Introduction
The Telehealth system uses modern technologies and telecommunications for the remote provision of medical services. For instance, due to videoconferencing, medical workers can not only examine patients remotely but also conduct medical consultations, collect anamnesis, request and send information about the course of diseases, and prescribe treatment. Telehealth systems currently encompass self-education, health care management, research, and development; they have already become standard services. Since most medical specialists in various healthcare fields operate in particular medical centers in cities, this has led to an inevitable medical care centralization.
In recent years, telemedicine has acquired the position of one of the most promising areas in American healthcare development. There are several factors determining the growing popularity of this method of providing medical services at home. The main reason for it is the fact that telemedicine is convenient; it saves time and additional costs and is available to everyone who has Internet access. This paper aims to analyze several pieces of research providing various data about the usage of telehealth systems.
Annotated Bibliography
Lee, P. A., Greenfield, G., & Pappas, Y. (2018). The impact of telehealth remote patient monitoring on glycemic control in type 2 diabetes: A systematic review and meta-analysis of systematic reviews of randomized controlled trials. BMC Health Services Research, 18, 495. Web.
This study aims to examine randomized controlled trials to formulate an evidence-based telehealth systems’ effectiveness on glycemic administration in patients with type 2 diabetes. The article includes relevant systematic reviews issued between 1990 and 2016, supplemented by evidence from the appropriate assessments (Lee et al., 2018). Methods such as pairwise and network meta-analyses were conducted. The principal purpose of type 2 diabetes treatment is to maintain blood sugar levels as close to normal as possible.
Monitoring glycemic control allows a patient and a medical specialist to assess the disease’s treatment’s accuracy. If the level exceeds the glycaemic target, then there are risks of developing macrovascular and microvascular diseases (Lee et al., 2018). The study shows that telemedicine provided a small but significant improvement in HbA1c levels correlated with usual care (MD: -0.55, 95% CI: -0.73 to − 0.36) (Lee et al., 2018). It is necessary to evaluate telemedicine’s effectiveness in a larger sample and study the duration of the effect after the intervention.
Considering the fact that diabetes is a chronic disease that requires long-term outpatient follow-up, its effective therapy at the current level requires self-monitoring of blood glucose. Patients using the telehealth system can determine their outpatient glucose profile, a glucose index condition during a day that indicates trends and potential problems (Lee et al., 2018). Patient education and organization of the glycemic self-control process are an essential element of long-term disease management in diabetes mellitus. An individualized approach to self-control consists of several collaboration stages between a medical specialist and a patient (Lee et al., 2018). However, this control does not improve compensation; a patient should use telehealth data to make the right decisions regarding vital actions for the treatment of diabetes, including nutrition, physical activity, and a dose of antidiabetic drugs (Lee et al., 2018). In this case, telemedicine will have the most significant impact on therapy outcomes.
Lang, R. L., Wilson, C., Stockton, K., Russell, T., & Johnston, L. M. (2019). CyFiT telehealth: Protocol for a randomized controlled trial of an online outpatient physiotherapy service for children with cystic fibrosis. BMC Pulmonary Medicine, 19, 21. Web.
This research intends to evaluate the efficacy of a telehealth outpatient physiotherapy service (CyFiT OPS) on patient quality of life, clinical effectiveness, and cost-effectiveness of healthcare delivery. This study is a randomized, controlled, and non-inferiority trial to select well above 100 children with cystic fibrosis from 8 to 18 years old (Lang et al., 2019). This application intends to provide access to telemedicine services and enable people to monitor their health autonomously.
The goal of creating a self-monitoring system for this disease is to help patients to decrease the number of time-consuming visits to clinics and to detect deterioration in health promptly so that treatment can begin as early as possible. Cystic fibrosis, a severe genetic disease caused by a mutation in one of the genes, disrupts the transmembrane conductance regulator’s structure and function (CFTR) (Lang et al., 2019). Telehealth systems provide services for several self-control methods; first of all, they help since systems are used to measure respiratory rate during sleep and chest mobility, measuring the chest’s circumference (Lang et al., 2019). It is useful for peak flowmetry; measurements are carried out two times a day (Lang et al., 2019). Self-control can tolerate provoking factors, as their exacerbation directly affects the patient’s well-being (Lang et al., 2019). Moreover, it indicates the amount of sputum, its purulence, which most likely shows a deterioration of the process and a need for antibacterial therapy.
The telehealth outpatient physiotherapy service allows people with cystic fibrosis to monitor their health with devices that measure vital indicators such as lung function, blood oxygen levels, and activity (Lang et al., 2019). With this data, the physician can identify trends and track when the person’s condition begins to deteriorate. By observing their data, patients can start to take action at an earlier stage and possibly prevent serious lung infections; improved screening and therapy have significantly increased life expectancy. However, the illness treatment requires daily medication and is often unpredictable, introducing various unexpected changes and disruptions to patients’ lives. It also necessitates hospital visits every four to six weeks, which takes most of the day and requires a multidisciplinary team of specialists.
Toniazzo, M. P., Nodari, D., Muniz, F. W. M. G., & Weidlich, P. (2019). Effect of mHealth in improving oral hygiene: A systematic review with meta‐analysis. Journal of Clinical Periodontology, 46(3), 297−309. Web.
Telemedicine in dentistry is an innovative way of serving patients to reduce costs and therefore price for clients. The research, provided by Toniazzo et al. (2019), is a randomized clinical trial assessing the use of mobile applications linked to oral hygiene and education. The study has shown that preventive examinations using special visualizing devices with the transmission of information via telemedicine channels can reduce the number of visits to departments and emergency departments of dental care by 19% (Toniazzo et al., 2019). The ubiquitous use of smartphones has been accompanied by an increased number of medical applications.
The findings suggest that applications with more comprehensive functionality are more efficient. The study also measured the ease of usage of the applications and user satisfaction with their performance (Toniazzo et al., 2019). Applications are user-friendly; for example, some of them are developed by dentists, being suitable for anyone who wants to improve oral health by maintaining hygiene and fresh breath (Toniazzo et al., 2019). At the same time, the popular functions, as expected by the developers of mHealth applications, in the next five years will be monitoring, diagnostics, management of the patient’s health, medical consultations, and data recording.
With regard to the high prevalence of tooth decay and periodontal diseases, dentists strive to use all existing methods of prevention to anticipate dental conditions and reduce the intensity of their progression. One of the most effective and the most uncomplicated affordable measures for preventing these diseases is the correct and effective care of the teeth, using the entire amount of current means.
Koehler, F., Koehler, K., Deckwart, O., Prescher, S., Wegscheider, K., Kirwan, B. A., Winkler, S., Vettorazzi, E., Bruch, L., Oeff, M., Zugck, C., Doerr, G., Naegele, H., Stork, S., Butter, C., Sechtem, U., Angermann, C., Gola, G., Prondzinsky, R., … Stangl, K. (2018). Efficacy of telemedical interventional management in patients with heart failure (TIM-HF2): A randomized, controlled, parallel-group, unmasked trial. The Lancet, 392(10152), 1047−1057. Web.
The TIM-HF2 study compared the conventional management of patients with chronic heart failure (CHF) with the methods of using standard observations and those based on telemedicine’s capabilities. The study included 1571 patients of II – III functional class hospitalized for CHF within the last 12 months; the observation period was about a year (Koehler et al., 2018). Each Charité study patient was monitored over the phone by a doctor as a contact person. People had a so-called safety net, where they entered daily measurements (Koehler et al., 2018). Due to this action, the patient’s lifestyle is changed, the dose of regularly taken drugs and the number of drinks consumed were adjusted. The data arriving at the telemedicine center was processed using specially developed software.
Based on the data obtained, including the level of several biomarkers, the telemedicine center personnel, specializing in the management of patients with CHF, gave particular recommendations following predetermined algorithms. Distant monitoring of patients with CHF in the TIM-HF2 study showed that telemedicine technologies could help identify early signs of decompensation before forming a full-fledged clinical manifestation (Koehler et al., 2018). In turn, changing therapy in the early stages of circulatory failure decompensation is useful in terms of reducing the need for hospitalization.
Technologies open up new possibilities for remote monitoring of patients with cardiovascular diseases and increase the efficiency of treatment and medical care availability. Medical specialists recommended adjusting the drug dose over the phone or sent an ambulance team to the patient. Koehler et al. (2018) emphasized that with such knowledge, they predicted a deterioration in the patient’s well-being in advance, even before patients complained of apparent symptoms. The choice of device depends on the study’s purpose, the patient’s ability to self-control, and economic opportunities. The problem of people suffering from heart failure is that they cannot recognize the deterioration at early stages, appearing in the disease’s course—the purpose of the telemedicine-system is to monitor cardiac activity and timely response.
Conclusion
In most countries of the world, the tendency of the government to spend more money on the healthcare system continues to rise. The use of telemedicine will optimize these costs in the long-term perspective. The main advantages of telemedicine are a decrease in the number of medical errors. It also saves time for patients and specialists, increasing medical institutions’ efficiency. Moreover, telehealth provides timely and high-quality assistance for significant portions of the population living in geographically remote areas with difficult socio-economic conditions, particularly rural ones.
Specialists of various medical fields can be involved in conducting telehealth services. The examined studies show that telemedicine has become part of clinical centers’ treatment process to accelerate service and optimize the patient’s well-being. Telemedicine is actively developing; it is often considered an independent market for providing online consultations, but it cannot exist without medical organizations’ treatment. In present days, the COVID-19 pandemic has led to a virtual suspension of routine medical care for millions of patients, creating additional risks of increased morbidity, complications, and mortality. Telemedicine is a promising area that can radically change the healthcare sector in the country.
References
Koehler, F., Koehler, K., Deckwart, O., Prescher, S., Wegscheider, K., Kirwan, B. A., Winkler, S., Vettorazzi, E., Bruch, L., Oeff, M., Zugck, C., Doerr, G., Naegele, H., Stork, S., Butter, C., Sechtem, U., Angermann, C., Gola, G., Prondzinsky, R., … Stangl, K. (2018). Efficacy of telemedical interventional management in patients with heart failure (TIM-HF2): A randomised, controlled, parallel-group, unmasked trial. The Lancet, 392(10152), 1047−1057. Web.
Lang, R. L., Wilson, C., Stockton, K., Russell, T., & Johnston, L. M. (2019). CyFiT telehealth: Protocol for a randomised controlled trial of an online outpatient physiotherapy service for children with cystic fibrosis. BMC Pulmonary Medicine, 19(21). Web.
Lee, P. A., Greenfield, G., & Pappas, Y. (2018). The impact of telehealth remote patient monitoring on glycemic control in type 2 diabetes: A systematic review and meta-analysis of systematic reviews of randomised controlled trials. BMC Health Services Research, 18, 495. Web.
Toniazzo, M. P., Nodari, D., Muniz, F. W. M. G., & Weidlich, P. (2019). Effect of mHealth in improving oral hygiene: A systematic review with meta‐analysis. Journal of Clinical Periodontology, 46(3), 297−309. Web.