At a time, when social distancing is among the major measures used to fight COVID-19 pandemic, telehealth is stepping-up as a key technology for safe and efficient communications. The World Health Organization mentioned telemedicine among essential services in “strengthening the Health Systems Response to COVID-19” policy. According to a new WHO policy, within the optimizing service delivery action, telemedicine should be one of the alternative models for clinical services and clinical decision support.
EU countries have imbalances and shortages of healthcare professionals, together with unequal quality and access to healthcare services. The number of clinicians vary from 1.9 in Turkey to 5.2 in Austria per 1,000 population. The structure of the health workforce is changing, one out of three physicians is older than 55 years. Healthcare professionals at the frontline of the COVID-19 epidemic response have the highest risk of infection. Telehealth can help to mitigate this risk by minimizing the amount of face-to-face interactions.
'Flattening the curve'
Telehealth can directly influence flattening the curve of demand on health systems worldwide, slowing transmission and spreading incidence over a longer time period. Almost all telehealth providers have already faced a tsunami of demand, which may be better described as a global real-time piloting and go live.
Some of the COVID-19 telehealth usage cases for patients include: self-isolated/ home-isolated patients (self and distance monitoring), patients with mild cases (distance monitoring and treatment), patients after discharge (follow-ups). For health workers: clinicians with mild symptoms can still work remotely with patients, retired clinicians, second opinion for severe cases, cross-border experience exchange, teleradiology, online trainings for health workers. Telehealth can be used as a mental health support tool for patients, health workers and be included in SARS-CoV-2 testing process (e-schedule for clinical and home tests), and managing the patients’ waiting time by using e-schedule.
The COVID-19 pandemic is a challenging test for all solutions to prove how reliable and agile they are in the new circumstances.
One of the obvious challenges is the system scalability. The opportunity to increase the number of users within hours, not days is the main requirement and cloud-based solutions have less issues with this. Having so many new users onboard, telehealth solutions should be an easy-to-use tool and be available through existing users’ devices: computers, smartphones, notebooks and tablets.
The majority of telehealth solutions have statistics and dashboards together with a well-functioning e-schedule, which is useful when the capacity of human resources and systems are critical. Furthermore, the opportunity to integrate medical digital devices with telehealth solutions is a big advantage.
As European hospitals are faced with an increased wave of cyber-attacks, the secure exchange and storage of data is one of the main priorities. The 'Ministere des Solidarites et de la Sante' published a list of telehealth solutions available for citizens. All these solutions comply with GDPR regulations, hosting health data regulations and information system security requirements.
Other countries announced new telehealth regulations for the duration of COVID-19, including the USA. More countries will make their decisions about telehealth inclusion in the fight against COVID-19 in the upcoming weeks. We will see more examples of telehealth usage and integration with other technologies, specifically targeted to the current pandemic. But there are no doubts that telehealth is already recognised as a mandatory technology for any epidemy response.
Telehealth platform implementation
Telehealth has the ability to unite several medical organisations into one virtual network, led by the central clinic. This network can include different physical locations: central and remote clinics, state and private clinics, rehab centres and prevention centres, physicians’ private offices and all registered patients within their locations. The following functions should be the priorities: audio/video-conferencing, secure messaging, electronic scheduling, analytics and reports, billing and online payment, image and files uploads, integration with EHR systems, and e-prescribing.
All users can use any devices, from computers to smartphones, to connect and participate in video/audioconferencing sessions and exchange information. Patients’ data: general personal information, primary examination results in a local clinic, lab tests results, MRT, CT, ECG results, data from medical digital devices etc.
Today we are looking for the best practices and implemented solutions from around the globe. The USA, Israel, UK, Nordics and France are among the leading countries with mature telehealth providers, and their cumulative experience is helping them to respond to the current situation.
For the European countries it’s critically important to share telehealth experiences and resources, while joint efforts against the COVID-19 pandemic will likely prove more effective when implemented with cross-border cooperation.