Telemedicine is a way of providing medical services at a distance using modern technology and special equipment. Just a few decades ago, ordinary people did not know what telemedicine was and how tightly it would enter the average patient’s life. As practice shows, this format of consultation and diagnosis can be very effective (Moran et al., 2022). However, it is seen only as a supplement to the traditional doctor-patient interaction. This type of observation with the doctor is more appropriate for patients with chronic diseases.
The use of telemedicine provides an opportunity, for example, to provide consultative medical services in areas where patients have no opportunity to receive care from narrow specialists directly at the medical institution. Nonetheless, in large metropolitan areas and developed countries, telemedicine is no less important. It significantly reduces treatment costs, increases the quality of diagnostics, and enables remote health monitoring. This is especially important for patients with chronic diseases and the elderly. While the physical exam is important when first visiting a physician, 90 percent of the medical history is needed for diagnosis and treatment (Hlavka et al., 2019). With this information, the physician can monitor treatment through telemedicine as if the patient were coming to see him or her. Telemedicine is becoming an excellent substitute for face-to-face examinations and consultations with a physician, demonstrating positive results.
If one considers traditional face-to-face medicine for chronic diseases, it is much more difficult for the patient to adhere to treatment. For example, hypertension requires constant monitoring. Hypertension is a diagnosis related to diseases of the heart and blood vessels associated with high blood pressure for a long time. The risks of complications from it are quite high and dangerous ― heart attack and stroke. One must come at least twice a year, even if nothing bothers the person. If there is no headache, this does not mean that the disease is not progressing (Hoffer-Hawlik et al., 2020). Heart attack and stroke risks may increase, and therapy correction may be necessary. On a repeat visit, the condition and risk factors are assessed, and the achievement of target blood pressure figures is assessed. If necessary, the doctor corrects the therapy.
The doctor must plan for future observation and the frequency of subsequent receptions. As a rule, it is difficult for the patient to follow all preventive prescriptions. Depending on what is happening in his life, the course of the disease may change. With a decrease in body weight by one kilogram, blood pressure decreases by 2 mm. With proper motivation in the future, the patient can give up tablet medications if his blood pressure has returned to normal. Nevertheless, only 3% of patients usually follow all the recommendations for lifestyle changes, and they may no longer need constant treatment (Haleem et al., 2021). Even if the symptoms have passed, the need for observation remains because the diagnosis has not gone away, the risks remain, and the symptoms may return. Therefore, remote patient monitoring will help stay in contact with patients attending physicians at any time.
In most follow-up visits, the doctor checks how the body responds to treatment. If there is equipment at home to measure blood pressure, blood sugar, or weight, the patient can send this information to the doctor directly from home by e-mail. Thanks to this, the doctor can monitor the body’s response to treatment and decide whether the patient needs to come to him personally for an examination. Doing this is virtually more convenient for both the doctor and the patient. In addition to managing chronic diseases, telemedicine can be useful in situations where the patient has undergone an orthopedic procedure and with a worsening depression.
The PICOT question of whether telemedicine management of adults with chronic conditions is more effective and efficient than traditional face-to-face management is controversial. The effectiveness of remote monitoring by a physician depends on many factors. For example, a patient’s disease type and capacity can significantly affect outcomes. Remote consultations also depend on a stable Internet connection and the ability to use a gadget. However, if the patient is competent, has some knowledge of how to use the devices, and the degree of their illness allows for care at home, telemedicine is an excellent substitute for in-person examinations. Changes can be provided as follows: telemedicine patient management is effective only when the type of illness, the patient’s awareness, and other related factors allow for this type of observation.
In scientific articles devoted to evaluating the effectiveness of patient-physician telemedicine consultations, researchers focus specifically on clinical performance; the following quality indicators are used:
- Frequency of antibiotic prescribing, including broad-spectrum antibiotics.
- The proportion of repeat consultations within 14-21-30-90 days after the first telemedicine consultation; at that, the repeat consultation can be both remote and face-to-face (doctor’s visit) and must be correlated with the first telemedicine consultation (deterioration of condition, development of complications, diagnostic errors in the prior consultation).
- Timing results – duration of the preparatory stage and duration of the consultation (comparing face-to-face and remote forms of patient-doctor interaction).
- Adherence of consulting physicians to clinical guidelines based on evidence-based care protocols.
- Frequency of interrupting telemedicine consultations with the patient’s referral to a face-to-face appointment.
Thus, the effectiveness of telemedicine is very individual. However, in the future, its development will be rapid. All hospitals should be equipped with special equipment transmitting images of good quality. Also, there is a need for staff who will maintain these gadgets. Undoubtedly, it is necessary to introduce information technologies globally into the practical activities of specialists. The use of extensive telemedicine capabilities will have a positive impact not only on the general condition of the patient but also will strengthen the healthcare structure (Jordan et al., 2021). This is possible thanks to improved communication between remote hospitals, polyclinics, and leading clinical centers of the country. The state controls telemedicine systems. The quality of the services received is also assessed.
Telemedicine can be an excellent substitute for face-to-face exams for improving health outcomes among adults with chronic conditions. These results could be a consequence of patients and their families learning how to manage illness at home so that they can take care of themselves or contact a doctor in critical cases. Hospital visits can become dangerous during a pandemic, especially for patients with poor health. Telemedicine is now more relevant than ever, so it can be considered an effective method of consulting a doctor.
Therefore, telemedicine is more suitable for patients with chronic diseases: consultations are available anywhere. This is especially important for those who find it difficult to reach a doctor. For example, for mothers with no one to leave their babies with or for people with limited mobility: the disabled and the elderly. Telemedicine helps out a lot for those who are abroad. Patients save time and money when they need to constantly monitor their health status with the help of tests or instrumental examinations. The doctor can check the results online; if everything is in order, a face-to-face visit is not required.
To increase the effectiveness of telemedicine, I suggest introducing refresher courses for doctors, where they will learn how to use the equipment for such examinations. For those patients who choose this care method, it is necessary to introduce compulsory training, in which they will be taught about their disease. The psychology of chronic diseases is an integral part. Patients may need to consult a therapist to maintain a stable psychological state during exacerbation.
References
Haleem, A., Javaid, M., Singh, R. P., & Suman, R. (2021). Telemedicine for healthcare: Capabilities, features, barriers, and applications. Sensors International, 2, 100117. Web.
Hoffer-Hawlik, M. A., Moran, A. E., Burka, D., Kaur, P., Cai, J., Frieden, T. R., & Gupta, R. (2020). Leveraging telemedicine for chronic disease management in low- and middle-income countries during COVID-19. Global Heart, 15(1). Web.
Jordan, D. N., Jessen, C. M., & Ferucci, E. D. (2021). Views of patients and providers on the use of telemedicine for chronic disease specialty care in the Alaska native population. Telemedicine and e-Health, 27(1), 82-89. Web.
Moran, B., Frazier, T., Brown, L. S., Case, M., Polineni, S., & Roy, L. (2022). A review of the effectiveness of audio-only telemedicine for chronic disease management. Telemedicine and e-Health, 28(9), 1280-1284. Web.
Hlavka, J. P., Mattke, S., & Liu, J. L. (2019). Assessing the preparedness of the health care system infrastructure in six European countries for Alzheimer’s treatment. Rand health quarterly, 8(3).