The Benefits and Limitations of Telehealth Applications, Essay Example

Abstract

The paper discusses the benefits and limitations of telehealth applications. The paper emphasizes the relevance and seriousness of ethical issues that necessarily accompany the use of telehealth solutions in medical facilities.

Informatics Paper

Postmodern technological advancement provides medical and healthcare facilities with unlimited technological opportunities. The cost of medical services constantly increases, and hospitals seek the means to raise the effectiveness of their limited resources, to meet the basic health needs of patients. Telehealth and telemedicine represent a new technological shift in the conventional healthcare paradigm toward better efficiency and lower cost of medical services. Telehealth has a potential to enhance significantly the quality of health care. However, before telehealth becomes an indispensable component of health care delivery, a whole set of issues must be resolved. These include the need for additional training, as well as ethical controversies that necessarily arise in the process of developing and using advanced medical technologies.

Telehealth: The Basics

Telehealth is “the use of advanced technologies to promote the exchange of medical information and images via a variety of communications services and to promote the delivery of clinical care” (Rheuban, 2009, p. 570). The current state of research treats telemedicine and telehealth as the two distinct technological categories – while telemedicine must have a clinician as at least one of its participants, telehealth implies any use of information technology in health care (Kaplan & Litewka, 2008). Yet, both categories use communication technologies and electronic information for healthcare, whenever participants are separated by distance (Kaplan & Litewka, 2008).

Telehealth services and applications can be used in a whole range of medical specialties, subspecialties, and settings – from hospital to home (Rheuban, 2009). Telehealth services are usually delivered via live interactive formats (e.g., videoconferencing), in which both the patient and the medical professional are present and can resolve various health issues (Rheuban, 2009). Medical services that are successfully integrated with telemedicine solutions include tele-ophthalmology, tele-radiology, tele-dermatology, tele-consultation, and remote monitoring (Rheuban, 2009). Telehealth as the broader form of telemedicine also involves health-related distance learning for health professionals and patients (Rheuban, 2009). Regardless of whether medical professionals speak of disease management, disease prevention, chronic disease monitoring, or any other type of health care services, the use of telehealth solutions translates into better efficiency and lower cost of health care.

Telehealth: Benefits and Limitations

That telehealth can benefit medical professionals and patients is difficult to deny. The value of telehealth solutions is difficult to underestimate. The use of telehealth technical solutions in medical care results in better patient outcomes (Norris, 2002). According to Jia et al (2009), the use of telehealth approaches in medical care reduces the number of preventable hospitalizations. These results indicate that telehealth improves the quality and efficiency of medical care. These telehealth solutions also have a potential to reduce the costs of medical care – fewer hospital admissions mean better opportunities for medical facilities to manage their resources. More often than not, the use of telehealth applications in medical care engages medical professionals in multidisciplinary activity, in order to provide their patients with the fullest range of services and consultations (Norris, 2002). Consequentially, the use of telehealth applications reflects through improved teamwork and better understanding by medical specialists of their roles and place in health care continuum (Norris, 2002).

Telehealth is associated with increased patient involvement. Telehealth is an excellent instrument of continuous audit and monitoring. Meanwhile, patients develop better understanding of their disease, its treatment, and its outcomes (Norris, 2002). By using telehealth solutions, medical professionals improve the efficiency of medical resource management and contracting: telehealth applications guarantee that all drugs and clinical tests are deployed only when they are needed and can maximize benefit (Norris, 2002).

Telehealth: A New Ethical Challenge

The need for additional training is among the most serious telehealth limitations – while implementing and using telehealth applications in medical care, health care facilities must account for both start-ups and ongoing training requirements (Norris, 2002). Because the system constantly develops and new staff is hired, medical facilities must engage their employees in ongoing education and training (Norris, 2002). Researchers and IT professionals sometimes fear that telehealth may result in poorer patient-carer relationships due to the intrusion of technology and its impersonal character; medical professionals also suggest that telehealth may reflect in organizational disruption and worsened relationships between the staff (Norris, 2002). All these fears are reasonable and valid, but not as serious as ethical issues that necessarily arise in the process of using healthcare technologies.

Despite its benefits, telehealth is just another form of technological solution and thus may lead to intrusion and security breaches. Other ethical issues include the lack of convenient user interface, the lack of user friendliness, the need to incorporate personal health information into the system and the need to integrate telehealth with the rest of health information infrastructure in health facilities (Kaplan & Litewka, 2008). Obviously, the effectiveness of telehealth in medicine and healthcare will decrease dramatically, if the system does not fit into the information exchange infrastructure and does not guarantee the necessary degree of confidentiality and health information protection (Kaplan & Litewka, 2008). All these issues are of purely technical character, but the major question is in whether patients are prepared to use telehealth solutions. This is the issue which medical professionals are still trying to resolve.

Today, medical facilities and healthcare professionals lack unanimous agreement about what constitutes usability and obtrusiveness in telehealth applications (Kaplan & Litewka, 2008). Obviously, different population groups will have different opinions and different criteria regarding these issues (e.g., the criteria of obtrusiveness for community centers will differ from those for individual patients at home). The extent to which telehealth applications are obtrusive will also predetermine the degree of usability and acceptability of telehealth among different groups of patients. Because telehealth for IT professionals is not simply a technological solution but is a state of mind, not all patients, due to their socioeconomic status and educational background may be prepared or willing to use these applications to monitor as an instrument of monitoring their health (Kaplan & Litewka, 2008).

Different individuals and different population groups attribute different meanings to one and the same technology. Some population groups view telehealth as a convenient means to reduce their medical care costs; others believe that telehealth results in increased patient dependence (Kaplan & Litewka, 2008). “What is acceptable in a particular country or region may not be acceptable in another, so the same design or technological approach may lead to different results in different user communities” (Kaplan & Litewka, 2008). While HIPAA and JCAHO regulations lay out the expectations for the protection of data in healthcare (Logan & Noles, 2008) cultural and socioeconomic differences are still an issue. In this situation, there is the need for cooperative effort, to ensure that telehealth applications account for the cultural differences across different groups of patients, and thus raise the degree of their acceptability across different population groups.

Conclusion

Telehealth is any form of technology used by medical facilities to enhance information exchange between medical professionals and patients who are separated by distance. Telehealth can benefit medical facilities in a number of ways, from cost reduction to better efficiency of health care. Unfortunately, ethical issues and the need for additional training are still the two most serious telehealth issues. The lack of usability and acceptability of telehealth across different groups of patients is another problem. For telehealth to become an essential component of healthcare delivery, IT professionals must embrace cultural and technological differences in different groups of patients, while medical professionals must promote the benefits of telehealth applications, to raise the degree of their usability and acceptability across all population groups.

References

Jia, H., Chuang, H.C., Wu, S.S. Wang, X. & Chumbler, N.R (2009). Long-term effect of home telehealth services on preventable hospitalization use. Journal of Rehabilitation Research and Development, 46(5), 557-566.

Kaplan, B. & Litewka, S. (2008). Ethical challenges of telemedicine and telehealth.Cambridge Quarterly of Healthcare Ethics, 17, 401-416.

Logan, P.Y. & Noles, D. (2008). Protecting patient information in outsourced telehealth services: Bolting on security when it cannot be baked in. International Journal of Information Security and Privacy, 2(3), 55-70.

Norris, A.C. (2002). Essentials of telemedicine and telecare. John Wiley & Sons.

Rheuban, K.S. (2009). Telehealth: Necessity is the mother of invention’. Pediatric Annals,  38(10), 570-573.