Many telemedicine solutions are more affordable than traditional interventions [4], especially the digital therapeutic branch of telemedicine which can help therapy reach millions of patients for significantly less than in-person interventions.
Co-creating the experience
More and more studies are showing that the appropriate use of health tech increases user satisfaction [5]. Whether you are using a hypnotherapy app, or you are video chatting with your doctor, the experience becomes more user-friendly and promotes patient autonomy.
Many experts argue that telehealth helps shift authority to the patient. We are witnessing a more egalitarian and informal relationship between the user and the healthcare provider and healthcare professionals.
Dr Eric Topol, an American cardiologist and a digital health pioneer, argues that our healthcare needs to enter a digital revolution, which should include relationship adjustments [6]. In other words, the traditional, top-down medical model of care is now being replaced with a fresh perspective. You can take a more proactive role and influence your care by contributing to data collection, monitoring, and knowledge acquisition. Telehealth puts you in the driving seat. You are no longer just a passive recipient of services.
Who uses telehealth?
In 2019, J.D. Power conducted a survey in the US, which showed that one in ten Americans use telehealth. As already mentioned, it is expected that this number will increase drastically with the emergence of coronavirus and further developments of telehealth.
Initially, telehealth was targeting people living with chronic diseases, seniors and people living in remote areas. However, survey results show that usage is more likely among young people and urban dwellers. In America, only 8.7% of rural residents have adopted telehealth services. People aged 18-to-24 years have used telehealth more than any other age group (13.1%), while older people (65+) have the lowest utilization rate of any age group (5.3%) [7].
Telehealth has a lot of potential to become more widely adopted, with greater involvement from payers and healthcare professionals as regulations and clinical evidence continue to progress.
Does it wWork?
There is a lot of scientific evidence for the use of telehealth. Nonetheless, some people are worried about the safety of this approach. Different regulations have been put in place to protect consumers. For instance, in the US, the Food and Drug Administration (FDA) monitors smartphone applications that pair with medical devices. However, a lot of telehealth devices and apps are not considered medical devices and don’t pose a significant risk if not working as intended, so there is less regulation.
Therefore, it is important for you as a user to vet the device before using it. Angela Hardi of the Washington University School of Medicine in St. Louis compiled a list of questions you can check when deciding on a telehealth device or app:
Tip: A credible mHealth program should probably include doctors and/or health experts.
Tip: The app shouldn’t seem like an advertisement for another product.
For telehealth within mental health, the American Psychiatric Association (APA) is offering a rating system based on the following criteria: background information, privacy and security, evidence, ease of use and interoperability.
When evaluating a telehealth device, program or app, you should also consider if it’s designed in a way that is functional for you; for instance, are you likely to use it over time?
Open questions about telehealth
Experts agree that telehealth is an excellent innovation that can promote our health. However, there is still a gap between the design of evidence-based, pilot telehealth interventions and implementation into practice. Also, it is not easy to design and implement a telehealth program that involves multiple stakeholders.
Dr Johanna Taylor from the Department of Health Sciences at the University of York, UK, mentions some of the barriers to the wider adoption of telehealth such as [8]:
inability to assess a patient’s telehealth needs,
technical/legal issues related to sharing protected health information,
equipment limitations,
inefficient service delivery resources,
perceptions of increased staff workload,
low staff awareness,
uncertainty regarding remote patient monitoring structures and processes.
Professor Deborah Lupton, an Australian sociologist who focuses on digital health, also warns that before using any online or remote service, it is crucial to understand who can access the data and how this data is being safeguarded [9]. A lot of work is being done to address these issues, so that people can feel more comfortable and empowered when using telehealth services.
The Wrap Up
Telehealth technology is maturing and it is expected that it will soon become a staple in our health industry. Many people could gain from telehealth services, so it is essential that telehealth gets promoted and utilized. However, it's important to ensure that telehealth is handled appropriately and safely, with time taken to overcome the open questions that still surround digital health as a whole. Nonetheless, a balanced combination of digital and in-person services could improve the quality of life for many people, especially in times like these when access to in-person support is less available.
References
Phillips, V., Vesmarovich, S., Hauber, R., Wiggers, E., & Egner, A. 2001. Telehealth: Reaching out to newly injured spinal cord patients. Public Health Reports, 116: 94–103. Link
Vissers, M., Van den Berg-Emons, R., Sluis, T., Bergen, M., Stam, H., & Bussmann, H. 2008. Barriers to and facilitators of everyday physical activity in persons with a spinal cord injury after discharge from the rehabilitation centre. Journal of Rehabilitation Medicine, 40: 461–467. Link
Davis, S. M., Jones, A., Jaynes, M. E., Woodrum, K. N., Canaday, M., Allen, L., & Mallow, J. A. 2020. Designing a multifaceted telehealth intervention for a rural population using a model for developing complex interventions in nursing. BMC Nursing, 19(1): 1–9. Link
de la Torre-Diez I, et al. 2015. Cost-utility and cost-effectiveness studies of telemedicine, electronic, and mobile health systems in the literature: a systematic review. Telemedicine Journal and e-Health, 21(2):81–5. Link
Werder M. Health information technology: A key ingredient of the patient experience. 2015. Patient experience journal, 2 (1): 143-147. Link
The Topol Review. 2019. Preparing the healthcare workforce to deliver the digital future. Available at: Link [Accessed March 24, 2020]
JD Power. 2019. Press Release [online] Available at: Link [Accessed March 24, 2020]
Taylor, J., Coates, E., Wessels, B. 2015. Implementing solutions to improve and expand telehealth adoption: participatory action research in four community healthcare settings.
