Introduction
Telehealth, a developing area of healthcare delivery, relies on technology to deliver services beyond physical clinics (Amjad et al., 2023). This novel method has gained more prominence, particularly after the recent world pandemics of public health that led to remote medical contact (Amjad et al., 2023). The emergence of telehealth signifies a breakthrough in the health sector, ushering into an age characterized by transformed norms of patient care and provider operations (Amjad et al., 2023). This paper focuses on the complex nature of telehealth, discussing its pros and cons, assessment methodology for conducting a telehealth evaluation process limitation, and providers’ and patients ‘ perceptions during their encounters through this delivery system.
Pros and Cons of Telehealth
Advantages of Telehealth
Calleja et al. (2022) note that telehealth has helped to make health care more accessible and convenient, especially for people living in distant or underserved areas. This form of healthcare makes it easier for patients to receive care from their homes, which reduces travel time and loss. Eldaly et al. (2022) and Lewinski et al. (2022) found that patients were more engaged due to the increased convenience of contact with a doctor due to telehealth applications. In addition, the cost-efficacy presented by Tsou et al. (2020) is indicated through reduced contact with physical infrastructure and travel. Telehealth has also been very useful in improving population health monitoring during the Covid-19 pandemic (Byrne, 2020). It provides continuous care for chronic conditions that allow regular follow-ups and modifications of treatment plans (Byrne, 2020).
Disadvantages of Telehealth
As Kruse and Heinemann (2022) note, technological impediments to healthcare access are further compounded by the requirement for digital literacy. As Chan et al. (2021) discussed, the restricted range of physical examination generates concerns about completeness and undetected diagnoses in care delivery. Issues of security and data privacy protection, referred to by Robson and Hosseinzadeh (2021), make the issue crucial as telehealth involves digital communication. Additionally, the threat of diminishing care continuity, especially while patients utilize different providers simultaneously, may lead to disjointed treatment, as Haque et al. (2023) highlighted. Finally, regulatory and reimbursement issues such as state licensure regulations and insurance coverage incoherence (Byrne, 2020) add the final layer to this onion peel that is often referred to as limitations for telehealth adoption.
Approaching and Performing a Telehealth Assessment
Preparation and Environment
When conducting a telehealth assessment, meticulous preparation and defining the appropriate environment are essential. The key to a successful telehealth session is the base of effective technology preparation. These include having a stable internet connection, operational audio-visual equipment, and compliance with HIPAA privacy regulations platforms.
Furthermore, patient education for telehealth is required. This preparation entails informing them about the technology use and establishing assessment expectations, as Lewinsk et al. (2022) recommended, with this approach contributing significantly to patient comfortability in cooperation aspects.
No less important is the configuration of physical space. First, healthcare providers and patients should have a quiet and private space. In doing so, privacy and minimizing distractions are ensured, leading to more effective communication and assessment processes (Eldaly et al., 2022). This accurate depiction of both technological and environmental elements prepares the ground for a more streamlined, effective telehealth evaluation closer to face-to-face consultation but in virtual space.
Conducting the Assessment
Conducting a telehealth assessment is an approach that requires close attention and centering on the patient. The first important prerequisite is the establishment of a good patient rapport mirroring the traditional face-to-face relationship between the consultant and his or her client. According to Chan et al. (2021), communication needs openness and a patient-centered approach; trust must be established before the session takes place in order for it to run smoothly or effectively.
Second, the core of this telehealth assessment is history taking and symptom analysis. As Kruse and Heinemann (2022) note, providers have to use open-ended questions to obtain all the necessary information but adjust their line of questioning depending on whether that communication occurs in a physical or virtual setting.
While the visual examination is clearly inferior to physical check-ups and can only be a small component of modern telehealth, it remains important. Robson and Hosseinzadeh (2021) suggest that providers can assist patients with simple self-examination tasks or teach them basic at-home devices used for medical measurement. This method contributes to collecting vital clinical information.
Finally, documentation accuracy and clear communication about follow-up are integral aspects of the telehealth process (Byrne (2020)
The Limits of Telehealth
While telehealth has many advantages and is becoming increasingly popular, it does not offer a universal solution to all healthcare concerns (Chan et al., 2021). It is crucial to identify and understand its limitations for it to be integrated into the healthcare system.
Limitations in Clinical Assessments
A significant drawback of telehealth is that it cannot be used for complete clinical evaluation (Chan et al., 2021). The inability to complete physical examinations is often a significant disadvantage, especially when hands-on evaluation is critical for accurate diagnosis and treatment planning. However, as Chan et al. (2021) discussed, such a limitation may sometimes result in delayed diagnoses or the requirement for further face-to-face appointments. However, relying on patient-reported symptoms and visual inspections through video can also be problematic in accurately determining a patient’s condition (Chan et al., 2021).
Technological and Accessibility Challenges
The effectiveness of telehealth is dependent on the availability and reliability of technology (Kruse & Heinemann, 2021). Some challenges that may prevent the success of telehealth services include unstable internet connections, inadequate appropriate devices, and poor digital literacy. As Kruse and Heinemann (2021) mentioned, these technological barriers can worsen healthcare disparities, especially in rural or disadvantaged areas with limited technology.
Legal and Regulatory Hurdles
Telehealth works in a complex legal and regulatory environment that can vary significantly by region or country (Byrne, 2020). Challenges like cross-state licensing in the U.S. or observing different telemedicine requirements worldwide can restrict access to and growth of telehealth services. In addition to this, as Byrne (2020) notes, inconsistent insurance reimbursements for telehealth services compared to in-person consultations can also pose financial challenges both for providers and patients.
Psychological and Relational Aspects
The lack of a physical presence in telehealth may affect healthcare’s psychological and relational components (Eldaly et al., 2022); building a therapeutic relationship or rapport over the screen is complex, and some patients may feel less connected or dissatisfied with their care. According to Eldaly et al. (2022), this feature is essential in mental health services because non-verbal signals and the therapeutic setting are critical factors.
Scope of Practice
Lastly, telehealth does not apply to all medical treatments (Watkins & Neubrander, 2022). Telehealth cannot be used to perform direct physical contact procedures, including surgeries, some diagnostic tests, and emergency care. Therefore, the scope of practice of telehealth is restricted to services that can be provided efficiently in a virtual setting (Watkins & Neubrander, 2022).
Provider vs. Patient Perspectives in Telehealth
The implementation and application of telehealth are very different, depending on the attitude of healthcare providers and patients. These differences are essential in understanding how to optimize telehealth services for the needs of both groups.
Provider’s Perspective
For the provider, telehealth is an opportunity to reach a larger patient population, including those in rural or underserved areas (Calleja et al., 2022). However, it also presents its own set of challenges. Providers must adjust the care provision without physical examination tools and cues but rely on verbal communication and visual assessments. As Calleja et al. (2022) described, this development requires reconsidering diagnostic approaches and patient engagement methods.
Telehealth integration into providers’ practice workflows is another essential element (Kruse & Heinemann, 2022). This includes technical adaptations and administrative and scheduling changes to fit virtual consults. As Kruse and Heinemann (2022) indicate, the learning curve for providers to master telehealth platforms can be steep. Further, the legal and reimbursement landscape of telehealth services presents its challenges. Providers need to keep up with changing regulations and insurance policies, according to Byrne (2020).
Patient’s Perspective
For the patient, telehealth provides convenience and accessibility in most cases with a more comfortable environment of care provision. As Eldaly et al. (2022) noted, many patients value telehealth because it saves time and money by eliminating travel while taking less work or leisure activities out of their daily routines.
However, patients also have problems with telehealth. Robson and Hosseinzadeh (2021) note that technological barriers implied by the need for digital literacy can be pretty intimidating, especially to older adults or those not used to working with electronic tools. Privacy issues and virtual interactions that are not personal can also affect the quality of care for patients. In addition, individuals with more complicated health needs may regard telehealth as inadequate for comprehensive care purposes and thus require face-to-face consultations in some cases.
Conclusion
Telehealth positions itself as a revolutionary instrument in medical practice with the potential to provide unparalleled access and convenience while posing specific challenges like technological obstacles, diagnostic restrictions, and regulatory complexities. The analysis highlights the need to recognize these aspects to incorporate telehealth into current healthcare systems successfully. In this digital era, telehealth presents an opportunity yet also a challenge to the development of healthcare; it requires careful consideration. This strategy should harness the advantages of telehealth while overcoming its drawbacks, ensuring that the healthcare system remains flexible, pluralistic, and operational in meeting the varied needs of patients and providers.
References
Calleja, P., Wilkes, S., Spencer, M., & Woodbridge, S. (2022). Telehealth use in rural and remote health practitioner education: an integrative review. Rural and remote health, 22(1), 1-13.https://search.informit.org/doi/pdf/10.3316/informit.411913428041345
Eldaly, A. S., Maniaci, M. J., Paulson, M. R., Avila, F. R., Torres-Guzman, R. A., Maita, K., … & Forte, A. J. (2022). Patient satisfaction with telemedicine in acute care setting: A systematic review. Journal of Clinical and Translational Research, 8(6), 540.
Tsou, C., Robinson, S., Boyd, J., Jamieson, A., Blakeman, R., Bosich, K., … & Hendrie, D. (2020). Effectiveness and cost-effectiveness of telehealth in rural and remote emergency departments: a systematic review protocol. Systematic reviews, 9(1), 1-6.
Byrne, M. D. (2020). Telehealth and the COVID-19 pandemic. Journal of PeriAnesthesia Nursing, 35(5), 548-551.
Lewinski, A. A., Walsh, C., Rushton, S., Soliman, D., Carlson, S. M., Luedke, M. W., … & Goldstein, K. M. (2022). Telehealth for the longitudinal management of chronic conditions: systematic review. Journal of Medical Internet Research, 24(8), e37100.
Kruse, C., & Heinemann, K. (2022). Facilitators and barriers to the adoption of telemedicine during the first year of COVID-19: systematic review. Journal of Medical Internet Research, 24(1), e31752.
Chan, R. J., Crichton, M., Crawford-Williams, F., Agbejule, O. A., Yu, K., Hart, N. H., … & Chan, A. (2021). The efficacy, challenges, and facilitators of telemedicine in post-treatment cancer survivorship care: an overview of systematic reviews. Annals of Oncology, 32(12), 1552-1570.
Robson, N., & Hosseinzadeh, H. (2021). Impact of telehealth care among adults living with type 2 diabetes in primary care: a systematic review and meta-analysis of randomised controlled trials. International journal of environmental research and public health, 18(22), 12171.
Haque, S., DeStefano, S., Banger, A., Rutledge, R., & Romaire, M. (2023). Telehealth Impact in Frontier Critical Access Hospitals: Mixed Methods Evaluation. JMIR Formative Research, 7, e49591.
Watkins, S., & Neubrander, J. (2022). Primary-care registered nurse telehealth policy implications. Journal of Telemedicine and Telecare, 28(3), 203-206.
Amjad, A., Kordel, P., & Fernandes, G. (2023). A Review on Innovation in Healthcare Sector (Telehealth) through Artificial Intelligence. Sustainability, 15(8), 6655.
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