We're sorry but mesimedical.com page doesn't work properly without JavaScript enabled. Please enable it to continue.
MESI logo
  1. Home
  2. integration of ...

Integration of telemedicine in outpatient care


LinkedIn icon Twitter icon Facebook icon

Telemedicine has proven to be an effective and convenient avenue to healthcare. Combined with the growing and extensive adoption of electronic health records (EHRs), it has resulted in improved access to higher-quality care in outpatient facilities, particularly in home care and underserved communities like those in remote areas. However, as is the case with any novel yet beneficial technology, its adoption is slow due to a number of complex challenges.

In this blog you will learn:

What are the benefits of telemedicine in outpatient care?

Improved access to quality care

Technological progress in the field of wireless data transmission and the proliferation of portable devices with integrated cameras has greatly increased the utility of telemedicine, although is yet to provide acceptable alternatives to many diagnostic modalities, most obviously those that require a physical examination [1] [2] [3] [4] [5] [6] [7] [8]. However, some areas of medicine, like cardiology (or more precisely, telecardiology), have already significantly benefitted from new technologies, like lighter wearable monitoring devices, more reliable implants, and even smartphone-based systems [9].

Nevertheless, most of the diagnostic (and treatment) challenges associated with telemedicine in comparison to in-person consultations are non-existent or greatly mitigated if telemedicine is used to augment the traditional, hands-on approach. For example, a patient comes to an outpatient facility for a regular check-up, during which the physician or other healthcare professional finds something suspicious or beyond their expertise. What is the solution if there are no specialists at hand? Use videoconferencing or send pictures and other health data over the internet to a specialist at another location for further evaluation, expediting the referral process and greatly increasing the quality of care (especially if the patient needs additional examinations or even urgent treatment) [10]. The same advantages apply if the patient has a home visit by a nurse, who performs the diagnostic measurements and transmits their results to the patient’s GP.

There are many technological solutions for all of that (i.e. videoconferencing, health data capture, data transfer, etc.), but many of them suffer from interoperability issues or don’t offer seamless data transfer from the diagnostic device(s) to a PC, tablet, or smartphone for further dissemination, or enable (automatic) data entry in the patient’s EHR (if available). Still, there are solutions like the MESI mTABLET: they offer all that in one package, saving time and reducing costs without sacrificing the quality of care.

Cost-effectiveness and time-saving

One of the most obvious benefits of telemedicine is cost-effectiveness. For example, patients who are ill but are not experiencing a medical emergency or are in a stable condition that requires monitoring, don’t have to physically visit a healthcare facility or at least more seldomly than they would normally have to. They can consult a primary care physician or a specialist from their home using teleconferencing, and can have their vitals and other selected parameters taken remotely (using wearable monitoring devices). Consequently, the patients save on transport costs (which can be substantial in more remote locations) and commuting time [11] [12]. Another option is for the patient to be visited by a nurse at home, with their diagnostic measurement results communicated immediately with a GP or a specialist.

Cost-saving benefits extend to the healthcare providers as well, although the cost-effectiveness varies greatly between medical fields. Examples of fields economically benefitting from telemedicine are psychiatry, ophthalmology and many more, although in some the cost-effective nature comes into play only under specific circumstances (e.g. a sufficient number of consultations) [13] [14] [15]. An important area of medicine increasingly benefitting from telemedicine is family medicine, for example in Germany, where patients can be visited by nurses, who send the results of their diagnostic measurements directly to their family doctor (Ger. ‘Hausarzt’).  These benefits, including a decreased work burden, particularly for medical support staff (i.e. less administrative work with fewer patients etc.) are even greater if telemedicine is augmented with a robust EHR system.

What are the benefits of electronic health records (EHRs) in outpatient care?

Improved quality of care

Proper implementation and integration of EHRs greatly improves the quality of care (by streamlining the healthcare provider’s workflows and thus increasing efficiency), and reduces the number of medical errors by improving the reliability of data and increasing its accessibility [16]. Furthermore, easy access to the patient’s health data and its uniformity enables more reliable analyses with the aim of improving patient outcomes [17].

Reduction of medical (transcription) errors

Illegible handwriting is a significant problem in medicine and is the cause of many medical errors, often with serious and even fatal consequences [18]. It is estimated that, in the United States alone, more than 251 thousand people die each year due to medical errors; this makes medical errors the third leading cause of death [19]. The problem is probably most acute when prescribing medications and has led to several highly publicised deaths, including that of a 42-year-old patient who died in 1999 when he received a wrong medication because the pharmacist misread the name of the prescribed medication [20]. In general, it is estimated that each year, in the United States alone, at least 7000 to 9000 people die because of prescription errors [21].

These issues can be greatly mitigated or virtually eliminated through the use of EHRs. They offer data uniformity and traceability (when, why and by whom any record alterations have been made) and consequently a reduction in malpractice claims. This reduction can be significant. A study found that, while 6.1 % of users of EHRs had a history of paid malpractice, that number was far higher with users of paper-based medical records (10.8 %, i.e. nearly 80 % more than in EHR users) [22]. Furthermore, bits and bytes are far easier to share than paper and there is no transcription necessary.

Greater data accessibility

Easy health data sharing has numerous advantages. Healthcare professionals treating a patient have an easier time coordinating their work since they can exchange data about treatment and prescribed medications and thus make better, more informed decisions [23] [24]. In contrast to paper records, there is even a convenient possibility to allow patients access to their own EHRs from the comfort of their homes. That has numerous benefits, but is associated with a few concerns, like data security [25]. This brings us to the challenges of telemedicine.

What are the challenges of digital healthcare?

Data security

One of the biggest safety concerns associated with telemedicine and the use of EHRs is data security. Acknowledged from the nascent period of EHRs, it has gained greater attention during the COVID-19 pandemic, when there was an unprecedented surge in the use of digital healthcare, particularly telemedicine [26]. Cyberattacks against the healthcare industry are on the rise and have already caused hundreds of millions of dollars in direct damage (ransomware attacks) and have compromised the health data of millions of patients [27] [28].

Another aspect of healthcare cybersecurity associated with telemedicine is cyber vulnerabilities of wearable monitoring devices. A comprehensive 2021 study by the Kaspersky Lab cybersecurity company found that the Message Queuing Telemetry Transport (MQTT) protocol, a commonly used protocol for transmitting data from wearable monitoring devices, stated at least 90 vulnerabilities [29].

Interoperability

There is a growing number of healthcare institutions that are in the process of integrating wearable health technology with EHRs, but their efforts are hampered by interoperability issues. Device manufacturers and EHR system developers use different, often proprietary, data transfer protocols, which makes mutual communication between systems and transfer of data streams difficult [30]. Interoperability between EHRs systems themselves also leaves much to be desired, even though there is evidence that EHR interoperability positively influences medication safety, reduces patient safety events, and even reduces costs [31] [32]. For this reason, MedTech developers need to bear in mind that a stand-alone diagnostic measurement device is not effective if it is not easily connectible with the EHR solution that the customer uses. The MESI mTABLET diagnostic system not only offers fast and easy diagnostic measurements, but also their easy management and integration with the software you already use.

User training

It would be unfair to put the blame for less-than-desired utilisation of digital healthcare tools just on healthcare professionals themselves, since many of them may not have been given proper training in their use [33]. Medical and nursing school curriculums may have kept up with the latest advancements in medical treatments and procedures, but many have neglected to incorporate teaching digital competences, which area necessity today. However, it is imperative that the user-centred approach is applied in the development of MedTech solutions in order to make them intuitive and easy to use. The MESI mTABLET diagnostic system can be used by medical professionals with very little training necessary.