Telemedicine is the practice of using electronic information and communication technology to support and give medical care to patients from home who are unable to go to a facility for treatment. [1][2] Telemedicine can be used for a variety of purposes, including reducing the demand on current hospital and healthcare services, promoting health education, lowering the cost of care, monitoring and praising treatment adherence, detecting disease worsening quickly, and increasing the accessibility of services to patients who live in remote areas. Therefore, telemedicine is a comprehensive term that covers illness prevention, health promotion, monitoring, education, and treatment.[3]
Telemedicine has taken on particular significance in the context of the coronavirus disease 2019 (COVID-19) pandemic, notably to evaluate patients with suspected infections or with chronic conditions, minimizing visits to health centers. [4][5]. Additionally, the emergence of innovative, simple-to-use, and affordable technology will undoubtedly lead to an increase in the number of patients seeking out telemedicine services.[6]
Cost-effectiveness and reduced healthcare expenses:
In order to provide users with health information and therapies remotely, telemedicine includes a number of communication tactics. Telemedicine is anticipated to improve distance communication between patients and doctors, and it is particularly acknowledged as a supplement to other healthcare access tools for those who have transportation issues or who live in rural or distant places.[7]
Telemedicine Technologies and Tools:
Telemedicine is usually comprised of video (videoconferencing or videophone) (40%),[8]telephone-based (phone call or text message) (31%),[9]web-based information (18%),[10]and telemetry/remote monitoring (electronic data collection) (11%)[11]. Video conferencing is the most commonly used technology in telemedicine. It can be made by means of any online meeting applications like Zoom, Google Meet, and MS Teams. Additionally, many mobile applications are also present on the web stores to consult a doctor or physician in any part of the world. The health records can also be managed for regular online check-ups in case of any chronic illness.
Telemedicine in Specialized Healthcare:
The world is now considered a global village because of the ease of communication due to the overwhelming response to the internet. Telemedicine is one of the most fruitful branches of this online global village. It has been adopted by many health specialties and healthcare setups because of its potential and promising benefits.
Tele-psychiatry:
Inequitable access to psychiatric care exists in many nations, including the US, in part because of an unequal distribution of psychiatrists, psychologists, and other mental health specialists. Patients with psychiatric illnesses may be overrepresented in emergency departments (EDs) due to limited access to psychiatric inpatient care, posing risks to patient safety and driving up medical expenses. Lack of or failure to follow up following psychiatric inpatient discharge can also result in medication non-adherence, readmission for patients at high risk, and even suicidality. Tele-psychiatry has been endorsed by mental health advocates as a potential remedy for the scarcity of mental health specialists. Tele-psychiatry may allow professionals to carry out virtual psychiatric evaluations, do tele-therapy, speak briefly and check in with patients, and provide patient education inside a hospital context. Additionally, telepsychiatry may help patients obtain mental health services from a secure place, which may help overcome some care-related obstacles. These virtual care systems have been shown to be cost-effective, well-liked by patients, and linked to a decline in new admissions or readmissions to psychiatric hospitals. [12]
Tele-cardiology:
Tele-cardiology is one of the fastest-growing fields in telemedicine. In primary care, teleconsultations, tele-diagnosis, and tele-education, applied in an integrated manner, possibly associated with tools such as computer decision support systems, may improve the quality of care for cardiovascular diseases, especially hypertension, atrial fibrillation, heart failure, and acute myocardial infarction (AMI). Several studies have demonstrated that hypertension tele-monitoring strategies have a beneficial short- and medium-term impact on blood pressure control. Tele-cardiology has also different applications in emergency services, including electrocardiogram transmission, which can be associated with synchronous teleconsultation, to assist in the early diagnosis and management of patients with acute coronary syndrome (ACS), with evidence of reduced AMI short- and long-term mortality. Decision support systems could also aid in the diagnosis, management, and prediction of cardiac complications in patients with ACS. Remote monitoring using implantable devices has mixed results in clinical outcomes. Cost and quality in a telecardiology service are strictly related to the monitoring and management of the process.[13]
Tele-oncology:
According to the World Health Organization, cancer is a public health issue that has been growing recently. The majority of cancer patients obtain their preferred form of treatment, such as chemotherapy, which uses a variety of application strategies and antineoplastic medicines. Because it has been seen that it is crucial to have post-chemotherapy information acquired by telephone, for example, post-chemotherapy toxicity, to be addressed in a timely manner, the monitoring of side effects should be integrated into nursing practice as a normal duty. The World Health Organization (WHO) notes that telemedicine is being discussed more and more and emphasizes that it is nothing more than using ICT information and communication tools in an effective and cost-effective manner. This stage of monitoring is also becoming an important option for nurses and patients to communicate in connection to the transfer of the patient to the hospital center and provides comfort to get care in the comfort of your home.
Telemedicine in developing countries:
Healthcare services in developing countries like Bangladesh, India, and Pakistan are divided into two categories: urban and rural. Most of the people of these developing countries live in rural areas where healthcare setups are not up to par. Due to a huge shortage of doctors and proper health facilities, people from these areas have to travel long distances to urban areas to get better health facilities. The fees of expert doctors and different service costs will have to bear of the patient. In order to address the present healthcare issues in developing nations like Pakistan, India, and Bangladesh, telemedicine may be an efficient option. Through telemedicine, the lack of skilled medical professionals in outlying places can be eliminated. In order to improve healthcare decision-making, noninvasive technologies are currently coupled with illness management processes to deliver additional patient information.[14]
Challenges and Limitations of Telemedicine:
- Technical Infrastructure: Access to dependable internet connectivity and cutting-edge telecommunications technologies may be limited in remote places. The successful delivery of telemedicine services can be hampered by insufficient infrastructure.
- Digital Divide: The digital divide can make it difficult for remote people to obtain and use telemedicine services since it includes differences in internet access, technological literacy, and availability of the right devices.
- Establishing and maintaining a solid provider-patient relationship can be more difficult when providing treatment remotely. Patient trust, involvement, and communication may suffer in the absence of in-person interactions.
- Limited Physical Examination: The capacity of healthcare professionals to conduct thorough physical examinations may be hampered by remote consultations through telemedicine, which may affect the precision of diagnosis and treatment choices.
- Data security and privacy: Sensitive patient data is transmitted across telemedicine networks and stored there. Protecting patient confidentiality and upholding trust require ensuring privacy, data security, and compliance with laws.
Conclusion:
In conclusion, telemedicine has the potential to completely change how vulnerable populations, particularly those living in rural and underserved areas, can receive and benefit from healthcare. This research study has looked at the different uses of telemedicine, analyzed its advantages and disadvantages, and investigated the ethical issues and policy ramifications connected with its acceptance. With remote consultations, medication delivery, and remote patient monitoring, telemedicine has proven it can connect patients with healthcare practitioners across geographic boundaries. Telemedicine has the power to eliminate healthcare inequities by facilitating prompt access to specialists, lowering travel expenses and time, and improving patient self-management.
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