Telehealth: Delivering Health Care Services from a Distance

According to the World Health Organization (WHO) Blaisern et al., 2013), telehealth involves the delivery of health care services, in situations where distance between the patient and a health facility is a critical factor. This is enabled through the use of information and communication technologies by health care providers to exchange valid information regarding diagnosis, treatment, and prevention of injuries and disease as well as to conduct research and evaluation. Further, it facilitates education of health related information between care providers, with the interest of advancing the health of individuals and their respective communities.

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Thus, the concept of telehealth increases access to healthcare services provision and it therefore has the capacity of making sure that healthcare provision is more convenient for patients, especially those with mobility problems, those with children and those living in rural areas. However, there are several limitations to the realization of full adoption of telehealth including the acceptance of this type of technology by clinicians as well as by patients, its sustainability in terms of economic factors, and sustainable reimbursement systems, compatibility between electronic patient record systems, and technological capacity to integrate bandwidth-heavy telehealth programs in small hospitals, clinics, and at home. To this effect, the aim of this paper is to discuss the challenges associated with the promotion of telehealth implementation and advancing its adoption.

Telehealth Challenges

In most advanced economies, there exist financing models for the health care sector. For example, in the US a national quality strategy for identifying the aims and priorities for quality improvement, commonly referred to as the "the Triple Aims" was established in 2011. It included the desire to improve the general and total quality of health care, enhance better outcomes for the community, and facilitate the reduction of the total costs for the provision of healthcare (Joseph et al. 2010). Thus, in economies like the US and the European Union, it is clearly expected that technology will play a major role in the realization of these critical goals.

However, even with the support from the government as well as the growing evidence base that illustrate the benefit of telehealth care financing models, there remain many limitations encountered while establishing and sustaining an effective Telehealth program (Joseph et al. 2010). Specifically, financial sustainability of the telehealth models of care remains the greatest challenge even in economies like the US that have a functioning Affordable Care Act. Specifically, reimbursement remains and therefore continues to focus more on how care services should be paid for and especially where it happens within health care facilities rather than care processes that have a direct impact on the outcomes of a patient (Joseph et al. 2010). Although reimbursement for Telehealth increased in the United States, payers such as Medicare do not recognize the home as a reimbursable originating site of care.

There also exist additional limitations beyond reimbursement to bringing telehealth models to scale across various health systems methods and that also consider independent practitioners. Besides, the best telehealth models would need extensive care teams including disease management nurses and other personnel (Ellimoottil et al. 2018). To this end, independent practitioners are likely to be left out since they may not be able to employ such teams and for this reason they would be required to rely on an intensive service model, such as from visiting nurses for home health care (Ellimoottil et al. 2018). Further, for the implementation to be effective telehealth often requires the reception and processing of data from numerous and this would require that such data be analyzed and translated into actionable clinical information for physicians and other health care givers.

Hence, if data Telehealth technologies are to be relied on so that clinical decisions can be effectively made, the clinician must be guaranteed that activity and physiological data are accurate. It is for this reason that the Personal Connected Health Alliance exist since their purpose was to assure that this happened (Blaiser et al. 2013). Accordingly, as data from telehealth becomes highly standardized and universal, and as health data are assembled and stored in standard formats, there are significant opportunities required for the application of predictive analytics. Rationally, clinicians must be equipped with interpretable dashboards that are user friendly identifying and those that can easily track each patient's data and health issues (Blaiser et al. 2013). For instance, there exist opportunities to the adoption of off-the-shelf technologies, that can serve to serve as tools in remote chronic disease management.

Conclusion

Eventually, if telehealthis to be given a chance, extensive research is required in relation to determining the preferences of both the patients and their care givers as well as for care models and methods that can ensure accurate data. Thus, as new technology solutions, such as mobile devices, sensors, and self-tracking technologies, become more ubiquitous, institutions will increase use and reimbursement of technology-driven health care services. Further, as technology-driven health care services become common, this will demand the development of resourceful business models and cases for all telehealth stakeholders.

References

Blaiser, K. M., Behl, D., Callow-Heusser, C., & White, K. R. (2013). Measuring costs and outcomes of tele-intervention when serving families of children who are deaf/hard-of-hearing. International Journal of Telerehabilitation, 5, 3-10.

Dearholt, S., & Dang, D. (2017). Johns Hopkins nursing evidence-based practice: Models and guidelines. Indianapolis, IN: Sigma Theta Tau International.

Ellimoottil, C., An, L., Moyer, M., Sossong, S. and Hollander, J. (2018). Challenges And Opportunities Faced By Large Health Systems Implementing Telehealth. Health Affairs, 37(12), pp.1955-1959.

Joseph, V., West, R., Shickle, D., Keen, J. and Clamp, S. (2010). Key challenges in the development and implementation of telehealth projects. Journal of Telemedicine and Telecare, 17(2), pp.71-77. doi: 10.1258/jtt.2010.100315