The intersection between medicine and technology is a complex, growing, and evolving space that continues to push the boundaries of feasibility. A long-standing product of this intersection is telehealth, which, per the WHO, “involves the use of telecommunications and virtual technology to deliver health care outside of traditional health-care facilities”.[1] Today, telehealth lies at the forefront of medical care delivery in rural America.
Innovations in telehealth have a great potential to minimize the differential between urban and rural areas by increasing people’s access to necessary medical services. These innovations allow for medical service delivery over long distances while facilitating knowledge-sharing and the distribution of medical decision-making across various, remote providers. However, evidence suggests that since the early 20th century, most innovations in telehealth have never been implemented beyond the pilot stage, despite their viability.[2]
For more specialized services such as anesthesia, the concept of using telehealth is still not entirely new. Reports of preadmission anesthesia or critical care consultations date back to the early 2000s. An example is a 2004 Canadian pilot study showing successful administration of preadmission anesthesia using telehealth technology. In the study, both patients and anesthesiologists were highly satisfied with the consultation experience. Specifically, the use of airway cameras allowed anesthesiologists to asses cardiac and pulmonary health in a similar manner to that of a conventional consultation, but with superior visualization due to illumination. However, there were also notable hindrances, including privacy concerns associated with electronic correspondence and the lack of physical contact between physicians and their patients. [3]
Since then, in 2009, the U.S. government enacted the Health Information technology for Economic and Clinical Health (HITECH) Act to promote and expand the adoption of health IT and the telehealth services. A major component of HITECH was to provide funding to implement telehealth networks for patients in rural and remote areas. [4]
Today, advances in health and communication technologies have allowed anesthesiologists to extend perioperative consultation services to geographically remote areas. Due to the increasing economic pressures on healthcare delivery and the decreased costs and comparable outcomes of telemedicine, the adoption of telehealth services is an increasingly attractive option.[5] It is well-founded to anticipate that the U.S. healthcare system’s quest for equality and efficiency of care will be defined by emerging telehealth technologies.
References
[1] Telehealth. (n.d.). Retrieved February 14, 2018, from http://www.who.int/sustainable-development/health-sector/strategies/telehealth/en/
[2] Alverson, D. C., Shannon, S., Sullivan, E., Prill, A., Effertz, G., Helitzer, D., … & Preston, A. (2004). Telehealth in the trenches: reporting back from the frontlines in rural America. Telemedicine Journal & e-Health, 10(Supplement 2), S-95.
[3] Wong, D. T., Kamming, D., Salenieks, M. E., Go, K., Kohm, C., & Chung, F. (2004). Preadmission anesthesia consultation using telemedicine technology: a pilot study. The Journal of the American Society of Anesthesiologists, 100(6), 1605-1607.
[4] Doarn, C. R., Pruitt, S., Jacobs, J., Harris, Y., Bott, D. M., Riley, W., … & Oliver, A. L. (2014). Federal efforts to define and advance telehealth—a work in progress. Telemedicine and e-Health, 20(5), 409-418.
[5] Galvez, J. A., & Rehman, M. A. (2011). Telemedicine in anesthesia: an update. Current Opinion in Anesthesiology, 24(4), 459-462.
