Reflect on how as health administrators we can best support patients using technology in the present and the future. How does this benefit organizations and what are potential obstacles?
Running head: TELEMEDICINE & COVID-19
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Telemedicine & COVID-19
Vinsetta Buford
American Military University
HCAD 501: Technology Applications in Healthcare Organizations
Dr. Jeremy Howell
07 Aug 2023
TELEMEDICINE & COVID-19
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The Evolution and Impact of Telemedicine: Pre-COVID-19 Era to the Present and Beyond
The COVID-19 pandemic was crucial in telemedicine’s growth from a specialized
technique to a general healthcare delivery paradigm. Telemedicine provides medical treatments
remotely using telecommunications technologies (Jagarapu & Savani, 2021). This research aims
to investigate the pre-pandemic environment of telemedicine, the challenges it faced, the causes
promoting its widespread adoption during the pandemic, the methods used to allay early
concerns, and the future course of telemedicine. This study attempts to give a complete overview
of the history of telemedicine, its pandemic-induced metamorphosis, and the opportunities it has
for influencing the future of healthcare delivery by looking at these factors.
Utilization of Telemedicine Prior to the COVID-19 Pandemic
Before the COVID-19 pandemic, telemedicine had a tiny foothold in the United States.
Despite its promise to revolutionize healthcare delivery, its acceptance and incorporation into
standard medical practices have been constrained by several problems. The absence of uniform
coverage policies across insurers and states was a significant hurdle. Healthcare professionals
and patients alike experienced ambiguity due to differences in how telemedicine services were
paid for and reimbursed (Metzger et al., 2021). The need for standardized coverage hampered the
motivation for medical practices to invest in telemedicine infrastructure and provide these
services on a larger scale.
Additionally, one of the significant challenges was the high initial expenses related to
telemedicine systems. Healthcare organizations had to pay for technology acquisition and
integration, personnel training, and regulatory compliance. These expenses often prevented many
smaller practices with insufficient resources from pursuing telemedicine, preventing
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telemedicine’s widespread acceptance. The need for process modifications within healthcare
institutions partly influenced the moderate use of telemedicine. It was necessary to reevaluate
patient management procedures, appointment scheduling, data exchange, and clinician-patient
interactions to integrate telemedicine into current workflows (Metzger et al., 2021). Such
changes presented difficulties in terms of time and effort, further impeding rapid and extensive
integration.
The slow adoption of telemedicine was primarily due to clinician acceptability and
preparation. Many medical professionals were used to receiving consultations and treatments in
person. Some doctors were unwilling to adapt to the learning curve and change in practice
dynamics that came with the transition to virtual care. Both patient participation and interest
were essential components. While some patients were anxious to investigate the practicality of
telemedicine, others had doubts about the kind of care they could get from a distance (Jagarapu
& Savani, 2021). Additionally, some people were deterred from using virtual healthcare services
by worries about data security and privacy.
Barriers and Concerns
The use of telemedicine encountered several obstacles prior to the COVID-19 epidemic
that prevented its mainstream acceptance. Patients and healthcare professionals were concerned
about the security of sensitive medical information conveyed via digital means, which raised
privacy issues. Medical personnel struggled with fragmented technological interfaces that made
it challenging to coordinate patients’ treatment effectively, which made the absence of seamless
interaction with current healthcare systems an even more significant barrier to telemedicine
adoption (Metzger et al., 2021).
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Furthermore, a significant barrier was the need for more data exchange for ongoing
patient care. The anticipated advantages of telemedicine in permitting smooth transitions
between virtual and in-person treatment remain to be met, given the absence of solid methods for
exchanging patient data across multiple healthcare contexts (Curfman et al., 2021). The
widespread lack of understanding of telemedicine services among medical professionals and
patient groups has hampered its adoption as a practical substitute for conventional in-person
treatment.
Technical literacy gaps among patients have become a significant worry, especially for
older adults or those needing more digital technology exposure. It was not always easy for
people to use telemedicine platforms and participate successfully in remote consultations,
thereby excluding disadvantaged groups from this method of healthcare delivery (Metzger et al.,
2021). Additionally, the expensive initial cost of implementing technology served as a
disincentive for healthcare organizations, especially smaller practices, which struggled with
financial limitations that prevented the adoption of telemedicine solutions.
Widespread Adoption of Telemedicine during the Pandemic
The COVID-19 pandemic was a pivotal turning point in healthcare delivery, necessitating
quick adjustments to protect patient safety and unrestricted access to vital medical treatment.
Telemedicine, which had previously served as a complementary tool but has now seen a boom in
usage, has emerged as an essential answer to this situation. Changes in federal and state policy
were essential to this development. An easing of constraints on Medicare telehealth coverage
was the federal government’s reaction. This critical decision reduced the danger of exposure by
allowing people to seek medical care from the comfort of their homes. In parallel, regulatory
agencies like the Drug Enforcement Administration (DEA) and the Department of Health and
TELEMEDICINE & COVID-19
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Human Services (HHS) acknowledged the gravity of the issue. They temporarily relaxed
telehealth-related rules (Curfman et al., 2021). More adaptable telemedicine procedures were
made possible by the HHS’s decision to waive the enforcement of some Health Insurance
Portability and Accountability Act (HIPAA) provisions, and patients’ access to medications was
uninterrupted thanks to the DEA’s relaxation of e-prescribing rules for controlled substances.
States have shown their dedication to increasing the use of telehealth by proposing
several initiatives. In order to ensure that disadvantaged people may continue to obtain medical
treatment without putting themselves in excessive danger, this included the extension of
Medicaid telehealth coverage. Many governments have relaxed licensing requirements to address
the provider side of the issue, allowing medical professionals to deliver telemedicine services
across state boundaries (Charman et al., 2021). States also encouraged the use of telemedicine by
recognizing the value of written permission in the context of online healthcare services.
The widespread understanding that sustaining traditional healthcare delivery paradigms
in the face of a highly infectious virus was unworkable sparked the pandemic-induced push for
telemedicine adoption. States’ proactive extension of Medicaid coverage and licensing flexibility,
along with federal relaxation of Medicare telehealth requirements, regulatory modifications by
agencies like the DEA and HHS, and state proactive expansion of Medicaid coverage, all worked
together to create a unified framework that enabled telemedicine to thrive (Curfman et al., 2021).
This approach provided access to healthcare for those who needed it right away and set the stage
for a paradigm change in how healthcare is delivered.
Addressing Prior Concerns
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Healthcare organizations responded quickly to the COVID-19 epidemic, which helped
allay worries that had previously prevented the broad use of telemedicine. Institutions made large
financial expenditures and staff changes after realizing the need to integrate telehealth
technologies. Despite being crucial in extending the scope of telemedicine, these changes also
brought forth a new set of difficulties. Notably, the move to telemedicine sparked concerns
regarding patient confidentiality and the maintenance of high-quality healthcare services.
Healthcare professionals struggled to maintain the same standard of care that in-person
consultations had typically delivered while protecting sensitive patient data as they navigate this
unfamiliar environment (Charman et al., 2021).
The pandemic’s aggressive settlement of service and payment parity problems was one of
its significant successes. Policymakers were able to increase access to telehealth services by
resolving these issues and giving healthcare providers a financial incentive to adopt this new care
delivery method. This accomplishment was not without its share of criticism, however. The rise
of telemedicine raised budgetary concerns because of the high expenses involved in
implementing new technology and providing services (Curfman et al., 2021). The need to
balance offering affordable, high-quality healthcare and budgetary sustainability has become a
paramount concern.
The epidemic also brought to light ongoing differences in patient groups’ access to and
use of technology. Despite widespread advocacy for telemedicine, certain sections of the
population encountered obstacles because they needed more access to digital equipment, internet
connection, and technical knowledge. Existing healthcare inequities were compounded by the
digital divide, which also created questions about fair access to healthcare (Bestsennyy et al.,
TELEMEDICINE & COVID-19
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2021). The inability of vulnerable and marginalized groups to fully engage in telehealth
consultations can exacerbate already-existing healthcare disparities.
Future Outlook of Telemedicine
The future of telemedicine is poised for extraordinary change, offering the possibility of
changing healthcare delivery in both urban and rural settings, increasing medical accessibility
while at the same time reducing costs. Forecasts show a bright future for the worldwide
telehealth and telemedicine industry, driven by a favorable Compound Annual Growth Rate
(CAGR) that denotes a rapidly expanding market (Curfman et al., 2021). Despite these
promising predictions, there are still unresolved issues in the US, such as the problem of
insufficient reimbursement rates and enduring barriers to interstate licensing.
The ability of telemedicine to eliminate geographical obstacles and provide universal
access to healthcare regardless of a person’s location is its most significant promise.
Telemedicine may provide virtual links between patients and medical professionals in rural or
underserved locations where there may be gaps in the infrastructure for traditional healthcare,
providing prompt treatments and preventative care. Additionally, the financial burden of
conventional in-person healthcare services may be significantly reduced because of
telemedicine’s cost-effectiveness (Bestsennyy et al., 2021). Telemedicine has the potential to
significantly reduce costs for both healthcare professionals and patients by reducing the
requirement for physical infrastructure and simplifying administrative procedures.
Unquestionably optimistic predictions are made for the telehealth and telemedicine
industry, supported by a robust CAGR. This bodes well for the development of technology,
novel solutions, and better patient experiences. The rise in demand and acceptability of telehealth
TELEMEDICINE & COVID-19
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services during the epidemic has spurred industry participants to invest in improving user
experiences, extending service offerings, and correcting the shortcomings that were once
adoption obstacles (Curfman et al., 2021). There is significant potential for developing integrated
platforms that seamlessly link patients, healthcare providers, electronic health records, and
wearable health devices, leading to delivering holistic and personalized healthcare as
telemedicine technologies advance.
However, despite the positive trend, there are still difficulties in the US telemedicine
market. The problem of reimbursement rates is one significant barrier. The financial feasibility
of telemedicine services for healthcare practitioners should be improved by telehealth
interactions, often getting less compensation than in-person appointments. Furthermore, the lack
of standard rules and nationwide licensing limitations presents complications that obstruct
smooth care delivery across state boundaries (Curfman et al., 2021). The spread of telemedicine
services is constrained by this need for more harmonization, especially when addressing patients’
requirements across regional borders.
Furthermore, it is still being determined if the enhanced use of telemedicine will continue
after the epidemic. Although the crisis hastened acceptance, it remains to be seen if telemedicine
will maintain its increased importance when the urgent need fades. Another significant difficulty
is providing fair access for marginalized people. The promise of telemedicine may only partially
be realized in certain areas due to disparities in technology availability, digital literacy, and
socioeconomic considerations (Bestsennyy et al., 2021). To address these disparities, a deliberate
effort is needed to close the digital divide and ensure that those most in need may benefit from
telemedicine.
TELEMEDICINE & COVID-19
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Conclusion
Telemedicine has the ability to revolutionize how healthcare is delivered, as seen by how
it has developed from its pre-pandemic restrictions to its extensive use during the COVID-19
crisis. The healthcare industry needed to adapt and make substantial legislative changes to
address pre-existing issues and impediments. Telemedicine has a promising future because of its
ability to close healthcare access gaps, enhance patient outcomes, and reshape the way medical
services are delivered. However, issues with payment and fair access should be carefully
addressed.
TELEMEDICINE & COVID-19
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References
Bestsennyy, O., Gilbert, G., Harris, A., & Rost, J. (2021). Telehealth: a quarter-trillion-dollar
post-COVID-19 reality. McKinsey & Company, p. 9.
Charman, S. J., Velicki, L., Okwose, N. C., Harwood, A., McGregor, G., Ristic, A., … &
Jakovljevic, D. G. (2021). Insights into heart failure hospitalizations, management, and
services during and beyond COVID‐19. ESC heart failure, 8(1), 175–182.
Curfman, A., McSwain, S. D., Chuo, J., Yeager-McSwain, B., Schinasi, D. A., Marcin, J., … &
Olson, C. A. (2021). Pediatric telehealth in the COVID-19 pandemic era and
beyond. Pediatrics, 148(3).
Jagarapu, J., & Savani, R. C. (2021, August). A brief history of telemedicine and the evolution of
teleneonatology. In Seminars in Perinatology (Vol. 45, No. 5, p. 151416). WB Saunders.
Metzger, G. A., Cooper, J., Lutz, C., Jatana, K. R., Nishimura, L., Deans, K. J., … & Halaweish,
I. (2021). The value of telemedicine for the pediatric surgery patient in the time of
COVID-19 and beyond. Journal of pediatric surgery, 56(8), 1305-1311.
Running head: EMPOWERING PATIENTS
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Empowering Patients
Vinsetta Buford
American Military University
HCAD 501: Technology Applications in Healthcare Organizations
Dr. Jeremy Howell
14 August 2023
EMPOWERING PATIENTS
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Empowering Patients
I am reminded of the riveting story of e-Patient Dave deBronkart when I consider the
transformational impact of the internet and online tools in changing the patient dynamic. His
experience is a powerful example of how patients’ access to knowledge and their subsequent
feeling of empowerment may lead to a revolution in healthcare (Dave deBronkart: Meet epatient dave 2011). The advantages of people managing their healthcare are best shown by
Dave’s path from having a near-death experience to being an outspoken supporter of patient
participation.
In the past, the word “patient” often evoked the idea of a passive individual constrained to
the position of a beneficiary of medical treatment. However, the introduction of the internet has
changed this perspective, allowing individuals to take an active role in their healthcare (Van de
Wetering & Versendaal, 2021). This transition was personally shown by Dave, who used web
research to learn about his medical condition. He used the internet to access trustworthy
resources like WebMD and interact with patient networks, gathering knowledge and asking
questions of individuals who had experienced similar difficulties. Dave could debate medical
advice, make choices about his treatment, and fight for his well-being because of his access to a
multitude of knowledge (Dave deBronkart: Meet e-patient dave 2011).
The growth of online patient communities, like the one Dave discovered on ACOR.org, is
evidence of the advantages of patients acting as more educated and involved consumers. These
online communities provide a forum for exchanging knowledge, viewpoints, and emotional
support. Patients may receive first-person stories of treatment alternatives, results, and
difficulties without following typical medical gatekeepers. This shared understanding enables
people to interrogate claims, get second views, and work with medical specialists (Johansson et
EMPOWERING PATIENTS
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al., 2021). Dave’s experience demonstrated the importance of patients sharing information since
it resulted in suggestions for a treatment strategy he would not have heard about.
The idea of patients acting as their health advocates takes center stage in e-Patient Dave’s
story. Dave’s drive to get his medical records and have open conversations with his doctors
shows how empowered people may oppose the status quo. His admonition to “Let patients help”
rings accurate as a request to medical professionals to accept patients as equal participants in
decision-making (Dave deBronkart: Meet e-patient dave 2011). The advocacy effort of Regina
Holliday, as shown in Dave’s tale, is a perfect example of how patients who are given the
capacity to influence change may do so. Holliday leveraged her struggle into a more
considerable appeal for openness and patient-centered care by utilizing art to emphasize the
significance of readily available medical data.
However, there are possible drawbacks to consider besides the beneficial changes. Since
the internet has democratized access to information, not all sources are trustworthy or truthful.
Patients need to be informed consumers who can differentiate between information from reliable
sources and false information. The risk of incorrect diagnosis or interpretation based on internet
information highlights the need for careful information intake. It can also be challenging to
balance patient input and medical knowledge if patients become increasingly involved and selfadvocating (Langford et al., 2020). Although patients’ views are priceless, medical experts also
have specialized knowledge essential for precise diagnosis and therapy. Ideal patient insights and
medical knowledge should be combined to create a harmonious relationship between patients
and healthcare professionals.
In conclusion, e-Patient Dave’s tale is a fascinating illustration of how the internet and
online tools have transformed the patient-provider relationship. Patients are far more empowered
EMPOWERING PATIENTS
than they were in the past because of access to information, participation in online groups, and
advocacy for their health. The experiences of Dave and others like him, who have utilized their
personal experiences to promote better healthcare procedures, demonstrate the advantages of
patients becoming more active and knowledgeable consumers. This change also emphasizes the
need for a balanced relationship between patients and medical providers and discernment while
browsing internet material. E-Patient Dave’s story is a sad reminder that the patient’s voice
should not be undervalued as we traverse the digital healthcare era and that a collaborative
approach is the key to a more patient-centered and efficient healthcare system.
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EMPOWERING PATIENTS
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References
Johansson, V., Islind, A. S., Lindroth, T., Angenete, E., & Gellerstedt, M. (2021). Online
communities as a driver for patient empowerment: Systematic review. Journal of medical
Internet research, 23(2), e19910.
Langford, A. T., Roberts, T., Gupta, J., Orellana, K. T., & Loeb, S. (2020). Impact of the internet
on patient-physician communication. European Urology Focus, 6(3), 440–444.
TED. (2011, July 1). Dave deBronkart: Meet e-patient dave. YouTube. https://youtu.be/oTxvicNnAM
Van de Wetering, R., & Versendaal, J. (2021). Information technology ambidexterity, digital
dynamic capability, and knowledge processes as enablers of patient agility: Empirical
study. JMIRx Med, 2(4), e32336.
Running head: PATIENT PORTALS AND COMMUNICATION
Patient Portals and Communication
Vinsetta Buford
American Military University
HCAD 501: Technology Applications in Healthcare Organizations
Dr. Jeremy Howell
30 July 2023
1
PATIENT PORTALS AND COMMUNICATION
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Patient Portals and Communication
In the healthcare sector, a patient portal is a website used for the personal healthcare of a
patient (Graham et al., 2020). It is easily accessible online and helps people track prescriptions,
test results, billing, and doctor visits. The patient portal has, in a significant way, improved
patient-doctor communications. The advancement of healthcare technologies and the positive
attitude of patients and caregivers towards its adoption has also resulted in increased use of
patient portals in ensuring improved healthcare quality. There is wide-ranging information
available in the patients’ portal that doctors, among other healthcare professionals, can use to
ensure they deliver high-quality patient care. Patient portals benefit and disadvantage patients,
healthcare providers, and healthcare facilities.
Patients benefit in different ways once hospitals have patient portals. First, patient portals
have resulted in patient satisfaction and empowerment (Lyles et al., 2020). Anytime patients gain
access to their medical or health information, they can be actively involved in the care delivery
process. They can embrace or refuse anything based on the perceived effect. The patients also
enjoy improved management of reminders and appointments. Patient portals are easily accessed
online. Hence, once a patient finds any update, it is readily available. Besides, the portals allow
the scheduling of appointments, thus lowering the chances of patients missing some medical
appointments. While operating online, most people are worried about their safety. However,
patient portals guarantee patients of secure information with healthcare professionals. Hence, the
patient is free to ask any question about their health.
Even though patients are guaranteed secure communication with healthcare providers,
there is a risk of privacy and security concerns. The ever-evolving schemes of cybercriminals
require the continued advancement of technology that hospitals adopt to secure patient
PATIENT PORTALS AND COMMUNICATION
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information. Hence, the disadvantage of the portal is the high risk or vulnerability of data
breaches. Besides, some patients can also misinterpret some of the provided medical
information, resulting in wrong self-diagnosis. Hence, it becomes vital for the facilities to follow
up to minimize the challenge.
Healthcare providers relying on information available on patient portals also benefit from
the technology. First, the portals improve communication since the system enables secure
communication between health practitioners and patients (Graham et al., 2020). The portals also
support improved efficiency for healthcare providers; in this case, doctors only sometimes have
to be physically available anytime patients require assistance or clarification. The patient portals
enable practitioners to do various tasks online, such as completing medical forms, making
medical prescriptions, and scheduling appointments (Turner et al., 2019). However, there are
also numerous challenges that healthcare providers experience when using patient portals. For
instance, they encounter communication overload. It takes work to respond to most patient
messages, manage the tasks online, and review test results. Healthcare providers can also be
overwhelmed, not knowing which messages to prioritize. Increased online communication, apart
from the other roles of healthcare providers, means an increased workload. The providers may
also experience increased demand for the best services. Increased awareness of patients on the
functioning of patient portals makes the patients demand instant feedback for their concerns or
inquiries.
As the technology evolves, it is vital to keep updated. However, awareness of the benefits
and risks of the technologies is critical. It ensures increased preparedness for handling any
possible challenges accompanying technological adoption. Despite the risks of using patient
PATIENT PORTALS AND COMMUNICATION
portals, patients and healthcare providers should continue using the technology because its
immense benefits outweigh the risks.
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References
Graham, T. A., Ali, S., Avdagovska, M., & Ballermann, M. (2020). Effects of a web-based patient portal
on patient satisfaction and missed appointment rates: survey study—Journal of medical Internet
research, 22(5), e17955.
Lyles, C. R., Nelson, E. C., Frampton, S., Dykes, P. C., Cemballi, A. G., & Sarkar, U. (2020). Using
electronic health record portals to improve patient engagement: Research priorities and best
practices. Annals of internal medicine, 172(11_Supplement), S123-S129.
Turner, K., Hong, Y. R., Yadav, S., Huo, J., & Mainous III, A. G. (2019). Patient portal utilization:
meaningful use before and after stage 2 electronic health record. Journal of the American
Medical Informatics Association, 26(10), 960–967.
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