Telemedicine: Transforming Healthcare through Innovation

The concept of using telecommunication technologies in the field of healthcare has been around for a long time. The majority of patient consultations can be conducted through telemedicine platforms. In addition to providing secure platforms for exchanging medical information, telemedicine can also help to promote medical tourism. Telemedicine applications can give access to high-quality healthcare to all. Digital health startups have become more popular among healthcare providers, patients, and insurers.

What are Telemedicine and Remote Healthcare?

Telemedicine is defined as the usage of audio-visual technology to enable healthcare professionals to provide their services to remote patients.

The term telediagnosis is used to refer to the process by which diagnosis is formulated from a remote location. Telediagnosis allows medical records to be transmitted to a physician who works in the same location or at a distance. The quality of the transmitted records does not decrease even after being compressed. Telediagnosis, which includes both synchronous and asynchronous aspects, is beneficial for healthcare providers and patients.

Teletherapy refers to the process by which therapists offer mental health counseling to patients through the use of technology. Applications of teletherapy include therapy sessions conducted through smartphones or e-mail, video calls for individual and group therapy, and mental health apps. Teletherapy offers clients a range of benefits which include a high level of satisfaction, increased privacy, and cost-effectiveness. Teletherapy is available in both synchronous and asynchronous forms. The former takes place in real-time whereas the latter enables clients to follow treatment plans according to their pace.

Remote healthcare, a subcategory of telemedicine, allows healthcare providers to collect and analyze physiological data about patients at home through the use of mobile devices. It is highly beneficial in the fields of cardiology, psychiatry, obstetrics, senior care, and pulmonology. It is becoming more widespread as it enables doctors to diagnose and assess patients.

Evolution of Telemedicine

Earlier, patients had limited options and in-person consultation was the only choice even though it was sometimes inconvenient. Telemedicine came into existence due to the foundation built by technological innovations in the field of telephone communication. Since telephone calls have become a routine part of consultations with doctors, it is rarely considered part of telemedicine.

In the 1960s, telemedicine developed in the form of closed-circuit television. NASA and the Nebraska Psychology Institute conducted projects that led to this development. Telemedicine had its first usage at the beginning of the 20th century in the form of ECG reading. An article that appeared in 1950, details how radiologic images were transmitted by telephone across 24 miles between Pennsylvania and West Chester. In the 1950s, radiologists in Canada improved on this technology and built a teleradiology system.

In 1961, a report on the application of radiotelemetry in patient monitoring appeared in the journal Anesthesiology. In 1965, a report was published that described the transmission of X-rays and electrocardiograms (ECGs) from ships to land. In the 1970s and 1980s, a succession of teleradiology projects led to the Digital Imaging Network Project. This project promoted the growth and application of military and civilian teleradiology. In the 1980s, a few radiologists started to use economical systems for image screening.

In the early 1980s, the high cost of transmission led to a decrease in the use of telemedicine. However, a renewed interest was observed towards the end of the decade due to reduced costs and improvements in telemedicine technology. Telemedicine services were utilized by NASA when disaster struck in the form of earthquakes in 1985 and 1988. Telemedicine’s satellite technology facilitated communication and helped to overcome technological barriers.

Early telemedicine was used to aid communication in the field of speech therapy, psychiatry, and consultations with doctors. Telemedicine proved to be helpful to patients in both rural and urban areas, especially in remote locations and during cases of emergency. Over the years the usage of mobile phones and the internet has increased rapidly, along with the evolution of smart devices such as biosensors. It has become more convenient for patients to send emails, text messages, and medical records to healthcare providers and to receive scans, X-rays, and medical consultations.

Global Adaptation of Telemedicine

In the aftermath of COVID-19, the need for telemedicine escalated in many countries. While face-to-face meetings between doctors and patients decreased, there was a spike in the use of telemedicine. Telemedicine has influenced healthcare all over the world.

Telemedicine can transform healthcare in Africa. Teleradiology, Tele oncology, and telepathology were originally introduced in Nigeria, Ghana, and the surrounding countries. The usage of telemedicine has been prevalent in 16 disciplines. The most common field where telemedicine is used is mental health. National Digital Health Strategies have been established in 41 countries.

Telemedicine applications are widespread in several countries in cancer treatment and awareness. Cloud- computing, which comprises patient surveillance, was introduced in several regions of Africa. The advent of COVID-19 has necessitated the use of telemedicine applications, with a few rural areas utilizing drones to dispatch COVID-19 samples. While Rwanda benefited from the employment of telerobotics to treat COVID-19, Uganda observed a spike in teleconsultation services.

The demand for teleconsultation apps, which are predicted to improve healthcare in underdeveloped areas, is on the rise in several regions of Southeast Asia. The outbreak of Coronavirus witnessed a rise in the use of telemedicine and e-pharmacies. Digital health solutions were adopted in several ASEAN nations in 2020 and 2021. Although the population of smartphones and internet users is on the rise, telemedicine services have not been able to reach their full scope in Asia. Factors such as technology illiteracy and the high cost of telemedicine devices have slowed down the incorporation of telemedicine in developing countries.

The members of the Gulf Cooperation Council (GCC) adopted telemedicine services in healthcare. Qatar is among the members of the GCC that launched a project with the following results in mind: the development of e-health infrastructure and a health data warehouse. Although research in the field of telemedicine is in the beginning stage in the Middle East, experts say that digital healthcare can become normalized.

The UAE government encourages the country-wide application of telemedicine services. Since more people have access to technology, telemedicine applications have scope in these countries. 90 percent of doctors give medical advice through healthcare apps and smartphones. More than 50 percent of hospitals in the UAE utilize IoT-based solutions. Interdisciplinary research should be promoted in these countries.

In the United States, organizations such as the American Telemedicine Association are involved exclusively in using telecommunication technologies to provide adequate healthcare. Many hospitals in the United States enable the connection between users and healthcare providers through audio-visual means. One significant application of telemedicine is in prisons. There is no need for the physical presence of a doctor at prison facilities or for additional costs for an inmate to be transported. Thus, a large amount of money spent on the medical care of inmates is saved in this manner.

The hospital infrastructure in the countries of Latin America is of good quality, according to the CEO of Global Health Intelligence. However, the number of hospitals that can develop into expertise centers is low. There are also a few locations that can incorporate telemedicine technology. Despite these limitations, telemedicine has achieved remarkable progress in Latin America.

In Europe, the telemedicine field has witnessed considerable development. Members of the private sector have been observed to incorporate telemedicine technologies more than their public sector counterparts. The fields of hospitality and travel are also expressing a growing interest in the field of telemedicine.

Telemedicine facilities in India

Currently, India’s doctor-population ratio is only 0.62:1000 and is lower than the WHO recommended ratio of 1:1000. However, telemedicine services in various parts of India compensate for the shortage of physicians. Hospitals in India employ telemedicine services in mammography, oncology surgery, and more. Telemedicine is utilized in areas where occasional gatherings take place.

ISRO developed the concept of Village Resource Centers or VRCs to operate as learning centers, provide telemedicine, Tele-education, and online-decision support, and enable villagers to utilize the services of qualified physicians. Traditional medicine also employs the services of telemedicine in India. The National Rural AYUSH Telemedicine Network helps people get information about the advantages of traditional healing methods.

The number of people who require care for their mental health is on the rise in India. Telepsychiatry caters to those in need of psychiatric care by connecting them with qualified mental health care providers. It is promising that India has the technological expertise to make this ambitious dream a reality. Teleradiology services were used by healthcare professionals during the pandemic. Many teleradiology providers attended specifically to the needs of COVID patients.

“eSanjeevani ”, an integrated telemedicine solution is a doctor-to-patient (outpatient – OPD) telemedicine system. It has been deployed nationally by the Ministry of Health & Family Welfare under Ayushman Bharat Scheme. It has facilitated thousands of consultations until now. There are more than 100 financially supported telehealth startups in India. There is an upsurge in the number of companies that offer telemedicine services to their customers. They offer services such as appointment booking, online consultation, medical directory, and delivery of medicine among others.

Apps that assure medicine delivery and access to prime-quality healthcare are rising in popularity. Manufacturers in India have developed innovative telemedicine products such as Archiving Software, Cloud Software, Dental Software, Central Patient Monitoring Systems, Hospital Management Systems, Surgical Navigation Systems, ICU Monitoring solutions, etc. Some of them can be found on Medzell here.

Benefits and challenges

Telemedicine offers a variety of advantages for its users:

Telemedicine consultations cost less than face-to-face meetings with doctors and cut transportation costs and long waiting hours.
Telemedicine enables people in rural areas to get easy access to healthcare, mostly those who live far away from the nearest hospital or clinic. It is also helpful in events of rough weather, such as heavy rain and snowstorms.
It offers patients the convenience of getting medical advice from doctors from their own homes, especially those who are unable to take work leave or assign someone for childcare.
It prevents people who have highly infectious diseases from spreading them to others, particularly to pregnant ladies and senior citizens who are at risk.
Telemedicine also gives people the opportunity to consult specialists who may be able to give better advice than those closer to home.
Telemedicine can facilitate parents of infants and toddlers to get expert advice from qualified physicians in the event of sudden illness, instead of depending on dubious healthcare advice available on the internet.
Telemedicine benefits people who may have phobias like agoraphobia that may stop them from meeting doctors in person.

Telemedicine has benefitted numerous healthcare practitioners worldwide:

Many doctors’ offices have reduced their hours due to the pandemic. Telemedicine offers doctors the option of offering consultation from the comfort of their homes. They are able to connect with their patients even after working hours and during weekends. Moreover, they can reduce additional costs by eliminating the need for office staff such as receptionists and cleaners.
Many therapists have been able to provide consultations to people with mental illnesses such as depression and anxiety. Telemedicine is a blessing to those who want an immediate meeting with their therapist at any time of the day.
Certain specialists can benefit from being able to see their patients in their homes. Allergy specialists may be able to determine the cause of allergies by observing the home environments of their patients.
There is less chance for people to become late or cancel their online consultation appointment, thereby eliminating frustration for healthcare providers.

Despite its numerous advantages, telemedicine has certain limitations:

Telemedicine does not permit doctors to take blood or urine samples and check vital signs. In addition, tests such as mammograms, sonograms, and the like can be done in person only.
The patient’s personal information may be at risk of being hacked. It may be difficult for the physician to provide adequate medical advice if the connection is of poor quality.
In the case of an emergency, a doctor will not be able to provide urgent care through telecommunication technologies.
Children who receive speech therapy may not be able to focus properly during their meetings with speech therapists.
There may be cases where patients may not get access to the same doctor and face a reduction in care continuity as a result. The healthcare provider may not have complete information about the patient’s medical history.

Future of Telemedicine

It is safe to assume that telemedicine will further revolutionize the healthcare industry in the coming years. It has already proved its effectiveness in the last two years, by connecting numerous patients and healthcare professionals. Developments in technology will further create a niche for the telemedicine market and promote its growth in the future. Patients who suffer from rare diseases can receive specialized care through telemedicine technology. The rising number of senior citizens and the need for remote patient monitoring will increase the demand for telemedicine.

India has seen rapid innovations in telemedicine. The Tele-digital Health Pilot Program aims to generate electronic health records (EHRs) for the population of India and save around 5 billion US dollars each year. The Indian government founded the National Digital Health Mission to offer support to the digital health infrastructure. The government may engage in the monitoring of the privacy and security of startups. ISRO-based services can be augmented by improvements in mobile services.

Conclusion

In 2020, The value of the global telemedicine market was roughly calculated to have a value of $60908.9 million. Currently, the global telemedicine market is growing at a rate of 1820.0% and is expected to reach a value of $186765.7 million by 2027.

Telemedicine is highly valuable in India, a country that has grown economically but faces issues of the rising cost of healthcare. According to a recent study, the value of the telehealth market in India was estimated to be at 13.15 billion US dollars in the financial year 2021 and is predicted to increase at a CAGR of 22.31%. The e-Health sector shows the maximum potential for the growth of telemedicine in India. It is expected to grow at a CAGR of 31% and touch 5.4 billion dollars by the year 2025, according to India’s eHealth Market Opportunity Report, 2021.

Although there is a rise in the demand for telemedicine services, it might not be an adequate substitution for conventional healthcare which includes in-person consultations, surgeries, and examinations. Telemedicine gives healthcare providers and patients affordable tools that can decrease unnecessary waiting periods and give better access to healthcare. The need of the hour is to promote telemedicine to bridge the gap between healthcare providers and those in need, especially in the post-pandemic era.