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Telehealth: Implications for Medical Tourism

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The worldwide telehealth market is forecast to be worth $6.5 billion by 2020, marking a shift in the provision of traditional healthcare services. And with many national healthcare services facing dwindling budgets, combined with aging populations and pressures on hospitals, the increasing use of technology to support such health services appears inevitable. But, such growth presents an increasing need for cross-border solutions.

What it Means

The telehealth industry, which uses information and communication technologies to deliver healthcare services from a distance, includes both preventive care as well as curative aspects and encompasses a wide range of services.

Examples include the use of email by physicians to communicate with patients, order drug prescriptions and provide other health services. Assistance can be provided in an international setting when the doctor and patient are in different countries as well as on a domestic basis when both the doctor and patient are in the same country.

Business-types, many of whom travel frequently to remote or unfamiliar locations, are most likely to take advantage of telehealth. A practitioner in a new or different city might need a range of medical advice or help in accessing the local health service.

Alternatively, a crew member on an oil rig might need emergency treatment. Today, globalisation and modern technology have dissolved traditional borders, and more employees work in unfamiliar environments.

Enhanced Communications; Enhanced Diagnostics

Drivers behind the growth of telehealth lie in improvements and cost reductions in telecommunications, as well as patient-driven demand. When we began assisting travellers in remote sites 30 years ago, the phone was at the centre of activities.

The advent of video now means that patients and medics in remote locations can have a visual interaction with medical specialists, remotely. The doctor can see the patient and assess the physical signs, which make a substantive difference.

Moreover, as the capability and coverage of satellite systems has grown globally, the connectivity and bandwidth has improved at client sites. As employees operate in increasingly remote environments, this creates a growing opportunity to deploy sophisticated telehealth solutions, and overcome geographical limitations.

From anywhere in the world, patients can now successfully transmit X-rays via satellite to radiologists, allowing a specialist to review the images within minutes. It means a quick and informed diagnosis, as well as treatment decisions made hours or even days away from the nearest hospital.

Duty of Care

While the expansion of telehealth services is strongly patient-led, from an employer and business perspective the growth is driven by a greater duty of care for employees.

For businesses, there are significant benefits to key stakeholders and, not only for patients in terms of getting fast, appropriate medical guidance from their homes or offices. Employers gain from the reduced numbers of lost hours for their employees in terms of travel and waiting times.

For insurers, telehealth offers a much more cost-effective method of healthcare treatment. And in the event a patient requires subsequent in-person care, telehealth can be used to triage and validate patients needs, or provide initial guidance quickly and improve the longer term outcome, and total cost of care.

Technology also eases the burden on hospitals, reducing the number of non-acute patients making their way to emergency rooms.

Patient Power

Patients are taking greater control of their healthcare and leveraging the internet to do so from researching medical conditions via Google, or self-diagnosis using online resources, to comparing doctors or booking appointments. And as this shift toward patient empowerment continues, the growth in telehealth and expectation around fast, mobile access to doctors looks set to continue.

People increasingly want to use their smart phones and video to access healthcare. Many doctors already communicate with their existing patients via phone or email when needed and this will expand even further.

By 2018, telehealth will encompass 18 million video consultations, worldwide, and related services will have been integrated into existing practices rather than as standalone facilities.

Right Fit Telehealth

While the telehealth industry will continue to grow, it is important that services are used to provide the best fit, and where most benefit is derived. If a qualified, appropriate doctor is easily accessible in person without barriers of distance, language or scheduling, an in-person visit may make most sense.

In an international context, if an area is underserved or highly remote, even an initial telehealth consultation with a doctor can be a great value-add, particularly as a method of initial triage, and even for a second opinion.

Solutions in Regulated World

Informed and educated consumers increasingly demand telehealth services, and we have seen exponential growth in countries like the United States. Regulation is trying to catch up, yet we see fragmented positioning across jurisdictions and countries ranging from financial incentives for doctors to deliver telehealth consultations to heavy restrictions on telehealth and the blocking of remote prescribing offerings.

As the industry evolves and proves itself, we expect that regulation will eventually become more aligned across jurisdictions.

About the Author

Dr. Jonathan O' Keeffe is the regional medical director in North Europe for International SOS, which works on behalf of multinational corporations, governments and NGOs globally to provide emergency assistance to clients facing disasters on the ground, as well as preventive care to mitigate risks.

A general practitioner with experience in primary care, emergency care and tropical diseases, Dr. O' Keefe qualified from the Royal College of Surgeons in Ireland and worked in Great Ormond Street as a Paediatric Fellow and at a government hospital in Uganda before returning to the United Kingdom to complete his membership in the Royal College of General Practitioners. His professional interests include health systems design, clinical governance and extreme remote medical environments.

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