Telehealth Technology: What’s Under the Hood?
Imagine you didn’t have to leave home to consult your doctor, to get educated about proper treatment, or to monitor your vital signs. State-of-the-art technology has changed the way we live, and now that mobile devices and the Internet of Things (IoT) are on the map, telehealth can bridge the distance between doctors and their patients, especially in remote areas or when servicing patients with long-term conditions.
What Is Telehealth?
Telehealth is a relatively new, modern form of health care services delivery. The Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services defines telehealth as “the use of electronic information and telecommunications technologies to support and promote long-distance clinical health care, patient and professional health-related education, public health, and health administration”. Telehealth, also known as telemedicine, is 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 used mainly in the UK and Europe that includes telehealth, electronic medical records, and other components of health information technology.
Telehealth technologies include:
· store-and-forward imaging,
· streaming media, and
· terrestrial and wireless communications.
The history of telemedicine technology goes back to the twentieth century. Telemedicine gained momentum in the 1960s when NASA started using it in spacecrafts 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 the situation has changed substantially – telehealth offers a modern form of healthcare services 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. 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 2016 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 percent 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 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 options 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.
Want to know more? Check out how you can manage your health and well-being better using telehealth technologies.
Four Types of Telehealth
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. See a short educational video, Telehealth Saves Lives, by The Center for Connected Health Policy.
Of course, 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.
- Video-based virtual doctor visits allow provision of healthcare services in isolated communities and remote regions where there is no clinician available
- Video chats are a good alternative for home-bound patients
- Video conferences facilitate doctors’ collaboration for remote diagnosis and patient treatment
- Video-based interactions allow primary care physicians to replay patient visits when necessary
- 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
- Technology is dependent on power supply and proper internet connection
- Specialized data management equipment is necessary
- Technology requires technical training
- Not all insurance policies cover telemedicine
Examples of live video telehealth technologies include:
- 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.
What’s next? The next type of telehealth services uses recorded information.
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 percent of consumers feel comfortable communicating with doctors via text, email, and video instead of seeing them in person. And 63 percent 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:
- Healthcare professionals from several hospitals can share information and discuss patient issues as if they were in the same place
- MRIs and X-rays can be transmitted to specialists for a second opinion
- Electronic health records are always accessible
- Compliance with HIPAA laws, which aim to prevent private or secure medical documents from being leaked
- Improved professional education
- Low-quality records (X-ray and other images) pose a risk of faulty clinical treatment
- Low internet speeds or server problems can make virtual communication impossible
- Store-and-forward systems cannot provide immediate treatment
- Requires a high-quality security module in every such software solution
Store-and-forward telehealth solutions include:
- Collaborative patient assessment applications for capturing and sharing medical exam information
- Web-based systems for information exchange
- EHR systems
- Mobile applications for uploading data
The next telehealth modality is widely used for the care of chronically ill patients.
Remote patient monitoring (RPM) involves collection and transmission of patient’ 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 show a:
- 15% reduction in visits to A&E (accident and emergency centers)
- 20% reduction in emergency admissions
- 45% reduction in mortality rates.
Check out some pros and cons of RPM:
- Extra attention to at-risk patients and early detection of deterioration
- Continuity of care after leaving hospital and possibility to adjust prescriptions
- Proactive communication between doctors and patients
- Education and support of patients with chronic illnesses
- Better nurse availability
- Greater patient engagement
- Special medical devices necessary for monitoring vital data; monetary investments are needed
- Safe data transmission is still a problem
- More specialists needed to process and interpret data
- Possible faults with monitoring devices
Examples of telemedicine technologies include:
- 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 an mHealth gateway or hub
- Mobile applications and specialized platforms
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, and by 2018 there will be over one billion mHealth users.
- Improved data accuracy and access
- Facilitates better diagnosis
- Focus on personalized precise medicine and better preventive and predictive functionalities
- Great management for chronic illnesses
- Support for workflow of clinical practitioners
- Encourages better patient commitment
- Data security is not always provided
- No unified, formalized systems (for now); no integration with existing IT systems
- Apps must be updated to stay relevant
mHealth solutions include:
- Mobile-enabled connected medical devices
- Mobile apps
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.
Want to know 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 some feedback from you to:
1. Find out what features you need in your solution and define objectives.
2. Define the user experience and choose an app design that will increase user adoption and create a competitive advantage.
3. Clear up potential regulatory challenges so that your developers can adapt your solution for the next generation of healthcare.
How much will a telehealth app cost?
Fact: outsourced development is cheaper than developing in the US or in Europe. The cost of development depends on several factors:
- Type of service you want to provide
- Whether this service is a completely new solution or is an add-in to an existing solution
- Number of features you want
The price ranges provided below are just ballpark estimates. Keep in mind that the final cost will depend on specific software features, and can change dramatically either upward or downward especially when dealing with incremental development by prototype, MVP, and product stages.
For telehealth and wellness video conferencing apps, the common solution is an add-in to existing software.It’s possible to embed video chat features in several ways:
- Make a plug-in for existing cloud solutions like Zoom or Webex. This is the fastest way to get your own video conferencing solution, as simple integration will take about a month and does not overload servers. Later on, however, you will have to subscribe to the cloud service on a constant basis.
- Deploy your own server for video streaming based on existing free or pay servers. The advantage of this solution is that it’s almost free to use (excluding the costs of support and extra server capacity) and offers good opportunities to customize. 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.
The price range here may be $20–40K, and the development timeline is 2–5 worker-months.
As for store and forward solutions, such solutions can look like online patient accounts containing electronic health records and providing doctors with access to this information. Store and forward systems are complex, often involving both mobile and desktop versions, must meet HIPAA requirements, and require deep customization and integration for particular clinics.
Depending on the features needed to get an MVP, the development of a multichannel PHI big data collection, aggregation, processing, and analysis system can take six months or more by a team of specialists. This puts the price range around $150–250K, and the development timeline at around 10–20 worker-months.
It’s commercially reasonable to develop a solution as a platform with further customization available for particular clinics, as the development cost is quite high and the payback for a single clinic is low.
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, including recommendations;
- optional features such as involving specialists (doctors, consultants, nurses) to give recommendations and instructions, or connection to a clinic’s existing online patient accounts.
Depending on the features desired, the cost to develop a system for remote patient health and state tracking (via wearable devices and behavioral analysis) can vary significantly. But the initial features of patient data collection and sending data to the server can take 1–2 months of development, and other features are heavily reliant on business needs. For such a system, development costs range from $60–80K, and the development timeline is 6–8 worker-months.
Click here to learn more about developing telehealth solutions.