Telehealth Medicine

Telemedicine
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1 What are the Pros and Cons of telehealth?
Telehealth has garnered popularity from the beginning of the COVID-19 pandemic due to travel restrictions and instigation of social distancing. This method helps deliver health care services despite the distance between the health provider and the patients. This is possible because medical assessments can be done through video conferencing or phone calls. However, it requires continuing education and massive training for the health providers (Monaghesh & Hajizadeh, 2020).
Telehealth can be delivered in three ways: First, synchronous telehealth can be done as the health provider communicates to the patient via computer or telephone in real-time. Second, it can be done asynchronously such that the patient or the laboratory shall send the results of the diagnostic examinations via images or e-mails to the health provider at a later time. Lastly, this can be used to monitor the patient remotely, such that the patients shall record their blood pressure or blood glucose results daily and send these to the health care providers (Watson, 2020).
Telehealth has many advantages. First, it provides services to rural or remote areas with prompt access to health care. Rural areas are far from the cities, where physician’s clinics and laboratory and diagnostic centers are rampant. Traveling from rural to urban areas requires money for private or public transportation and time, which can take hours—only 8% of the physicians in the United States practice in rural areas. Through telehealth, civilians in rural areas can connect with the providers on the national level. The lack of services can be communicated through telehealth so that the government can arrange to transfer them when necessary or provide unavailable services. The physicians can also provide prescriptions and referrals through telehealth. Second, it is cost-effective. A private clinic or hospital visit costs around 40 to 50USD, including transport and other related expenses. Telehealth reduces the costs by providing a platform where the patients do not need to travel and go to the hospital, especially for non-emergency cases. Third, it reduces the transmission of infection, protects the immunocompromised from nosocomial infections, and protects the otherwise healthy individuals. Fourth, it renders an easy follow-up, especially for post-surgical patients. Fifth, it is convenient and prevents spending too much time on all the preparations. Lastly, it allows for more excellent coverage of healthcare (Moneypenny, 2020; Watson, 2020).
Conversely, it also has many disadvantages. First, although the patient can consult the physician, the ordered tests must still be done in the office, hospitals, or diagnostic centers. Second, there is a question for data privacy as the transfer of information from the patients to the physician’s side might be tampered with. Third, some insurance companies do not cover all of the requests, and the telehealth consults are done (Watson, 2020; Gajarawala & Pelkowski, 2021). Lastly, it limits physical assessment (Moneypenny, 2020).
2 How will you approach and perform a telehealth assessment?
The subjective assessment can be done via video conferencing, video calls, or via telephone. The health provider will interview the patient using the same format used in the clinical setting or utilize validated questionnaires appropriate to their chief complaint to collect information. Video conferencing will provide more information as the clinician can see the patient’s expressions and validate if he is talking to the correct patient and not manipulating others. Moreover, the clinician can observe the patient and perform a proper inspection while not being aware (Hajesmaeel-Gohari & Bahaadinbeigy, 2020). This is important because 80% of clinical impressions are derived from history (Knott & Tidy, 2021).
Specifically, the following steps can be done. First, a pre-visit assessment must be conducted before the actual interview. Here, the questionnaires can be provided for the patients, and the clinician can advise the patient on the necessary equipment to conduct the telehealth. This is also when the clinician will grasp if video conferencing is necessary or if a telephone or mobile phone call will suffice. The technicalities will also be checked, including the webcam or camera, audio, and internet connectivity to ensure a continuous assessment. Second, during the virtual visit, the clinician shall establish rapport and ensure that there is consent. The same techniques used in the actual setting can be applied during this time. Third, the physical assessment should be significantly modified. Initially, inspection should already be done while the clinician interviews the patient. Then, the following steps require the collaboration of the patient because he will do the assessment and report the result while the clinician observes. The patient shall be guided through the pal...