Accessibility & Equality in Telemedicine: How the Pandemic Improved Healthcare for Some
“COVID-19 pushed telemedicine ahead a decade” — Mayo Clinic
The COVID-19 outbreak threw a wrench in the works. It compelled a shift to virtual health care delivery and for the first time exposed many patients, clinicians, and health-care delivery organizations to the benefits and advantages of telemedicine. The pandemic also pushed venture capital investments in digital health to an all-time high; by the end of the second quarter of 2021, investments had surpassed the total for all of 2020.
The transition to telemedicine has the potential to overhaul our entire health-care model, potentially improving the health and well-being of millions of people. Consider the standard model first: It’s basically a “sick care” system that waits until patients get sick before intervening. This reactive approach of care frequently fails to fully engage patients in their own health management.
Using at-home gadgets and virtual visits to offer a continual flow of information to both people and their doctors, streaming health care can enable a proactive and preventative approach of care. Continuous biometric and symptom data can help doctors intervene earlier in patients’ lives, preventing illness progression and even development and saving money on emergency treatment and surgery. Personal health devices can provide not only more data over time, but also a more holistic perspective of the patient, allowing for better-calibrated treatment.
How Gadgets Can Transform Your Life
We can deliver real-time and tailored feedback to users using self-tracking devices that may be used at home, allowing them to gain knowledge of how their activities affect their health and become active participants in their health care. Knowledge is a powerful tool: People can gain actual insights into their own health preservation by viewing how actions like exercise, food, and sleep affect health in real time.
Sensor-embedded wearables, supplementary devices, cellphones, and software are all examples of digitally connected self-tracking gadgets. These tools enable users to capture and gather numerous measures of human health and behavior over a lengthy period of time. Heart rate, sleep duration and quality, metabolism, fertility, neuromotor function, cognition, mental health, nutrition, and physical conditioning are all aspects that these gadgets can monitor.
The distinction between consumer and medical technologies is becoming increasingly blurred. Many consumer wearables now come with sophisticated health management software that allows users to use the data obtained to help them achieve their health objectives. Medically regulated wearable devices, such as glucose-measuring patches for diabetics, provide continuous glucose information and enable diabetics to adopt proactive measures in insulin administration, food, and activity to improve their blood sugar levels. The same type of glucose sensor, on the other hand, may be used to help non-diabetics regulate their nutrition and improve their physical or cognitive performance. Similarly, data obtained by a consumer wearable that records respiratory rate might be supplemented with an oxygen sensor to allow people to track their clinical status if they are infected with COVID-19.
The new wave of digital health diagnostic gadgets and software not only deliver unprecedented volumes of user data, but they also provide new potential to integrate digital medicines into patients’ homes. For instance, Nightware, a recently licensed digital therapy, is helping people with PTSD-related nightmares sleep better. The system detects a nightmare using the sensors on an Apple Watch (specifically, the heart sensor, accelerometer, and gyroscope), and then sends a vibration stimulus to the wrist, ending the nightmare without awakening the user.
Continuously collected data offers a lot of promise in terms of filling in information gaps about a person’s risk of developing disease over time. While we know that physical activity diminishes with illness and that obesity is linked to an increased risk of type 2 diabetes, how does that shift look in the data? Is it possible to develop individual risk and susceptibility profiles based on what we understand about data trendlines? We could warn people about their hazards using artificial intelligence and predictive analytics.
However, simply providing information is insufficient. The user experience that comes with digital health and self-tracking is crucial in assisting people in interpreting, comprehending, and acting on their data. People are motivated to grow and change when their requirements for autonomy, competence, and relatedness are met, according to the well-established theory of self-determination. These solutions can empower patients to make meaningful behavioral changes by delivering immediate feedback on activities that affect one’s health, as well as education and supporting narratives.
These days, providing health care can be a painful experience. Physician burnout is at an all-time high, thanks to a slew of time-consuming and career-threatening compliance obligations that put the provider under a lot of pressure. Digital tools, such as electronic medical record (EMR) software, make it easier to retrieve patient data, but they also put a lot of pressure on doctors, detracting from the doctor-patient connection.
Provider burnout is usually caused by routine and repetitive work, which can be alleviated through streaming health care. This alleviation can be obtained if physicians are aware that automated systems are handling the custodial activities required in patient care, such as symptom checks, vital sign monitoring, biometric data collection, medication adherence monitoring, and patient education. Bots, validated voice recognition, and embedded artificial intelligence can handle common questions while also ensuring that the quality of information supplied to patients is consistent.
In addition, the doctor-patient relationship would benefit. Increasingly accurate and convenient technologies can offer users with a continual stream of information about their own health, allowing them to better understand their condition and view their doctor as a partner rather than an authoritative figure. All of these improvements have the potential to revolutionize the experience of being a doctor: doctors might spend more time giving treatment to individuals who need it and reach a larger number of patients, regardless of their location.
The Big Problem– Privacy
While much study has been done to validate the effectiveness of virtual care, nothing has been done to investigate the model’s ethical difficulties, privacy implications, or role in perpetuating health imbalances.
One of the most crucial aspects is the ethical use of digital health data, which is necessary to gain consumer trust. Ethical data governance is still mostly a topic of scholarly debate; this debate has to grow into universally adopted policies that safeguard persons’ data while also ensuring their privacy and autonomy.
Another major issue that needs to be addressed right away is cybersecurity. The spread of ransomware and other cyberattacks on health-care systems poses a threat to the new digitally enabled health-care model, as virtual assessments and the continuous collection of people’ biometric data will generate large volumes of important data. Legislation and regulation are now being developed to ensure these safeguards. However, they must adapt swiftly to keep up with the rapid advancement of digital health; otherwise, sloppy practices and data breaches may limit customer trust and adoption.
Accessibility is another impediment to adoption. On the one hand, remote health monitoring can make health care more accessible to persons in rural areas with little resources, people with mobility issues, and people who do not have access to transportation. Certain groups, on the other hand, may be excluded because they lack the essential gadgets or have insufficient technical abilities, perpetuating health disparities. More health economics research is needed to determine whether virtual health care solutions that improve outcomes justify providing patients with devices and data plans as covered services.
Medicine is not one-size-fits-all, and there is no universal standard for human treatment. We can have a better understanding of ourselves through better knowing our health and behaviors. Connected smartphones, wearables, software, and services offer a once-in-a-generation chance to change the role of patients in medicine by appealing to their autonomy and competence, encouraging active participation in their own care. Continuous health streaming may relieve anxious and sedentary patients of their dread of the unknown, allowing them to gain self-awareness and improve their health.
