Tele-Health & Covid-19
To limit worker exposure to infectious patients; (1) personal protective equipment (PPE), (2) decreasing a spike in patients in hospitals, (3) improvements in the way health care is provided, are required during this pandemic. Using approaches that do not focus on in-person facilities, healthcare providers have had to adapt the way they triage, treat, and care for patients. Telehealth systems aid in delivering needed treatment to patients while reducing the risk of SARS-CoV-2, the virus that causes COVID-19, being spread to healthcare professionals and patients.
Though telehealth technology and its use are not recent, widespread acceptance among Health Care Professionals (HCPs) and patients has been gradual, going beyond basic telephone correspondence. Prior to the COVID-19 pandemic, developments indicate that both HCPs and patients were becoming more interested in using telehealth facilities, however, since the COVID-19 pandemic, new legislative reforms have lowered obstacles to telehealth coverage and encouraged the usage of telehealth to provide emergency, chronic, primary, and specialty treatment. Many specialist medical associations support telehealth programs and provide advice on how to practice medicine in this changing environment.
HCPs and patients can interact using technology to provide health care through a range of telehealth modalities:
- Synchronous: This refers to real-time phone or live audio-video communications with a patient, usually from a smartphone, tablet, or computer. If the consultant care practitioner performs a remote examination, another HCP (e.g., nurse, medical assistant) may use peripheral medical instruments (e.g., optical stethoscopes, otoscopes, ultrasounds) physically for the patient.
- Asynchronous: This involves “store and forward” technology, which collects texts, photographs, or data at one point in time and interprets or responds to them later. Via encrypted communications, patient portals may promote this form of contact between provider and patient.
- Remote patient monitoring: This allows for the automatic transfer of a patient’s clinical measurements to their healthcare provider from a distance (which may or may not be in real time).
Telehealth’s Benefits and Possibilities
Telehealth networks will aid public health response efforts through this pandemic by increasing social distancing and furthermore reducing possible bacterial exposures. These facilities will ease the burden on healthcare services by reducing the use of personal protective equipment (PPE) by healthcare providers and mitigating the increase in patient demand on hospitals.
Due to the new protocols for triaging patient care during the pandemic, delayed preventive, chronic, or basic treatment has had additional detrimental effects on quality of care. Additionally, for those who are medically or socially disadvantaged, and those who do not have easy access to doctors, remote access to healthcare facilities may improve participation. When an in-person appointment is not possible, remote access will also help maintain the patient-provider relationship.
Telehealth may be used for a variety of purposes, including, but not limited to:
- Following up on patients after they’ve been admitted to the hospital
- Case management for people who are having trouble getting treatment
(e.g., those who live in far rural settings, populations at high risk of contracting SARS-CoV-2 including the elderly, those with limited mobility)
- Provide advance treatment plans and consultation of patients and families so that wishes can be documented in the case of a life-threatening event or medical problem.
- For non-COVID-19 illnesses, provide low-risk urgent treatment, recognise those that may need further medical consultation or review, and refer if required.
- For underlying health problems and drug treatment, see primary care physicians and clinicians, including psychiatric and behavioral health.
- Provide coaching and assistance of people who are dealing with debilitating illnesses, such as weight loss and diet therapy.
Telehealth Safety Measures
Keep in mind that telehealth is not excluded from legislation and governance.
- Recognize specific local and international rules and restrictions, as well as temporary mandates and orders, and their expiration dates.
- For hospital facilities and HCPs, keep an eye out for new regulatory decisions.
- In cases where telehealth has the opportunity to provide services internationally or across multiple regions, special attention must be paid to the needs of each individual region or state.
- HCPs should keep track of their profession’s qualifying requirements.
- Providers and personnel should be educated on telehealth procedures, methods, and guidelines, such as patient preparation, reporting, and accounting, specialty referral systems, critical and emergent treatment, testing facilities, pharmacy prescriptions, medical devices, and follow-up appointments.
Telehealth’s Possible Weaknesses
- Because of the urgency, existing health problems, or failure to perform an accurate medical test, in-person appointments are in some cases preferred.
- The need to discuss sensitive issues, especially if patients are uncomfortable or concerned about their privacy.
- Restricted or limited access to electronic equipment available for a telehealth visit (e.g., mobile phone, tablet, computer) or tele-communication and infrastructure problems.
- HCPs and patients’ levels of technology comfort and computer literacy skills.
- Virtual visits by HCPs and patients are accepted as a cultural norm rather than in-person visits, which may affect bedside manor and communication breakdown between patient and care provider.