has showcased the value that technology could bring to expand and permanently transform patient care. The urgency of adapting to new norms during a health crisis forced state governments and the federal government in the United States to waive regulations that posed challenges to the delivery of remote medical care. In Canada, Alberta is moving to make virtual care a permanent part of its health care system. Health minister Tyler Shandro said in early June that “virtual codes will no longer be restricted to only a public health emergency” and that new billing codes will be adopted to enable fair compensation for physicians who provide virtual care for patients. In the Maritimes, the president of Doctors, Nova Scotia, Dr. Robyn MacQuarrie, is pushing the provincial government to make the services that have been provided remotely during the pandemic a permanent option for residents. Additionally, through a partnership with Johnston Group Inc., Teladoc Health Inc. has committed to provide telemedicine to 350 First Nations, Metis, and Inuit employers whose employees live far away from primary care providers.
Although 58% of patients say they would still prefer to have in-person doctor visits post-pandemic, there are several specialties such as pediatrics, obstetrics and behavioural health that could continue to benefit from telemedicine. As we all continue to adapt to the changes that the current pandemic has imposed on our lives, it is important to stay open-minded to new, innovative methods of receiving daily services including healthcare.
Written by Bonnie Hassanzadeh, IPilogue editor and Clinic Fellow at Osgoode Innovation Clinic.
One Response
In addition to adopting telemedicine platforms, there could be an opportunity for public healthcare providers to incorporate the use of wearables in between visits. “Wearables” are devices that track movement and biometrics, often using Bluetooth and Wi-fi to connect to a mobile app. A common example is a smartwatch. (1)
Fitbit and Apple recently teamed up with Stanford Healthcare Innovation Lab on its COVID-19 wearables study. (2) While there have been no conclusive results published yet, the researchers’ initial findings revealed that patients could use their wearables to help detect signs of the coronavirus by tracking biometric data, such as heart rate. (3)
Wearables could empower patients to observe their biometrics, reporting early deviations to their physicians before they become symptomatic. However, it is important to recognize the caveats; at this early stage, wearables are not meant to be a tool for diagnosis, nor are they meant to replace physicians. (4)
Privacy issues are another hurdle to overcome (5), including discrepancies between the governance of private companies and public health care providers when they engage with personal health information. Ontario’s Personal Health Information Protection Act (6), for example, applies to “health information custodians”. As the term is currently defined in s 3(1), there is no inclusion of private companies that help consumers measure biometric data through wearables. This gap will be crucial to address as technology decentralizes health care and patients have increased access to tools to help them manage their well-being at home.
(1) Chris Smith, “What is Wearable Tech? Everything You Need to Know Explained” (17 August 2019), online: Wareable .
(2) Stanford Healthcare Innovation Hub, “COVID-19 Wearables”, online: Stanford Healthcare Innovation Hub .
(3) Geoffrey A Fowler, “Wearable Tech Can Spot Coronavirus Symptoms Before You Even Realize You’re Sick”(28 May 2020), online: Washington Post .
(4) Andrew Steger, “Can Wearable Tech Spot COVID-19 Symptoms?” (13 August 2020), online: Health Tech Magazine .
(5) Laura Bliss, “Wearable Tech Enters the Fight Against COVID-19” (19 August 2020), online: Bloomberg .
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