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Introduction to Telemedicine Practice

Telemedicine facilitates the delivery of health services for rural regions, and under ideal circumstances, it is useful for patient education and administrative meetings. Nearly 50 years ago, when telemedicine was introduced to the general population, the developers were uncertain how doctors and patients would react to a new way of practicing medicine. Of course, half a century ago there were no computers, so telemedicine included the use of the telephone, and sometimes, a 2-way radio. Now, telemedicine has many names, and a variety of services are offered virtually.


e-Health, i-Health and Telehealth


Telemedicine, a commonly used umbrella term, refers to any clinical activity associated with an element of distance. For most people, telemedicine involves interaction between a doctor and patient. Also called telehealth, a more politically correct word, distance patient care also goes by such fashionable names as e-health and i-health.


Over the past five decades, there have been numerous advances in modern medicine. Robots now perform surgery, and scientists have cures for many diseases that did not even have a name back years ago. Additionally, we now have telemedicine, a high tech way of providing patient care, and it has made huge strides in health related fields.


In addition to doctor and patient satisfaction, the government is also a big fan…well, for the most part. Many government officials believe that telemedicine is one of the greatest inventions in history. This online practice of medicine is a big money saver for the federal government, and the patients still receive quality healthcare. This is why the government offers many companies grants that fund research regarding telemedicine.


Teleradiology and PACS


Telemedicine is on the verge of major breakthroughs in the areas of diagnostics, and physicians can order diagnostic tests via online methods. This allows a patient to receive testing without having to travel hundreds of miles to the facility. Also, virtual healthcare permits patients to receive necessary education and counseling, without having to deal with the inconveniences of coming in to the office.


Much of the growth of telecommunication technology has occurred in the form pilot trials and feasibility studies. Because of this, there is not convincing evidence regarding the cost effectiveness of the various applications, other than teleradiology.  Advanced technology with digital imaging makes it possible for a doctor to view diagnostic images on computer screens.


Computer programmers and software developers work constantly to perfect teleradiology, and one innovative development is “Picture Archiving and Communications Systems” or “PACS.” This advancement allows management and storage of large amounts of information, freeing up healthcare facility file space.


Patient and Doctor Satisfaction


It has been proven that patient satisfaction has a huge effect on the outcome of individual health. If a patient has a positive experience with telemedicine, he or she is more likely to recover quicker than with a negative experience. Telemedicine researchers conducted several studies to determine if telemedicine has a place in the future of healthcare. These studies involve the satisfaction level of both patients and doctors.


Overall, most physicians are satisfied with the use of telemedicine, especially now that it has become so advanced. As the technology continues to advance, so will the rate of satisfaction for healthcare providers. When telemedicine first started to come into the light in the 90s, doctors were excited about the possibilities of providing better care, but cautious about the means of the health provision.


Confidentiality was an initial major concern for many doctors, according to recent studies. The healthcare professionals feared that the systems were not secure enough to protect patient identities and test results. With higher security standards in place, doctors and patients are now more comfortable. In another study, many physicians expressed concern about education and training to operate the equipment and devices involved with online care provision. Additionally, many providers still feel like the face-to-face contact with patients is necessary for adequate healthcare delivery.


Most patients express reserves about the use of telemedicine. However, several studies found that patients were satisfied with the results from online healthcare. In one study, researchers sent 60 patients to a rural area where the quality of the telecommunications was poor. The patients used telemedicine for a determined amount of time, and the overall results of the study indicated that the patients appeared pleased with the use of online healthcare.


In another study, patients first used telemedicine, and then followed up with a face-to-face encounter with their doctor. The majority of these patients agreed that the online healthcare was acceptable, but they expressed preference for face-to-face encounters. Regardless, in the majority of all studies, the younger generation appears more acceptable of telemedicine than older generations.


Final Thoughts


Telemedicine is becoming increasingly popular among patients and doctors. However, it will never completely replace the face-to-face doctor/patient visit that we have all come to know. Telemedicine is suitable for many clinical uses, but there will always be health conditions, emergencies and critical care cases that cannot be treated virtually. Regardless, traditional medicine and telemedicine nicely complement each other.


References


Smith, AC, Bensink, M, Armfield, N et al. (2005). Telemedicine and rural health care applications. Symposium, 51(4): 286 – 293.


Whitten, P & Love, B. (2005). Patient and provider satisfaction with the use of telemedicine: Overview and rationale for cautious enthusiasm. Symposium, 51(4): 294 – 300.


Wootten, R, (2001). Telemedicine. BMJ, 323(7312): 557 0 560.

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