While not a challenge for the average adolescent, there are clearly challenges in the transition to new or different communication modalities in the adult population. While we all watch television and often enjoy the various interactive programs as passive observers, when a group of professionals convene and are asked to communicate with a similar remote group using analogous television techniques, an interesting spectrum of avoidance and hesitant attitudes appears that frequently hinders successful encounter, regardless if it is a Continuing Medical Education event, active consultation, or telesurgery.
More passive, less interactive applications, such as electronic medical records, are understandably more acceptable, although we all share the frustrations, sometimes anger, that exist around their implementation and inefficiencies. Our profession is many times a solo venture encompassing long hours, either in the clinic or in the operating room. Unidirectional encounters, such as patient education or even e-prescriptions, are often more intuitively comfortable, while electronic interactive exchange tends to meet with more resistance, often reflected as skepticism.
Putting communications in order
To firm believers, such as the editors, the use of a computer or mobile devices, camera, software, and good communication lines seems natural. The enormous improvements that telemedicine can bring about to our profession, the provision of better care to large populations, the higher standards of care, and the advancement of technology are promising. With the rapid advent of access to the Internet, increasing Internet speed (Internet 2.0), and increasing use of mini-computers, smart phones, and mobile devices, we will witness in the forthcoming years increasingly useful applications. Hopefully, we will also see improved and wise management strategies as well as user-friendly administrative and regulatory approaches.
It is becoming apparent that the worldwide cost of mobile devices and communication has reached a level that makes these commodities widely available and affordable. In parallel, interest of consumers increases exponentially, although it is focused among younger people. Like many new technologies, adoption by the older generation follows.
eHealth is becoming a strong and rapidly evolving industry. Several fields are emerging within this trade. Mobile health monitoring is a broad category, involving now-termed traditional issues such as glucose and blood pressure monitoring, and newer biometric remote monitoring solutions via wearable devices or smart phones that may monitor health and fitness habits, balance, voice, hearing, rehabilitation exercises, or adherence to medications.
Interactive real-time telemedicine services, as one form of telemedicine, include phone or video conversations, up to virtual home visits, which may provide history review, some measure of physical examination, and mental and behavioral evaluations, which are comparable to those done in traditional encounters. These services may be less costly than in-person clinical visits.
Some diagnostic medical devices may be mobilized and used in underserviced areas. Tele-audiology and tele-neurootology are good examples. Remote robotics is currently limited in testing and implementation, due to the high cost of development, integration, stretched operation, and maintenance learning curves. We share the belief that this will develop in our field as well and will enable the deployment of sophisticated surgical services in more detached places. The importance of mobilizing services is strongly demonstrated in various disaster scenario and humanitarian ventures.
Short Message Service SMS-based appointment reminders and prescription reminders, specific notification of completed lab results, in addition to basic fitness and wellness applications, are becoming prevalent, improve administrative efficiency, and, with the evolution of social health-care-oriented communities, render more responsibility of personal wellness to the patients rather than solely relying on health care professionals. These are reflections of a fascinating on-going social and psychological transformation.
The privacy and security concerns associated with the electronic transmission of health care information are an important consideration. The Health Insurance Portability and Accountability Act, the Health Information Technology for Economic and Clinical Health Act, and their surrounding regulations and guidelines demonstrate the difficulties and attempted solutions to integrate eHealth applications into evolving social changes.
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