How Is Telemedicine Improving Health Care in Nepal?

Telemedicine is now living up to its potential after years of lofty promises. More health professionals are turning to electronic communications to do their work, driven by quicker internet access, ubiquitous smartphones, and evolving insurance standards—and it's upending the delivery of health care.

Doctors interact with their patients via phone, email, and webcam. They're often communicating remotely, sometimes making split-second decisions about heart attacks and strokes. Meanwhile, patients are using modern technologies to transmit their blood pressure, heart rate, and other vital signs to their physicians, helping them to treat chronic illnesses at home.

Telemedicine also makes it possible to provide better care in areas where medical knowledge is limited.

Doctors Without Borders sends questions about difficult cases to its network of 280 experts around the world five to ten times a day, through the internet, from its physicians in Niger, South Sudan, and elsewhere.

In the woods outside of St. Louis, Mercy health system's new Virtual Treatment Center—a "hospital without beds" that offers online assistance for intensive-care units, emergency rooms, and other services in 38 smaller hospitals from North Carolina to Oklahoma—shifts of doctors and nurses operate around the clock. Many of them do not have a physician on hand 24 hours a day, seven days a week.

Critical-care doctors sit at oversize video monitors in the TeleICU section, gathering data on every far-flung ICU patient and detecting signs of impending trouble. If a patient requires assistance, Mercy doctors can use a two-way camera to zoom in close enough to read the tiny print on an IV bag.

“It's almost like being at the bedside,” says Vinaya Sermadevi, a critical-care professional. “I can't shock a patient [restart his heart with electrical paddles], but I can send an order to the nurses there.”

ICUs tracked by Mercy specialists have seen a 35 percent drop in average duration of stay and 30 percent fewer deaths than predicted in the last year. According to Randy Moore, president of Mercy Virtual, “that translates to 1,000 people who were supposed to die getting to go home instead.”

The Virtual Physician Has Arrived

Consider the following as an example of how quickly telemedicine is spreading: According to the American Telemedicine Association, a trade organization, more than 15 million Americans received remote medical treatment last year, with that number expected to rise by 30% this year.

None of this means that telemedicine has entered every field of medicine. According to a new HealthMine survey of 500 tech-savvy users, 39 percent had never heard of telemedicine, and 42 percent of those who had said they favored in-person doctor visits. Just 15% of 1,500 family doctors had used it in their practices, but 90% said they would do so if they were properly reimbursed.

Moreover, despite the rapid expansion, major concerns and obstacles remain. The laws that define and regulate telemedicine vary greatly from state to state and are constantly changing. Different physician associations are releasing recommendations on what form of treatment should be provided in which environment.

Some critics still wonder if the standard of treatment is keeping up with telemedicine's rapid growth. There's also the issue of what services doctors should be compensated for: Insurance coverage varies by insurance plan, and often broad government programs only cover a small number of services.

The future of telemedicine will be determined by how regulators, suppliers, payers, and patients approach these issues. Let's take a closer look at a few of these concerns:

Do patients make a trade-off between efficiency and convenience?

The fastest-growing telemedicine systems link patients with clinicians they've never met for one-time phone, video, or email visits—on demand, 24 hours a day, seven days a week. They typically cost around $45, compared to around $100 at a doctor's office, $160 at an urgent-care facility, or $750 and up at an emergency room for non-emergency problems including colds, flu, earaches, and skin rashes.

Many insurance plans and employers have hurried to provide the programs and encourage them as a convenient way for plan members to receive medical coverage without having to leave their homes or places of employment. Digital doctor visits will be provided as a perk to workers by nearly three-quarters of large employers this year, up from 48% last year.

According to the American Telemedicine Group, online companies such as Cura Health, Doctor on Demand, and American Well are expected to host 1.2 million virtual doctor visits this year, up 20% from last year.

Critics, however, are concerned that such services could be sacrificing efficiency in the name of convenience. Patients should visit a random doctor they would never see, they claim, because even minor problems like upper respiratory infections can't be properly examined by a doctor who can't listen to your ears, culture your mouth, or feel your swollen glands.

Researchers posing as patients with skin problems sought assistance from 16 telemedicine sites in a study published in JAMA Dermatology last month, with unsettling results. Only 32% of the 62 experiences revealed the clinician's credentials or allowed patients to choose; only 32% addressed the possible side effects of prescription medications. According to the researchers, some sites misdiagnosed severe conditions, owing to a failure to ask simple follow-up questions.

I was experienced a major health issue and I was treated and checked up by various doctors. I, Ansul want to suggest you to solve your major health issues without visiting hospital or clinic would suggest you the Telemedicine app or website where you can book your specialist doctors at Cura Health. You can also download the app.