Meet an Informaticist – Telemedicine – A Patient’s Perspective

Telemedicine is continuing to increase in popularity as a strategy for treating and managing patients. Telemedicine is the ability for providers to interact with patients in a private and electronically connected environment. With any new technology, there are some challenges that patients face when using telemedicine. Highlighted below are potential resolutions on the challenges faced by patients participating in telemedicine activities and ideas for organizations desiring to offer telemedicine services.

Patient Telemedicine Experience –Best Practice Recommendations

  • Provide patients with technical requirements and testing tool prior to session
  • Make patients aware of the extent of services able to be provided (e.g., prescriptions or just advice)
  • Real-time follow-up appointments
  • Enable patients and caregivers to access telemedicine resources

There are a variety of ways to design, implement, and use telemedicine:

  • Home-based care activities
  • Remote monitoring of vital statistics
  • Palliative care program

Home-based care leverages telemedicine technologies to facilitate a patient’s interaction with a medical provider. Below are two common situations where a patient encounters an issue and a solution is provided.

Scenario #1

A patient schedules an appointment for a physician consultation with a wellness coordinator via an online portal.

Issue

Scheduling a home-based care interaction is relatively straight forward. However, the process leading into the consultation can potentially have technical issues such as browser or webcam incompatibility.

Solution

Organizations are encouraged to provide a comprehensive explanation of the technical requirements necessary for the session; including browser and camera diagnostics to get the session to work properly. Certain telemedicine sites enable a patient to run a test of their equipment prior to the session. This test is a good best practice to consider implementing so that patients can verify their ability to interact with the telemedicine provider with ease.    

Scenario #2

The consultation session with the medical provider occurs. The provider reviewed the patient’s history and symptoms. The patient provided simple vital signs (e.g., temperature and pulse) and using the patient's background information, the provider is able to make a preliminary diagnosis.

Issue

Due to licensing regulations in the patient’s state, the provider was not able to prescribe any medications. The provider is only able to reassure the patient that the illness did not appear serious and provides the name and contact information for a local urgent care center.

Solution

One recommendation to telemedicine providers is to conference in the urgent care facility to make an appointment for the patient in real-time. It also would have been helpful for the provider to send the patient information on the recommended treatment for the diagnosed condition.

Telemedicine also has many practical applications in supporting end of life (palliative) care. In hospice and palliative medicine, the goal is no longer a curative approach to healthcare; the emphasis shifts to palliation of symptoms and the minimization of suffering associated with illness. In telemedicine, it is recommended that hospice or other providers to deliver a daily phone call to monitor the patient and adjust care based on their immediate needs. Studies indicate the frequency of provider to patient or caregiver interactions yields a positive impact on the patient’s quality of life. The phone call alone has reduced the number of hospital re-admission rates, and alleviated the overall distress of the patient.

Clear communication is essential to provide a high quality of care for the entire care team. Telemedicine can also be used to support the patient and the caregiver via video discussions, instant messaging within a secure portal, or encrypted emails. Using this service is invaluable to not only reassure caregivers but to provide them with a place to talk about their own concerns as they witness their loved one in the final stages of their life.

Conclusion

Telemedicine offers a great deal of promise in its ability to provide medical services to populations unable to obtain them. Telemedicine provides a lifeline between physician, caregiver, and patient so that questions can quickly be answered. Telemedicine provides a quick and easy way for providers to monitor large numbers of patients and still provide critical care when and where it is needed.   The major challenge that providers and patients need to be aware of is that telemedicine requires commitments from both sides to provide the right technology and training so that telemedicine can be properly used. Providers must be sure that staffs are trained to properly use and educate on telemedicine technologies. Patients must commit to taking the time to understand the technologies and the limitations associated with telemedicine.

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