Telehealth Services: Challenges & Issues

Instructor: Artem Cheprasov

Artem has a doctor of veterinary medicine degree.

Telehealth services helps to support healthcare, but it has its challenges, including cost, varying regulations, over-promotion, adoption/competition, technology, lack of studies, and success. We'll go over all these in this lesson.

Telehealth Service

Have you ever used a messaging application to ask a doctor a question? What about using a video app to talk to a nurse? If you have, you've used a telehealth service. This term refer to the use of electronic/telecommunications technologies to provide and support:

  • Health information, education, and care to patients
  • Professional medical education for healthcare practitioners
  • Public health and health administration

Telehealth services are thus achieved using a combination of

  • The internet
  • Videoconferencing
  • Streaming media
  • Wireless communications
  • Patient portals
  • Remote vital monitoring
  • Nursing call centers

Let's learn about some of the general challenges surrounding telehealth services.

Law & Money

One of the concerns, as you can only expect, has to do with money. It's much easier to press a button and chat with a doctor than it is to put on some big boy pants, start the car, and drive to see the doctor.

So there is a worry that the adoption of telehealth services might lead to overutilization of strained medical resources, including a healthcare practitioner's time, and thus it will drive up the costs of healthcare in general, including insurance premiums.

Speaking of insurance companies, there is also a worry that these companies, and Medicare, may not want to reimburse for telehealth services. However, telehealth does have the potential to drive down costs either directly, by avoiding an unnecessary and more costly physical visit to a doctor, or indirectly, by keeping patients healthier by preventing disorders and thus avoiding the need to go to the doctor period.

Another challenge to telehealth is the law. See, each state may have its own rules and regulations with respect to requiring insurers to cover telehealth services. There can also be different laws about when these services can be engaged and what type of healthcare professional can deliver them.

Why is this a problem? Well, telehealth services are location independent. What if you need to consult with a specialist who is several states away? They might not be able to help you unless you come to them physically.

Hype, Evidence, and Adoption

Many consumers might be eager to adopt telehealth services due to the hype by media, bloggers, and maybe even family. But we have to move carefully to evaluate whether the hyped up benefits of telehealth are actually realized.

Since this is a relatively new thing, there aren't many studies examining exactly which types of telehealth services are beneficial. More studies are needed to evaluate the cost-benefit analysis with respect to the patient, provider, and society in general.

Perhaps because of this lack of evidence, not all healthcare providers have taken very well to adopting telehealth services. But there could be other reasons for why adoption is slow. For some, it's just a generational issue.

It's less likely a 70 year old doctor set in his/her ways is going to adopt telehealth services when compared to a new graduate. Simple as that. For others, even the newer grads, they may not want to deal with telehealth services because it increases competition. There may be enough competition as it is within a city. Imagine telehealth opening up an entire state or nation of doctors to a patient!

Technology and Success

Another issue surround telehealth services is something big data in general is creating: a big headache of what to do with a large amount of gathered data thanks to new technology! For example, telehealth services may include the remote monitoring of things like heart rate. But monitoring heart rate continuously and remotely is a new thing.

Not long ago, doctors only had so many data points to deal with. With near-continuous monitoring of vital signs, there could be a flood of data that may be useless or even misleading. So there will be a bit of catching up to do with respect to how such technologies are properly put into clinical context.

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