What is telehealth?

Telehealth is that the use of digital information and communication technologies, like computers and mobile devices, to access health care services remotely and manage your health care. These could also be technologies you employ from home or that your doctor uses to enhance or support health care services.

Consider, for example, the ways telehealth could help you if you have diabetes. You could do some or all of the following:

Ø     Use a mobile phone or other device to upload food logs, medications, dosing and blood sugar levels for review by a nurse who responds electronically.

Ø     Watch a video on carbohydrate counting and download an app for it to your phone.

Ø     Use an app to estimate, based on your diet and exercise level, how much insulin you need.

Ø     Use an online patient portal to see your test results, schedule appointments, request prescription refills or email your doctor.

Ø     Order testing supplies and medications online.

Ø     Get a mobile retinal photo screening at your doctor's office rather than scheduling an appointment with a specialist.

Ø     Get email, text or phone reminders when you need a flu shot, foot exam or other preventive care.

The goals of telehealth, also called e-health or m-health (mobile health), include the following:

Ø     Make health care accessible to people who live in rural or isolated communities.

Ø     Make services more readily available or convenient for people with limited mobility, time or transportation options.

Ø     Provide access to medical specialists.

Ø     Improve communication and coordination of care among members of a health care team and a patient.

Ø     Provide support for self-management of health care.
The following samples of telehealth services could also be beneficial for your health care.

Patient portal

Your medical care clinic may have a web patient portal. These portals offer an alternate to email, which may be a generally insecure means to speak about private medical information. A portal provides a more secure online tool to do the following:

Ø  Communicate with your doctor or a nurse.

Ø  Request prescription refills.

Ø  Review test results and summaries of previous visits.

Ø  Schedule appointments or request appointment reminders.

If your doctor is during a large health care system, the portal also may provide one point of communication for any specialists you'll see.

Virtual appointments

Some clinics may provide virtual appointments that enable you to ascertain your doctor or a nurse via online videoconferencing. These appointments enable you to receive ongoing care from your regular doctor when an in-person visit isn't required or possible.

Other virtual appointments include web-based "visits" with a doctor or NP . These services are generally for minor illnesses, almost like the services available at a drop-in clinic. Some large companies provide access to virtual doctors' offices as a neighborhood of their health care offerings.
When you log into a web-based service, you are guided through a series of questions. The doctor or NP can prescribe medications, suggest home care strategies or recommend additional medical aid.

Similarly, a nursing call center is staffed with nurses who use a question-and-answer format to provide advice for care at home. A nursing call centre doesn't diagnose an illness or prescribe medications.
While these services are convenient, they have drawbacks:

Ø    Treatment may not be coordinated with your regular doctor.

Ø    Essential information from your medical history may not be considered.

Ø    The computer-driven decision-making model may not be optimal if you have a complex medical history.

Ø    The virtual visit lacks an in-person evaluation, which may hamper accurate diagnosis.

Ø    The service doesn't easily allow for shared doctor-patient decision-making about treatments or making a plan B if an initial treatment doesn't work.

The limitations of telehealth

While telehealth has potential for better coordinated care, it also runs the danger of fragmenting health care. Fragmented care may cause gaps in care, overuse of medical aid , inappropriate use of medicines , or unnecessary or overlapping care.

The potential benefits of telehealth services may be limited by other factors, such as the ability to pay for them. Insurance reimbursement for telehealth still varies by state and type of insurance. Also, some people who would benefit most from improved access to care may be limited because of regional internet availability or the cost of mobile devices.

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