The pandemic and lockdown measures have forced health organizations to rapidly change the way they provide their health services.
Advancing in the non-face-to-face care model, including teleconsultation, has served to protect and guarantee the continuity of care for patients.
Teleconsultation is one of the digital solutions that are included within the concept of telehealth or eHealth (eHealth), and under the more general concept of digital health.
Depending on the moment of contact, communication can be classified as synchronous and/or asynchronous communication.
Synchronous communication is one that occurs in real time with live attention and that is when we talk about video consultation.
On the other hand, asynchronous communication refers to a communication in which the two people do not have to be connected at the same time, such as contact via email or eConsultation.
Although eHealth is commonly associated in recent decades with the expansion of information and communication technologies, for the health system this is not new .
In 1879, an article in The Lancet explained the relevance of using telephone calls as a strategy to reduce unnecessary visits to the health professional’s office.
The inventor of the electrocardiogram, Willem Einthoven, tested and published an article on telecardiograms in 1906.
In the 1920s, radio was used to give health advice and second opinions to teams of health professionals on ships.
The definitive leap occurred from the last decade of the 20th century and the first of the 21st century with the emergence of the digital society and the appearance of the Internet.
Thus, eHealth has been of interest to health organizations and their professionals for more than a century.
A study carried out by the Platform of Patient Organizations in 2021 states that the advantages of using teleconsultations would be:
- Greater accessibility for people who have difficulties to attend in person, such as due to working hours, carers of dependent people or long distances.
- Savings in travel time and associated costs.
- Decrease in absences from work and risks of dismissals.
- Reduction of the average waiting time to access a specialist consultation.
- Agility to solve low complexity problems and resolution of simple queries.
- Ease of communication and interconsultations between health professionals.
Likewise, some barriers are established regarding the use of this type of technology applied to health, such as:
- Absence of the legal framework defined and adapted for the use of daily practice.
- Cybersecurity problems and confidentiality of the consultation.
- Absence of non-verbal communication in the telephone consultation, making it difficult to interpret the information.
- Risk of duplicate queries if you don’t optimize well and prepare the query.
- Lack of training in digital skills for its efficient use for both patients and professionals.
- Lack of accessibility and management of technologies by certain more vulnerable groups such as people with hearing problems, cognitive problems, dependents, the elderly, etc.
The review of the scientific evidence of published studies shows that the virtual health consultation provides important benefits related to health outcomes, the experience of the patient and the professional, and the sustainability of the health system.
The combination of virtual consultation for follow-up with face-to-face consultation for appointments allows to improve health results.
Some of the applications of teleconsultation in health would be in the areas of primary and community care and focused on diagnosis and treatment.
Teleconsultation can be used to read diagnostic tests, prescribe and resolve doubts in treatment, follow-up of post-surgical patients, follow-up of home hospitalization and even monitoring and/or patient support through communication.
The working group on Telemedicine and Neurology of the Spanish Society of Neurology (SEN) recommend:
- Find a quiet space with good lighting.
- Carry out a preliminary test of the connection and of the system that will be used for the teleconsultation.
- Prepare ahead of time by making sure your device has a sufficient battery and adequate internet connection.
- Write a list of main complaints and/or questions for the professional.
- Have records (data) on hand that can be requested, such as the value of blood pressure, capillary blood glucose, recent clinical reports and medication that you are currently taking.
- If the service is carried out through a mobile application, have it downloaded on your phone or tablet before starting the service.
- Make sure that the professional has your contact information (phone and email) in order to receive written instructions.
The consolidation of teleconsultation in Spain can only be successful if all the agents in the system really collaborate.
Meanwhile, the world continues to move forward and large television companies such as Samsung are beginning to partner with entities to develop new virtual primary care capabilities.
Regulatory, organizational and economic changes must be made to facilitate its consolidation by promoting the participation of health professionals and patients.
References:
Fries D. CONSUMER HEALTHCARE SURVEY 2021 [Internet]. Oliverwyman. 2022 [cited 2022 Oct 17]. Available at: https://www.oliverwyman.com/our-expertise/insights/2022/jan/health-innovation-journal/consumer-healthcare-survey-2021.html
Study on the virtual health consultation and its benefits for the health system [Internet]. Barcelona HealthHUB. 2022 [cited 2022 Oct 17]. Available here.
Evaluation of the safety, efficacy/effectiveness and efficiency of teleconsultation in primary care, and of the organizational, ethical, social and legal aspects linked to its use [Internet]. Agency for Quality and Health Assessment of Catalonia (AQuAS). 2022 [cited 2022 Oct 17]. Available here.
Telematic care model centered on the person [Internet]. Platform of patient organizations. 2021 [cited 2022 Sep 16]. Available here.
Ezpeleta D. TELEMEDICINE IN NEUROLOGY Coordination and editing David Ezpeleta. SEN Telemedicine and Neurology Working Group [Internet]. Spanish Society of Neurology. 2022 [cited 2022 Sep 16]. Available here.
