E-Health and telemedicine: Opportunities and obstacles surrounding digital medical services

This article was exclusively written for The European Sting by Mr. Cyubahiro Karangwa Vérité, a 20-year-old second-year medical student at the University of Rwanda College of Medicine and Health sciences in Rwanda. He is affiliated with the International Federation of Medical Students Associations (IFMSA), cordial partner of The Sting. The opinions expressed in this piece belong strictly to the writer and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.

Telemedicine is a mode of healthcare delivery that provides care remotely with electronic systems and telecommunication technology. Services are digitally mediated but supported by direct communications. In this article, I will discuss different opportunities, benefits, and obstacles of telemedicine.

According to World Health Organization (WHO), Telemedicine is the delivery of healthcare services, where distance is a critical factor, by all healthcare professionals using information and communication technologies for the exchange of valid information for the diagnosis, treatment, and prevention of disease and injuries, research and evaluation and the continuing education of healthcare providers, all in the interests of advancing the health of individuals and their communities. (³)

Across the globe, many countries have seen a shift towards telephone and video consultations as this eases the burden of having to travel long distances for health conditions that could be managed from where you are. (¹)Patients have been sent home with devices such as pulse oximeters and instructions on self-management to minimize the load on healthcare systems as well as minimize people in hospitals where they are likely to get infections and other complications. During the covid-19, telehealth services helped prevent the spread of covid-19 to health care providers or those seeking help. Some hospitals have introduced robots and tablet computers to facilitate physical distancing while monitoring and communicating with patients.

This has not been only a tool of health but also enhanced education in the health care system across the globe. Studies have shown that telemedicine promotes continuity of care including post-hospital care, decreases the cost of care, and improves patient self-management as well as the overall clinical outcomes. (^9;6) Telemedicine has increased opportunities in the tech sector to develop reliable materials to be used such as mobile medical applications for phones, wearable devices such as watches, instrumented (smart) homes, and others. More devices are being analyzed and developed to enhance E-health.  

Nevertheless, (²)telemedicine comes with risks such as poor software engineering as many developers lack medical training, security breaches hence privacy is not guaranteed. (⁴)Many medical applications are not easy to use, hence hard for doctors and patients (particularly disabled and older adults) to communicate easily including language barriers. Some medical conditions require physical exams for proper diagnosis which would lead to more complications if misdiagnosed. (^8;9)Many medical applications are marketed directly to consumers without any formal safety testing and now there are more than 100,000 applications hence less efficacy. It also provides space for self-medication that would lead to intoxication and drug abuse(⁷).

On the whole, telemedicine has demonstrated many positive effects on care despite its concerns hence it should not be thrown away. There is a need for more research, efforts, commitment, and funds from all sectors to work hand in hand solving issues to enhance Telemedicine. We need to balance our commitment to the ethical principle of nonmaleficence (do no harm) with the need to adopt technology-driven innovations in health care to enhance quality and efficiency hence better standards of health for all.      

References

1.       Blandford, A. (2020) ‘Opportunities and challenges for telehealth within, and beyond, a pandemic’, The Lancet Global Health, 8(11). Available at: https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(20)30362-4/fulltext.

2.       C, S.K. et al. (2018) ‘Evaluating barriers to adopting telemedicine worldwide: A systematic review’, Journal of telemedicine and telecare, 24(1). doi:10.1177/1357633X16674087.

3.       Dasgupta, A. and Deb, S. (2008) ‘Telemedicine: A New Horizon in Public Health in India’, Indian Journal of Community Medicine : Official Publication of Indian Association of Preventive & Social Medicine, 33(1), pp. 3–8. doi:10.4103/0970-0218.39234.

4.       Dm, S. et al. (2014) ‘Medication error reporting in rural critical access hospitals in the North Dakota Telepharmacy Project’, American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists, 71(1). doi:10.2146/ajhp120533.

5.       Eysenbach, G. (2001) ‘What is e-health?’, Journal of Medical Internet Research, 3(2), p. e20. doi:10.2196/jmir.3.2.e20.

6.       Melanie T. Gentry and Ajeng J. Puspitasari (2021) ‘Clinician Satisfaction with Rapid Adoption and Implementation of Telehealth Services During the COVID-19 Pandemic’, Telemedicine and e-Health, 27(No. 12). Available at: https://www.liebertpub.com/doi/10.1089/tmj.2020.0575 (Accessed: 20 December 2021).

7.       Pj, S. (2013) ‘Evaluating the impact of telepharmacy’, American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists, 70(23). doi:10.2146/ajhp130138.

8.       S, K., G, P. and M, J. (2015) ‘Effects of home telemonitoring interventions on patients with chronic heart failure: an overview of systematic reviews’, Journal of medical Internet research, 17(3). doi:10.2196/jmir.4174.

9.       Stephen Agboola, MD, MPH, and Joseph Kvedar, MD (2016) ‘Telemedicine and Patient Safety’. Available at: https://psnet.ahrq.gov/perspective/telemedicine-and-patient-safety (Accessed: 24 December 2021).

 About the author

Cyubahiro Karangwa Vérité is a 20-year-old second-year medical student at the University of Rwanda College of Medicine and Health sciences in Rwanda. He is a member of the Medical Students’ Association of Rwanda (MEDSAR, Rwanda), an affiliated NMO of IFMSA, and currently serves as a member of the SCOPH standing committee.