The healthcare landscape has changed drastically following the global COVID-19 pandemic. The weaknesses of our healthcare systems have been laid bare by the pandemic – such as the lack of testing facilities, the decentralization of healthcare policies, and the ever-thorny issue of insurance coverage and healthcare access.
While the COVID-19 pandemic has been a “stress test” for the US healthcare system, it has also given us the opportunity to reflect on areas in our healthcare system that need to be addressed urgently. One such area has been the telehealth sphere.
Telehealth or telemedicine is the distribution of healthcare through telecommunication technologies. The most common form of this is having a doctor consultation over a video call. This means that patients do not have to physically come to a clinic to receive an evaluation and treatment.
Once seen as a niche area, telehealth has now become an integral part of the US healthcare system–all in the course of less than a year. Out of necessity due to the lack of available in-person doctors and to help avoid exposure to COVID-19, all 50 states loosened their regulations in regards to telehealth and the Department of Health and Human Services (HHS) even allowed practicing telemedicine across state lines.
The U.S. Drug Enforcement Agency (DEA) for the first time has given the permission to certified addiction specialists to offer medication-assisted treatment for opioid use disorder (MOUD) for patients suffering from opioid use disorder via telemedicine and prescribe (buprenorphine) online (teleMOUD). All these were important changes, because the COVID-19 pandemic caused many parts of the U.S. to undergo lockdowns, with a large portion of in-person clinics being closed and many transmissions and exposures happening in healthcare facilities that were still open.
This forced patients and doctors to become familiar and comfortable with the concept of telehealth.
Advantages of Telehealth Services
There are many advantages that come with telehealth services. The core advantage is that it increases options for patients to see a doctor. With telehealth services as an option, patients can choose to dial in and speak to a doctor instead of having to take the trouble to travel to their nearest clinic. This means that patients need not be denied treatment access just because of geographical or travel barriers and it also means not having to potentially take off time from work in order to see a specialist.
Besides widening access to healthcare, telehealth services also mean that patients have an added dimension of privacy when consulting with a doctor. This is especially important when it comes to treatment of generally more sensitive matters, like STDs, or psychiatric or substance use disorder treatment. This allows patients who highly value their privacy to receive treatment from the privacy of their homes.
When you combine the above advantages with the fact that connecting to your doctor via telemedicine technology is also substantially less costly than an in-person visit (not even accounting for the societal loss of productivity from missed days at work for in-person appointments), it becomes clear why the telehealth sector has experienced such a boom.
Limitations of Telehealth Services
Telehealth services do have their limitations. First of all, telehealth services are usually not meant for emergency cases – such as chest pain and significant breathing problems, for example. Patients must be educated that in emergency cases such as these, they must go to their nearest emergency department for an in-person evaluation.
In cases where telehealth services are appropriate, the doctor’s diagnostic tools, however, are limited to what is available at the patient’s home, which may include such tools as a thermometer, blood pressure cuff or a pulse oximetry device.
While wearable health technology is getting more advanced, most people do not yet have access to these yet. Yet, the future of wearables as it related to telehealth does look promising: the newer Apple Watch includes a heart rate monitor, pulse oximeter, and EKG functionality that can help recognize arrhythmias; however until its routine integration with telehealth solutions there is still a long way to go.
And any further workup, such as blood work or urine testing, needs to be conducted in-person.
There is also some concern about whether the over-reliance on telehealth services would negatively impact the doctor-patient relationship. The worry is that a relationship consistently conducted remotely would be inferior in quality compared to a relationship that is conducted in-person. Cues like body language and non-verbal communication may get lost via video. This is a fair concern; however, the boom in teleconferencing platforms following the COVID-19 pandemic suggests that this form of communication might be the new normal in the years ahead.
Telehealth or telemedicine services offer tremendous benefits to patients by increasing patient’s options, access to healthcare, and by saving time and decreasing healthcare costs. They are, however, mostly limited to non-emergent cases–and even in those cases, diagnostic limitations do still exist.
Overall, the increasing availability of telehealth services and the loosening of restrictions and red tape by the government represents a step in the right direction. It may help to fix a deeply broken healthcare system that is far more costly than any other comparable healthcare system in the western world. We are therefore likely to see an even greater expansion of the telehealth sector in the near future.