About the author: Aline Noizet is a connector by heart. Founder of Digital Health Connector, she is passionate about digital health, innovation and connecting the right people to have an impact on patients' lives and support healthcare professionals.
Telemedicine is not new, but people have been reluctant to use it for many reasons including technical barriers, security concerns, and a lack of availability or access.
But telemedicine has evolved significantly - platforms are increasingly secure and provide higher quality images, connectivity and sound that make the virtual consultation comparable to a face-to-face visit. Furthermore, remote devices are helping to bring patients and healthcare professionals closer and ensure a more accurate remote diagnosis.
Tytocare was one of the first companies to develop a device that the patient could use at home during a teleconsultation to measure vital signs. The doctor would guide the patient in taking those vital signs using the device, gathering real-time data to establish a better diagnosis.
Wearables are also playing a key role in telemedicine. Many patients are monitoring themselves on a regular basis. "The use of wearables has the potential to increase the health information gathered by a patient to improve the breadth of care one can perform at home," says Dr Aditi Joshi, medical director of JeffConnect telehealth, Jefferson Hospital, US.
Maneesh Juneja is a digital health futurist based in London, who is renowned for being at the forefront of the latest innovations, including wearables and sensors in healthcare. He started feeling unwell in mid-April this year, and after using different online symptoms checkers to assess his condition, he contacted his GP:
"I never imagined how valuable telemedicine could be until my GP diagnosed me 42 days ago with suspected COVID-19 during a telephone consultation. It was more of a partnership than a normal doctor-patient interaction, because my GP was open to me sharing the patient generated health data from all my sensors at home to help her make her diagnosis. The data from my sensors helped her determine I was not in immediate need of hospitalisation. She asked for that data in every phone call after the original diagnosis, to better understand my progress," recalls Juneja.
It's clear that healthcare professionals need to be able to use the data appropriately, and ensure that the data can be trusted and therefore of use. Juneja concluded that he wished that one day his data could be uploaded automatically to his doctor without having to do anything, which would clearly take monitoring to another level.
The doctor at home
Telemedicine and monitoring are about to progress a step further with companies like Binah.ai using the power of artificial intelligence (AI) and signal processing to measure patients’ vitals via a smartphone’s camera. Imagine how convenient it would be to be able to check patients’ oxygen saturation with a simple phone during COVID-19.
There has been a clear shift in moving healthcare from the doctor’s office to where the patient is. Telemedicine, and especially video-consultation brings a different dimension to the patient-healthcare professionals’ relationship. You are not just going to the doctor‘s office but the doctor also comes to your house.
According to Dr Joshi, telemedicine allows us to see patients where they reside and where the bulk of their 'health' occurs rather than the short period of time the healthcare professional may see them in the clinic or hospital. A lot can be learned from seeing someone in their home: for example, a physician can help the patient understand how to take their medication, ensure they are taking them correctly, evaluate for potential allergens or risks of falls etc.
Nonetheless, as reported by HSJ recently, the majority of patients accessing care remotely in the UK are using telephones or online requests, rather than video-consultations. Fewer than one per cent of requests were for video-consultations, as reported by the NHS.
'Telemedicine has tremendous potential'
Telemedicine is also very valuable to enhance care where it cannot always physically get. "Not all telemedicine is provider to patient. Provider-to-provider telemedicine used in remote consults is especially useful accessing sub-specialists to take care of patients at a distance, evaluate need for transfer or advise onsite physicians how to care for their patients in their community," says US-based Dr Joshi.
Telemedicine has tremendous potential, not only in bringing healthcare closer, but also improving it. There is no doubt that the pandemic over the past few months will help to make it an integral part of the healthcare systems. As Dr Joshi says, ‘like all changes, telemedicine requires some flexibility, creativity and ability to see what healthcare can be, not what it has been’.