Telehealth technology: What’s under the hood?

Archer blog - Telehealth platforms and how to build your own
Now that mobile devices and the Internet of Things (IoT) are an integral part of our lives, telehealth can reduce the distance between doctors and their patients, especially in remote areas or when treating patients with long-term illnesses, as well as become a stand-alone option of the healthcare delivery. Let's take a brief look at the types of telemedicine solutions and their functions, as well as discuss ways to create your own telemedicine product.

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What is telehealth?

Telehealth is a relatively new form of health care delivery, but getting extremely wide-spread especially amid worldwide healthcare crises. Telehealth solutions are used to save people’s lives in emergency situations and for critical care, too. Another related term is eHealth, which Wikipedia defines as an umbrella term that includes telehealth, electronic medical records, and other components of health information technology.

Telehealth technologies include:

  • videoconferencing,
  • store-and-forward imaging,
  • streaming media,
  • terrestrial and wireless communications.

Telemedicine gained momentum in the 1960s when NASA started using it in spacecraft and spacesuits to monitor astronauts in space, and since then telemedicine technologies and other technological advancements have spread around the world. Traditionally, telehealth services were used for specialist treatment.

Clinicians provided consultations to their colleagues and patients using wireless communication for transmitting X-ray images, electrocardiographs, and other patient information, and using web chats to talk to their patients. But now answering the challenges of today's situation telehealth offers a stand-alone self-sufficient form of healthcare service delivery and a new way for patients to manage their health and well-being.

Now that mobile and medical technologies are quickstepping, new medical devices are smaller in size and provide a greater scope of features, and with faster internet connection provided by 4G and 5G networks. Various affordable wearables like heart rate monitors, glucose monitors, temperature monitors, fitness wristbands, and smartwatches track patients’ vitals and are able to transmit that data in real-time.

According to the Pricewaterhouse Cooper Consumer Intelligence Series survey on wearables, the primary motivator for buying and using wearable gadgets is health. The study also says that people have more trust in doctors and hospitals that are using wearables to monitor patients’ conditions.

Another fact revealed in the “State of the Connected Patient” report by Salesforce is that younger patients are more keen on using digital health tools to stay in touch with their doctors. According to this report, 60% of millennials would prefer using telehealth options like video chats and telemedicine patient engagement platforms that provide nearly 24/7 access to health care services from home, work, or even on the road.

There’s no doubt about it – innovations are at the heart of the healthcare industry, and they allow modern medicine to be more interactive and accessible for patients who have certain problems with mobility due to physical or mental health conditions, remote locations, or financial limitations.

Telehealth solutions can be used to:

  • assist with diagnosis,
  • follow-up care,
  • appointments,
  • therapy,
  • education, and more.

And it’s clear that telehealth solutions can be categorized based on the types of services they offer and the way those services are delivered. The Center for Connected Health Policy (CCHP) subdivides telehealth modalities into four groups according to their domains of application.

Four types of telehealth solutions

Live videos and video chats

Live video (synchronous) services offer live, video-based interactions between a patient and a caregiver (doctor, nurse, or service provider). This is a real-time online service that can be a substitute for in-person communication with clinicians when it’s not possible to visit a doctor in person. Live video can be used for consultations, patient observation, patient monitoring, health education, and training.

Live video telehealth services furnish certain benefits both for patients and for doctors, including better accessibility and lower costs. But like any other service, they have some disadvantages due to their nature.

Pros

Cons

Video-based virtual doctor visits allow the provision of healthcare services in isolated communities and remote regions where there is no clinician availableTechnology is dependent on the power supply and proper internet connection
Video chats are a good alternative for home-bound patientsSpecialized data management equipment is necessary
Video conferences facilitate doctors’ collaboration for remote diagnosis and patient treatmentTechnology requires technical training, especially for elderly citizens
Video-based interactions allow primary care physicians to replay patient visits when necessaryNot all insurance policies cover telemedicine
Video calls are convenient for patients who don’t have enough time to visit a doctor in person and or who don’t like to waste time in a waiting room 

Examples of live video telehealth technologies:

  • Online video conferencing systems for medical check-ups, therapy sessions, and patient visits
  • Patient assessment applications for clinicians, allowing capturing and sharing of medical examination information
  • Video systems for group practices
  • Patient portals
  • Mobile platforms

As a rule, the deployment model used for these solutions is cloud, SaaS, and web technologies as well as via mobile (Android and iOS) applications.

Store-and-forward telemedicine systems

Store-and-forward (asynchronous) systems support collection, recording, and transmission of health history data through a secure electronic communications system to a specialist to evaluate the case or to render a service outside of the live interaction. See CCHP’s micro-documentary Telehealth and Access to Care about possible uses of this service.

The results of Cisco’s Global Customer Experience Report Focused on Health Care show that people’s attitudes toward personal data and telemedicine have shifted significantly. Today, 70% of consumers feel comfortable communicating with doctors via text, email, and video instead of seeing them in person. And 63% of surveyed respondents say they are satisfied with storing their medical records in the cloud.

There are distinct advantages to store-and-forward systems, such as improved access to information and better communication between patients and practitioners, but there are also disadvantages due to the fact this technology is still evolving:

Pros

Cons

Healthcare professionals from several hospitals can share information and discuss patient issues as if they were in the same placeLow-quality records (X-ray and other images) pose a risk of faulty clinical treatment
MRIs and X-rays can be transmitted to specialists for a second opinionLow internet speeds or server problems can make virtual communication impossible
Electronic health records are always accessibleStore-and-forward systems cannot provide immediate treatment
Compliance with HIPAA laws, which aim to prevent private or secure medical documents from being leakedRequires a high-quality security module in a software solution
Improved professional education 

Examples of store-and-forward telehealth solutions:

Remote patient monitoring (RPM)

This telehealth modality is widely used for the care of chronically ill patients. Remote patient monitoring (RPM) involves the collection and transmission of patient’s data to a provider in a separate location for care or support. RPM provides patients with more control and a better understanding of their health conditions, while clinicians using RPM telehealth technologies can address any negative changes in a timely fashion and improve their patients’ quality of life.

According to the Telecare Services Association, telehealth services, when used correctly, can substantially benefit patients. The association’s data shows:

  • 15% reduction in visits to A&E (accident and emergency centers);
  • 20% reduction in emergency admissions;
  • 45% reduction in mortality rates.

Pros

Cons

Extra attention to at-risk patients and early detection of deteriorationSpecial medical devices necessary for monitoring vital data; monetary investments are needed
Continuity of care after leaving the hospital and the possibility to adjust prescriptionsSafe data transmission is still a problem
Proactive communication between doctors and patientsMore specialists needed to process and interpret data
Education and support of patients with chronic illnessesPossible faults with monitoring devices
Better nurse availability 
Greater patient engagement 

Examples of remote patient monitoring solutions: 

  • Special devices and sensors with embedded cellular chips that transmit biometric data to servers or to the cloud
  • Medical devices with short-range sensors that wirelessly connect with a mHealth gateway or hub
  • Mobile applications and specialized platforms

Mobile health (mHealth)

The last but most widespread type of telehealth service is mobile health. Mobile health (or mHealth) means health care and public health practice and education through smart devices and wearable technologies. According to the US Food and Drug Administration (FDA), about 500 million people all over the world are already using personal healthcare apps.

ProsCons
Improved data accuracy and accessData security is not always provided
Facilitates accurate diagnosisNo unified, formalized systems (for now); no integration with existing IT systems
Focus on personalized precise medicine and better preventive and predictive functionalitiesApps must be updated to stay relevant
Great management for chronic illnesses 
Support for the workflow of clinical practitioners 
Encourages better patient commitment 

Examples of mHealth solutions:

  • Mobile-enabled connected medical devices
  • Mobile wellness apps
  • Wearables

It’s clear enough that the growth of mobile device technologies is where the future of medicine lies, and it’s time to use these technologies to reach consumers, i.e. patients.

How to develop your own telehealth solutions?

Telehealth solutions not only facilitate the workflow of healthcare services, foster professional and patient education, and increase specialist collaboration, but also allow remote doctors to monetize their assistance. Now is a good time to use telehealth solutions to reach consumers and increase their loyalty.

Software development companies can offer you various solutions, but they will always need your input on:

  • Features you need in your solution and business objectives you want to achieve through them;
  • User experience and preferred app design;
  • Potential regulatory requirements you want your solution to comply with.

Here're a few examples of how the telehealth solutions could be built:

For telehealth and wellness video conferencing apps, the solution could be developed as an add-on to the existing third-party service. It’s possible to embed video chat features in several ways:

  • A plug-in for existing cloud solutions like Zoom or Webex is a fast way to get your own video conferencing solution, as your team will build an integration rather than a whole solution from scratch. You will also exploit the IT infrastructure of the third-party vendor, which could be a good cost saver, but the quality and accessibility of your service will be completely dependent on the third party too.
  • The advantage of deployment on your own server for video streaming is that despite the additional costs of extra server capacity support you are in full control over the provision of your services and are able to customize everything according to your needs. The disadvantages are obvious: big initial investments for server configuration and integration, involving several specialists’ work over several months and, possibly, purchase of a license if a paid solution is chosen.
Ebook - How to build your own Telehealth app

Store-and-forward solutions can look like cloud databases containing electronic health records of the patients and allowing doctors with access to them. Store-and-forward systems are complex, often involving both mobile and desktop versions, must meet HIPAA provisions and require deep customization and integration with various data sources, unified algorithms of collection, aggregation, processing, and analysis.

Remote patient monitoring systems using various portable devices and wearables involve several processes:

  • data collection through a device and data transfer to a server;
  • data aggregation and visualization in an easy-to-use format;
  • optional features such as involving specialists (doctors, consultants, nurses) to give recommendations and instructions, or connection to a clinic’s existing online patient accounts.

How much will a telehealth app development cost?

Outsourced development is cheaper than hiring an in-house team and developing the solution in the US or in Europe. But even if you build a cost-efficient team yourself there's always a question of how versatile the team's experience would be. With a reliable outsourcing partner, you can be sure that whenever you need an engineer bearing knowledge of a very specific tech stack, they will either offer you one instantly as they have them on the team already or staff much quicker and with less pain than you could do on your own.

The cost of development depends on several factors:

  • The complexity of the technological architecture,
  • Business and technological risks,
  • Building the solution from scratch or dealing with legacy code and refactoring,
  • Number of features you want,
  • Intended timeline of the project.

In simple words, the faster you need to have the product built, the more people you would need on the team, and the more complex the architecture and features are, the more rare and more expensive tech talents will have to be hired. 

It's wise to invest most in the business analysis phase at this point: get a team of business and system analysts do the research, validate your product idea with users and stakeholders, develop the system architecture, discover and evaluate risks, define what would be the right team setup and only then provide you with the estimates of the project budget

Contact us at info@archer-soft.com to learn more.

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