The purpose of this paper is to discuss how technology has impacted the health care delivery system. Health care technology is advancing at an increasingly rapid rate in the United States, and globally. Patients and providers are witnessing these changes through the use of telehealth, and telemedicine applications. Telehealth, and telemedicine are often used interchangeably, however there is a difference between the two applications. Telehealth is the use of technology to deliver health care, health information, or health education at a distance (U. S. Department of Health and Human Services, n. d. ). Telemedicine is the use of medical information exchanged from one site to another via electronic communications to improve a patients’ clinical health status. Telemedicine includes a growing variety of applications and services using two-way video, email, smart phones, wireless tools and other forms of telecommunications technology (American Telemedicine Association, 2012). There are two basic types of technology that make up telemedicine services.
One, called “store and forward,” consists of capturing a digital image using either digital cameras, or digitizing a hard copy of the image. Once the image is captured (stored), it is then sent to another location (forward), where the physician can make a diagnosis. The most common use of this type of technology is teleradiology, where X-rays are captured in one location, and sent to a radiologist in a separate location. Patients’ can receive a diagnosis within 24 to 48 hours after his or her office visit.
The second type of telemedicine technology is known as “real-time,” meaning that the patient and physician are interacting at the same time. Also called two-way interactive television (IATV), this method uses television screens set up in two different locations. The patient is able to interact with the physician through videoconference. This offers real-time consultations and creates the impression of a face-to-face interaction between the physician and patient. The physicians’ diagnosis can be given immediately during the e-visit.
A third party is required when using the real-time form of telemedicine. The third party is responsible for operating the equipment at the originating site and recording any special instructions or prescriptions given by the physician. Many of the physicians utilizing telemedicine will use a combination of store and forward and real-time technology to optimize the care they provide. All telehealth applications require health information technology (IT), but not every use of health IT can be called telehealth.
Stand-alone systems like Electronic Health Records (EHRs) or Computerized Decision Support (CDS) are types of health IT that are not typically thought of as telehealth applications (U. S. Department of Health and Human Services, n. d. ). EHR is an electronic version of a patients medical history, that is maintained by the provider over time, including but not limited to, demographics, progress notes, medications, vital signs, past medical history, etc. The EHR automates access to information and has the potential to streamline the clinician’s workflow (Centers for Medicare and Medicaid Services, 2012).
Where as, CDS are computer applications designed to aid clinician’s in making diagnostic, and therapeutic decisions in patient care. They can simplify access to data needed to make decision, provide reminders, and prompts at the time of a patient encounter, assist in establishing a diagnosis, and in entering appropriate orders (Centers for Medicare and Medicaid Services, 2012). Telemedicine Example and Impact on Health Care Mobile health (mhealth) is the use of mobile and wireless devices to improve health outcomes, healthcare services and health research.
It is a tool that can provide access to health care information at a low cost for consumers. Mhealth is meeting people where they are not just geographically but also emotionally. Mhealth has reached the poorest of communities (U. S. Department of Health and Human Services, n. d. ). More than 9 million patients email their physician in 2009 (Digital Health Care, 2010), because patients’ busy lifestyles do not allow time for an office visit for non-emergent health conditions. In recent years, the expansion of mobile health (mhealth) technologies, including health text messaging, mobile phone applications, remote monitoring, and portable sensors, have changed the way health care is being delivered in the U. S. and globally (U. S. Department of Health and Human Services, n. d. ). Patients like the convenience of communicating with his or her physician through advanced technology. Employers are beginning to incorporate telemedicine into the benefits package for their employees.
Recognizing e-visits are beneficial to the employer, because the employee will not need as much time away from work to have non-emergent health conditions treated. In addition, the service is a cost savings to both the employer and employee. There are some employer groups covering these services at 100 percent for their employees’. E-visits are cheaper than clinic, and office visits. Relay Health and American Well Corporation are two companies that provide telemedicine services. Relay Health facilitates web visits for 13 insurers and 25,000 providers.
Through Relay Health a patient can schedule doctor appointments, renew prescriptions, request referrals, and get test results. Patients’ who use Relay Health can only have web visits with their existing doctor;” where as American Well Corporation allow visits with any participating provider using American Well’s web service (Digital Health Care, 2010). Live Health Online is an internet based communication tool intended to facilitate health care services rendered by physicians to the consumer.
The consumer can talk to doctors seven days a week through videoconferencing, secure chat, or telephone (American Well Corporation, 2011). The e-visits are approximately 10 minutes long, and cost $49. 00 per e-visit. E-visits are not design to provide care for emergency health conditions. It is an alternative way for consumers to seek treatment for non-emergent conditions, such as a cold, sinusitis, headache, etc. A consumers’ reason for using Live Health Online can vary, but typically individuals use the service, because it is convenient.
Socio-economic and Ethical impact of Telemedicine From a quality-of-life perspective, telemedicine allows consumers in different areas of the country to be monitored by physicians. From an economic standpoint, the induction of telemedicine into the community can have many benefits, such as significant savings to both the provider and the patient that participate in telemedicine. These savings take the form of reduced provider payments for services rendered through the use of telemedicine, less time spent travelling to appointments for both the hysician, and patient, and a reduction in emergency visit by the patient. Telemedicine has enabled distance education and the rapid, efficient sharing of information, not only with patients, but also between providers who are separated either geographically or within facilities. Utilizing this form of technology has been shown to reduce the cost of healthcare and increase efficiency through better management of chronic diseases, shared health professional staffing, reduced travel times, and fewer or shorter hospital stays.
Ethically, there are concerns with security, privacy, and confidentiality, in telemedicine e-visits; therefore companies providing these services are responsible for the safety and security of the consumers’ data. Also, there is fear that patients’ may abuse the system by scouting for physicians who will more readily issue prescriptions, especially for controlled substances. Conclusion Consumers are embracing the new and innovative technology being introduced into the health care delivery system. Consumers want to receive quality health care, at a reasonable cost, that is easily accessible.
They want to obtain these services through safe and secure mechanism. Telehealth and telemedicine are an integral part of reforming the United States health care system; therefore the government is supporting the development of these applications by increasing funding of these programs. Through telemedicine, providers will be able to provide health care to the uninsured and underinsured throughout the country. Ultimately, this technology will impact the cost of care by reducing the cost of delivery services.
American Telemedicine Association. (2012). What is Telemedicine? Retrieved from http://www.americantelemed.org American Well Corporation. (2011). Live Health Online. Retrieved from http://www.livehealthonline.com Centers for Medicare and Medicaid Services. (2012, March 26). Electronic Health Records. Retrieved from http://CMS.gov Digital Health Care. (2010, July 29). E-Medicine Increases in Popularity 4 of 10 doctors connect with patients online. Does yours? Retrieved from http://www.aarp.org U.S. Department of Health and Human Services. (n.d.). Health Resources and Services Administration. Retrieved from http://www.hhs.gov
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