Chronic illnesses, such as arthritis, asthma, COPD, pulmonary disease, diabetes, stroke, cancer, heart failure, and hypertension, represent a significant disease burden, imposes enormous costs on the healthcare system responsible for managing them. Approximately 75% of all healthcare expenditures are spent on chronic illness. Nearly 70% of deaths in the United States occur due to chronic diseases, with an estimated 50% from stroke, cancer, and heart disease. Hence, chronic illness is a growing problem, and remote areas with inadequate healthcare access suffer the most.
There are multiple factors responsible for the increased prevalence of chronic conditions, such as an aging population and a rise in risk factors like obesity.
Thus, an intervention that promises to involve patients in their care through continuous monitoring by their healthcare providers, identifying early symptoms, and prompt response must be seriously considered and carefully assessed.
Can telemedicine manage chronic diseases?
Before considering this question, one should always think about where telemedicine would fit into the disease management process. We believe that the active participation of healthcare staff in managing chronic diseases would reduce morbidity and mortality. But it’s the integrated care, otherwise termed as coordinated care delivered to the patient on a personalized level, which becomes more significant.
How can we use telemedicine to support integrated care in chronic disease management?
Telemedicine can be used in both the process of care and the outcome of care.
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The role of telemedicine includes electronic health record improvement, facilitating contact with health professionals (e.g., phone support and follow-up), enabling data transfer (e.g., telemonitoring), and providing education for self-management.
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Interactions via telemedicine are of two types; either it takes place in real-time (e.g., videoconferencing) or asynchronously (e.g., store-and-forward data transmission from medical instruments).
What are the benefits of telemedicine?
As with any other technology-based application, telemedicine has costs and benefits. The expenses include investment in technology, human resources, and organizational development.
But when appropriately implemented, telemedicine can improve care coordination across various providers, ensure continuity of care regardless of site, and enable on-site triage whenever needed.
Telemedicine service at one’s convenience can turn out to be more efficient and responsive than patients or professionals having to travel for face-to-face appointments.
Earlier recognition of health problems through remote monitoring technologies promises to improve clinical management of chronic diseases, expand access to quality health care services, and increase cost savings through decreased emergency department (ED) visits and hospital readmissions.
Additionally, telemedicine improves patient engagement and self-management to foster increased adherence to treatment plans through patient education.
A Hopeful Future
The face of healthcare is changing, but prioritizing relationships is at the core of what creates value and better outcomes in health care. When implementing telemedicine programs, it is essential to consider the patient's health first and design an interaction model that will create the most effective patient-provider relationship.
Although it seems like a catch-all, it is essential to note that telemedicine is not a replacement for an annual, in-person physical; it is used most effectively to manage chronic conditions and prevent health care costs.
Currently, the U.S. House of Representatives and Senate are considering two new bills: CONNECT and MTPA, to reduce the barriers that the Centers for Medicare & Medicaid Services (CMS) currently have on telemedicine coverage. If passed, the two bills will expand the list of providers eligible to provide telehealth services, remove geographic barriers to telemedicine, and expand the services suitable to be offered via telemedicine. Convenient and timely access to healthcare services would be provided for patients from remote areas. In healthcare providers, incorporating telehealth services with remote patient monitoring technology can offer more efficiency and improve patient outcomes with an increase in additional revenue.
Though telemedicine has not yet reached its full potential, unresolved problems in health care delivery and technology advancements promise to expand its reach.
References
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3366107/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4148063/
https://www.healthit.gov/sites/default/files/pdf/RCCHCandPHS_CaseStudy.pdf