User:Thomas Simbo K./Telehealth

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Major implications and impacts

Telehealth allows multiple, varying disciplines to merge and deliver a potentially more uniform level of care, using technology. As telehealth proliferates mainstream healthcare, it challenges notions of traditional healthcare delivery. Some populations experience better quality, access and more personalized health care.

Health promotion

See also: Health promotion

Telehealth can also increase health promotion efforts. These efforts can now be more personalised to the target population and professionals can extend their help into homes or private and safe environments in which patients of individuals can practice, ask and gain health information. Health promotion using telehealth has become increasingly popular in underdeveloped countries where there are very poor physical resources available. There has been a particular push toward mHealth applications as many areas, even underdeveloped ones have mobile phone and smartphone coverage.

In a 2015 article reviewing research on the use of a mobile health application in the United Kingdom, authors describe how a home-based application helped patients manage and monitor their health and symptoms independently. The mobile health application allows people to rapidly self-report their symptoms - 95% of patients were able to report their daily symptoms in less than 100 seconds, which is less than the 5 minutes (plus commuting) taken to measure vital signs by nurses in hospitals. Online applications allow patients to remain at home to keep track of the progression of their chronic illnesses. The downside of using mHealth applications is that not everyone, especially in developing countries, has daily access to internet or electronic devices.

Limitations and restrictions

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A major legal action prompt in telehealth thus far has been issues surrounding online prescribing and whether an appropriate clinician-patient relationship can be established online to make prescribing safe, making this an area that requires particular scrutiny. It may be required that the practitioner and patient involved must meet in person at least once before online prescribing can occur, or that at least a live-video conference must occur, not just impersonal questionnaires or surveys to determine need.

Telehealth has some potential for facilitating self-management techniques in health care, but for patients to benefit from it, the appropriate contact with, and relationship, between doctor and patient must be established first. This would start with an online consultation, providing patients with techniques and tools that help them participate in healthy behaviors, and initiating a collaborative partnership between health care professionals and patient. Self-management strategies fall into a broader category called patient activation, which is defined as a “patients' willingness and ability to take independent actions to manage their health.” It can be achieved by increasing patients’ knowledge and confidence in coping with and managing their own disease through a “regular assessment of progress […] and problem-solving support.” Teaching patients about their conditions and ways to cope with chronic illnesses will allow them to be knowledgeable about their disease and willing to manage it to improve their everyday life. Without a focus on the doctor-patient relationship and on the patient's understanding, telehealth cannot improve the quality of life of patients, despite the benefit of allowing them to do their medical check-ups from the comfort of their home.

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We must also be wary of equitability. Many families and individuals in the United States and other countries do not have internet access in their homes. Not to mention they may lack the necessary equipment to access telehealth services, such as a laptop, tablet, or smart phone.

Developing countries

[..] However, provision of telemedicine and eHealth from urban centers or from other countries is hampered by the lack of communications infrastructure, with no landline phone or broadband internet connection, little or no mobile connectivity, and often not even a reliable electricity supply.

Telemedicine in developing countries

Telemedicine in India

Similarly, India have broad rural-urban population and rural India is bereaved from medical facilities, giving telemedicine a space for growth in India.

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Telemedicine in Sub-Saharan Africa

Travel time to the nearest health-care facility by sub-Saharan African region, for adults aged 60 years or older.

Sub-Saharan Africa is marked by the massive introduction of new technologies and internet access. Urban areas are facing a rapid change and development, and access to internet and health is rapidly improving. Populationin remote areas however, still lack access to healthcare and modern technologies. Some people in rural regions must travel more between 2 and 6 hours to reach the closest healthcare facilities of the country, leaving room for telehealth to grow and reach isolated people in the near future.

Internet via satellite in rural areas

The Satellite African eHEalth vaLidation (SAHEL) demonstration project has shown how satellite broadband technology can be used to establish telemedicine in such areas. SAHEL was started in 2010 in Kenya and Senegal, providing self-contained, solar-powered internet terminals to rural villages for use by community nurses for collaboration with distant health centers for training, diagnosis and advice on local health issues. Those methods can have major impact on both health professionals to get and provide training from remote areas, and also on the local population who can receive care without traveling long distances. Some non-profits such as the Christian organization Mission Aviation Fellowship (MAF) provide internet to rural places around the world using a mobile VSAT terminal. This VSAT terminal equips remote regions allowing them to alert the world when there is a medical emergency, resulting in a rapid deployment or response from developed countries. Technologies such as the ones used by MAF allows health professionals in remote clinics to have internet access, making consultations much easier, both for patients and doctors.