Telemedicine in the Age of COVID-19
In early 2020, the emergence of COVID-19 in the United States brought a new obstacle to health care providers with the onset of social distancing practices. Especially in health care settings, social distancing is necessary to prevent the spread of COVID-19 and to keep patients safe from potentially infected individuals. Instead of allowing these safety measures to limit patient visits and medical attention, telehealth allowed health care providers to see patients and offer ambulatory care virtually and safely. Telehealth encompasses a variety of remote methods to provide clinical healthcare using telecommunication technologies. Compared to the same time period in 2019, the last week of March 2020 saw a 154% increase in telehealth visits. During the last three weeks of March 2020, the amount of COVID-19-related telehealth visits increased from 5.5% to 16.2%. These stark increases may have been influenced by pandemic-related telehealth policy changes and public health guidelines like social distancing. While telehealth helped health care providers and those seeking health care overcome obstacles posed by the pandemic, barriers to telehealth, such as limited internet accessibility and the need to conduct in-person physical examinations or diagnostic testing in certain situations, prevail despite its notable benefits.
Patients and clinicians responded relatively well to the stark shift to telemedicine during the pandemic. From a survey of nearly 800 gastroenterology and hepatology patients and their physicians at Penn Medicine, 67 percent of both groups viewed their telemedicine appointments as suitable alternatives to in-person appointments. However, patients over the age of 60 and black patients responded to telemedicine less positively compared to other demographics surveyed. Also, while telemedicine appointments consisted of both video and telephone visits, video visits were preferred by patients. As older patients did not perceive telemedicine favorably, researchers suggest that many older adults’ unfamiliarity with technology may have contributed to their responses. However, black patients’ negative response to telemedicine requires further investigation, especially if the telemedicine becomes more common in the future, as its reasons are less clear.
Limitations to telemedicine are important to consider as the need for well-executed telemedicine will prevail, even after COVID-19 transmission rates subside. Researchers share that limited access to technology needed to participate may hinder patients from seeking telemedical care. As telemedicine began to be utilized during the pandemic, many risks unraveled in regards to information security and privacy. As patient confidentiality is a key factor in health care, governmental agencies warned the public of the increased risk of cyberattacks towards healthcare sectors and organizations. While health care providers may have utilized any video conferencing telemedicine at first due to the lack of standardized telemedicine platforms, an enterprise, or health care specific, video conferencing product includes security features like encryption that protect the patient’s information. By standardizing the use of an enterprise for an entire healthcare organization, telemedicine can be utilized in a safe and effective manner.
The future for telemedicine in a post-pandemic era remains unknown. The rise of telemedicine technology during the initial periods of COVID-19 allowed physicians to comply with pandemic guidelines to deliver health care when possible. A study of Israeli pediatricians predicts that in a post-COVID-19 time, the use of digital photos and videos to obtain health care will diminish from its peak during the pandemic, but project higher than pre-COVID-19 levels. While this study found that the likelihood of treating a patient via telemedicine increased during the pandemic, the likelihood after the pandemic is projected to decrease. Many of these pediatricians expect the levels of telemedicine to recede after the pandemic as they prefer to base their clinical decisions from in-person visits to obtain more objective data rather than gathering data through telemedicine. While the progression of the pandemic may further develop telemedicine technologies, the evolution of healthcare during the pandemic will lead to lasting changes through the integration of telemedicine in healthcare.
References:
Gardner, A. (2020, June 24). Research Shows Patients and Clinicians Rated Telemedicine Care Positively During COVID-19 Pandemic. Penn Medicine News. https://www.pennmedicine.org/news/news-releases/2020/june/patients-and-clinicians-rated-telemedicine-care-positively-during-covid.
Grossman, Z., Chodick, G., Reingold, S. M., Chapnick, G., & Ashkenazi, S. (2020, October 20). The future of telemedicine visits after COVID-19: perceptions of primary care pediatricians. Israel Journal of Health Policy Research. https://ijhpr.biomedcentral.com/articles/10.1186/s13584-020-00414-0.
Jalali, M. S., Landman, A., & Gordon, W. J. (2020). Telemedicine, privacy, and information security in the age of COVID-19. Journal of the American Medical Informatics Association : JAMIA, 28(3), 671–672. https://doi.org/10.1093/jamia/ocaa310
Koonin, L. M., Hoots, B., Tsang, C. A., Leroy, Z., Farris, K., Jolly, B. T., … Harris, A. M. (2020, October 30). Trends in the use of telehealth during the emergence of the Covid-19 Pandemic - United States, January–March 2020. https://www.cdc.gov/mmwr/volumes/69/wr/mm6943a3.htm.
