Writers: Michelle Tran & Aamna Raza
Editor: Isabella Io
Introduction to Telemedicine
Telemedicine has been widely used among many healthcare systems because it is efficient, advanced, and easily accessible. The growth of telemedicine started mainly during the COVID-19 pandemic. Due to their fear of in-person visits, patients decided to avoid physical interactions and opted for virtual interactions with their medical providers to provide safe yet reliable visits. [1]
Telemedicine provides patients with similar perks as if they were to visit physically. The virtual program has the benefit of being remote, allowing patients to seek treatment and diagnostics in the comfort of their homes. The system assists hospitals in organizing patient data effectively and monitoring their recovery statuses. Its unique abilities have allowed its usage to expand widely across the internal healthcare system. Due to the benefits of telemedicine, despite the decrease of COVID-19, its popularity has continued to skyrocket, allowing patients to receive immediate care from the comfort of their homes [1].
The Increased Usage of Telemedicine During COVID-19
Telemedicine has been prevalent in the healthcare industry for years, yet there has been a spike in its usage ever since the COVID-19 pandemic started, with an increase of patient usage from 15.5% in 2019 to 86.5% in 2020, according to the Centers for Disease Control and Prevention [2]. At this time, three in five Canadians who were seeking care had done so virtually [3].
With this growing reliance on telemedicine in a time when face-to-face interaction was limited due to the pandemic, there were many policy changes across different countries to facilitate the integration and usage of telemedicine. For example, in the United States, many states loosened licensing requirements, allowing more physicians to practice across the state through telemedicine, [4] and temporarily allowing practitioners to prescribe controlled substances virtually without needing in-person visits [5]. Along with these changes, confidentiality policies were also changed to facilitate interactions between physicians and patients virtually. The Health Insurance Portability and Accountability Act (HIPAA) enforced security and privacy standards to ensure the protection of patient information, with certain penalties for violations. These were temporarily lifted to allow flexibility on video conferencing apps that do not meet the standards. [6]
The Impact on Patient Outcomes
On March 17, 2020, the Centers for Medicare & Medicaid Services (CMS) implemented new policies aimed to supply better facilitation of patient care, safety, and privacy. They called for healthcare providers to use telemedicine, as its goal to provide localized care remotely had just become much more efficient. [7]
The current impact on patient outcomes is that telemedicine minimizes direct contact between patients and providers. Telemedicine visits are great as they eradicate the risk of cross-contamination for both parties, but still allow them to communicate. Telemedicine is especially great for interactions as it allows international doctors to chat with patients who lack medical availability in their area. The efficiency empowers patients to get fast care, which decreases wait times in hospital rooms. ER rooms have a massive problem with availability, and telemedicine can provide those at home with care right at the hands of their devices. Doctors can recommend possible solutions to patients at home, rather than patients waiting up to weeks for care from the local family doctor [8].
Limitations of Telemedicine
Of course, telemedicine could be better - it still has some flaws that may be hard to find solutions for. Diagnostic tests, for example, are the most significant limitation of telemedicine. They cannot be run remotely, requiring the patient to come in person to conduct the test or imaging. With the patient physically present, doctors can do diagnostic tests like blood tests and MRI scans. [7]
Many medical devices are available for patients to buy and use at home to combat this. For example, blood pressure monitors can be purchased at local grocery stores. However, they are pricey and may not be available in rural areas. It is also important to note that diagnostic tests like blood tests require professional assistance to ensure safe and adequate results.
Telemedicine has risks of security breaches, and telehealth providers must take precautions to ensure patient privacy is confidential and safe. There are serious consequences if patient data is exposed, which may result in irreversible damage to the telemedicine model altogether [8]. In addition, the legal aspects of telemedicine also need to be considered to guarantee that telehealth care is respectful of ethics and morals [8].
Patient Perspectives on Telemedicine
The integration of telemedicine came with the inevitable feedback and opinions of patients, many of whom felt positive towards the system. Those in particular who felt satisfied with telemedicine have shared that they felt that the access to care from the comfort of their own home felt convenient [9], with 40% of patients stating in May 2021 that even after the pandemic they would continue to use the telehealth system and 55% of patients in November 2021 who stated that they felt more pleased with virtual sessions with their physicians than in-person visits [10].
Along with the positive feedback, some patients shared their issues with the overall system. Many expressed their discontent with some of the limitations and/or challenges that came with telemedicine. Some expressed their concerns with the ability of older adults to use the technology of telemedicine due to some having lower digital literacy. There were concerns not only about liabilities and potential malpractice but also regarding the accuracy and thoroughness of virtual physical examinations [11]. These concerns should prompt consideration about addressing the issues and making improvements, to ensure patients feel they are comfortable and can rely on telemedicine at a time when it’s necessary.
Ultimately, by taking a look at the features of telemedicine, we can see that it is an efficient alternative when unable to attend in-person visits. We often saw this during the COVID-19 pandemic. Though some challenges and limitations come with this alternative, as mentioned above, by addressing said issues, we can improve the system. We can allow patients to feel more satisfied with the care conveniently provided by physicians.
Sources & Works Cited
[1] National Library of Medicine. "Telemedicine for healthcare: Capabilities, features, barriers, and applications", 24 July 2021, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8590973/
[2] National Center for Health Statistics. "Telemedicine Use Among Physicians by Physician Specialty: United States, 2021", https://www.cdc.gov/nchs/products/databriefs/db493.htm
[3] Statistics Canada. "Three in five Canadians seeking care used virtual healthcare services during the COVID-19 pandemic", 14 Nov 2023, https://www.statcan.gc.ca/o1/en/plus/4968-three-five-canadians-seeking-care-used-virtual-healthcare-services-during-covid-19
[4] National Library of Medicine. "The State of Telehealth Before and After the COVID-19 Pandemic", 25 April 2022, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9035352/
[5] Telehealth.HHS.gov. "Telehealth policy changes after the COVID-19 public health emergency", https://telehealth.hhs.gov/providers/telehealth-policy/policy-changes-after-the-covid-19-public-health-emergency
[6] Systems, Applications & Products in Data Processing (SAP). "Telehealth: A Temporary Fix or the Future of Health Care?",
[7] National Library of Medicine. "Telemedicine: Current Impact on the Future", 20 August 2022, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7502422/
[8] National Library of Medicine. "Telehealth Benefits and Barriers", 21 Oct 2020, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7577680/
[9] Harvard Business Review. "What Patients Like — and Dislike — About Telemedicine", 8 Dec 2020, https://hbr.org/2020/12/what-patients-like-and-dislike-about-telemedicine
[10] McKinsey & Company. "Patients love telehealth—physicians are not so sure", 22 Feb 2022, https://www.mckinsey.com/industries/healthcare/our-insights/patients-love-telehealth-physicians-are-not-so-sure
[11] National Library of Medicine. "Patients’ perspectives and preferences toward telemedicine versus in-person visits: a mixed-methods study on 1226 patients", 15 Nov 2023, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10647122/
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