The future of telehealth: Advantages beyond COVID-19

In the first article in our Future of Telehealth blog series, we explored how the COVID-19 pandemic put the many different faces of telehealth in the spotlight. Although the technology allowing telehealth has been available for years, COVID-19 produced a sudden and extreme need for some of the features telehealth can provide.¹ Most importantly, it gave healthcare providers the ability to care for many patients at a distance, helping them to help prevent further spread of the disease.

During the pandemic, many people began to use telehealth services to meet medical needs. In the process, they began to discover that telehealth offers far more than video visits between patients and healthcare providers. In this article, we discuss the many advantages telehealth offers to both patients and clinicians. We also talk about some of the specific situations where telehealth may be preferable to a face-to-face visit.

The many advantages of telehealth

The past year has shown that telehealth offers numerous advantages for both patients and healthcare providers.

Comfort and convenience

One obvious advantage of telehealth is the comfort and convenience of having a medical visit without the need to travel to the doctor’s office.² Telehealth visits may be easier to fit into the patient’s busy schedule. Since they can meet with their clinician using a phone, mobile device, or computer, patients often don’t need to take time off work or find childcare.^{1, 3-5} In addition, patients who are injured or recovering may find travel to the hospital or provider’s office uncomfortable or painful. Telemedicine allows these patients to stay in a comfortable, known environment.²

Timeliness of care

With telehealth, patients can more easily receive care when they need it rather than having to wait for an appointment. In some cases, telehealth allows the patient to receive care immediately, to help them until they are able to reach their healthcare provider’s office.²

One study found that telemedicine use tends to increase on weekends and holidays, when many healthcare providers’ offices are closed, and telehealth offers an alternate source of immediate care.²

Control of infectious illnesses

Telehealth is an excellent way to help control the spread of infectious illnesses, such as COVID-19, the flu, and other contagious diseases. By holding patient-clinician meetings at a distance, telehealth protects both patients and healthcare professionals. This is especially important for those who are:^1,4-6

May provide a better assessment

It may be advantageous for some specialists to see the patient in their home environment when assessing their condition. Seeing their surroundings may provide clues that help the clinicians to better understand the patient’s condition. For example, an allergist might identify things in the environment that could contribute to the patient’s allergies. Neurologists and physical or occupational therapists may be able to see the patient’s ability to navigate their home environment.⁵

May provide family connections

Often, it can be helpful for the patient to have a family member available during their consultation with a healthcare provider. A family member may be able to help the patient answer questions or provide additional information. In addition, a family member can help record important information from the patient’s visit.⁵

May provide cost savings^{1, 3}

Since telehealth visits do not require the patient to travel, they can reduce secondary expenses, such as gas and childcare.⁴ This can be particularly important in cancer-specific populations. Patients faced with a cancer diagnosis and treatment often face significant indirect expenses. Telemedicine offers time and cost savings by reducing transportation costs, reducing the need for childcare, and reducing time away from work.⁶

Research also suggests that patients who use telehealth spend less time in the hospital, reducing associated expenses.^{4, 7} One study showed the use of telemedicine to be associated with decreases in hospital admissions related to heart failure. It also showed a decrease in the length of heart failure-related hospital stays and a decrease in mortality.⁷

Finally, telehealth can contribute to reduced medical overhead costs, as healthcare providers can pay less for expenses such as front desk staff and rental of offices and exam rooms.⁴

Better access to care for underserved patient populations

Telehealth may help providers care for patients in populations who have difficulty accessing healthcare, such as:

For instance, patients who have difficulty transporting themselves may not have family or friends available who can take them to a medical appointment. Telehealth is not only a way to reach these patients; it can also help them to feel more independent. One study found that the use of telemedicine-based care improved functional independence in a group of elderly veterans with chronic disease.^{2, 8}

Some patients, especially those in rural settings, may not have the resources required to travel to their healthcare provider. Healthcare access is becoming more difficult for many living in rural environments, as more and more hospitals shut their doors.² According to the National Rural Health Association, more than 129 rural and community hospitals shut their doors between 2010 and 2020, and nearly 700 more hospitals are still at risk of closure.^{9, 10}

Travel to a healthcare facility can be difficult even in an urban environment, because travel via public transportation may be difficult or uncomfortable for a sick or injured patient.^{1, 2}

Also, although primary care is generally available in prisons, prison inmates often have a lengthy wait before they gain access to non-urgent secondary care. In addition, inmates are frequently reluctant to go to care appointments in the community, due to the stigma associated with being at the local hospital in handcuffs. There is quite a bit of evidence showing that telehealth is an effective way to improve inmates’ access to healthcare. It has also been shown to help reduce the cost of healthcare in prisons.¹¹

Easier access to specialists

Some online medical facilities offer access to a wide variety of specialist types, without an appointment, twenty-four hours a day. This can make it much easier for patients to access a specialist for a consult when they need one, rather than having to wait weeks or months to schedule an appointment.1 For rural patients, telemedicine can be particularly helpful, because it can provide access to specialists that rural hospitals are generally unable to attract.^{2, 12}

Online mental health support and emergency care

One study of telehealth usage found that telehealth visits were more popular for mental health patients than for patients seeking other types of medical care, with 46% of mental health visits taking place via telehealth versus 22% of medical consults.^{13, 14} In addition, telehealth enables mental health professionals to provide emergency support and mental healthcare to patients at any time of day or night.¹

At-home physical therapy

Physical therapists can view and supervise patients performing their exercises at home using video technology. Having access to physical therapists via telehealth may help patients to recover more quickly from accidents or surgeries.¹

Research shows that physical therapy delivered via telehealth is effective. One recent study looked at 287 patients (with a mean age of 65) who had received total knee replacement surgery. Half received in-person physical therapy, while the other half received therapy using the Virtual Exercise Rehabilitation Assistant (VERA), a system that uses a digitally simulated instructor to give instructions for physical therapy exercises and provide feedback on the patients’ movements. The VERA group also met weekly with a live physical therapist via telehealth, who created individualized therapy programs for them.¹²

The result: Those patients using the VERA system were hospitalized less than those receiving traditional physical therapy. They were also able to be more physically active.¹²

Support for patients with chronic infections

At-home monitoring tools can transmit patient readings directly to their healthcare provider. This can alert providers to any new symptoms, worsening health, and potential emergencies. It may help patients to get potentially lifesaving assistance more rapidly.¹

Easier access to preventative care

Telehealth may make it easier to access preventative care that will improve patients’ long-term health, especially for patients who have financial or geographic barriers to care.⁴ For example, one study used a web-based telemonitoring system to connect patients diagnosed with coronary heart disease with a cardiologist for monitoring and recommendations. The patients used self-measurement devices to track cardiovascular risk factors such as weight, heart rate, and blood pressure weekly, and capillary plasma lipid profile and glucose monthly. A cardiologist accessed their data using the web interface and sent recommendations to the patients using text messages. After twelve months, the telemonitoring group was more likely to show improvement in the status of their cardiovascular risk factors than the control group (69.6% vs 50.5%).¹⁵

Taking telehealth’s advantages into the future

Telehealth has been an invaluable tool during the COVID-19 pandemic. It has offered numerous advantages, both in treating COVID-19 and in treating patients with unrelated conditions from a distance, to help prevent spread of the disease.

However, if you take a closer look at these advantages, you will see that most of them will continue to apply in a post-COVID-19 world. Research clearly shows that telehealth works, even for serious medical conditions. As we discussed in our last post in this series, telehealth has even been shown to lead to superior results when used to help fight certain health conditions.^{4, 6, 7}

By using telehealth in your practice, you can make medical appointments easier, more convenient, less time-consuming, and less expensive for many of your patients. Check out the next post in our Future of Telehealth series to learn some of the specific telehealth solutions that might help your practice.

References:

1. Whelan C. 17 Benefits of Telemedicine for Doctors and Patients. Healthline. Updated November 9, 2020. Accessed June 1, 2021, https://www.healthline.com/health/healthcare-provider/telemedicine-benefits.
   
2. Healthcare Value Hub. Research Brief No. 22, Telemedicine: Decreasing Barriers and Increasing Access to Healthcare. Healthcare Value Hub. Updated November 2017. Accessed June 6, 2021, https://www.healthcarevaluehub.org/advocate-resources/publications/telemedicine-decreasing-barriers-and-increasing-access-healthcare.
   
3. Telehealth: The advantages and disadvantages. Harvard Health Publishing. Accessed June 1, 2021, https://www.health.harvard.edu/staying-healthy/telehealth-the-advantages-and-disadvantages.
   
4. Telemedicine benefits: For patients and professionals. Medical News Today. Updated April 20, 2020. Accessed June 1, 2021, https://www.medicalnewstoday.com/articles/telemedicine-benefits.
   
5. Hasselfeld BW. Benefits of Telemedicine. John Hopkins Medicine. Accessed June 1, 2021, https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/benefits-of-telemedicine.
   
6. Kircher SM, Mulcahy M, Kalyan A, Weldon CB, Trosman JR, III ABB. Telemedicine in Oncology and Reimbursement Policy DuringCOVID-19 and Beyond. J Natl Compr Canc Netw. September 30, 2020 doi:10.6004/jnccn.2020.7639
   
7. Lin M, Yuan W, Huang T, Zhang H, Mai J, Wang J. Clinical effectiveness of telemedicine for chronic heart failure: a systematic review and meta-analysis. Journal of Investigative Medicine. 2017 65(5):899-911.
   
8. Chumbler NR, Mann WC, Wu S, Schmid A, Kobb R. The association of home-telehealth use and care coordination with improvement of functional and cognitive functioning in frail elderly men. Telemed J E Health. Summer, 2004 10(2):129-137. doi:10.1089/tmj.2004.10.129.
   
9. Toney ME, Becker RB. Rural and Community Hospitals–Disappearing Before Our Eyes. National Rural Health Association. Updated July 31, 2020. Accessed June 6, 2021, https://www.ruralhealth.us/blogs/ruralhealthvoices/july-2020/rural-and-community-hospitals-%E2%80%93-disappearing-befor.
   
10. Seigel J. Rural Hospital Closures Rise to Ninety-Eight. National Rural Health Association. Updated February 20, 2019. Accessed June 6, 2021, https://www.ruralhealthweb.org/blogs/ruralhealthvoices/february-2019/rural-hospital-closures-rise-to-ninety-seven.
    
11. Edge C, George J, Black G, et al. Using telemedicine to improve access, cost and quality of secondary care for people in prison in England: a hybrid type 2 implementation effectiveness study. BMJ Open. February 4, 2020 10:e035837. doi:10.1136/bmjopen-2019-035837
    
12. Ellin A. Telemedicine for Physical Therapy: It Works! Everyday Health. Updated May 19, 2021. Accessed June 6, 2021, https://www.everydayhealth.com/pain-management/telemedicine-for-physical-therapy-it-works/.
    
13. Nelson H. Social Determinants of Health Stymied Pandemic Telehealth Use. mHealth Intelligence. Updated March 24, 2021. Accessed June 1, 2021, https://mhealthintelligence.com/news/social-determinants-of-health-stymied-pandemic-telehealth-use.
    
14. Weiner JP, Bandeian S, Hatef E. In-Person and Telehealth Ambulatory Contacts and Costs in a Large US Insured Cohort Before and During the COVID-19 Pandemic. JAMA Netw Open. 2021 4(3):e212618. doi:10.1001/jamanetworkopen.2021.2618
    
15. Blasco A, Carmona M, Fernández-Lozano I, et al. Evaluation of a Telemedicine Service for the Secondary Prevention of Coronary Artery Disease. Journal of Cardiopulmonary Rehabilitation and Prevention. January/February 2012 32(1):25-31.