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Telehealth services, Telehealth marketThe future of telehealth is the most popular topic nowadays, and there is no doubt that telehealth services will continue to be in high demand as the pandemic disrupts the traditional practice of consultation and the provision of healthcare worldwide. An analysis by Frost & Sullivan estimates that the U.S. telehealth market will grow sevenfold by 2025, representing a growth rate of 38.2% over five years.

The report suggests that the telehealth market will not only grow beyond the COVID-19 pandemic, but that vendors will deliver increased efficiencies through technologies that have been available for more than a decade, but that had not yet been recognized by mainstream healthcare. These include:

      1. Remote diagnostic equipment
      2. User-friendly sensors
      3. Robotic applications

In the latter category of robotic applications are Interactive Virtual Assistants (IVAs), Artificial Intelligence (AI), and robotics that elicit responses from patients. An interactive virtual assistant is a digital “entity” created with software to interface with human beings in ways that approximate human interactions. This technology may include elements of interactive voice response and other digital tools to converse with patients about routine, repetitive issues. This will modify the future of the telehealth market.

Wearable, user-friendly sensors enable the continuous monitoring of human physical activities and behaviors. A commonly measured dataset recognized in the behavioral world is that of physical activities. In a review article published through HIMSS, the following summary explains the range of places such sensors can be placed in someone’s environment:

Potentially, wearable photo or video devices could provide additional clinical information. Wearable devices can be attached to shoes, eyeglasses, earrings, clothing, gloves, and watches. Wearable devices also may evolve to be skin-attachable devices. Sensors can be embedded into the environment, such as chairs, car seats, and mattresses.  

Robotic applications in behavioral care have been researched for several decades for many areas, such as special education, physical rehabilitation with children and seniors, as well as actual behavioral treatment interventions.2,3,4 In addition to lowering staff costs, such advanced technologies can gather big data analytics to learn more about a client’s or patient’s performance, as well as how back-office business technology can track and analyze a telehealth service’s functioning. Also not to be minimized, all telehealth services, including those reflecting the newer technologies described above, are subject to HIPPA Cybersecurity and privacy regulations to avoid data breaches.

With the growing popularity of the telehealth market, practitioners across the globe are adapting to this new trend in health care and learning a variety of new skills, including how to perform a thorough examination virtually. It is to be noted that, when using telemedicine and telehealth, practitioners need to look for subtle nuances and frame their questions differently than they might normally to get the desired response from patients. For those clinicians whose alarm bells get triggered by the idea of artificial intelligence and robots replacing clinicians in telehealth of the future, the need for professionals to stay abreast of these issues is paramount. The ability of leaders in our professions to adopt technology in ways that reflect an awareness of the overall technology ecosystem is key.

Important Factors to Consider When Providing Telehealth Services

  1. It is important to choose a telehealth platform that is easy to use from the patient’s perspective since many behavioral patients may not be able to grasp the instructions or navigate technology without assistance. Involving family or friends can be quite helpful. Developing a protocol for how such collaborators will be involved can help the clinician avoid undue mistakes that could put the client or patient in jeopardy. 
  2. Practitioners must learn how to deliver telehealth services according to HIPAA regulations if in the US, and according to other privacy laws if working in other countries.
  3. Another important aspect of telemedicine is obtaining consent. When healthcare practitioners connect through videoconferencing, obtaining informed consent is required at the first meeting by many licensing boards across the US, Canada, as well as other countries. It also is required that additional patient notes be taken to expand the initial informed consent when new technologies are introduced, such as apps, texting, etc.
  4. Managing risk with staff training and credentialing. For example, knowing how to conduct a full telehealth informed consent mentioned above is important, as it will not only inform the client or patient of the clinician’s policies, but also serve as the cornerstone of risk management for clinicians and their organizations.

Despite its benefits, concerns remain about the efficacy, affordability, and accessibility of telehealth services, particularly with people who experience disparities. The majority of low-income and disadvantaged patients cannot access telehealth because they lack the visual literacy or technological access to reap the benefits of telemedicine. Furthermore, both patients and providers are often confronted with technical problems, and clinicians are sometimes expected to provide IT support as well. Providers often also are faced with clinical situations that leave them at a loss for how to manage difficult or complex cases. 

Despite its shortcomings, the future of telehealth is promising. Telehealth facilities can offer patients access to a wide range of medical and behavioral specialists, allowing them to obtain focused and specialized care as and when required.

Resources

  1. For an overview of the literature related to user-friendly sensors, see the HIMSS article: Wearable Technology Applications in Healthcare: A Literature Review
  2. Luxton, D. D., & Riek, L. D. (2019). Artificial intelligence and robotics in rehabilitation.
  3. Cao, H. L., Esteban, P. G., De Beir, A., Simut, R., Perre, G. V. D., Lefeber, D., & Vanderborght, B. (2017). A survey on behavior control architectures for social robots in healthcare interventions. International Journal of Humanoid Robotics14(04), 1750021.
  4. Robinson, N. L., Connolly, J., Hides, L., & Kavanagh, D. J. (2020). Social robots as treatment agents: Pilot randomized controlled trial to deliver a behavior change intervention. Internet Interventions21, 100320.
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