The medical community has seen dramatic changes in the past few years, thanks to technological advances. Electronic health records allow authorized users to see patient records at the tap of a button, devices on the Internet of Things give patients and healthcare workers a chance to interact with patient data and create a plan of care, and telehealth provides a way for hospitals and other organizations to help more patients than ever before.
Telehealth, or telemedicine, gives healthcare workers a chance to interact with patients via video chat and, in some cases, can eliminate the need for patients to visit the doctor in person. It’s convenient, affordable and allows for easier access to specialized care. However, it isn’t 100% foolproof and can present challenges of its own.
The Downside of Practicing Telehealth
With more changes on the horizon for the nation’s healthcare system, the future of coverage is unclear. In a survey conducted by ReachHealth, only 20% of respondents felt that Medicare reimbursement was either fully addressed or not a challenge, while 24% felt the same way about Medicaid reimbursement. Private payor reimbursement had even less who felt confident about it, with only 17% reflecting a positive view.
Larger insurance companies like Cigna, Anthem and Aetna already offer telehealth services, but services that cross state boundaries can present issues. The Texas Medical Board requires that physicians be face-to-face with a patient before they can prescribe some types of medications, meaning telehealth can’t service all needs.
For those who live in rural areas, it may be difficult to obtain a reliable internet connection for a video chat with a healthcare provider. Additionally, rural physicians might not possess the resources to take advantage of telehealth technologies. A 2012 study found that rural physicians did not know about a virtual clinic, even though there had been advertising through several different platforms, and that it took more time to enter appointments into the system instead of handwriting them.
Another challenge telehealth may present is that some users might not know how to use the technology. In the same study, the researchers found that there was an overall 13% failure rate in elderly patients reading the metrics output by the telehealth equipment used to measure vital statistics, even when a caretaker assisted. Faulty statistics being reported to medical staff can have adverse results, so measures need to be taken to ensure that the user is fully trained on the equipment.
Affecting Patient Privacy, Autonomy and Quality of Care
Can telehealth interfere with a patient’s autonomy and privacy? A device that constantly monitors and sends data back to a healthcare provider might present ethical challenges.
For example, an elderly person could be pushed into a monitoring situation they might not want because a well-meaning caretaker wants them to be monitored.
Privacy is another issue, as hackers look to find ways to steal health data. Healthcare organizations also need to ensure that assumptions built into algorithms for these programs and software won’t replace clinical judgment. Telehealth policies should ensure that a patient’s autonomy and privacy will be protected.
According to a Wall Street Journal article, some also worry that telehealth appointments will cause quality of care to suffer if people use telehealth services all the time instead of going to their primary care physician in person. A doctor can’t listen to heartbeat, feel for swollen glands or take a strep test via video chat.
A study published in JAMA Dermatology, cited in the Wall Street Journal, found that when researchers posed as patients with skin issues, just 32% of the telehealth sites they accessed discussed potential side effects of prescription medications, while several sites didn’t ask follow-up questions and misdiagnosed ailments.
“Telemedicine holds enormous promise, particularly in dermatology, but these sites are just not ready for primetime,” said Jack Resneck, the study’s author in an interview with the Wall Street Journal.
What is the Future of Telehealth?
Some of those drawbacks can be addressed with proper care and attention. According to a 2017 study published by the National Institutes of Health, patient autonomy could be empowered “when it goes along with a personal relationship based on trust, assistance and support.” Additionally, telehealth could even lead to a quality of life improvement if caretakers work together to ensure it adheres to the patient’s individual needs. Training the patients and caretakers can help to eliminate false readings.
As telehealth continues to advance, regulations will need to be put in place. Rules for telehealth differ from state to state, and different physician groups have different ideas of how it should be used. Organizations like the American Telemedicine Association and American Medical Association have worked to establish accreditation programs and ethical guidelines to make sure the telehealth entities are following them.
With the right regulations and guidance, telehealth can be a great tool for patients who need access to care. A Master of Science in Health Informatics from Jacksonville University provides students the knowledge and insight they need to understand the evolving landscape of telehealth and how it will affect the healthcare field going forward.