Utility of Telehealth

Summary of Research

The rapid implementation and development of telehealth technologies, particularly over the last decade, can be attributed to the benefits that this mode of health care delivery provides. The common benefits described in the literature include convenience, increased accessibility, increased patient participation, and decreased cost. In addition, telehealth gives power to the patient and encourages self-efficacy in one’s own disease management. Telehealth also facilitates a multidisciplinary team approach to care. The dominant support, however, for the adoption of telehealth practice comes from an economic perspective, showing increased efficiency and cost-savings (Dorsey & Topal, 2016). Despite its efficacy, questions have arisen regarding the ethical considerations of this modality, the security and privacy of the data transmitted, and the sanctity and intimacy of the patient-clinician dyad. Research for this topic topic has shed light on common themes with consideration of ethical and legal implications for both patient and clinician. In the many modes of health care service, the introduction of new modalities, e.g. telehealth, undoubtedly increases the complexity of how care is delivered. It is imperative health clinicians proceed with caution, identify the potential pitfalls from multiple perspectives, and carefully consider the ethical and legal aspects of this new mode of healthcare delivery.

Driving Forces

“Despite outspending all other comparable high-income nations, our system ranks last or near last on measures of health, quality, access, and cost (Salmond & Echevarria, 2017).

 

Technology is breaking new ground, offering innovations in care delivery to address:

  • ...the aging population.
  • ...healthcare worker shortages.
  • ...the unsustainable cost of healthcare.
  • ...poorly managed chronic illness.
  • ...the ignored needs of underserved & vulnerable populations.
     

Who Stands to Benefit from Telehealth?

Stake·hold·er /ˈstākˌhōldər/ noun
(in gambling) an independent party with whom each of those who make a wager deposits the money or counters wagered.
a person with an interest or concern in something, especially a business.

  • Insurance companies
  • Health care organizations
  • Underserved populations
  • Clinicians
  • Heath Information Technology (HIT) companies 

Barriers to Telehealth Adoption

  • Start up and roll-out costs
  • Challenges to reimbursement for service
  • Patient acceptance and adoption of a “new” method of healthcare delivery
  • Federal and state regulations and licensure
  • Security and IT managment 
  • Broadband and internet access

Benefits of Telehealth Adoption

  • Increases access e.g. patients in rural areas have remote access to healthcare & disabled or geriatric populations with transportation limitations can have virtual visits. 
  • Greater continuity e.g. clinicians and patients can "check-in" between appointments, continuous sharing  of health data.
  • Promotes ownership of care and patient self-efficacy. 
  • Supports collaboration with team-based approach to care.
  • Reduces cost by decreasing need for hospitalizations, specialists, internests, and other providers can be remotely "shared" among critical access hospitals.

In one study the cost of care to monitor diabetic patients through telehealth was approximately $87,000 as compared to the $232,000 spent by the control group for traditional home health nurse visits (Clark, Capuzzi, & Harrison, 2010).