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Differences Between Telehealth and Telemedicine and Associated Concerns

Keeping medical records is key in a hospital setting or any other healthcare facility, since well-kept patient records will improve the quality of health services. These records can be stored and accessed using information systems, therefore telemedicine comes in since it basically involves the use of medical information exchanged through electronic communication from one site to another to improve patient’s clinical health status. Telemedicine involves multiple uses of technological communications such as mails, smartphones, videos and several other forms of telecommunication technologies. (Emery, 2015) The use of telemedicine has been vastly used in most of the countries, for instance its use began some 4 decades ago where clinical health services was provided to people in remote areas. The major concern in telemedicine is that; it’s not a medical profession different from the other professions, most of the services in telemedicine forms the part of services offered in normal healthcare settings mostly in form of information technology or other clinical services offered. Through Medicare, patients are able to consult healthcare providers through video, conferencing and even transmit images that are immobile.

Differences Between Telehealth and Telemedicine and Associated Concerns

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Telemedicine has a number of benefits for patients and healthcare providers; first telemedicine improves access to healthcare services, through telemedicine, healthcare services has been brought close to the people.  Secondly, telemedicine is cost effective; telemedicine has been associated with the reduction of healthcare cost and increase effective management of non-communicable diseases. Use of telemedicine improves quality, research has shown that, use of telemedicine has been associated to quality services in healthcare, for instance the ICU services and patient’s consultation has so far shown positive results of telemedicine use. Finally, use of telemedicine has increased patient’s demand, patients and families may not be interested in making trips to hospitals maybe for services such as consultation. Therefore b using telemedicine, they are able to consult with the doctor, through emails, video and use of smartphones.  Telemedicine is closely related to Health Information Technology (HIT) except of a small different in that HIT is mostly referred to as electronic medical records.

Closely similar to telemedicine is telehealth, telehealth basically is composed by different varieties of technologies and knowledge to deliver medical health and health education services. It’s not always a specific service but a collection of services to enhance medical delivery. Telehealth is different from telemedicine in that telehealth is broader when describing the range of services offered mostly diagnosis, management and education in healthcare. According to health resources and service administration, telehealth is the use of electronic information and telecommunication technologies to support long distance clinical care, patient and professional health. Telehealth encompasses the use of modalities to deliver services to patients.

To begin with, telehealth uses live video; the use of video provides a platform for live interaction between the patient and the doctor or anybody in need of service using audiovisual telecommunication services. The second model used by telehealth is the store and forward model, this model facilitates the transmission of the record health history such as previous done x-rays and diagnosis.  Remote patient monitoring (RPM), this model allows the collection of medical data from an individual in a far location via electronic communication technologies which is then transmitted to the healthcare provider. (Kirkpatrick, 2015)  This model is very effective since it allows the monitoring the health records of a patient even after his / her release.  The final model is mobile health; this model supports health education and public health services via communication mostly by the use of mobile phones. For instance this model can tune people to a discussion about health broadcasted in their phones.

Defensive medicine can be defined as the practice of suggesting a form of treatment by a physician to a patient which is not the best option in regard to the illness faced by the patients. Defensive medicine can also be referred to as defensive, medical decision making. The defensive medicine is not for the interest of patient but mainly to protect the doctor against some malpractices.  Defensive medicine mostly evolved from the reactions towards the increasing malpractices in insurance premiums and patients not being considerate and fair in suing a physician for late diagnosis and treatment. Defensive medicine often have some underpinnings, defensive medicine is contributed by the rising cost of malpractices in insurance premiums, patients biasness for suing the missed or delayed diagnosis. Defensive medicine has influenced healthcare in many ways; defensive medicine is the cause of increasing cost of healthcare services. According to utilitarism arguments, it concludes that defensive medicine is partly harmful to patients. Defensive medicine facilitates defensive decision making, however, defensive medicine doesn’t only help in the hospital but other business institutions.

The Emergency Medical Treatment and Labor Act (EMTALA), is a federal law that guarantees every patient coming to an emergency department to be stabilized and treated regardless of their insurance status or ability to pay treatment fee. However, this law has remained unfunded since its enactment. (Limpton, 2009) This law was enacted to mainly to protect the interests for the patients, for instance; the law was designed to deter hospitals from transferring uninsured patients to public hospitals without adequate medical screening that could prove that they were stable enough to be transferred to the public hospitals. Secondly EMTALA requires medical care participating in emergency care services, to attend to emergency requirements of their patients without any form of biasness or discrimination. EMTALA also provided a platform in which the hospitals offering emergency services to report to CMS or the state survey agency any time it may have an individual whom they suspect has been transferred to a public hospital when they are not in stable condition. Finally, EMTALA provided that hospitals with capability to handle patients who requires emergency medical services must be obligated to receive the referred patients from the hospitals without capability to handle such patients.

Trauma center levels are levels I, II, III and IV, for our discussion we’ll focus our discussion on the first three centers and the requirement for their accreditation.  For a trauma center to be accredited it has to meet the following standards; it has to have 24 hours in house coverage and general surgeons and prompt availability of care in specialties, secondly, it must have referral resources for the nearby communities. The level I must also incorporate a comprehensive quality assessment program and finally it must have a program for substance abuse, screening and patient intervention. Level II has to meet the following qualifications for accreditation; 24-hours immediate coverage by the general functions and specialists in other fields, secondly, it has to provide a comprehensive quality assessment, it has to meet tertiary needs such as cardiac surgery. And finally, level II must have the capability to provide trauma prevention and patient’s education programs. Finally, for level III to be accredited as a fully functional trauma center, it has to meet requirements such as; 24- hour’s immediate coverage by emergency medicine physicians and the prompt availability of the general surgeons and doctors from other specialty. Secondly, it must incorporates a comprehensive quality assessment program, has developed transfer agreements for patients requiring more comprehensive care from level I and II, level III must have the ability to offer continuous education of the nurses and all health care providers and the trauma team, and finally, they should have the ability to provide backup care to rural and community hospitals.

The level of services or the point of patient’s admission in a hospital will depend on the level of what the patient is suffering from. Patients can be directed to a number of services in a hospital setting, such services may include; emergency care center, urgent care centers and primary services offered by the physician. A patient with a critical condition who requires immediate medical attention will be admitted in emergency center, for instance a victim of road accident will automatically require emergency admission or else they will bleed to death. Patients with critical injuries and illness an also be admitted in emergency centers. Close to emergency center is the urgent care center, patients who are admitted in urgent center are patients who require urgent medical attention especially attention on the same day when the injury or illness was contracted.

Hospital Emergency Department plays an important role in taking care of patients who are in critical condition and require to be attended to in an emergency.  It has been found that, emergency departments increasingly support primary care providers by performing those diagnoses which are complex and cannot be done in clinical offices. However, many people might think that emergency departments are the most expensive when it comes to getting medical attention, but emergency rooms still are crucial safety for those individuals who cannot seek health attention elsewhere and this is important in playing a role when it comes to reducing healthcare cost. (Jansen, 2015) Emergency department in a hospital setting helps to save lives of patients who are in critical condition, and if the emergency services could have not been there, then a good number of deaths could have been witnessed thank God the emergency services are there to help these patients recover from their critical conditions.

References;
  • Emery, S. (2015). Telemedicine in hospitals: Issues in implementation.
  • E-medicine, e-health, m-health, telemedicine, and telehealth handbook. (2015): Crc Press
  • Jensen, K, & Kirkpatrick, D. G. (2014). The hospital executive guide emergency department management
  • Lipton, M. S, & California Healthcare Association. (2009). EMTALA: A guide to patient anti-dumping laws, Sacramento, CA: California Hospital.

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