Telehealth in the COVID Era

Abstract

Introduction: There has been an unprecedented growth in the use of telehealth throughout the COVID 19 pandemic. Telehealth has enabled the delivery of essential healthcare services via remote consultations, while reducing physical contact with healthcare providers. Although the advantages of delivering healthcare to patients in their own home are undeniable, it is important to be mindful of the associated risk to the quality of care and the need for robust clinical governance. Aims Objectives Theory or Methods: Telehealth provides accessible patient centred care through the use of video consultations, telephone calls, email or text messaging systems. It overcomes geographical barriers and is time efficient for both patients and clinicians alike. Its use is widespread in primary care, secondary care and in the community. However, implementation may be challenging as it requires changes to clinical processes, information technology, data protection and administrative processes. It is also important to recognise that telehealth is not appropriate for all consultations due to clinical need or patient preference. Some patient groups may be less digitally literate and may require more assistance. Highlights or Results or Key Findings: It is essential that clinicians adopt a comprehensive framework for the clinical and operational use of telehealth, to ensure patient safety and quality of care are maintained. Several frameworks have been devised for the best practice use of telehealth. For example the American Telemedicine Association Standards Framework, American Medical Association Digital Health Implementation Playbook, National Health Service (NHS) Guide to Good Practice for Digital Health and Data Driven Health Technologies or the Irish Medical Council Telemedicine Phone and Video Consultations Guide for Doctors. Irrespective of the framework used, the fundamental principles of professionalism, consent, confidentiality, record keeping and accountability are common to all. Conclusions: Telehealth enables healthcare providers to maintain continuity of care while reducing unnecessary visits to healthcare environments. This supports public health mitigation measures and minimises the risk of transmission of COVID 19 to patients and healthcare providers. Implications for applicability/transferability sustainability and limitations: Moving forward the challenge will be to integrate telehealth into existing health infrastructure in a secure manner.