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Telehealth Implementation amidst the COVID-19 Pandemic: Barriers and Opportunities

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(@ashishjoshi)
Posts: 121
Reputable Member Admin
Topic starter
 

The rapid spread of SARS-CoV-2 imposed an excessive burden on health care systems. Telehealth has considerably transformed health care delivery since the beginning of the COVID-19 pandemic. Patients perceive primary care video visits as convenient and efficient. Telehealth uptake may improve public health crisis may but may also deepen health inequities. Telehealth adoption imposes significant challenge to the health care system. Initial reports from the early phases of the pandemic suggests that health care providers’ unwillingness is one of the barriers to telehealth implementation in practice. There is significant variability in telehealth education and training among clinicians.  Patients may not have access to technology that enables telehealth, have poor internet connectivity, or face technical challenges. There are concerns about privacy issues. Further research needed how the adoption of telehealth demanded affect health care providers’ physical and mental workload.

Interesting Read: Identifying Barriers to and Opportunities for Telehealth Implementation Amidst the COVID-19 Pandemic by Using a Human Factors Approach: A Leap Into the Future of Health Care Delivery?

 
Posted : April 15, 2021 9:33 am
kanishk, Mirzaadil, Harini_r and 2 people reacted
(@rohitashwa)
Posts: 8
Active Member
 

Whenever I think about the telemedicine or Telehealth, two things come in my mind i.e. older generation’s capability to use technology and lack of infrastructure (fast internet connection and electricity). Telemedicine can be definitely useful in current covid situation however it will be more beneficial for younger generation as they are more tech savvy but for older generation people it would be difficult to communicate through technology. Secondly, there are many places where faster internet connectivity is not available especially in the village area of country like India. In that case, need to think about alternatives. In today’s scenario, most of the families have at least one digital device for example smartphones, webcams etc. which provides a platform to implement telemedicine/telehealth. However, it would be more successful if need of older generation can be understood and solutions for internet connectivity can be provided before implementing telemedicine services.

Overall, there are various benefits in using telemedicine/telehealth especially in non-emergency / routine care and in cases where services do not require direct patient-provider interaction.

 
Posted : April 15, 2021 12:54 pm
(@harpreet)
Posts: 60
Trusted Member
 

@rohitashwa

The COVID-19 pandemic has increased the vulnerability of older population to various diseases which is exacerbated by the lack of access to health care due to restricted movement as a preventive measure. The pandemic has also led to a rapid increase in utilization of telehealth services. This paper discusses the scope of telehealth care for geriatric care during the COVID-19 pandemic. They also discuss the strengths, weaknesses, opportunities, challenges and recommendations for improving telehealth services for older people.

//www.mdpi.com/1660-4601/18/4/1755

 
Posted : April 15, 2021 4:26 pm
(@kamalpreet)
Posts: 69
Estimable Member
 

The article “Telemedicine barriers and challenges for persons with disabilities: COVID-19 and beyond” talks about the following barriers which required to be addressed systematically  

  • Infrastructure and access barriers
  • Operational challenges
  • Regulatory barriers
  • Communication barriers and
  • Legislative barriers

During pandemic less attention was given to the healthcare access of person with disabilities and they have unique social, economic, and environmental disadvantages and more likely to have far worse healthcare outcomes than persons without disabilities.

Therefore, long term changes in above mentioned barriers and custom solutions to unique patient and health system needs are required to improve healthcare access and outcomes for persons with disabilities.

Read more:

//www.ncbi.nlm.nih.gov/pmc/articles/PMC7346769/

 
Posted : April 15, 2021 6:40 pm
(@mandasor)
Posts: 6
Active Member
 

Some of the barriers mentioned are age related whereas others are more demographic oriented.

The age related barriers towards implementing telehealth on a wider basis would be common for people all over the world, irrespective of where they live or what they do.

However, the problems associated with no internet connectivity or underdeveloped infrastructure vary from place to place. For example, if we compare Singapore and India, the former has incomparable internet coverage with free Wi-Fi in all tourist spots. The same cannot be said for India. Of course the size of the countries play a very big role here, but I just used the comparison to put my point across.

Treatment can go wayward as well, seeing that there is no real contact between the physician and the patient and it is all virtual.

That being said, advancements in telehealth would be welcome as for me, the advantages overweigh the barriers.

Thank you.

 

 
Posted : April 15, 2021 8:38 pm
(@khruthi-r)
Posts: 2
Member
 

            I think the use of Telehealth has equal advantages and disadvantages . The use of telecommunications to support long distance clinical health care requires a good environmental setup like network facilities which should be ensured from both health care providers and public . 
         
           In a normal case scenario , patients are forced to transfer from primary to tertiary health care facilities in case of advices for advanced or complex clinical conditions . This could be a major advantage in telehealth services , as this could be cost-effective considering the transportation charges . 

             Some advantages of telemedicine from my point of view are :

       1) The treatment could be given to the right people , with right sources and in right time 

       2) Telehealth services works better in case of requirement of psychiatric counselling , and for any nutritional advices for diabetes or cholesterol control . 

        3) Considering the Covid pandemic , the risk of environmental transmission is also less . 

      There are also some disadvantages like : The physician cannot physically examine patients which can lead to inaccurate diagnosis . With reference to a diverse country like India , Language barrier could also become a problem . 

 As the saying goes something is better than nothing , the proper implementation of telehealth services could possibly give a better outcome when compared to no treatment at all . 

       Thank you ! 

This post was modified 3 years ago by KHRUTHI_OR
 
Posted : April 15, 2021 9:51 pm
Shirley Nivedhana, Harini_r, Sanjeev and 1 people reacted
(@sanjeev)
Posts: 1
Member
 

I believe that Telehealth implementation is a double edged sword. It comes with many advantages and challenges.

The advantages being

  • It does not necessitate physical contact and thus reduces the risk of infection (of any communicable disease, not necessarily COVID-19)
  • Reducing the prevalence of nosocomial infections.
  • The economical impact too, where a person might not need to travel (be it a few miles or between countries) to seek proper medical guidance.
  • Easy availability of medical guidance and conservation of time.

The challenges are: 

  • Implementation of Telehealth medical guidance needs to be done securely (where the data is protected) and in an easy to use platform.
  • Procuration of DATA needs to be done responsibly and to ONLY benefit the needs of the patient
  • The integration of patient data available across different hospitals and nationwide health systems needs to be achieved to provide comprehensive patient care not only in one clinic, but any clinic equipped to handle telehealth consultations
  • The patients need to be made aware of their rights and how it could change differently in an online environment.
  • The medical staff themselves need to be educated so that they don't commit any mistakes or divulge data to external sources knowingly or unknowingly
  • The effectiveness and genuineness of such a online based platform for administration of health services might come under scrutiny and take long periods of time for the patients to actually trust them.
  • The obvious challenge being absence of internet facilities to certain people who actually need them.

Thus Telehealth implementation could prove to be very beneficial but only when used responsibly and in a transparent manner to truly benefit the needs of the patient.

 

Thank you!

This post was modified 3 years ago by Sanjeev
 
Posted : April 15, 2021 11:24 pm
(@kanagavalli)
Posts: 2
New Member
 

Telehealth / Telemedicine has its own opportunities and barriers.

In Indian scenario:

Telehealth in urban setting:

The term Telehealth is most appropriately suitable for urban people. Factors postively supporting Telehealth include good internet connectivity, higher literacy rate, accessible to pharmacy shops,comparatively increased awareness about use of Telehealth app, facilties related to it. 

Telehealth also reduces the exposure to infection unnecessarily. It save the  alot of time as there is no need to stand/ wait for a long hour in queue to consult a doctor. In this COVID-19 time, it an excellent model for the patients who are on regular check up for Non-communciable diseases, minor illness.  

It can be used as an alternative for face-face consultation for "short-term" and unavoidable circumstances like COVID

Barries include:

1. Eventhough awarenss about the telemedicine is somewhat high inurban setting but still a people are reluctan to use and adopt the change.

 

Telehealth in rural setting:

Telehealth is not at all suitable for rural setting due to various factors like low literacy rate, poor internet connectivity, difficulty in using the mobile application among geriatric age groups.

 

Common barriers in both urban and Rural setting: 

1. Telemedicine doesnot give the sense of connectivity towards doctor-patient relationship 

2. Not suitbale in case of major / emergency scenario.

3. Doctors will experience alot of drop -out cases in Telemedicine 

Steps to be taken:

1. Create awareness consistently among the people about the use of telemedicine

2. Behavioural modification of the people about Telemedicine

3. Providing the facilties for the use of Telemedicine like increased internet connectivity from public and private sectors.

 

Global Scenario:

It is an opportunity for the people residing in the COVID-19 hotspots to make use of telemedicine. It is best suited model for developed countries as compared to the developing and under developed countries. 

Conclusion:

To summarize, Telehealth is the exceptional model for the people with minor illness and residing in urban area. Creating awareness about the people will promote in use of Telehealth.

 

 

 
Posted : April 15, 2021 11:25 pm
(@trushar-parmar)
Posts: 14
Eminent Member
 

The extensive uptake of telehealth has considerably transformed health care delivery since the beginning of the COVID-19 pandemic and has imposed tremendous challenges to its large-scale implementation and adaptation. Given the shift in paradigm from telehealth as an alternative mechanism of care delivery to telehealth as an integral part of the health system, it is imperative to take a systematic approach to identifying barriers to, opportunities for, and the overall impact of telehealth implementation amidst the current pandemic. While the pandemic has shown tremendous growth by leveraging technology including health services, there are few of the fundamental barriers particularly from health care perspective that needs consideration. These can be summarised as: older patents with limited access and understanding of technology, lack of infrastructure and high speed Internet connectivity, confidence on maintaining privacy and confidentiality and limited examination leading over testing or over prescribing.

 
Posted : April 16, 2021 6:16 pm
(@ashok-kumar)
Posts: 14
Active Member
 

Telemedicine is making a very positive contribution to healthcare during the pandemic, and is being used in a variety of ways. But telehealth technologies do have certain limitations when it comes to treating patients during a pandemic. Further, there is a chance telemedicine could add to hospitals being overwhelmed, unless it’s used well. But hospitals are learning to adapt to telehealth during a pandemic.

During this global pandemic, telehealth is emerging as an effective and sustainable solution for precaution, prevention and treatment to stem the spread of COVID-19.

Telehealth is bridging the gap between people, physicians and health systems, enabling everyone, especially symptomatic patients, to stay at home and communicate with physicians through virtual channels, helping to reduce the spread of the virus to mass populations and the medical staff on the frontlines.

 
Posted : April 17, 2021 10:11 am
(@aafreen-khan)
Posts: 1
New Member
 

With high risk and spread of SARS- CoV-2,Telehealth emerged as a potential method to relieve stress on health care industry and also served as an effective way for patients to receive their treatment without further risking any chances of spread of infection.

With added benefits of reduced infection to health care providers and the recipient,it lowered hospital load and helped in maintaining social distancing. Regional clinics were also able to gain the required assistance and expertise through the same.

Telehealth Implementation may involve certain obstacles with regard to the technical skills of the patient as well as the clinician, availability of resources, adequate internet facilities, older group of people may fail to understand and keep up with the instructions, patients may get overwhelmed and not deliver their correct health portrait to the clinician which affects further quality of their treatment.Privacy policy and including Telehealth Insurance coverage are added limitations that need to be dealt.

Although knowledge about such barriers can be beneficial in further improving and upgrading the guidelines around implementation of Telehealth

and can act as an alternate method for receiving quality treatment from various experts from a distance.

 

 
Posted : April 17, 2021 6:54 pm
(@isha09)
Posts: 30
Eminent Member
 

Telehealth has been advancing everyday. It was in use even before Pandemic began, especially in non-emergency cases or routine care and where no requirement of direct patient-care provider interaction was needed, such as psychological services. This technology is a safe, effective, and affordable option for many people now. Remote care reduces the burden of usage of resources in healthcare centers, improves access to healthcare, while minimizing the risk of direct contact with the patient.

In addition to being beneficial in keeping people safe and informed, including the general public, patients and health workers. Moreover, providing wide access of Telehealth based program or interventions to care givers is an added advantage. Patients are eager to use this concept of telehealth, but hindrances do exist such as the barriers of implementing these programs also largely depend on patient's knowledge and capability to afford, accessibility to the device needed, accreditation, payments systems, and insurance claims. Furthermore, many clinicians are now concerned about quality, privacy, safety and accountability for what Telehealth is actually used for.

Telehealth is becoming a basic need for the general population, health care providers, and especially when people are in quarantine, managing themselves in real time through contact with the health care provider for advices on their health related issues. 

 
Posted : April 18, 2021 4:38 am
Loghashree reacted
(@preetiparna)
Posts: 2
New Member
 

The term 'telehealth' refers to the delivery and facilitation of health and health-related services including medical care, provider and patient education, health information services, and self-care via telecommunications and digital communications technologies - without direct physical contact with the patient. The pandemic COVID-19 has altered the world's economy, society and healthcare, also catalyzed the rapid adoption of telehealth or the entire spectrum of activities used to deliver health service by adhering to social distancing norms. As evidenced from the article " COVID-19 transforms healthcare through telmedicine: Evidence from the field ",  at New York city COVID-19 pandemic, empirically demonstrates telemedicine's transformative effect on healthcare delivery and the rapid shift in telemedicine adoption among both patients and providers.

Considering stay -at-home orders, telehealth services provide the accessibility and continuity of medical services while reducing the risk of community spreading as well as nosocomial infection. To meet the demand of COVID care services, all the medical personnel were engaged to provide COVID treatment while treatment of  critically ill patients and patients with chronic disease were mostly not on focused. Considering these situations, telehealth was best suited to provide care to ill patients while at the same time contributing to the reduction of virus transmission.

 Barriers for the use of telehealth can be considered as lack of physical examination, direct contact and communication of patient with physicians, requirement of adequate technology infrastructure and staffing like broadband internet connection in outpatient department, computer/smart devices, digital peripherals (stethoscope, otoscope),  inpatient department requires mobile/zoom-able camera with microphone and speaker etc. And it is not possible for all the hospitals to afford the same. Treatment of patients can get affected because of miscommunication between health care provider and patient which need to be considered. Some of the developing countries like India, don't have insurance coverage for telehealth which weakens the use of telehealth. 

 

 

 
Posted : April 20, 2021 1:25 pm
(@rahulshrivastava)
Posts: 16
Active Member
 

Use of telehealth in present situation is definitely improving the provision of health services globally. Its an important tool in caring services while keeping patients and health providers safe during COVID-19 outbreak. Perhaps the video conferencing and similar telecast systems are also used to provide health care programs for people who were hospitalized/quarantine to reduce the risk of exposure to others and employees. Infact, the physicians who are in quarantine can employ these services to take care of their patients remotely. Hospitals are quickly adopting telehealth to treat quarantined patients infected with COVID-19. By keeping potentially infected individuals out of hospitals and doctor offices, the healthcare system can lower the risk of transmission to other patients and healthcare staff. What challenges I foresee is regarding integration of hardware-agnostic system like camera, sound quality, access to broadband, signal, licenses of paid software, etc.

Strengthening these area will help to overcome the challenges or lets say barrier in effective and efficient way of consulting and managing health issues during pandemic.

 
Posted : April 21, 2021 6:46 pm
(@mirzaadil)
Posts: 10
Active Member
 

the test-driven world of paediatric division practice is rapidly shifting to remote hands-off telemedicine to keep patients and their physicians safe during this pandemic.

Live Example of myself-

yesterday whole night i was surfing in my city of Gorakhpur to get an oppointment from any paediatrician  on emergency basis, all the link, jack have been implemented but failed total 5 paediatrician consulted including medical college not a single doctor was ready for it.

at last any how situation managed for night, in the next day, took my nephew to a paediatrician hospital and were counsaltation via WhatsApp Video call.

  • Specific tips include those for the video visit, such as conducting the visit as if the patient is in the room, taking a history, answering questions, reviewing medications, providing guidance and reassurance, and sharing the screen to review imaging or offer education.
  • The physical examination is limited to visual inspection with patient assistance (eg, pressing on their skin to demonstrate edema).
  • Data from BP cuffs, weight scales, heart rate monitors, and pulse oximeters, when available, can be shared over the patient portal or during the visit or uploaded to the electronic health record (EHR).
  • In hopes of reducing barriers to telehealth, the FDA has also issued a new policy that temporarily loosens previous restrictions on connected remote monitoring devices: ECGs, cardiac monitors, ECG software for over-the-counter use, pulse oximeters, noninvasive BP monitors, respiratory rate/breathing frequency monitors, electronic stethoscopes, and clinical electronic thermometers.
 
Posted : April 22, 2021 3:00 am
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