By the end of this module, you will be able to:

 Explain the concepts of telemedicine.

 Discuss the benefits of telemedicine.

 Define remote monitoring and state hindering factors.

 State the need for communication and collaboration in telemedicine.

 Identify the factors hindering communication in telemedicine.

 Describe the downside of BANs technology in telemedicine.

 Summarize the merits of continuous live monitoring in telemedicine.

 Introduction
 In the not-so-distant past, health care professionals would set aside time to
make house calls to patients who needed medical care but were unable to
come to the provider’s clinic.

 In many rural or poor areas, it was often the only way people could receive
preventive or emergency medical care.

General Overview of Telemedicine

Telemedicine involves providing interactive health care from a distance. This can
include video conferencing, the sharing of electronic information, and even a phone
call. Currently, more than half of the hospitals in the United States utilize some
form of telemedicine (American Telemedicine Association, n.d.).

Telemedicine is meant to augment, not replace, in-person patient care (Thomas,

n.d.). Even if a clinician works exclusively through virtual tools, patients must still
be assessed in person by a provider on a regular basis.

Although it is still making its way into the everyday practice of medicine,
telemedicine has been a common part of delivering health care during crises, such
as wars, natural disasters, and pandemics, for several reasons (Smith, Thomas, &
Snoswell, 2020):

 Telemedicine technology makes it possible to quickly deploy a large number of

providers to the areas where they are needed the most.

 Telemedicine technology reduces the burden on front-line providers and facilities

by making it possible to triage patients remotely.
 Telemedicine can be used to ensure continuity of care when clinics and hospitals
are unable to operate.

 Telemedicine reduces the risk of disease transmission during pandemics.

Telemedicine Terminology
The terms telemedicine and telehealth are often used interchangeably, but they are
different. According to the American Academy of Family Physicians, telemedicine
strictly involves clinical interactions.

Telehealth, on the other hand, also includes meetings, clinical training, and
continuing education for health care providers (American Academy of Family
Physicians, n.d.).

Telemedicine

Remote Monitoring

Real-time Interaction

Use of Smart devices

Telemedicine is based on the “store and forward” concept. This means that information is updated by one
individual and then accessed by another individual at a later time.

For example, a patient’s cardiologist may upload information that is later accessed by the patient’s primary
care provider (Smith Y., n.d.).


 Today, many health care providers, from general practitioners to specialists
and mental and behavioral health professionals, connect with patients using
cell phones, computers, and other technology.
 Although providing medical care outside of the traditional clinic setting is
not a new concept, modern technology has expanded the potential for
delivering patient care in new settings and enabling practitioners to take
their services directly to the patient.

Telemedicine provides interactive health care from a distance in which

of the following ways? Choose three answers.

Interpersonal Communication in
Telemedicine.
 From primary care physicians to specialists and allied clinicians, effective patient
care involves ongoing communication and collaboration between the patient’s
entire health care team.

Telemedicine, such as texting, video conferences, and online forums or chat

rooms, facilitates team communication and provides patients with access to
specialists and allied clinicians in a more efficient and cost-effective manner.

In cases where the patient has multiple comorbidities, the care team can
teleconference as a group with the patient or individually as needed regardless of
their locations.

With the widespread availability of global telecommunication technology, it is

possible for a patient’s care team to involve providers from across the globe.

In cases where a patient has vague or inconsistent symptoms, providers can even
crowdsource potential diagnoses (Ciemins, Coon, Peck, Holloway, & Min, 2011;
Meyer, Longhurst, & Singh, 2014).

Privacy Concerns in Telemedicine

Of course, there are privacy concerns any time protected health information is
transmitted electronically. For instance

 The email and texting accounts that most of us use are not encrypted and can be
hacked with relative ease, and data security on websites and forums is left up to
the host of the site. It is up to practitioners to review the privacy policies of these
sites before posting protected health information.

 Practitioners must also ensure that all devices are in compliance with Health
Insurance Portability and Accountability Act regulations (Hernandez, 2014; Alonso-
Zaldivar, 2015).

Telemedicine Communication
Technology
Telemedicine utilizes a number of different technologies. The most common and
straightforward are two-way radios, telephones, and the internet.

Unfortunately, internet coverage is still limited in many rural areas where

telemedicine could play a major role in providing face-to-face and specialty health
 care. Efforts are underway to improve internet access in these areas through
expanded broadband and satellite internet and improved wireless access.

These connections enable providers and patients to conduct two-way visual

interactions ranging from conducting physical exams to sharing educational
materials (Federal Communications Commission).

Communication Challenges in
Telemedicine
Satellite Internet

Cellular Technology

Broadband Internet

Since satellite internet simply requires a receiver on the ground capable of connecting with the satellite, it
is quick and easy to provide to remote areas and less expensive than laying cables.

The downside is that weather and landscape can affect signals or even cause delays, which can make real-
time communication more difficult.

There is also a limit to the bandwidth of these satellites; however, the capacity is increasing year by year
(Federal Communications Commission; Finley, 2015).

The Use of Body Area Networks

Body area networks, also known as personal area networks, play an important role
in remote monitoring. A BAN consists of implants or wearable patches that are
local to the patient’s body.

These devices may be wired or communicate wirelessly, and they may be

connected to the internet or operate as a self-contained unit.

 A self-contained BAN is known as an intra-BAN. Examples include cardiac or sleep

apnea sensors that connect to a small base station.

 A BAN that connects to the internet is known as an extra-BAN. Examples include

fitness trackers that connect to cell phones and continuously upload heart rate,
pulse oximetry, and other vital signs to a website.

The downside of BAN devices is that they are susceptible to interference from
other wireless signals and artifacts or incomplete information caused by movement
or connections becoming kinked or disconnected (PBS.org, 2015; Kenyon, 2012).