Far apart yet close: how telemedicine revolutionized healthcare

1796: Edward Jenner, an English physician, performs his first smallpox vaccination on the eight-years-old James Phipps. 1846: William T. G. Morton, an American dentist, becomes the first person to publicly demonstrate the use of ether as a surgical anesthetic. 1954: Joseph Murray and his colleagues perform the first successful human organ transplant. These three breakthrough moments alone prove that medicine is incredible indeed – and it continues to evolve every year.

Over the last couple of years, the healthcare innovators have had the state of the art tech at their disposal, ranging from AI and machine learning to AR and Big Data. The technological advancement has contributed to enhancing access to the telehealth services, especially telemedicine, which are much needed in the times of Covid-19 pandemics. How exactly do these solutions work and how do they benefit the 21st-century patients? These are the questions that we’re going to answer in this article.

What’s the difference between telehealth and telemedicine?

Reading about remote telehealth services, you may come across terms “telehealth” and “telemedicine” being used interchangeably. Although both fall within the category of Healthcare Information Technology, the difference between the two is striking.

As defined by the Health Resources Services Administration, telehealth is

the use of electronic information and telecommunications technologies to support long-distance clinical health care, patient and professional health-related education, public health, and health administration.

In other words, telehealth is an umbrella term denoting the use of telecommunications technologies to provide both clinical and non-clinical health services, such as providing online diagnosis or holding provider training. Solutions it relies on range from video conferencing, through streaming, to wireless communications.

Telemedicine, on the other hand, is a broader term referring to the use of telecommunications technology for the purpose of providing clinical services, such as attending a virtual doctor appointment or having your heart rate monitored from a distance. Patient-facing and processing sensitive medical data, telemedicine technology is bound to be not only user-friendly and efficient but above all to comply with the highest security standards.

How telemedicine revolutionized healthcare: from the futuristic radio doctor to the hi-tech healthcare services

Telemedicine as we know it today didn’t emerge overnight. In fact, a century has to pass before patients could enjoy all the benefits of remote healthcare services.

Past: the dream of virtual house calls getting real

When discussing the history of telemedicine, we need to go back to the 1920s when the radio started reaching American households as the major broadcast medium. Back then, Hugo Gernsback, a Luxembourgish-American inventor, came up with an idea for a teledactyl – a device that would allow doctors not only to see patients through a viewscreen but also to touch them from miles away with robotic arms.

Doctor examining his patient with a teledactyl. Source: Smithsonian Magazine

Although the device described in the 1925 issue of Science and Invention didn’t make it to the production phase, we need to acknowledge the fact that Hugo Gernsback had quite accurately predicted the onset and value of telemedicine in the upcoming decades. To see it happen, however, Americans had to wait another twenty years.

It’s safe to say that practical telemedicine dates back to 1948 when the transmission of radiology images between West Chester and Philadelphia took place. Now, covering the distance of 24 miles is nothing impressive – back then, however, it was a major breakthrough that gave birth to the teleradiology system used all across Montreal.

Next decade, television stepped in. In 1959, clinicians working at the University of Nebraska set up two-way television transmission to send neurological examinations to medical students scattered across the campus, thus pioneering the use of video for medical purposes. Five years later, they used the same technology to hold the first remote consultations.

Nurses using telemedicine technology in the 1960s

As the years went by, the potential of remote healthcare was noticed by the government, leading to increased investment in telemedicine research. One notable project run in the 1960s and 70s was Space Technology Applied to Rural Papago Advanced Health Care (STARPAHC) – its aim was to test satellite-based communications as a means to provide medical assistance to astronauts in space and the residents of the Papago Reservation. After the project’s success, telemedicine kept evolving and became a part of the healthcare system for good.

Present: an uptick in popularity due to Covid-19

With the beginning of the new century, telehealth equipment grew smaller in size, bigger in the scope, and more convenient in use. This alone, however, wasn’t enough to make remote healthcare services prevalent.

According to the survey conducted by Software Advice in February 2020, 66% of the questioned patients had never consulted with a medical provider remotely. A study carried out two months later by Sermo, on the other hand, showed that 63% of healthcare professionals had experience working with telemedicine equipment and 57% were being treated remotely.

And the reason for such a state of events was, as is usually the case with sudden 180 degrees changes, an external factor: the Covid-19 pandemic which sped up the digital transformation in a number of industries.

📚 Now you might be interested to read about HealthTech companies switching medical industry to the remote mode.

Like it or not, the restrictions brought about by the pandemic are here to stay and healthcare is no exception to that. And if that’s the case, let’s take a look at some predictions.

Future: the ubiquity of telemedicine

To give you a greater insight into what the future holds for telemedicine, let us refer to the 2022 Hospital Vision Study by Zebra. The report shows that while only 36% of hospitals are using mobile devices, this number is believed to double by 2022. Over the next two years, mobile devices, including the ones using predictive analytics, are expected to become indispensable to over 95% of surveyed bedside nurses, physicians, pharmacists, and lab technicians. This change will be accelerated by patients’ positive approach to telemedicine software and mobile devices.

Source: The Future of Healthcare 2022 Hospital Vision Study

The change is already happening and the chances that the healthcare stakeholders will use telemedicine as a means for embracing clinical mobility are growing every day.

Three types of telemedicine services

When defining what telemedicine is, we gave you two strikingly different examples to illustrate our point: virtual appointments and monitoring vital parameters. Telemedicine, however, goes way beyond these two – and bearing in mind the types of services it offers, we can assign them to one of three groups: real-time, store-and-forward, and remote patient monitoring.

The doctor will see you now: real-time telemedicine

Let’s start with the category that most people have in mind when they think about telehealth in general. Real-time medicine is basically an online equivalent of an in-person doctor appointment. It utilizes video conferencing software, chat applications, as well as phone calls to connect patients with specialists and enable medical examinations.

Real-time telemedicine is particularly fit for screenings, general assessments, and follow-up visits that do not require the use of any advanced medical equipment. In fact, it is said that almost 3/4 of all doctor, urgent care, and ER visits are either unnecessary or could be handled safely and effectively over the phone or video.

Real-time medicine can work pretty well for behavioral therapy sessions – especially that one of its main advantages is the maintenance of close doctor-patient relationships. And while there are cases which call for an in-person consultation, this kind of telemedicine (as opposed to the other two categories) can not only enhance traditional healthcare services but it also has the potential to replace some of them entirely.

Store-and-forward or asynchronous telemedicine

Unlike the above mentioned real-time telemedicine, asynchronous telehealth services do not allow for personal interaction. Instead, they assume gathering patient’s medical information such as video recording, x-ray images, or lab reports and sharing them with the doctor in charge of the examination. On the face of it, store-and-forward telemedicine does not differ significantly from sending your results via email. In practice, however, it’s more sophisticated and secure.

Asynchronous telehealth is popular among specialists who rely on detailed evidence when diagnosing and treating patients, e.g. radiologists or dermatologists. Since the medical data they work with is stored on a platform, clinicians can access it whenever and how often they want so as to ensure high accuracy of their opinions.

Remote patient monitoring

Last but surely not least, there’s also remote patient monitoring: a telehealth service allowing clinicians to track patients’ vital signs like pulse rate, respiration rate, or blood pressure. It’s most often used in two scenarios: when the patient suffers from a chronic condition such as asthma or heart disease or if they have been recently released from a hospital.

In either case, the greatest benefit of telemonitoring is that it saves high-risk patients the hassle of having to visit the clinic every day without compromising on the quality of healthcare services provided. And if at any point the results will get alarming, the medical provider will be able to react immediately.

21st-century healthcare: where does telemedicine stand?

As of 2019, the global telemedicine market was valued at around 45 billion USD, and in 2026, it is expected to almost quadruple its value. These statistics show that telemedicine is the force to be reckoned with – and its importance is growing at a blistering pace. To shed more light on the reasons for such a state of events, let’s take a look at the advantages of this form of telehealth.

Greater efficiency of the healthcare system

Let’s begin by stating the obvious: healthcare systems across the globe are often overburdened, for various reasons. One is the insurmountable amount of red tape. Another is the growth of consumer demand for high-quality medical services utilizing top-notch technologies. Not to mention the overall lack of funding and resources that many facilities have to deal with.

Fortunately, telemedicine is capable of addressing many of these issues. In terms of increasing the healthcare system’s efficiency, its inception leads to:

• Fewer no-shows

Patients who fail to notify the clinic about the failure to make it to the appointment significantly affect delivery, cost of care, and resource planning. To illustrate the point, the no-show rate of 62 appointments per day costs an average community hospital 3 million USD per year. Luckily, introducing telemedicine to the hospital offering can turn the tables and reduce the no-show rates by 50% – as was the case with Nebraska Children’s Hospital.

• Improved accessibility

Here we need to take into consideration two major factors: distance and time. First of all, think about the elderly, the disabled, and all geographically isolated patients. Telehealth allows them to access care in the privacy of their own homes and doesn’t require asking others for help in getting to the clinic. Secondly, consider how long it takes to get medical help.

Source: Ortholive

The total time of the traditional in-person visit equals 2 hours – and only 16.7% of that is devoted to the actual examination. A real-time appointment, on the other hand, takes about 16 minutes. Not only is it more convenient but it also allows for making more appointment slots available.

• Cost-savings

This one is pretty straightforward: fewer visits canceled last minute plus more available appointment slots equals higher income for the clinics and additional revenue streams for physicians. And as far as savings are concerned, medical providers offering telehealth services on a daily basis tend to incur fewer overhead costs. To give you a practical example, they don’t need as much front desk support or as many examination rooms.

Increased satisfaction and patient engagement

According to NEJM Catalyst’s report, healthcare leaders believe that only 34% of their patients are highly engaged. At the same time, however, nearly 75% of patients surveyed by HealthMine claim that easy electronic access to health data would improve their knowledge of their health and make them more proactive in this matter. That’s an invaluable insight since increased patient engagement translates into greater self-care and more satisfaction. The latter is also fostered by the positive patient-doctor relationship built through regular video appointments.

📘 Here’s a list of 5 healthcare startups that can change the industry. Enjoy!

Enhanced safety

It’s quite a paradox: healthcare facilities are to treat people but they’re also the only places in which you can be 100% to meet loads of sick people. Because let’s face it, unless you require medical assistance, rarely go to a hospital, do you? And while medical personnel does their best to keep patients safe, it’s not always easy – especially if we’re talking about crowded waiting rooms.

In the middle of Covid-19 pandemics, it’s more important than ever to apply safety measures. As Kari Olson, the chief innovation and technology officer for Front Porch told Senior Housing News,

any expansion of telehealth services is a very good thing. Especially during this time when we need folks to stay home, and in particular, to safeguard people over 65 as well as other high-risk individuals.

Telemedicine does exactly that: it allows people to consult physicians online without either patients or healthcare workers having to worry about exposure to dangerous pathogens.

A fly in the telemedicine ointment: challenges and limitations

The surge in popularity of telemedicine doesn’t mean, however, that the implementation of remote healthcare is a piece of cake. On the contrary, there are still some limitations that healthcare incumbents need to bear in mind when expanding their offerings with advanced technology.

• Budget and time constraints

While telemedicine saves time spent on in-person doctor appointments and reduces overhead costs, it may be pricey to introduce. On the one hand, the medical provider needs to find a reliable digital platform. On the other, they need to train the staff to provide high-quality service. On top of that, as observed by Chiron, not all types of telemedicine are covered by insurance providers and worker’s compensation plans as well as small group plans may be eligible to opt out of coverage for telemedicine.

• Security issues

At first glance, telemedicine may sound like chatting with friends through Facebook or Whatsapp. In reality, however, telehealth software needs to meet strict security requirements; for instance, be HIPAA compliant. This way, patients can be sure that their sensitive data will not be accessed by unauthorized parties.

• Reduced care continuity

In the case of on-demand consultations, patients rarely get to see the same physician twice. If they have to explain their symptoms every visit or – even worse – the clinician has limited access to records from previous visits, satisfaction with the service is significantly lowered. For that reason, telemedicine provided a need to implement means to diminish fragmentation and facilitate efficient communication between doctors in charge of treating the same patient.

• Necessary in-person visits

Finally, sometimes online consultations simply won’t do. Here’s what Dr. Allan M. Block, a neurologist in Scottsdale, has to say about what happened after a couple of weeks of treating most patients remotely:

Headaches had recently gotten worse, but now I couldn’t do a fundoscopic exam. A stable seizure patient mentioned he’d had a month of worsening lumbar pain and right-leg weakness, but I can’t really check strength, reflexes, or sensation remotely. (...) Neurology is a contact sport. We spend years learning to recognize minutiae from the moment we first see a patient. The way they speak, and walk, and move. These are not, for the most part, things you can do with a camera. Other specialties may be less exam dependent, but not mine, and definitely not me. I’d be practicing substandard care if I did otherwise.

Doctor Block is not the only one claiming so. There are cases that require conducting in-person check-ups and nothing is going to change this.

Notable telemedicine solutions and apps in mid-2020

On the one hand, we’re dealing with the shortage of medical personnel, chronic diseases, and the spread of pandemic. On the other, we’re experiencing the impressive technological progress as well as the growing access to sophisticated apps and solutions. As you may expect, medical issues and tech trends are permeating each other, leading to the dynamic development of the HealthTech industry. And there’s some hard data proving this point: the global mHealth solutions market is believed to reach USD 213.6 billion by 2025 from USD 50.8 billion in 2020.

mHealth solutions market by region (USD Billion)

Core features of the telemedicine software and examples of telemedicine apps

Before we introduce you to some of the world’s best mHealth apps, it’s worth taking a moment to define the core components of any telemedicine software. As is usually the case, the exact scope will depend on a number of factors, in particular the type of service you decide to provide. Is it going to be a web application, a mobile app, or maybe an all-round telehealth platform? Are you planning to use AR, AI, or maybe Big Data? Either way, you should remember about the following features:

• EHR/PM integration for smooth data sharing
• Data encryption and HIPAA compliance for video consultations
• Medical prescription
• Eligibility verification to check whether patients are eligible for certain appointments
• Payment option for situations in which the insurance provider doesn’t cover the costs of a given service
• Chatbot or support facilitating real-time issue resolution
• Rating system fostering feedback

⚕️ Curious what it takes to build a digital healthcare product? Read about it here, on our blog.

Now, how about learning how the telemedicine giants have implemented these features in their solutions?

• Doxy.me – a HIPAA, GDPR, PHIPA/PIPEDA, & HITECH-compliant platform offering HD video streaming, a live chat, a virtual waiting room, and meeting history. Being a cloud-based web application, it doesn’t require installation – and as such, it can be quickly accessed via computer, tablet, or mobile device.
• K Health Primary Care – an AI-based mobile primary care and symptom checker. On the one hand, asking smart questions about a user's symptoms and determining whether they need to see a doctor or not, the app eliminates unnecessary appointments. On the other, it grants access to a live chat with a doctor which makes treatment faster and cheaper.
• Mend – a full-featured telemedicine suite that aims at reducing no-shows and cancellations with PredictivelQ AI. It also boasts HIPAA-compliant video and audio, easy appointment scheduling and reminders, as well as a number of automated processes for increased productivity.

So, is the future really now?

Wristbands backed with sensors, mobile apps accurately diagnosing mild infections thanks to AI-fuelled engines, HD video chats with doctors at any time of day… If that’s not the future happening now, we don’t know what is. And yet, there’s still so much for telemedicine providers to offer – especially that the demand for digital healthcare services is steadily growing.

Would you like to build telemedicine software of the future? Consult our experts to match your expectations with state of the art technology!