Telehealth: The Future of Health Care

Details: Written by: Henna Razvi; 28 December 2022

Access, Technology, & Cost

During the pandemic, many Canadians were accessing healthcare online. Whether it's to look up symptoms, call a government health line or do an online consultation, the Covid-19 pandemic changed how Canadians accessed healthcare and magnified the flaws in healthcare systems worldwide. The main issues surrounding telehealth are accessibility, underutilization of technology, and healthcare funding.

Rural Healthcare Access

Whether it is due to safety concerns, lack of access, ease of use, or personal preference, telehealth is gaining popularity with Canadians. According to Dr. William Cherniak, founder, and CEO of Rocket Doctor, "Pre-pandemic, telehealth was less than 1% of all doctor visits. By the summer of 2020, roughly 70% of all medical visits in some communities were being done virtually." 33% of patient-reported visits between January 2021 and March 2022 were virtual, and 21% of healthcare visits were videoconferences. Between June 2021 and March 2022, 47% of patients who were given the option chose to videoconference over an in-person consult. Other forms of telehealth options include phone consultations and secure email or messaging. According to one study conducted in Nunavut, 50% of patient care visits would not have been used by a patient or a professional, or both, if telehealth had not been an option.[1] The cost and labor of traveling great distances to access healthcare are too great for too many people, which means that specific populations will be at higher risk of health issues. Telehealth can significantly reduce the disparity created by the uneven distribution of the traditional healthcare system.

Technological Advancement

The need for a more accessible healthcare system has pushed technological advances in medicine that may not have come about without the stressors of the Covid-19 Pandemic. Dr. Cherniak commented, “Alongside this boom of access has been enormous advances in digital health, including smart patient intake forms, natural language processing, data science / predictive analytics…”. A pilot study in Saskatchewan showed that the presence of robotic technology significantly reduced the need for transporting respiratory patients out of their homes, directly resulting in lower overall transportation costs for the province.[2] A similar project showed that robotic technology reduced the need for medical transportation by 60% in Labrador.[3] Telehealth accessibility also forces governments to improve internet infrastructures to maintain secure data and consistent access at specific speeds. Tele-psychiatry is also on the rise as more and more people are being affected by mental health issues emerging in the wake of the pandemic.

Challenges

Health practitioners are in the later stage of their careers, so incorporating telehealth training into their current ecosystem is challenging. Not every facility is equipped for access to telehealth technologies or databases. Patients who do not speak English also struggle to use the technology. Language barrier is the biggest factor for telemedicine cancellations according one study in adult cardiology. In the future, telehealth training will be a part of practitioners' training. Telehealth equipment will likely be set up in the emergency rooms, easy to access, and logged on immediately for stat calls.[4] Telehealth also makes it easier for health professionals to share information about medical cases internationally. Family members who are scattered over great distances can now participate in a group telemedicine call to support.

Cost and Funding

Compared to the rest of Canada, healthcare costs are twice as much in northern Canada, with large indigenous populations.[5] An unsustainable 40% of Nunavut’s annual health budget is spent on health-related travel and accommodation.[6] Telehealth makes it possible for patients to receive care without traveling long distances. An in-person consultation can cost up to CAD 1048 in Nova Scotia, while telehealth ranges from $17 to $70.[7] Care Management Solutions is estimated at US$11.5 Billion in 2020 and projected to reach 25.5 Billion in 2027. Telehealth is emerging as one of the fastest-growing industries in the world.[8] "Today, the key question to the future of digital health/telehealth is ensuring that our governments continue to adequately fund doctors to provide this service through our public healthcare.”, concluded Dr. Cherniak.

Physician and patient interest in telehealth services will ensure that it remains a permanent part of the Canadian healthcare system.[9] Canada Health Infoway's 2021 Digital Health Survey found that 90% of respondents with at least one virtual healthcare interaction were satisfied with the care they received. 69% of Canadians are interested in healthcare by telephone, 56% prefer video, and 57% secure messaging.[10]Telehealth is pushing the boundaries to bring accessible, immediate, and effective healthcare to people worldwide. The goal is to reach and save millions of lives.

Expert Contribution:

Photo Courtesy/OMA

Dr. William Cherniak, MD MPH CCFP(EM) DABFM

Founder and CEO - Rocket Doctor Canada / Rocket Doctor USA
Founder and CEO - Bridge to Health Medical and Dental Canada / Bridge to Health Medical and Dental USA
Associate Faculty – Johns Hopkins Bloomberg School of Public Health, Dpt. International Health
Asst. Prof. – University of Toronto, Division of Emergency Medicine
Adj.Prof. – Northwestern University, School of Professional Studies, MSc in Global Health