Telemedicine: Changing the delivery of healthcare
In the last few years, demand for telemedicine has been rising, mainly due to advances in technology, increasing accessibility and affordability of technological devices and the internet. The market size for telemedicine was over US$45 billion in 2019, and is projected to grow to over US$175 billion by 2026, signalling the potential of this market .
Telemedicine goes back longer than you think
Since decades ago, hospitals have been exploring how telemedicine can be used in real-life scenarios; in the 1950s, Canadian physicians were able to implement a teleradiology system that transmits medical images through telephone . In 1973, NASA collaborated with the Indian Health Services to initiate the Space Technology Applied to Rural Papago Advanced Health Care (STARPAHC) project. This project allowed access to healthcare for indigenous populations living in the region now known as the Tohono O’odham Nation reservation in Arizona, and let NASA build a terrestrial analog to test the feasibility of longer human spaceflights . During the project, patients mostly leaned towards video consultations for diagnosis and treatment; whereas voice telecommunications were preferred for enquiries and appointments. Results showed that over 10,000 people benefited from healthcare, and the quality of service increased when compared to before the implementation of the project .
Presently, telemedicine has a variety of uses
Today, in the EU, telemedicine is mainly used in general medical consultations, as well as radiology, dermatology, neurology and monitoring . In teleradiology, teledermatology and teleneurology, telecommunication networks are used to transmit medical images such as X-rays or CTs to other locations for further analysis by healthcare providers. “Connected healthcare”, which is the notion of linking all segments of healthcare, has also been flourishing due to the convenience of telemonitoring; in which patients can measure their own health parameters at home by using equipment supplied by their provider. Today, telemonitoring is mostly used for diabetes and chronic heart failure care .
COVID-19 put telemedicine in the spotlight
Adaptation of telemedicine services brings many benefits, with the first one being increased access to healthcare in remote locations. Secondly, patients are able to receive instantaneous care for cases that are minor but require immediate attention. Another benefit is that it enables patients to receive care from the comfort of their home, which is especially appealing for the elderly as it minimizes the risk of exposure to pathogens. Lastly, telemedicine is a great approach to provide healthcare cost-effectively, especially in countries that have an established telecommunications system that people already use.
Especially in situations like the current COVID-19 pandemic where social distancing is of utmost importance, telemedicine becomes an immensely valuable tool. Several healthcare facilities have been able to swiftly adapt to virtual healthcare to deliver their services safely, with the most common strategy being the use of teleconsultations. Additionally, NYU Langone, in partnership with the software development company OneView, was able to implement a cloud-based managed solution that allows virtual physician visitations through tablets placed beside patients’ beds .
There are still several challenges to address
Telemedicine also has its own challenges around implementation; however, different solutions can be adopted to overcome these challenges. Firstly, many countries have strict conditions regarding the reimbursement of telemedicine services. For instance, to be eligible to get reimbursed through the Health Insurance Program in France, the patient receiving teleconsultation must be referred by their usual treating physician if the teleconsultation is not conducted by them. Some countries already brought forth solutions – in Germany, video consultation hours and digital health app costs are reimbursed by both public and private insurance. In the UK, the patient does not need to go through the reimbursement process at all; the services are provided free of charge at the facility if they are covered by the National Health Service (NHS) .
The complexity of the reimbursement systems also creates confusion among the patients, as it prevents them from understanding the scope and the extent of the reimbursement .
The lack of infrastructure is another challenge to the implementation of telemedicine, as well as connectivity, electricity and internet issues in regions such as Sub-Saharan Africa where the disease burden is high and healthcare providers are scarce .
Management of the patient flow is also a crucial issue, as patient crowding hinders the facilities’ ability to operate efficiently. Some facilities have been working on sorting systems to quickly determine what services patients need, streamlining the process. During the COVID-19 pandemic, this idea has been used to design automated logic flows that separate and redirect COVID-19 suspected patients to testing facilities, thus greatly minimizing the virus exposure risk of healthcare providers .
The last implementation challenge is the prescription process. In most countries, electronic prescriptions (e-prescriptions) are used for teleconsultations. However, e-prescriptions require the establishment of appropriate network systems across healthcare facilities and pharmacies, which not all countries can achieve on a country-wide scale. France has been testing out this system with small-scale programs: patients can buy certain prescribed medications from online pharmacies and get them shipped to their homes .
Rapid improvements keep increasing the adoption of telemedicine
All in all, over the years, many initiatives have been developed around telemedicine; however, challenges still do exist. In order to best utilize telemedicine to reach large populations, it is necessary to understand these challenges and develop appropriate strategies that will allow institutions to overcome them. Telemedicine’s potential was also recently highlighted during COVID-19. The fast adaptation and simple application of telemedicine during the pandemic proved that it is a viable and convenient healthcare solution that is compatible with people’s lifestyles. The increasing conversion to remote work culture in companies seems to be cementing the fact that there will be more and more need for telemedicine in the future, and that it is here to stay.
EMH Consultants can support organizations in gaining a deeper understanding of the market in their countries, as well as perform strategic analysis to pinpoint the challenges and identify innovative solutions to overcome them.
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