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What is telemedicine?


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Telemedicine uses communication and information technologies to help provide healthcare services at a distance. It is a rapidly evolving field with numerous applications: it can be used for information exchange between the patient and the medical professional or between health professionals only. Some of its uses include online consultations, monitoring certain physical functions at a distance, or facilitating diagnostic and/or treatment processes. If you are a medical professional, this blog can provide you with a comprehensive insight into its forms, benefits, challenges and practical use around the world.

In this blog you will learn:

What is telemedicine?

The definition of telemedicine is “the use of electronic information and communication technologies to provide and support health care when distance separates the participants[1]. The word itself was coined in the 1970s by Thomas Bird from the Greek words “tele” and Latin “medicus” which, when combined, literally mean “healing at a distance” [2].

The World Health Organization defines telemedicine as “the provision of health services by health professionals, where distance is a critical factor, using information and communication technologies to exchange valid information for the purposes of diagnosis, treatment and prevention of disease and injury, research and evaluation, and to facilitate the continuing education of health professionals, with the aim of safeguarding the health of individuals and communities” [3].

Why do we need telemedicine?

Telemedicine can effectively contribute to addressing many challenges of today’s healthcare systems. Here are some of primary care, which directly influence all other healthcare levels: [4]

Demographic changes

  • More need for geriatric care
  • Additional workload for GPs and family doctors: elderly patients are ill more frequently and need more care

Increase of chronic conditions

  • More chronically ill patients mean greater need for time, care and resources

Lack of medical personnel

  • In heavily populated and/or remote areas (countryside)
  • Bottlenecks in medical care: patients are not processed quickly and efficiently
  • Overburdened medical staff
  • Longer waiting times

Administration

  • More work is required from nurses and doctors
  • Growing administrative burden eats into patient time and affects patient care

Forms of telemedicine

Telemedicine has diverse forms and can effectively support existing healthcare structures. As an example, here are the forms of telemedicine available in Germany: [4]

Video calls

Consultations with various doctors online. Used in general practice, family medicine, psychotherapy, etc.

Health monitoring apps

Examples are apps for heart rate monitoring, medication reminders and therapy support.

Telemonitoring

Patients, especially those with chronic conditions, can be monitored at home. In this, various data (blood sugar level, blood pressure) are sent electronically to the healthcare providers.

Approved digital medical apps (Ger. ‘DiGA’)

Apps approved by the German Federal Institute for Drugs and Medical Devices (BfArM). They can be prescribed by a doctor and covered by health insurance.

E-prescriptions

Electronic prescriptions provided to the patient for the pharmacy.

Home visits in family medicine

A nurse from the family doctor’s office visits the patient and sends the diagnostic measurement results to the remote family doctor.

Information platforms

Websites and apps with medical information, advisors and support.

Telepathology and teleradiology

Medical imagery and pathology results are sent to remote specialists for diagnosis.

Tele-emergency doctor

A tele-emergency doctor (Ger. ‘Telenotarzt’) is a highly experienced emergency doctor with additional certification for tele-emergency medicine. They consult the emergency team remotely by interpreting the vital signs sent to them in real time, and through live video transmission from the ambulance.

What are the benefits of telemedicine?

By enabling remote consultations and sharing diagnostic data, telemedicine provides better access to healthcare and an excellent support to home care services, promoting psychological well-being, improved care quality and heightened safety, especially for the elderly. Moreover, it contributes to significant cost reduction by eliminating the need for travel expenses and support staff associated with in-person visits, while also lowering hospitalisation rates through timely diagnostic measurements. Importantly, telemedicine helps lower the risk of infectious disease transmissions that often occur in hospital settings. Click here for a detailed description of these advantages.

What are the challenges in telemedicine?

The COVID-19 pandemic shed light on the many vulnerabilities of even the most advanced healthcare systems. Nevertheless, these challenges also provided an impetus for greater expansion of telemedicine. However, the pace of integrating telemedical services into medical practice is relatively slow, and more successful in some areas of medicine than others. Click here to find out in detail why this is the case, considering the following factors:

  • A limited number of assessment types
  • Data quality concerns
  • Data security concerns
  • Digital divide
  • Legal and reimbursement issues

Telemedicine in outpatient care

Telemedicine offers numerous new avenues how people can access medical services. A very important stepping stone has been its integration with electronic health records (EHRs). It resulted in better healthcare accessibility and quality, particularly benefitting outpatient facilities, home care services, and communities in remote areas. Click here to find out more about:

benefits of telemedicine in outpatient care:

  • improved access to quality care,
  • cost-effectiveness and time saving.

benefits of EHR records in outpatient care:

  • improved quality of care,
  • reduction of medical (transcription) errors,
  • effective data sharing between medical professionals.

Telemedicine in primary care

The use of telemedicine varies considerably between countries. In German primary care, for example, telemedicine can be used for video consultations with patients as well as for communication between members of the medical team:

Medical aspects in patient communication [4]

  • simple diagnostics (e.g. colds)
  • initial consultation and follow-up (in the process of diagnostics and examinations)
  • patient educationpatient care in care facilities
  • second opinion

Administrative aspects in patient communication [4]

  • prescription issuing
  • sick note issuing
  • appointment setting

Communication between nurse and remote family doctor

Teleconsultation between patients and physicians has its limits. For one, patients lack the tools and knowledge for basic clinical examinations. If a visit at the doctor’s office is not possible, the patient can be visited by a nurse at home. The nurse acts as a bridge between the patient and the physician, conducting simple diagnostic tests like blood pressure or ECG measurements and communicating the measurement results to the doctor. To read more, click here.

Conclusion

Telemedicine offers a variety of benefits for both patients and medical professionals. With certain conditions and medical fields, it offers effective patient monitoring and exams even without in-person contact. However, it is also marked by many challenges. In part, these can be addressed with hybrid forms of in-person exams and diagnostic data sharing with remote GP or specialist. The backbone of telemedicine and its most important advantage should be electronic health records (EHRs), where the diagnostic measurements are automatically stored (saving time and preventing transcription errors). In this way, the diagnostic results can be y compared to previous ones for effective diagnostics and treatment. 

There are new digital diagnostic solutions on the market that integrate EHRs and thus offer automatic data storage. They enable healthcare professionals more flexibility. Firstly, they let them decide where the patient should be examined (at the medical facility or at home). Secondly, they allow them to share diagnostic measurements for consultation – either with the remote doctor’s office or specialists for faster diagnostics and treatment.