Understanding Telemedicine
Telemedicine refers to the remote delivery of healthcare services using the telecommunication infrastructure and information technology. It is meant to eliminate barriers and improve access to medical services that would often not be consistently available in certain communities.
Ideally, this delivery method should complement face-to-face consultation, not replace it.
Categories of telemedicine include:
- Remote patient monitoring, which allows patients with chronic diseases to be monitored in their homes
- Store and forward technology, which stores clinical data and forwards it to other locations for evaluation
- Interactive telemedicine, which allows physicians and patients to communicate in real time
Telemedicine Enhances Patient Safety
Among the benefits of telemedicine are convenience, lower waiting times for consultations, access to high-quality medical diagnosis and treatment, and lower cost of remote consultations. In addition, the availability of patient records online has the potential to make patient prescriptions more reliable and accurate.
Studies have shown that this delivery method promotes continuity of care and improves overall clinical outcomes. Recent research has shown that heart failure telemonitoring reduced all-cause mortality by 15 to 40 percent and heart failure–related hospitalizations by 14 to 36 percent. Similar studies have also found that, compared with traditional care, telemonitoring for patients with heart failure was associated with significant cost reductions, ranging from 1.6 to 68.3 percent.
Telemedicine surveillance applications have been found to detect preventable, treatment-related adverse events that may otherwise go unnoticed by healthcare providers. A study of ambulatory patients with diabetes found that a weekly interactive, automated telephone application that provided patient education and self-management support with targeted nurse follow-up detected more (59 percent) treatment-related adverse events than either nurse elicitation (30 percent) or patient detection (11 percent) alone.
Assessing the Risks
While the benefits of telemedicine are verifiable, healthcare providers should be aware of its possible pitfalls. Inherent risks — including breaches in patient and staff privacy, inaccuracies in self-reporting, and failure to recognize symptoms that can only be caught in person — must be considered when embracing the remote delivery of healthcare.
Joseph Kvedar, MD, Partners Healthcare’s vice president of Connected Health, and Stephen Agboola, MD, MPH, associate director of Connected Health Data Science & Analytics at Connected Health Innovation, agree that healthcare providers and innovators should be mindful of the risks associated with telemedicine strategies. They offer the following guidelines for improving patient safety in telemedicine programs:
- Ensure patient safety is addressed at all stages of the program’s life cycle.
- Integrate safety testing in all usability and efficacy trials, regardless of whether they are conducted in academic medical settings.
- Certify all data security and encryption protocols are up-to-date.
- Include input from regulatory, professional and healthcare organizations in creating consensus-driven guidelines, operational protocols and standards … and ensure they are updated regularly.
- Confirm all possible risks are disclosed prior to patient enrollment.
- Create platforms that enable clinicians to document their telemedicine use and integrate those services into their workflows.
- Improve engagement in telemedicine services for patients with low health literacy and those who speak other languages.
While new medical technologies and care models always come with risks, telemedicine has proven to provide many positive effects on patient care. By using strict protocols and guidelines that reduce the risks associated with telemedicine, healthcare professionals can use the innovations associated with it to improve the health of patients and revolutionize healthcare delivery.
