With most patients trying to avoid physical visits to medical institutions during the COVID-19 pandemic, many hospitals have had to accelerate their adoption of telehealth services in order to effectively serve their community.
But what happens when the pandemic finally becomes endemic?
When normal service in hospitals resumes, and patients once again feel comfortable visiting medical institutions, should healthcare providers continue offering telehealth services?
The answer is a resounding yes, says Dr Kaushik Banerjea, Executive Director of Medical Services at Portland District Health in Australia.
According to Dr Banerjea, it would be “really foolish” if the healthcare sector does not capitalise on the current widespread adoption of telehealth – indeed, he believes it should become the norm for the majority of consultations moving forward.
“In the health sector, we are very slow on the uptake when it comes to technological advances, much to the detriment of ourselves and our patients,” said Dr Banerjea, who was among the panellists at last year’s Hospital Management Asia (HMA) conference.
“But today, after a year and a half with COVID-19, we know that telehealth can work. So, I think that we would be really foolish if we don’t continue to use this learning beyond the pandemic.”
A more accurate reflection of patients’ vitals
Highlighting that hospitals are inherently designed, first and foremost, to serve their doctors, nurses and other staff, Dr Banerjea believes it is only natural that patients would feel more relaxed consulting with a healthcare professional from the comfort of their own homes.
This, in turn, would lead to a more precise reading of a patient’s vitals, thus allowing the healthcare professional to better decide on an appropriate course of action.
Explained Dr Banerjea: “We have readily available technology today that can provide me with information about a patient, such as their blood pressure and pulse rate. This is important because a patient’s vitals at home is what I’m more interested in, rather than the false vitals that a patient very often depicts in a hospital setting.
“Having those digitised modalities linking to a telehealth consult will definitely give us greater fidelity in our consultation. As doctors, we should be treating what the patient’s normal is…in an environment where they spend most of their time, so that we can more accurately decide the kind of treatment we want to provide.”
Dr Banerjea even foresees a future whereby medical providers are given 24-hour access to a patient’s vitals while they go about their day.
“There is even technology now which can monitor a patient for 24 hours while they are outside of the hospital,” said Dr Banerjea. “There are, for example, ingestibles which can record a patient’s blood sugar, oxygen level, saturation level, as well as other important information.
“If we, as healthcare providers, can get that sort of in-depth information at our fingertips when we consult with our patients, we will be able to know exactly what we need to treat.”
The challenges of telehealth
Given that the concept of telehealth is in its relative infancy, there are still several barriers to overcome before it is widely accepted by the healthcare industry.
For one, telehealth has to move beyond telephone consultations – which several healthcare providers and patients still prefer – and embrace video call technology in order to be truly effective.
“Telephone consult will not cut enough ice, we need to have that enforcing to say that it has to be at the next level,” insisted Dr Banerjea. “The teleconsult experience has to be as similar to a physical consult as possible. Therefore, doctors need visualisation, and they need access to the type of data they can get during a physical consult.
“This requires a certain level of digital exposure and acceptance, as well as an improvement in the level of health literacy – not just among patients and doctors, but within the health sector in general. So, this means having someone who is willing to foot that digitalisation bill as well.”
Another issue that is often brought up is the uncertainty over the worth of telehealth when it comes to billing.
For example, in Australia – which practices universal healthcare – the decision was made by the government at the start of the pandemic to allow telehealth to be billed at the same rate as a regular physical consult for the period of one year.
Once that timeframe passed, however, the number of teleconsultations conducted dropped significantly, as it was no longer subsidised by the government.
While the Australian government subsequently extended their telehealth subsidies for another six months, the root of the issue remains: telehealth is still viewed by many, including governments, as inferior to a physical consultation.
“That is the big problem for telehealth in terms of financial component – is it billable?” Dr Banerjea mused. “If it’s not, then it stands to reason that doctors and other healthcare providers will not spend their time using telehealth.
“So, in the environment of private health, where the government is not paying, the level of health literacy needs to come from the patients and even insurance companies. They have to start accepting telehealth as a legitimate consultation, and must be willing to pay for it as such. But this requires a significant paradigm shift from the patient’s perspective.”
Another common worry surrounding the widespread adoption of telehealth is the issue of cybersecurity.
But Dr Banerjea believes this concern is misplaced, as it can be addressed with the right amount of support and investment into telehealth security.
“We all trust our banks to keep our money and personal information safe, and they are able to provide that required level of security,” said Dr Banerjea. “If the banks can do it, what’s stopping us in the health sector from having the same level of scrutiny in how we do things, and provide the same level of security?
“We just need to wake up to it and adapt from the rest of the business world. Yes, it will cost a certain amount of money as an investment, but at some point, telehealth will become the norm, so we have to prepare for that.”
Nonetheless, Dr Banerjea acknowledged that there are limitations to telehealth, especially in terms of the provision of treatment to patients. However, he is confident that it will only be a matter of time before technological advances allow for such treatments to be performed remotely.
“At this point in time, we don’t have a system yet that can, for example, fix broken bones via telehealth. So yes, there are limitations,” Dr Banerjea conceded.
“But we also know that robotic surgery already exists. So, there is evidence that things can be done remotely. And as technology advances, I am sure the possibilities of what we can do in remote healthcare will grow.”
Why telehealth should be the norm
Ultimately, though, Dr Banerjea has no doubt in his mind that remote medical care models, like that of telehealth, should be the norm in healthcare in future.
After all, he reasons that the large amounts of reliable data that can be gleaned from remote care will lead to a substantial improvement in the quality of patient care.
Indeed, Dr Banerjea believes the day will come when face-to-face consultations will be viewed as “unsafe” for patients when compared to remote care.
He elaborated: “It would be inherently unsafe to use information from a single point in time – such as the data recorded during a physical consultation – to make my decisions about a patient’s management, when there is data recorded over 24 hours or longer that we could potentially use.
“With far more data, I can fine-tune my treatment. But if I choose not to use that data, then I’m really doing a disservice to my patient.
“So, we have to accept remote care and telehealth as the future. We’ve seen over the last 18 months that it can work, so to walk away from that technology now would be a real setback to the advancement of healthcare.”
HMA 2021, which will take place from 14-16 September, will feature discussions on topics such as virtual care and telehealth, and its place in the future of healthcare. Click here to register for the conference now.