Guest Post by Dr. Gauri Behari, MD
Dr. Gauri Behari is an Endocrinologist and author. She is the Director of Medicine Telehealth at the Veterans Affairs Hospital in Phoenix, Arizona. She also serves as a clinical assistant professor of Endocrinology at the University of Arizona College of Medicine Phoenix.
Contrary to popular belief, telehealth is not a new concept or technology that came out of the COVID-19 pandemic. The history of telemedicine extends as far back as ancient Greece and Rome in 500 BCE. Ancient telemedicine included the use of human messengers to transfer medical advice or medicine. Smoke signals and light reflection were used to communicate medical information, such as signaling the outbreaks of plagues and to notify about health events such as births or deaths. American Indian tribes also used smoke signals to relay health events.
Modern telemedicine was ignited with the inventions of the electric telegraph in 1837 and the telephone in 1876. On November 29th, 1879, the Lancet reported the practicality of telephone for reducing unnecessary physician visits. In 1906, the inventor of the electrocardiogram published a paper on the telecardiogram. In 1925, the cover of Science and Invention magazine showed a doctor diagnosing a patient by radio, describing a device that would allow for the video examination of a patient over distance. Since the 1920s, the radio has been used to give medical advice to clinics on ships. The history of telemedicine includes the progression from using the telegraph to telephone to video visits.
Since then, telemedicine has further been divided into asynchronous telemedicine and synchronous telemedicine. The American Telemedicine Association (ATA) defines asynchronous telemedicine as store-and-forward transmission of medical images and/or data where the data transfer and interpretation does not take place simultaneously. Asynchronous telemedicine is most popular in the fields of radiology, ophthalmology, and dermatology.
Conversely, the ATA defines synchronous telemedicine as interactive audiovisual connections that transmit information in both directions during the same time period. It requires the presence of both parties at the same time and a communication link that allows a real-time interaction to take place.
The medical community has been divided in its views on using telehealth technology-- some seeing the utility in it and embracing it in their practice or seeking opportunities to learn about it while others have been resistant to its use. Despite telemedicine progressing for more than a century, it really wasn’t until the onset of the COVID-19 pandemic that every healthcare provider was suddenly scrambling to utilize telemedicine to serve their patients.
When the COVID-19 pandemic hit, healthcare providers had two options: Either embrace telemedicine and start utilizing it immediately or risk losing their income and/or jobs. In fact, health care spending declined at an annualized rate of 18% in the first three months of 2020 according to Commerce Department data, the largest reduction since the government started keeping records in 1959. This proved to be the biggest factor in the annualized 4.8% decline in the first quarter gross domestic product (GDP), which itself was the worst overall contraction in GDP since the Great Recession. This drop substantiates the health care sector as vital to the American economy. In fact, the Centers for Medicare and Medicaid Services (CMS) expanded telehealth reimbursement to help boost the healthcare economy during the pandemic.
One of the few silver linings of the pandemic is that it forced us to utilize telemedicine, which allows us to bring care to our patients in a convenient way while keeping patients, providers, and our families safe. The global COVID-19 pandemic is no doubt a pivotal time in human history. Future generations will look back on this time and be able to see how this unique period contributed to the advancement of healthcare technology with the use of telemedicine.
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