Today’s contributor, Charlotte Kellogg, has contributed a post about the ability for mhealth apps and telemedicine to monitor chronic illnesses. This blog has previously discussed potential drawbacks in telemedicine and Kellogg has built upon that by layering in a comparison of potential benefits and known drawbacks. Kellogg is a writer and researcher for an public health education resource that offers information about public health certification, classes and programs.
The Potential for Telemedicine to Monitor and Improve Public Health
The need for quality, consistent healthcare is growing in nearly every corner of the world. Modern scientists are finding new ways to treat conditions every day, but finding ways of bringing that care to the people who need it most is often logistically challenging—not to mention tremendously expensive. New developments in telemedicine, including mhealth, seek to bridge these divides.
Integrating technology into existing healthcare frameworks has the potential to help doctors and other medical providers work faster, more effectively, and with greater accuracy. More patients than ever before can be reached, and information that is centralized on a cloud-based server has much less of a chance of getting lost or overlooked, and can ensure more efficient coordination of care.
The cost savings alone are often substantial. For example, telemedicine has the potential to lower costs from preventing unneeded trips to the emergency room through reliable, real-time video communication between doctors and patients. Telemedicine also reduces the number of routine visits as doctors can effectively monitor a discharge patient from the comfort of their own home. This is especially pertinent for patients who live far from medical centers, as they will not need to travel to an office unless it is absolutely necessary.
Still, providers should be wary of jumping in too deep, too fast. The mobile health landscape is still very much under in the nascent stages of development, and improvements are needed before new technology will be able to fully manage chronic conditions and other public health concerns.
Benefits to Public Health
Health care providers across the board are finding tremendous success using telemedicine in the treatment of chronic conditions like congestive heart failure, diabetes, and HIV/AIDS. Doctors can equip patients with remote tracking devices, which allow for monitoring of blood pressure, glucose levels, and other vital statistics without requiring an in-person visit. Medical providers can also use technology to track pharmaceutical prescriptions and send patients personalized reminders of when and how each drug should be taken.
Telemedicine promises improved care to those living in rural or otherwise remote locations, as well. Patients are increasingly able to check their symptoms through mobile phone apps or online database systems, and also speak to physicians and other members of the care team through web-based video conferencing. This saves time and, increasingly, lives as patients become more empowered and are able to more readily determine when an injury or illness is something that should be waited out or needs immediate attention.
Potential Threats to Public Health
As advanced as many aspects of telemedicine are, the field is nevertheless still quite young. Providers and developers remain in the throes of figuring out how to tighten up on the platform’s accuracy and usability. In many cases the technology is very new and prone to have bugs in the code, and because these technologies are protected intellectual property, many of these bugs are not caught before the programs hit the market.
One of the biggest problem areas is the degree to which patients may elect to rely on apps or electronic information in place of, rather than in addition to, in-person primary care. “The problem with this kind of gold rush is that it attracts not only the best and brightest but also the fast and furious—IT developers looking for quick profits with minimal investment of resources,” Information Week said in a 2012 article evaluating some of the potential downsides of the telemedicine “revolution.”
There is also a concern when it comes to expectations. Medicine is an immensely nuanced field that often defies easy answers. A simple statement of symptoms can indicate a range of wildly different causes, which can lead patients and providers to overlook some of the most obvious possibilities. Researchers from Good Morning America exposed just how difficult online diagnoses can be when they visited three different telemedicine sites armed with the symptoms of Hodgkin’s Lymphoma—and did not get a correct diagnosis anywhere. “It’s totally, totally upsetting. It reduces medicine to piecemeal work,” Dr. Marie Savard, a medical contributor to the show, said in an article for ABC News.
While the diagnoses on these sites were incorrect, it is important to remember that the root cause of most misdiagnoses is poor communication. While these sites and tools may not be able to necessarily match symptoms with diseases, they can make it much easier for a patient to relay symptoms to a doctor who can then interpret the data.
In most cases, the benefits of telemedicine outweigh the potential risks, but there is still work to be done. The cost and time savings allowed through telemedicine, for example avoiding unnecessary appointments and being able to adjust dosage on prescriptions without needing to travel to a doctor’s office, are tremendous, and are likely to continue to grow in the years ahead. It is already the case that diabetes patients are more conveniently and effectively monitoring their health, something that has saved many lives and millions of dollars – something sure to continue as technology improves and people become more comfortable with telemedicine.
