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Telemedicine refers to the provision of remote clinical services, via real-time two-way communication between the patient and the healthcare provider, using electronic audio and visual means.
In primary care, telemedicine is usually in the form of phone calls, where the patient seeks the doctor’s advice about non-emergency medical problems which don’t require the doctor to see the patient. It doesn’t replace face-to-face consultation when it is needed, but complements it.
The real role of telemedicine at present lies in the convenience it offers to patients and practitioners by obviating the necessity for a physical visit to get medical advice or treatment. It is cost-effective, in comparison to the process of waiting to see a doctor or other practitioner.
It can help select urgent calls after a doctor’s office is closed. It is of immense value in the follow-up of patients with chronic diseases such as diabetes, high cholesterol, or high blood pressure. Such patients have no immediate medical problem, but require help with dosage adjustments, lifestyle regimens, prescription refills, or even just access to group support.
An added convenience is that telemedicine consultations can be so arranged as to follow all needed laboratory investigations or vital sign monitoring. In fact, telemedicine has been practiced by doctors for a long time, though not under this name. However, the use of broadband internet technology has made both audio and video calls affordable and available to a wider spectrum of society, making this a feasible alternative to the conventional system.
Telemedicine is practiced from a hub, which is the site from where the distant practitioner delivers a service through a telecommunications system. At first, specialized videoconferencing equipment was necessary, with customized diagnostic peripherals, such as stethoscope or EKG monitors attached to the system.
The health provider who was with the patient would use the diagnostic tools under the guidance of the distant physician, to provide the required patient data. Today, telemedicine usually employs a desktop computer, with a special video card. The computer’s advantage is that it can store data securely. High-speed telephone lines or satellite connections allow interaction between both locations.
On the other hand, the patient is at the originating or spoke site, and receives the service via a telecommunications service, often with the mediation of a telepresenter.
Telemedicine has several definitions, but the broadest one covers the use of services outside the traditional real-time interactive telecommunication health service. This includes services such as store-and-forward, where camera images are stored and forwarded, and consultation done, via a telecommunication system. Though these are not real-time or interactive, they are still useful for treatment delivery. Remote monitoring is another aspect of telemedicine.
Telemedicine requires no significant outlay other than two things: a web camera, and a secure patient portal that connects the doctor to a secured electronic medical record database online. This ensures safety, the ability to store necessary medical records, and connectivity. In addition, the physician needs a medical license in the same state as the state where the patient receives his prescription.
Those who support the use of telemedicine, point to the convenience, the lower waiting time for a consultation, the access it provides to high-quality medical diagnosis and treatment, and the lesser cost of most consultations. In addition, the ready availability of patient records online has the potential to make patient prescriptions more reliable and accurate.
By providing second opinions more easily and faster, it can also make the patient and physician experience better. Finally, it produces improved health outcomes, which should be the primary goal of all health services.
Studies which drew direct comparisons between telemedicine and other approaches to patient management mostly show that the benefit lay with telemedicine. The benefit was greatest in the areas of teleradiology, telemental health, telecardiology (echocardiography in particular), home telecare and teledermatology. Many researchers agree, however, on the limited evidence at present on the benefits or cost-effectiveness of telemedicine, which requires further studies.