Exploring the Roles of Telemedicine and Telehealth in Managing COVID-19
The current COVID-19 crisis is a disruptive event that raises important questions regarding healthcare responsiveness during untenable events. Centre for Service Management (CSM) former PhD representative, SBE alumnus and CSM affiliate member, Dr Higor Leite, from Federal University of Technology Paraná in Brazil invited us to join him to investigate the impact of telemedicine and telehealth on flattening the COVID-19 infection curve.
The terminologies telemedicine and telehealth are often used to refer to the same phenomenon; however, telemedicine is specific to the use of technology to enable care at distance, between patient and medical staff. On the other hand, telehealth is broader, and it comprises the use of a variety of technologies in different areas of healthcare. These two technologies were addressed by us in two contemporary articles that were recently published.
In the new development article: “‘Healing at a distance’ – Telemedicine and COVID-19”, published by Public Money & Management, we discuss the challenges and opportunities to telemedicine practices during the COVID-19 pandemic.
The COVID-19 virus is considered by many as an ‘invisible enemy’, with high rates of contamination and growing death toll. Therefore, the use of telemedicine to access healthcare support becomes an effective frontline service to the citizenry and medical staff. The use of telemedicine helps to reduce the risk of cross-contamination, protect vulnerable groups of patients, as well as those working to provide care in medical facilities. Mental health is another area for which telemedicine works well, as during long periods of quarantine, some people experience physiological effects, such as anxiety, sleeping issues, and in some cases (e.g. frontline works), post-traumatic stress disorder. Due to this, some countries, such as Australia and Brazil, are providing mental health professional support through telemedicine during the pandemic, with positive results.
Regardless of the benefits from telemedicine to date, there are several structural and legal obstacles to widely implementing telemedicine in some countries. For instance, access to broadband is still a huge limitation, especially for those living in rural areas, or vulnerable groups that cannot afford this service. The lack of more comprehensive regulations is another barrier to telemedicine. There are countries where telemedicine is still not a regulated practice, and others where regulations do not cover issues related to the patient’s data privacy and protection. In order to raise awareness, we addressed such issues and urged policy-makers to take advantage of the telemedicine experiences reported during this outbreak to enable practices of telemedicine considering issues of inclusiveness, privacy and data protection.
In our second article, “Flattening the infection curve – understanding the role of telehealth in managing COVID-19”, published by the Leadership and Health Services journal, we discuss the strategic role of telehealth technologies in managing the pandemic. Using a 3 T’s model (Tracking, Testing and Treating), we report that using telehealth has proved to be an effective tool to ‘flatten the infection curve’.
Tracking the disease provides invaluable information that addresses demographic, geographic and symptomatic patterns of the virus. To do so, there are collaborative apps that report real-time data from self-reported information on the COVID-19 outbreak. This type of e-health technology is believed to slow the spread of the virus, for instance in Belgium, South Korea and the USA, mobile technology traces patients’ whereabouts. In Singapore, an app helps people to avoid areas with high cases of contamination, also called ‘hot-spots’. Despite the benefits, there is a concerning fear related to data privacy and government surveillance. In the paper, we make an important observation about this concern: “While in such unprecedented times this might be an unfortunate trade-off for citizens to accept this technology application”.
Testing is the next crucial step, according to Dr Tedros Adhanom Ghebreyesus, the Director-General of the World Health Organization (WHO), “You can’t fight a fire blindfolded and we cannot stop this pandemic if we don’t know who is infected”. To date, unfortunately, it is not possible to test the global population as test kits are scarce. Therefore, two telehealth practices are enabling a prioritization of testing by providing virtual triage. First, patients can make a self-assessment using an app based on artificial intelligence, and when symptoms are identified, the patient is referred to the nearest ‘drive-thru’ test. Second, virtual triage enables patients to access a video consultation, where a physician is able to determine if the patient should be tested or only self-isolate.
Treating is the final step and it is based on the results from both tracking and testing. Unfortunately, there is no current vaccine or effective medication for COVID-19, therefore, this phase follows the protocol suggested by the WHO. Telehealth technologies play a strategic role in treating, either by promoting access to a physician via apps or websites, or the possibility to track patient’s vital signs via wearables, producing data for general practitioners monitoring of the patient. By doing this, physicians can prescribe, monitor, and refer patients to hospitals if necessary. Amongst several benefits, these practices reduce the pressure on healthcare operations during the pandemic, and keep patient and medical staff safe.
The COVID-19 pandemic has proved to be one of the greatest challenges of our generation, bringing social and economic implications. The use of telemedicine and telehealth is not the panacea for flattening the infection curve, but an important ally to track the virus, efficiently test people, and provide safe treatment. For healthcare organizations, such technologies provide the opportunity to manage demand and supply in a constrained situation. Finally, for medical staff, it is a support tool that enhance possibilities of virtual medicine, and keep frontline workers safe.
This blog post was written by Dr Higor Leite, SBE Alumnus and Associate Professor at Federal University of Technology Paraná, Brazil; Professor Ian R. Hodgkinson, Deputy Director of the Centre for Service Management (CSM) and Professor Thorsten Gruber, Director of the Centre for Service Management (CSM).
Read the full articles for free (open access) here:
Leite, H., Hodgkinson, I.R. and Gruber, T. (2020), “New development: ‘Healing at a distance’ – telemedicine and COVID-19”, Public Money and Management. Published online: 09 Apr 2020 https://doi.org/10.1080/09540962.2020.1748855
Leite, H., Gruber, T. and Hodgkinson, I.R. (2020), “Flattening the infection curve – understanding the role of telehealth in managing COVID-19”, Leadership in Health Services, Vol. 33 No. 2, pp. 221-226. https://doi.org/10.1108/LHS-05-2020-084