Target Health Blog

Telehealth and Telemedicine During the Coronavirus Pandemic

May 25, 2020

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Quiz
Source:

Telehealth Blood Pressure Monitor
Photo credit: by Flickr user Tunstall Telehealthcare -
https://www.flickr.com/photos/tunstalltelehealthcare/6850731499, CC BY 2.0, https://en.wikipedia.org/w/index.php?curid=34739378

1) _____ is the distribution of health-related services and information via electronic information and telecommunication technologies. It allows long-distance patient and clinician contact, care, advice, reminders, education, intervention, monitoring, and remote admissions. Telemedicine is sometimes used as a synonym, or is used in a more limited sense to describe remote clinical services, such as diagnosis and monitoring. When rural settings, lack of transport, a lack of mobility, decreased funding, or a lack of staff restrict access to care, telehealth may bridge the gap, as well as provider distance-learning; meetings, supervision, and presentations between practitioners; online information and health data management and healthcare system integration.

Telehealth could include two clinicians discussing a case over video conference; a robotic surgery occurring through remote access; physical therapy done via digital monitoring instruments, live feed and application combinations; tests being forwarded between facilities for interpretation by a higher specialist; home monitoring through continuous sending of patient health data; client to practitioner online conference; or even videophone interpretation during a consult.

Telehealth Versus Telemedicine

Telehealth is sometimes discussed interchangeably with telemedicine. The Health Resources and Services Administration distinguishes telehealth from telemedicine in its scope, defining telemedicine only as describing remote clinical services, such as diagnosis and monitoring, while telehealth includes preventative, promotive, and curative care delivery. This includes the above-mentioned non-clinical applications, like administration and provider education. The United States Department of 2) _____ and Human Services states that the term telehealth includes “non-clinical services, such as provider training, administrative meetings, and continuing medical education“, and that the term telemedicine means “remote clinical services“. The World Health Organization uses telemedicine to describe all aspects of health care including preventive care. The American Telemedicine Association uses the terms telemedicine and telehealth interchangeably, although it acknowledges that telehealth is sometimes used more broadly for remote health not involving active clinical treatments. eHealth is another related term, used particularly in the U.K. and Europe, as an umbrella term that includes telehealth, electronic medical records, and other components of health information technology. Telehealth requires a strong, reliable 3) _____ connection. As broadband infrastructure has improved, telehealth usage has become more widely feasible.

Delivery can come within four distinct domains: 1) live video (synchronous), 2) store-and-forward (asynchronous), 3) remote patient monitoring, and 4) mobile health.

Store-and-forward telemedicine involves acquiring medical data (like medical images, biosignals etc.) and then transmitting this data to a doctor or medical specialist at a convenient time for assessment offline. It does not require the presence of both parties at the same time. Dermatology, radiology, and pathology are common specialties that are conducive to asynchronous telemedicine. A properly structured medical record preferably in electronic form should be a component of this transfer. The store-and-forward process requires the clinician to rely on a history report and audio/video information in lieu of a physical examination.

Remote monitoring, also known as 4) _____-monitoring or testing, enables medical professionals to monitor a patient remotely using various technological devices. This method is primarily used for managing chronic diseases or specific conditions, such as heart disease, diabetes mellitus, or asthma. These services can provide comparable health outcomes to traditional in-person patient encounters, supply greater satisfaction to patients, and may be cost-effective. Examples include home-based nocturnal dialysis] and improved joint management

The COVID-19 pandemic is a turning point for virtual health, and how it can be used in a public health crisis. While the notion of seeing a doctor via your computer or cellphone is hardly new, telemedicine has yet to take off widely in the United States. Health insurance plans do typically offer people the option of talking to a nurse or doctor online as an alternative to heading to an emergency room or urgent care center, but most people do not make use of it. Now doctors, hospital networks and clinics are rethinking how the technology can be used, to keep the worried well calm and away from clinical care while steering the most at risk to the proper treatment.

Most physicians agree that the use of telemedicine is going to be critical for management of this pandemic. Supporting this use, telemedicine got an additional boost under the $8.3 billion emergency funding measure from Congress, which loosened restrictions on its use to treat people covered under the federal Medicare program. Under Medicare, the use of telemedicine will be expanded for people 65 and older. Private health insurers also said they would pay for the virtual visits for people who may have coronavirus to improve access to care for their customers.

By using their phone or 5) _____, patients will be able to get guidance about whether they need to be seen or tested instead of showing up unannounced at the emergency room or doctor's office. Patients, particularly those who would be at high risk for a serious illness if they were infected, can also opt to substitute a trip to a doctor's office with a virtual visit when it is a routine check in with a specialist or a primary care doctor. That way they can avoid crowded waiting rooms and potential infection.

When a hospital admitted a student last week who was believed to have the virus, the hospital was able to prepare for his arrival by clearing the ambulance bay of people and vehicles to protect patients and hospital staff from possible infection. Taken to an isolation room, he was examined, an emergency room physician, and a nurse, both in protective gear. An infectious disease specialist was consulted over an iPad. The patient, who did have the virus, when was released from the hospital, and the hospital was able to avoid the fate of other hospitals in the United States, where patients with COVID-19 led to the widespread quarantine of health care workers.

6) _____ care has its limits, of course, and many of the start-ups and others promoting their offerings may not be fully equipped to handle patients who might have the virus. At 7) _____ +Care, a chain of clinics in Oregon and Washington, consumers are being encouraged to use the company's online chat feature so that their risks can be assessed. Zoom+Care is being very explicit, explaining, that we cannot test you for 8) _____. Instead, people may be told to self-quarantine and keep a careful eye on their symptoms. But the idea of using telemedicine to prevent further spread of the virus is being adopted quickly.

Telemedicine companies say they are getting an increase in the number of calls, both from those who want to know more about what they can do to minimize their risk of catching coronavirus and those with worrisome symptoms. Doctor On 9) _____ is a company that sees the whole spectrum of patients and offers services to customers of some of the major health insurance companies. In evaluating whether patients may be safely monitored at home, doctors consider people's medical history and the severity of their symptoms. As for patients, they are extremely appreciative of telemedicine and the services offered. The 10) _____ of patients do not want to come in and be exposed in a clinic or office setting.

ANSWERS: 1) Telehealth; 2) Health; 3) broadband; 4) self; 5) computer ; 6) Virtual; 7) Zoom; 8) COVID-19; 9) Demand;  10) majority

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