Barriers to Telehealth: Difference between revisions
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=== Socio-cultural === | === Socio-cultural === | ||
Prior to the COVID-19 pandemic, the general perception and attitude of clinicians and patients towards telehealth was usually negative to mixed. Although the acceptability might have increased after the pandemic, certain populations, especially in rural settings might still express concerns about the use of telehealth for their healthcare needs. Increasing awareness through education can help mitigate these concerns. | Prior to the COVID-19 pandemic, the general perception and attitude of clinicians and patients towards telehealth was usually negative to mixed.<ref>Sahin E, Kefeli U, Cabuk D, Ozden E, Cakmak Y, Kaypak MA, Seyyar M, Uygun K. Perceptions and acceptance of telemedicine among medical oncologists before and during the COVID-19 pandemic in Turkey. Support Care Cancer. 2021 Dec;29(12):7497-7503.</ref><ref>Holtz BE. Patients perceptions of telemedicine visits before and after the coronavirus disease 2019 pandemic. Telemedicine and e-Health. 2021 Jan 1;27(1):107-12.</ref> Although the acceptability might have increased after the pandemic, certain populations, especially in rural settings might still express concerns about the use of telehealth for their healthcare needs. Increasing awareness through education can help mitigate these concerns.<ref>Alexander DS, Kiser S, North S, Roberts CA, Carpenter DM. Exploring community members' perceptions to adopt a Tele-COPD program in rural counties. Exploratory Research in Clinical and Social Pharmacy. 2021 Jun 1;2:100023.</ref> | ||
=== Technological === | === Technological === | ||
Revision as of 19:09, 30 January 2022
Introduction[edit | edit source]
Telehealth practice is increasing globally, partially in response to the sudden disruption brought upon by the COVID-19 pandemic.[1] Telehealth usage is not without significant barriers, specific to the setting, which need to be clearly identified beforehand and may necessitate the development of individualized strategies to address them appropriately.
Categories of barriers to telehealth practice[edit | edit source]
Most barriers can be categorized under the following:
Ethical[edit | edit source]
Due to widespread social media usage, there is generally a great awareness of data privacy and confidentiality issues associated with being online.[2] These issues are more pressing when it concerns health records and other private information related to treatment. These fears might discourage some from accepting telehealth as an alternative mode of availing healthcare services. Telehealth systems that incorporate data encryption and similar cyber-security measures must be employed.[3]
On the other hand, the internet could also enable quacks and other bad actors to defraud people for telehealth services. Patients should be educated to look up their service providers's credentials before accepting or paying for any telehealth intervention.[4]
Economical[edit | edit source]
Despite evidence to the contrary[5], the perceived cost is one of the perceived barriers that prevents the use of telehealth. This is more prominent in low-resource settings. Broadband expenses and the cost of telehealth equipment and personnel training is a concern for most.[6] The costs can be minimized by selecting the most appropriate telehealth delivery methods for the intervention, setting, and population. For example, clinicians can use SMS or other asynchronous methods instead of real-time videoconferencing. The modern smartphone is a comparatively inexpensive and self-sufficient device for most telehealth use cases.[7]
Another area of concern is billing and financial reimbursement for telehealth services. There might be guidance provided by the government or other regulatory body for billing for telehealth. Insurance coverage for telehealth services need to be determined. In its absence, alternate means must be identified in consensus with the client prior to commencement.[8][9]
Regulatory[edit | edit source]
Telehealth practice, depending on the country and state (as in the case of United States of America), may be under the purview of the law of the land. Clinicians may need to obtain the mandated licence and meet other legal requirements as stipulated by law. In countries without clear legal requirements, the presiding professional body may have set certain guidelines in place that may assist clinicians in setting up their practice. The law may also impose strict data privacy requirements for patient safety.[8]
Socio-cultural[edit | edit source]
Prior to the COVID-19 pandemic, the general perception and attitude of clinicians and patients towards telehealth was usually negative to mixed.[10][11] Although the acceptability might have increased after the pandemic, certain populations, especially in rural settings might still express concerns about the use of telehealth for their healthcare needs. Increasing awareness through education can help mitigate these concerns.[12]
Technological[edit | edit source]
These are usually associated with the technological requirements for conducting telehealth. They may include lack of broadband coverage or low bandwidth, lack of user-friendly telehealth hardware or software, and poor digital literacy. Broadband coverage and speeds are set to improve in the future. Furthermore, the rollout of 5G around the world will make telehealth easier due to the exponentially higher data transfer speeds. There has already been considerable improvement seen globally in the past decade. Clinicians must collaborate with engineers and designers must develop telehealth devices and software applications keeping in mind the needs of the target population. Poor digital literacy can be overcome with good design, besides patient education.
References[edit | edit source]
- ↑ Seivert S, Badowski ME. The Rise of Telemedicine: Lessons from a Global Pandemic. INNOVATIONS. 2021 Feb.
- ↑ Isaak J, Hanna MJ. User data privacy: Facebook, Cambridge Analytica, and privacy protection. Computer. 2018 Aug 14;51(8):56-9.
- ↑ Hall JL, McGraw D. For telehealth to succeed, privacy and security risks must be identified and addressed. Health Affairs. 2014 Feb 1;33(2):216-21.
- ↑ Canady VA. Survey finds telehealth services raise potential for fraud. Mental Health Weekly. 2020 Nov 9;30(43):3-4.
- ↑ Kane A, Katebi C, Subramanian M. Telehealth Saves Money and Lives: Lessons From the COVID-19 Pandemic. 2021. The Progressive Policy Institute.
- ↑ Jang-Jaccard J, Nepal S, Alem L, Li J. Barriers for delivering telehealth in rural Australia: a review based on Australian trials and studies. Telemedicine and e-Health. 2014 May 1;20(5):496-504.
- ↑ Scott RE, Mars M. Telehealth in the developing world: current status and future prospects. Smart Homecare Technology and TeleHealth. 2015 Feb 2;3:25-37.
- ↑ 8.0 8.1 Baker DC, Bufka LF. Preparing for the telehealth world: Navigating legal, regulatory, reimbursement, and ethical issues in an electronic age. Professional Psychology: Research and Practice. 2011 Dec;42(6):405.
- ↑ Gilman M, Stensland J. Telehealth and Medicare: payment policy, current use, and prospects for growth. Medicare & medicaid research review. 2013;3(4).
- ↑ Sahin E, Kefeli U, Cabuk D, Ozden E, Cakmak Y, Kaypak MA, Seyyar M, Uygun K. Perceptions and acceptance of telemedicine among medical oncologists before and during the COVID-19 pandemic in Turkey. Support Care Cancer. 2021 Dec;29(12):7497-7503.
- ↑ Holtz BE. Patients perceptions of telemedicine visits before and after the coronavirus disease 2019 pandemic. Telemedicine and e-Health. 2021 Jan 1;27(1):107-12.
- ↑ Alexander DS, Kiser S, North S, Roberts CA, Carpenter DM. Exploring community members' perceptions to adopt a Tele-COPD program in rural counties. Exploratory Research in Clinical and Social Pharmacy. 2021 Jun 1;2:100023.
