Telemedicine

Telemedicine

Telemedicine can be defined as remote clinical service that a provider uses to treat or communicate with a patient. This differs from telehealth in that telehealth has a broader scope. Telehealth is the use of technology to meet all aspects of healthcare (Healthit.gov, 2019). Telehealth can be used for the care team to meet to discuss a patient. It can also be used to gather data on a patient. The scope of telehealth is as wide as the technology we have can make it.

Telemedicine can be used to interview a patient, assess patient symptoms, set patient wellness goals, and to the extent of the technology in use to visualize to patient and their complaint. Telemedicine has its limitations in that there is not physical contact with the patient unless they are in office utilizing telemedicine to contact a specialty provider. So, any care needing an actual physical assessment cannot be conducted via telemedicine.

Telehealth has a broader scope and due to that has a broader range of uses. Telehealth has allowed us an increase in the amount of communication and the timeliness of it. Imagine thirty years ago getting an xray, having it “printed,” taking it to your provider, and then having the provider look at it. Hopefully, they did not need a second opinion. In today’s word we do not even “print” them anymore. Some providers do not even look at the image and rely on the report that was generated and placed in the patient file by the radiologist. One of the main drawbacks I see in telehealth in general is the abundance of information that is now bombarding the providers. Pop-ups for screenings, notices for lab results, messages in the inbox for refills. It is mostly non-billable time and effort. Prior to telehealth the patient would come in and see the provider for results or to get a new prescription. It seems as technology increases, we are losing touch with each other.

 

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Telehealth and telemedicine seem like they could be two terms that refer to the same thing. While this concept is not totally off-base, it is a little misleading. In actuality, telehealth encompasses a larger domain of electronic healthcare options than telemedicine. Telemedicine is a unique and important part of telehealth, but it only refers to the clinical piece of remote patient care. In addition to remote clinical care, telehealth also covers remote education and training of health staff and providers, virtual meetings, and administrative duties that can include public-health (HealthIT.gov, n.d.). This technology is used with phones, tablets, and computers. The methods of communication include: video, calls, texting, emails, and photos.

Prior to COVID-19, telehealth with telemedicine was practiced in many rural areas of the country where providers, specifically specialists, were rare. Although this is still the case, we are seeing the use of telehealth escalate in the healthcare industry secondary to non-essential in-person gatherings being avoided. We went from meeting in person, sometimes flying across the country to do so, to meeting on Zoom, Teams, or WebEx, to name a few. We starting providing education to our staff using these telehealth modalities as well. Our hospice providers stopped doing home visits and started using telemedicine to see our patients with the help of the nurses that were still in the patient’s homes. Recent studies show the rise in telehealth with the pandemic has a reported 30% of adults saying they have used some variation of it at with three quarters of them saying they would most likely continue to use it after the pandemic is over (North, 2021). In hospice, we are planning to continue to use telehealth for most of our education after the pandemic because we won’t have to pay our staff to drive to one location from all over the city, and we can also educate our regional partners in other cities at the same time. Our providers will try to do most of their visits using telemedicine as well, because they can see more patients in a day if there is no drive time; in home hospice, time is money.

With all of the great thing’s telehealth brings to the table like convenience and cost savings, there are some drawbacks. Technology can be frustrating; I am sure the whole country is now versed on saying, “you’re on mute,” or “can you see my screen?” We must also have connectivity if we are going to do a video visit; if the weather is bad, or the patients live too far out in rural areas, connectivity is sketchy at best. I believe that human touch is essential, and can be missed. There is something very comforting in physically seeing someone and shaking their hand or giving them a hug. Ultimately, telemedicine and telehealth have been around for many years, and will be around for many more. I am excited and sometimes even a bit scared of the technology that is to come in this fascinating arena of health

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