Telemedicine in the age of COVID-19


Think of a world where you can complete your doctor’s appointment from anywhere, be it from the comfort of your own bed, or in your garden while sipping a cool lemonade, or from your favourite couch in the house. With the increasing popularity of telemedicine over the last few years, this is not just a future reality, but rather one that we’ve become more than familiar with. Telemedicine, originating in the late 1950s, refers to the practice of medicine remotely through virtual methods of communication such as text, phone calls, emails or video conference (Morse, 2019). Such virtual methods provide healthcare professionals a way to practice medicine remotely without the patient and doctor having to be physically present in the same room. In the age of COVID-19, it is not hard to see why telemedicine is gaining traction and becoming more relevant; the onset of the pandemic has led to a social shift in the way we work, live and interact with one another. As we strive to minimize public exposure and physical interactions, telemedicine offers an alternative for providing an essential service without the risk of contracting the virus. There are other benefits too. Telemedicine seems to be both a more cost efficient and time efficient way of practising medicine (Scott, 2019). Furthermore, in minimizing unnecessary physical contact between a doctor and patient, telemedicine has proven itself to be a very useful tool in the current pandemic. While Canada was one of the early pioneers in the development and usage of telemedicine, during the time leading up to the pandemic, this initial fire had dwindled and Canada had fallen behind in the race to incorporate virtual healthcare systems (Owens, 2018). Before COVID-19, telemedicine in Canada was really more of a private healthcare phenomenon, with private companies such as Maple and Akira dominating the industry (Dialogue, 2020). This is not to suggest that the public interest toward telemedicine is or has ever been low, as several independent surveys and studies have demonstrated that Canadians are quite receptive to virtual healthcare. For example, one study by the Canadian Medical Association has shown that 7 out of 10 Canadians expressed that they would take advantage of virtual physician visits, with most Canadians viewing virtual visits as a segue into faster, more convenient, and higher-quality care (Canadian Medical Association, 2020). There has been, however, a huge disparity between what services people would like to see provided by telemedicine, versus what services physicians have offered. Surveys conducted by Canada Health Infoway demonstrate this clear gap. For instance, 63% of Canadians would like to be able to email their healthcare provider, but only 24% of family physicians offer this service; moreover, 41% of Canadians would like have video visits with their healthcare provider, but only 4% of family physicians offer this option (Staff, 2018). Such disparities show the need for physicians to adapt to public demand, but much of the responsibility also lies with provincial governments, who should be updating healthcare policies accordingly. For instance, coverage of virtual visits should be included in provincial healthcare plans. Perhaps this is the one silver lining of COVID-19: it has greatly accelerated the expansion of telemedicine into the public sector as provincial governments, realizing the value of virtual healthcare, began to pour funding into the industry. With the current pace of events and the recent spike in cases of COVID-19, very soon we should see telemedicine transform from a niche service to a mainstream delivery of healthcare. It is interesting to note though that, pre-pandemic, contrary to the demographics one would expect to benefit from telemedicine the most, that is, the elderly or individuals with disabilities for whom traveling to the doctor would be most arduous, it was actually younger demographics with which telemedicine had the greatest popularity. One pre-pandemic survey indicated that compared to the appeal of virtual health for 47% of the younger generation, only 31% of those ages 55 and older were open to using virtual healthcare (Reinberg, 2020). Markedly, there has been a shift with COVID 19, as more and more older adults have become receptive towards using telemedicine, but barriers and challenges remain as older adults are not the most tech-savvy (Reinberg, 2020). Some of these challenges include not owning internet enabled devices, or if owning them not knowing how to operate them properly, impaired vision and difficulty hearing, and lacking access to high speed internet. The lack of accessibility accommodations such as providing closed captioning for those with hearing impairments points to further advancements and improvements that are needed in telemedicine to bridge this digital divide successfully. Some say that in the future, virtual healthcare won’t be called virtual healthcare at all, but simply healthcare, as if to suggest that telemedicine will render traditional healthcare systems obsolete. It is here I have to digress: while there is much potential in telemedicine to transform the way medicine is practiced, its best use comes from complementing traditional healthcare rather than replacing it. Telemedicine simply cannot replace traditional medical practice as not every medical problem, particularly those requiring physical examinations, can be solved via virtual visits. What it can do, however, is to complement traditional medicine so that healthcare providers can reach patients beyond hospital and clinic walls. One thing is clear, though--telemedicine is here to stay and the Canadian health-care system will have to quickly evolve and adapt to include it. References Board on Health Care Services; Institute of Medicine. (2012). The Role of Telehealth in an Evolving Health Care Environment: Workshop Summary. Washington (DC): National


Academies Press (US); 3, The Evolution of Telehealth: Where Have We Been and Where Are We Going? Available from: https://www.ncbi.nlm.nih.gov/books/NBK207141/


Morse S. (2019). Telehealth eliminates time and distance to save money. Healthcare Finance https://www.healthcarefinancenews.com/news/telehealth-eliminates- time-and-distance-save-money


Scott BK. (2019) Arthur Maxwell House. BMJ. https://www.bmj.com/content /347/bmj.f7188.full.print


Owens B. (2018, Sept 6). Telemedicine on the rise but lagging in Canada. Cmaj News. https://cmajnews.com/2018/09/06/telemedicine-on-the-rise-but-lagging-in-canada-cmaj-109-5634/


Dialogue. (2020). The Ultimate Guide to Telemedicine for Canadian HR Leaders. https://www.dialogue.co/en/ultimateguide-telemedicine


Canadian Medical Association. (2020). Virtual Care in Canada. CMA Health Summit. https://www.cma.ca/sites/default/files/pdf/News/Virtual_Care_discussionpaper_v2EN.pdf


Staff. (2018) Majority of Canadians would take advantage of virtual doctor visits: survey. Benefits Canada. https://www.benefitscanada.com/news/majority-of-canadians-would-take -advantage-of-virtual-doctor-visits-survey-118099


Reinberg, S. (2020). Telehealth skyrocketing among older adults. US News & World Report. https://www.usnews.com/news/health-news/articles/2020-08-20/telehealth- skyrocketing-among-older-adults


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